$343 a Month for a Family of 5: The Health Insurance Play Founders Don't Know

Mike Bledsoe paid $80,000 for a hernia surgery. His friend got the same surgery for $5,000 in cash. That's the entire game. Michael Caz, founder of ShareWise and producer at Virtuous Benefits, walks Mike and Ted through what most operator-founders don't know about US health insurance — and the alternative that costs a family of five $343 a month. The conversation goes deep on why insurance companies want prices to go up, what a "Charge Master price" actually is, why United Healthcare's denial rate is 33% and CrowdHealth's is less than 1%, how Pharmacy Benefit Managers hide 40% of Big Insurance's profits, and the 100x markup on drugs like Ozempic. If you're a self-employed founder, a business owner running 6 to 7 figures, or a W-2 employee staying at a job you hate just for the benefits — this one's for you. Key insights from this episode: Why the average healthy founder is overpaying $5,000–$10,000 a year on insurance The Charge Master scam: how hospitals anchor a fake $80K price to negotiate with insurance Why insurance companies are incentivized to RAISE healthcare prices, not lower them The denial rate gap: 33% at United Healthcare vs. less than 1% at CrowdHealth What a health share plan actually is (and the two waiting-period rules that make it work) How a family of five can pay $343/month for healthcare instead of $1,800 Chapters: 00:00 What the fuck are we even paying for  01:00 Welcome to Full Stack Founders  02:20 The health insurance war zone for the self-employed 04:34 Michael's ACA marketplace nightmare  07:00 How Big Pharma, Big Insurance, and Big Hospital actually work together  09:49 The healthcare system isn't broken. It's working perfectly.  11:18 Why the healthy are subsidizing the sick  13:00 Why insurance companies want prices to go up  15:17 The $80K hernia surgery that costs $5K in cash  16:33 The Charge Master scam: how hospital pricing actually works  17:32 What a health share plan actually is  20:08 $343 a month for a family of five  21:00 The waiting period and the pre-existing condition rule 27:48 PBMs: how Big Insurance hides 40% of profits  29:14 The 100x Ozempic markup  31:44 Why insurance should be like car insurance  33:36 33% denial rate vs. less than 1% 36:07 Inside CrowdHealth's transparency model  40:01 The personal responsibility clause  44:28 What a health share covers (pregnancy, midwives, travel)  49:09 How to pick the right plan as a founder  51:08 ShareWise vs. Virtuous Benefits  54:50 Where to find the marketplace  55:30 Ted's recap and gems   Where does this fit in the Stack? This episode focuses on OUTPUT. To learn how to integrate this into your daily leadership practice, take our free training "See The Game" inside the Full Stack community: https://www.skool.com/ Connect with Michael Caz: ShareWise (the health share marketplace): https://www.sharewize.com/about   Follow Ted:  Website: www.themodernmanpodcast.com X: TheModernMan8 YouTube: The Modern Man Podcast Instagram:  themodernmanpodcast Facebook: TheModernManShow   Follow Mike:  Website: bledsoe.life YouTube: @MikeBledsoe Instagram:  @mike_bledsoe