The Most Powerful People in Healthcare No One Has Heard of (Part One) – Healthcare Blog
Author: Jeff Goldsmith
This has happened at least a dozen times. I mentioned John Arnold and was greeted by knowledgeable healthcare colleagues with blank stares. Houston billionaire John Arnold is the most powerful man in U.S. health care, but no one has heard of it. Arnold is an investing expert who made $50,000 in high school by trading collectors' hockey cards over the Internet. He became Enron's star natural gas trader in his early twenties. Arnold played no role in Enron's legendary collapse and left the company in 2001 with an $8 million bonus. In 2002, at the age of 28, Arnold founded Centaurus Advisors, a hedge fund focusing on energy investments. ten years 100% annual return.
Tired of investing, by which time he was already a billionaire, Arnold closed Centaurus in 2012 and decided to change the world. John has created a family foundation with his wife, Laura, who trained as a lawyer at Yale. and funded it with a significant portion of his personal wealth. For reasons we'll explore more fully below, Arnold converted their foundation into a “for-profit charity” in 2019 called Arnold Ventures. By 2024, Arnold Ventures will have nearly $4.7 billion in assets, about one-third the size of foundation giants Robert Wood Johnson ($14.7 billion in 2023) and Ford ($13.7 billion in 2024). The Arnold Ventures 501c3-funded subsidiary donated $194 million in 2024 to a dizzying array of grantees, including the American Enterprise Institute and Families USA.
But Arnold's business model is fundamentally different from these traditional philanthropic foundations.
Parent company Arnold Ventures is a for-profit enterprise with limited financial disclosure requirements. It has two main subsidiaries: the Laura and John Arnold Foundation (a traditional 501c3) and the Action Now Initiative (a 501c4 nonprofit), which provides funding for community-based policy advocacy. Arnold's for-profit parent company makes political campaign contributions and funds class-action lawsuits targeting policy goals, but the target or amount of the funding is not disclosed. Thus, Arnold Ventures is actually closer to a diverse political action committee/public interest lobbyist focused on a policy research agenda than a traditional foundation. As Arnold himself said in defense of the flexibility created by his structure: “If we want to solve a problem, we will do whatever it takes.”
Arnold Ventures has a bold policy agenda covering a wide range of domestic issues: criminal justice, housing, nutrition, infrastructure development (such as pipelines and electric grids), substance abuse, tax policy, education, retirement policy, and health care. Some of its earliest advocacy was on behalf of charter schools, but also on behalf of research integrity, through the Reproducibility Project and the Center for Open Science, trying to determine whether research results were real or whether commercial interests were filtering what made it from the laboratory bench to the public.
It’s difficult to place Arnold’s agenda on an ideological spectrum. Arnold was a major donor to both Obama campaigns and appears to have found his feet on the ground in the Trump era. While Arnold's agenda was generally progressive, advocating increased government activism, Arnold's advocacy also funded projects at the American Enterprise Institute, Oren Kass's libertarian project American Compass, and Brian Bryce's Paragon Health Institute. You can find here all members of the Arnold Ventures 990s listing research funding activities provided by ProPublica.
However, its massive health care agenda appears to consume a significant portion of its project funding. In 2017, Arnold hired Mark Miller, who for 15 years had been executive chairman of MedPac, the congressional policy advisory group that oversees the health insurance program. Miller brings with him a Rolodex of contacts in the health services research community and has spent the past eight years working to secure funding from Arnold Ventures for his colleagues. Not surprisingly, the biggest beneficiaries of Arnold's health policy funding are America's elite universities.
ARNOLD VENTURES Health Policy Grants Campaign at Selected Universities 2020-2025
Source: ProPublica Nonprofit Explorer, 2026
The list of Arnold-funded health policy experts is star-studded: Michael Chernew (Harvard, now MedPac president), David Cutler (also at Harvard), Jamie Robinson (UC Berkeley), Paul Ginsberg and Glenn Melnick (University of Southern California), Larry Casalino (Cornell University), Amy Finkelstein (MIT), Gerard Anderson and Ge Bai (Johns Hopkins University), Roslyn Murray and Chris Whaley (Brown) and Zach Cooper (Yale). As one prominent researcher said to me when asked what Arnold was looking for, “If you want to wage war on the medical-industrial complex, Arnold is your guy.”
The longer list includes dozens of younger and less well-known health research scholars who represent the next generation of health policy movers and shakers. Arnold's influence was broad enough to have widespread influence on peer reviewers of health policy papers in major journals, e.g. JAMA, New England Journal of Medicine and health affairs. As a refugee in academia, I can tell you that you have to work hard to identify leaders in health services research who are not receiving Arnold funding.
In the spirit of vertical integration, Arnold also generously supports an impressive array of health care foundations, nonprofits, and media organizations that promote the results of Arnold-funded research: Health Affairs, Kaiser Health News, and the Kaiser Family Foundation, Academy Health, ProPublica, Third Way, the RAND Corporation, the National Bureau of Economic Research, the National Association for State Health Policy, the Altarum Institute, the Brookings Institution, the Health Care Cost Institute, the National Conference of State Legislatures, and the Lorne Institute.
These organizations are a key part of the Arnold policy “ecosystem” because they both amplify and legitimize the work of Arnold Ventures grantees and/or organize conferences where Arnold-funded experts are exposed to the general media. You almost have to hide under a rock to avoid being inundated with Arnold Ventures-funded content in carefully curated post-publication press coverage, often without attribution!
Referring to his early work on scientific integrity from a decade ago, Arnold posted on The names of elite university academics are here . . ”. An almost irresistible publicity magnet. By incorporating the brand of elite university investigators into its policy agenda, it follows a classic progressive playbook.
We take a closer look at how this process works in the second part of this report.
Jeff Goldsmith is a veteran healthcare futurist, President of Health Futures Inc and regular THCB contributor. this comes from him Personal substack
