An Interview With Jake Frankel
Start pushing back on the insurance card reflex.
When you call your doctor’s office and they ask for your insurance card, push back. Ask for the cash price instead. That little card is the most expensive corporate credit card your company never meant to give you. We’ve been conditioned to follow the script, but if enough people start asking about price and quality, the entire system will start to shift.
As a part of our interview series called “5 Things We Must Do To Improve the US Healthcare System”, I had the pleasure to interview Ray Kober.
Ray Kober is the founder and CEO of Benefixa, a health insurance consulting agency dedicated to helping mid to large market businesses take control of their healthcare costs while improving employee benefits. He is also the host of the Broken Healthcare Podcast, where he shines a light on industry inefficiencies and interviews experts on how to pay less while accessing higher-quality care. With a passion for championing the underdog, Ray is committed to disrupting the traditional healthcare system by equipping employers with bold, data-driven solutions that reduce costs and improve benefits.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?
I didn’t take a straight line into healthcare. I grew up in a working-class household, raised by a single mom. We didn’t have much, but I saw early on how stacked the system was against families like mine. Fast forward a few decades — I spent over 20 years in sales and leadership at Aflac, and what I kept seeing over and over was employers and employees getting crushed by bloated insurance carriers, hidden fees, and games played by PBMs.
At some point, it clicked — I didn’t want to play their game anymore. That game is built to make sure the house always wins. I wanted to change the game — for my clients and their people. That’s when I launched Benefixa. And later, the Broken Healthcare Podcast. Now I spend my time helping employers take back control and pulling back the curtain on a system most people don’t even realize is rigged.
Can you share the most interesting story that happened to you since you began your career?
A CFO once looked me dead in the eye and said, “Ray, everything you’re saying makes perfect sense — but I can’t touch it. Our HR team is too close with our broker, and nobody wants to rock the boat.” That moment stuck with me. It was the first time I fully realized
how often the people in charge know what needs to be done — but they’re boxed in by internal politics.
Instead of walking away, I stayed close and helped him navigate it quietly. No drama, no public power plays. A year later, we’d saved the company millions and gave their people better coverage. That was a turning point for me. This work isn’t just about spreadsheets and savings. It’s about leadership, timing, and helping people find the guts to do what’s
right — even when it’s uncomfortable.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
When I first started working in Manhattan as a young insurance agent, there were no Zoom calls — because there was no internet. Everything was face-to-face. You’d run around the city hopping subway trains from one appointment to the next. And if you’ve ever been on a New York City subway in July, you know it’s basically a sauna on rails.
We wore full suits and ties back then, no matter the weather. One day, I showed up to support a broker on a big meeting, sweating head to toe. I wasn’t wearing an undershirt, and the sweat had soaked through so badly you could actually see my bare chest through the dress shirt. I looked like a total mess. Luckily, the broker — older guy, total class act — pulled me aside and, with a smile, said, “Ray, maybe next time wear an undershirt.”
He became a good friend, and I’ve worn undershirts ever since — no matter the season. Lesson learned: be prepared, and always respect the uniform.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
A few standouts come to mind. The Price We Pay and Blind Spots by Dr. Marty Makary are essential reads — they pull back the curtain on the hidden incentives and broken systems we’re all living with. I also really liked Good Energy by Dr. Casey Means and Calley Means.
It connects the dots between nutrition, chronic disease, and the bigger picture of healthcare in a way that’s both smart and practical.
As for media, I’m a fan of Joe Rogan — especially when he brings on guests in the health and fitness space. He’s not afraid to dig in and challenge the status quo. I also follow Dr. Eric Bricker’s YouTube channel, AHealthcareZ. His breakdowns are no-nonsense and incredibly useful for anyone trying to understand what’s really going on behind the scenes in healthcare.
Are you working on any exciting new projects now? How do you think that will help people?
There are a few projects on the horizon that I’m really excited about. One involves using AI to help people better understand and navigate their healthcare benefits — because let’s face it, most plans are confusing by design. I was also recently approached to host a podcast tailored to a specific healthcare population with several million members, which could be a great platform to educate and empower at scale.
What gets me fired up is innovation that improves access to care and puts people back in control. Whether it’s through tech or media, I’m all in on using my voice to reach the masses. That’s the power of a good podcast — and a host who actually gives a damn.
Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us a few reasons why you think the US is ranked so poorly?
Because we don’t have a healthcare system — we have a profit system. The incentives are backwards from top to bottom. Insurance carriers make more money when premiums go up. PBMs profit by inflating drug costs and pocketing hidden rebates. Hospitals charge more when patients are sicker. And employers — who fund the majority of healthcare in this country — are often left completely in the dark.
It’s not that we don’t spend enough. We spend more per capita than any other nation. It’s about where the money goes, and what we’ve been conditioned to tolerate.
We also have a “sick care” system, not healthcare. And much of that starts with how poorly we eat. The Standard American Diet (SAD) is a root cause of so many chronic conditions. If we want a healthier population and a more sustainable system, we need to get serious about prevention and self-care.
On the employer side, most don’t realize healthcare has a supply chain — just like any other major expense. It can be audited, managed, and optimized. That’s what we do at Benefixa. We help employers take a real look under the hood. Trusting your broker to handle that is like letting the fox guard the henhouse. It’s a bad idea — and legally risky.
Since the Consolidated Appropriations Act (CAA) went into effect in January 2021, employers are legally responsible for how their healthcare dollars are spent. If they don’t exercise proper oversight, they can be taken to court — by their own employees — and be personally named in class action lawsuits. That’s not theoretical. It’s happening. We make it easy for employers to be compliant, reduce waste, and actually take care of their people.
As a “healthcare insider”, if you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system?
1 . Start pushing back on the insurance card reflex.
When you call your doctor’s office and they ask for your insurance card, push back. Ask for the cash price instead. That little card is the most expensive corporate credit card your company never meant to give you. We’ve been conditioned to follow the script, but if enough people start asking about price and quality, the entire system will start to shift.
2 . Enforce fiduciary standards for all plan stakeholders.
Most brokers make more money when their clients spend more. That’s not just wrong — it’s dangerous. We need the same fiduciary rules in healthcare that already exist in retirement plans. Brokers, PBMs, TPAs — they should all be legally required to act in the best interest of the plan and its members.
3 . Ban spread pricing and hidden rebates in pharmacy benefit management. PBMs shouldn’t profit from prescription markups or secret rebate deals. We need pass through pricing and full transparency — no games, no hidden margins.
4 . Promote direct primary care (DPC).
DPC brings back the doctor-patient relationship and cuts out the billing nonsense. It leads to better care, fewer ER visits, and a stronger connection between patient and provider.
5 . Mandate real price transparency.
Hospitals and providers should be required to post actual prices, upfront. No more facility fees, shell games, or surprise bills. If we can shop for TVs and airline tickets online, there’s no excuse for healthcare to be exempt from transparency.
The COVID-19 pandemic has put intense pressure on the American healthcare system, leaving some hospital systems at a complete loss as to how to handle this crisis. Can you share with us examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these issues moving forward?
Anyone who lived through the pandemic doesn’t need a reminder — they just know they never want to go through that again. COVID put massive strain on our system, especially hospitals that rely heavily on elective surgeries and imaging to stay afloat. When that revenue dried up, it exposed just how fragile and business-driven the whole system really is.
But the hardest part wasn’t financial — it was human. Hospitals locked out family members from visiting dying loved ones. I understand the need for caution, but that kind of isolation wasn’t just painful — it was cruel. People died alone. That’s a failure of leadership and of basic compassion.
This is America. We have the resources. What we need is better judgment. Healthcare isn’t just about numbers — it’s about people. We need to remember that.
How do you think we can address the problem of physician shortages?
First, we need to open up more residency slots, streamline the path for foreign-trained doctors, and stop making it so hard for qualified professionals to practice. But it’s not just about quantity — it’s about sustainability.
Doctors are burning out because they spend more time on paperwork than with patients. That’s not what they signed up for. We need to get them out from under the weight of administrative nonsense — most of which comes from insurance companies — and let them do what they were trained to do. Technology can help, but the real fix is cultural: we’ve got to stop letting bureaucracy call the shots in medicine.
How do you think we can address the issue of physician and nurse burnout?
Burnout isn’t just about long hours — it’s the result of a broken, pressure-packed system. Providers are drowning in documentation and red tape. Most of it has nothing to do with patient care and everything to do with satisfying billing requirements.
We’ve got to reduce that burden, invest in mental health support, and restore autonomy. Let doctors be doctors again.
And let’s not forget: physicians die by suicide at more than twice the rate of the general population. That should stop everyone in their tracks. Nurses, too — they’re the backbone of this system. They face trauma, chaos, and emotional weight every single day. They need more than praise. They need support, proper staffing, and better working conditions. We
have to stop pushing healthcare workers to the edge and start taking care of the people who take care of us.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
It’d be this: ask for the non-insurance cash price. Every time. At the doctor’s office, the hospital, the pharmacy — ask what it costs if you just pay. That one question can expose just how inflated and ridiculous the pricing really is.
If enough people started doing that, it would force providers and systems to compete on price and quality. And it would remind us that we do have power. Change doesn’t always start with a protest — it can start with a question.
How can our readers further follow your work online?
You can start with The Broken Healthcare Podcast — it’s on YouTube and all the major podcast platforms. I sit down with doctors, insiders, and innovators who are working to fix what’s broken in the system. You can also find me at benefixa.com or connect with me on LinkedIn. I’m always up for a good conversation — because together, we can change healthcare for the better.
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
Ray Kober Of Benefixa On 5 Things We Must Do To Improve the US Healthcare System was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.