Dave Chase is the CEO and founder of Health Rosetta, an organization transforming healthcare by empowering community-owned health plans (COHPs). Under his leadership, Health Rosetta has improved benefits for thousands of employers, eliminating high deductibles and co-pays, and reinvesting $1.5 trillion in wasted healthcare costs into social determinants like income and community well-being. Dave's work has driven significant legislative changes and set new industry standards. A best-selling author and speaker, he continues to inspire and lead efforts to restore hope, health, and well-being to communities across the nation.
Nick Soman, Decent: Why did you get into healthcare in the first place, and why have you stayed?
Dave Chase: I originally got into healthcare while working in management consulting with Accenture, where I was placed in a hospital to help implement health IT systems. After several years, I was recruited by Microsoft to start their healthcare business. This initiative has grown to encompass 28,000 software and services companies, all built around Microsoft's platform, providing an array of healthcare solutions.
In a way, I didn't stay in traditional healthcare. I left because I saw that healthcare was the only industry where technology was used as an excuse for prices to go up and productivity to go down, turning clinicians into glorified billing clerks. However, after several years away, I was drawn back due to a personal tragedy—losing a friend to a wrong cancer diagnosis, which occurs in over 20% of cases. I found that 400,000 people per year die due to wrong diagnoses. My instinct was that this wasn't because we have bad doctors, but because we have a bad system. Having played a driving role in two large-scale industry shifts, I felt called to tackle this enormous problem.
I stay in this field because we have fostered the development of an incredible community of change makers who are transforming healthcare from being the number one driver of wage stagnation, debt, and bankruptcy to something that can restore the American Dream. It's incredible to see working middle-class individuals go from being terrified of the financial devastation healthcare brings to finally being able to afford medications, great primary care, and necessary surgeries so they and their families can thrive. These stories bring tears to your eyes and remind us why this hard work is worth it. We're tackling a large-scale problem that will take over a decade to spread around the country, but the impact we're making keeps us motivated every day.
Nick Soman, Decent: What are the best and worst things about writing a book?
Dave Chase: The worst part of writing a book is that there are so many successes and lessons learned from our incredible community that not all of those stories can make it into the book. I feel bad after I've interviewed people or read interesting research and articles that it can't all fit into a book of a reasonable size. The constraint of space means that many inspiring and educational stories have to be left out, which is always a difficult decision.
On the other hand, the best part of writing a book falls into two main buckets. Firstly, people from various parts of the industry and even outside of it (but who were victims of the old system) have told me that reading my book led them to change their career or career focus. We've had traditional insurance brokers who were burnt out from delivering the annual "pay more, get less" health plan renewal story and are now souls on fire, transforming their communities. They tell me it’s the most fulfilling work they've ever done. Similarly, many clinicians who were suffering moral injury inside large healthcare organizations have found a new path. They learned that there is an entirely new environment where they can fulfill their calling to be clinicians without the pressures that drove many of their colleagues to leave the profession or even die by suicide.
Secondly, due to these career changes, they share stories of incredible human impact. If one could bottle the improved health outcomes of members of Health Rosetta-style plans, it would be the blockbuster drug of the century. These stories are a testament to the power of our community and the real-world difference we are making. Writing about these transformations and knowing the ripple effect they have on improving lives and communities is the most rewarding aspect of the entire process.
Nick Soman, Decent: What misconceptions about US healthcare would you like to clear up?
Dave Chase: One major misconception about US healthcare is that it isn't fixable. Decades of evidence show that trying to make meaningful, positive changes to the current system is impossible due to the entrenched interests and the $4.8 trillion spent annually. Buckminster Fuller aptly said, "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete." That's precisely what we're doing in the Health Rosetta community—building a new model that makes the old one irrelevant.
Another misconception is that we need more money to address the social determinants of health (which drive 80% of health outcomes) and to expand coverage to more people. In reality, as many in our community have proven, starting with Rosen Hotels, we're already investing more than enough money to have a world-class healthcare system. This existing investment can also fund or restore funding to critical social determinants such as education, income, safe neighborhoods, and healthy food.
Finally, there's a misconception that healthcare is inherently expensive. For most people, healthcare means the services provided by nurses, doctors, and other clinicians, which actually only account for about a quarter of every dollar spent on healthcare. What’s truly expensive is the profiteering, price-gouging, fraud, administrative bloat, and inappropriate care that pervades the current system. Our community chooses not to participate in those schemes, leading to what we call the Health Rosetta Dividend. This dividend can be redirected to fund everything from college educations and childcare to subsidizing solar energy and providing healthy food. By eliminating waste and inefficiency, we can make healthcare affordable and accessible while improving overall health outcomes.
Nick Soman, Decent: Who else in healthcare inspires you, and why?
Dave Chase: In healthcare, inspiration comes from many sources, and I'm fortunate to witness it across a wide spectrum of our ecosystem. From clinicians and employers to unions, advisors, and patient advocates, the dedication and innovation I see daily are truly remarkable. Health Rosetta's role as a connective force across these critical areas gives me a unique vantage point to observe and be inspired by these individuals and groups.
I'd like to highlight two examples that particularly move me: one general and one specific.
Broadly speaking, I'm consistently inspired by clinical leaders who've chosen to challenge the status quo. Despite intense pressure and gaslighting to remain within a system that's clearly underperforming, these clinicians have stepped out to create a parallel economy that's humane to both healthcare providers and patients. It's unconscionable that those called to the most human of professions are often reduced to billing clerks, their reputations used to perpetuate a system that inflicts financial toxicity and predatory billing on patients. This broken system has left over 100 million Americans in medical debt and driven millions into bankruptcy. Moreover, it's created a climate of fear where half of Americans avoid or delay care due to the threat of financial ruin. The courage of these clinical leaders to break away and establish more ethical practices is truly inspiring.
On a more personal level, I'm deeply inspired by Bryce Heinbaugh, who exemplifies the best of Health Rosetta Advisors. Bryce's journey is particularly moving because it demonstrates the power of aligning one's work with one's values. Several years ago, Bryce realized that his work in the traditional health benefits world conflicted with his moral principles. Despite the uncertainties, he took a leap of faith and fully committed to a model that aligned with his values. What might have seemed like a risky career move at the time has proven to be prescient. Bryce has shown that the real risk lies in staying tethered to outdated, harmful systems. His diligence in building an operationally sound business while humbly serving thousands more people than he initially envisioned is truly inspiring. Even more admirable is how, despite his extraordinary growth, Bryce consistently finds ways to share his lessons and resources with others in the field.
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