Pulling Back the Curtain on the Great American Healthcare Heist
In our latest episode of Take Charge with HELPcare, Dan Hinmon and I had the privilege of interviewing Chris Deacon, author of The Great American Healthcare Heist and one of the featured voices in the documentary It’s Not Personal, It’s Just Healthcare.
Chris and I first met in person at RosettaFest, a gathering of people passionate about reforming how healthcare is paid for and delivered. I was already impressed by her work and her willingness to speak uncomfortable truths about our broken system. Our conversation for the podcast confirmed that impression and deepened it.
Chris’s background is remarkable. Trained as a lawyer, she moved into public service and eventually became responsible for one of the largest public-sector health plans in the country, covering more than 820,000 New Jersey employees and retirees. But her time inside the system also revealed how deeply entrenched and misaligned the incentives are. As she explained, she ultimately had to leave government when she could no longer “look the other way.” That decision—following her moral compass—led her to start her own consulting firm and become one of the most articulate advocates for reform I’ve met.
In her book, and in our discussion, Chris describes America’s healthcare system as a “coordinated heist.” Everyone—large hospital systems, insurers, pharmacy benefit managers (PBMs), and even policymakers—plays a role in maintaining a structure that takes more from us while giving less in return. “The heist,” she told us, “is that we’re paying more and getting less.”
Her analogy immediately resonated with me. I told her it reminded me of Ocean’s Eleven—a highly coordinated operation where everyone knows their part, and by the time the casino owner figures out what’s happening, the money’s gone. The difference, of course, is that in this story, we’re the ones getting robbed.
Chris explained that the fundamental problem is misaligned incentives. Hospitals measure success by growth—more beds, bigger buildings, more revenue—not by healthier patients. “Keeping people healthy doesn’t generate income,” she said. The same is true for insurance companies and PBMs. Because their profit margins are capped as a percentage of total premiums, they actually make more money when costs rise. “Twenty percent of $1,000 is more than 20 percent of $100,” Chris pointed out. “There’s every incentive for prices to keep going up.”
We also discussed the massive consolidation in healthcare—how insurers own PBMs, physician groups, and pharmacies, effectively profiting at every step. “They’re on both sides of the table,” she said. “It’s house money.” It’s no wonder costs keep spiraling while outcomes decline.
What I appreciate most about Chris is that she doesn’t just point fingers—she’s using her experience to help employers, unions, and individuals take charge of their healthcare. The Great American Healthcare Heist isn’t just an exposé; it’s a guide for understanding who profits, who pays, and what we can do to change the system.
Our conversation was eye-opening, and I’m excited to share it with our listeners. If you’ve ever wondered why healthcare costs so much and delivers so little, you’ll want to hear this episode—and read Chris’s book.
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