Gott's Gulch - Craig’s Substack

PBM Suit: Spread Pricing on Steroids, Engineered Retroactively

How Pharmacy Benefit Managers Siphon Millions From Safety Net Hospitals

Jul 7 • Craig Gottwals

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Working Inside the Box

Embracing the Limits That Finally Fix Large Group Healthcare

Jul 2 • Craig Gottwals

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June 2026

No More Tears & the Annihilation of the Medical Ethos

How Big Pharma and Wall Street Looted American Healthcare

Jun 18 • Craig Gottwals

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The Hospital Monopoly Extortion Playbook

Exposing the exact mechanisms hospital systems use to block fair pricing and crush local competition.

Jun 16 • Craig Gottwals

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Big Pharma’s Legal Playbook Against International Sourcing and What It Means for Self-Funded Plans

Gilead’s trademark theory is real, but so are its limits.

Jun 9 • Craig Gottwals

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Hospital Prices Are the Problem. Everyone Knows It. Few Will Say It.

America’s Health Insurance Plans, the “AHIP,” of all people, just published a roundup of expert opinion pointing the finger directly at hospital prices…

Jun 3 • Craig Gottwals

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May 2026

Decapitating the Carrier Network

How Indiana Built the Ultimate Reference-Based Pricing Safe Harbor.

May 19 • Craig Gottwals

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Nasty Surprises Riddle The No Surprises Act

How a $20,000 Breast Reduction Surgery Extracts $440,000 from the Government-Healthcare Industrial Complex

May 4 • Craig Gottwals

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April 2026

Reference-Based Pricing Is a Leadership Decision, Not a Plan Design

The savings are real. So is what happens when leadership flinches.

Apr 20 • Craig Gottwals

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Why does healthcare cost so much in America? More importantly, what exactly can we do to fix it?

It is the single most common question I receive as a healthcare attorney and large group benefits consultant.

Apr 13 • Craig Gottwals

21:39

Why does healthcare cost so much in America? More importantly, what exactly can we do to fix it?

It is the single most common question I receive in my career as a healthcare attorney and large group consultant.

Apr 13 • Craig Gottwals

3

March 2026

The Grand Healthcare Price Illusion

Most people assume that when a massive insurance company negotiates with a doctor, there is a single, disciplined price for a routine visit.

Mar 31 • Craig Gottwals

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