Dr. Jonah Essers fights insurance red tape with the same rigor he once brought to genetic research at Columbia and Harvard. In this conversation with Ryan, he explains how his blunt LinkedIn posts—naming pharmacy-benefit managers and citing peer-reviewed data—have forced billion-dollar payers to reverse drug denials within hours, delivering treatments that 45-day appeals would delay. He recalls the day a hospital CMO tried to silence him but, after hearing the evidence, granted full support. Ryan and Dr. Essers also unpack Walter Cronkite’s jab at America’s “healthy, caring system,” debate fairness versus justice, and explore the quiet fear doctors feel when advocacy risks their jobs.