The “murder hornet,” the world’s biggest species of wasp, has an MO that reminds me of a particular human species. The murder hornet feeds on other insects and kills off the worker bees until the workforce is severely depleted. Sounds like the MO of the U.S. health insurance industry.
Here is a recent photo and clip of the “profit over people” gang before the U.S. House Ways and Means Committee. Rep Jason Smith (R-Mo.) published a clip of the questioning on X: “It’s the best short explainer of everything wrong with Obamacare and our ‘healthcare’ system. It should be mandatory viewing for all Americans.”
Representative Smith, Chairman of Ways and Means, asked the assembled CEOs a series of pointed questions about their companies.
SMITH: Which of your companies owns or controls a health insurance division? Raise your hand.
CEOs: All raise hands.
SMITH: Please keep your hand up if you also employ healthcare providers, or own clinics, specialty pharmacies, or any other kind of medical practice or pharmacy?
CEOs: All raise hands.
SMITH: Please keep your hand up if you also own or control a pharmacy benefit manager?
CEOs: All raise hands.
SMITH: Please keep your hand up if you lead a publicly traded company at which you have a legal responsibility to maximize shareholder value?
CEOs: All raise hands.
Let’s not, for example, forget what some of the “non-profit” CEOs make: The Kaiser Permanente CEO Gregory Adams’ total compensation from 2017-2023 was $82 million; 12.7 million in 2023. Rod Hochman, President and CEO of Providence St. Joseph Health, had a reported compensation of over $11 million in 2022.
Exhibit A
Conflicts of interest in medicine between drug companies bribing doctors to choose their drugs over a competitor’s that may be less expensive and more appropriate is not the only conflict. Health insurers and drug store chains and pharmacy benefit managers (PBMs) and doctor groups have turned into financial giants.
According to Emma Freer, a health policy analyst at the American Economic Liberties Project writing for Matt Stoller’s Update: “The stated rationale these firms use is that bigness is more efficient, lowering costs for consumers, patients, whomever. There are reams of evidence to the contrary. Indeed, a recent study found UnitedHealth Group pays its affiliated providers 17% more than unaffiliated competitors – and up to 61% more where it has at least 25% market share.” In her article, Freer pointed out that “seven insurers have annual revenues larger than the GDP of mid-sized European countries. UnitedHealth Group, the biggest of Big Medicine, is the nation’s largest insurer, physician employer, and claims processor; third-largest PBM; and fourth-largest pharmacy operator.”
“In America,” she writes, “health care is really, really expensive. Employer-sponsored family coverage tops $35,000 annually, equivalent to buying a new Tesla sedan, paying the in-state cost of attendance at Ohio State, or throwing a very nice wedding every year. Despite the $5 trillion of financial resources in this sector, there doesn’t seem to be enough. Independent physician practices, local pharmacies and safety-net hospitals are closing, and premiums keep going up.”
“Americans and our political leaders are increasingly refusing to accept the argument that big vertically integrated health conglomerates do anything but waste time, money, and lives. State and federal policymakers have proposed a host of policies that nibble at the problem. But the biggest and best one just dropped.
A Light at the End of the Profit Tunnel?
Senators Elizabeth Warren and Josh Hawley have introduced recent legislation to “break up seven out of the Fortune 20, all of which are vertically integrated health care monopolies.
The Warren/Hawley Break Up Big Medicine Act would splinter companies like McKesson and UnitedHealth Group.
The Break Up Big Medicine Act would prohibit insurers, PBMs, and wholesalers from owning medical providers, including pharmacies, or controlling them via what’s called a management service organization (MSO). To ensure compliance, it would enable federal agencies, state attorneys general, and private citizens to bring civil enforcement actions. Lastly, it would authorize the Federal Trade Commission (FTC) and Department of Justice to block future actions of mergers and acquisitions that reintroduce the insurance companies raw power over health and medicine.
Is This the Beginning of the End for Corporate Medicine?
Does this bill have a chance? It’s early days but given the level of trending frustration, it’s possible. While it is often hard to discern, there appears to be the beginning of a departure from the status quo in health care policy, moving control away from financiers and towards doctors and the government setting prices and policies.
At this point, everyone, from patients to clinicians to employers to nurses to unions, hate the existing system. The question is this – Will Congress finally act in the best interest of Americans? They will have to go against their own corrupt funding by Big Medicine and others. Shareholders will push back, but this bill is a win for everyone but health care conglomerate CEOs.
In a recent poll conducted by YouGov and commissioned by the American Economic Liberties Project, a supermajority of U.S. voters – including 72% of Democrats and 70% of Republicans – supported breakup legislation. And doctors themselves, a traditionally staunch conservative lobby, are increasingly revolted by the control these corporate goliaths exert over their practices. Patient support can be expressed by contacting our congressional reps and let them know we are in favor of the bill.
In the 2023-2024 election cycle, the health insurance industry and its affiliates contributed over $60 million to federal candidates, parties, and outside groups. Data indicates that in the 2024 cycle, 93% of running House incumbents and 100% of Senate incumbents received contributions from “Big Insurance,” which includes major players like UnitedHealth Group, Humana, CVS/Aetna, and Blue Cross/Blue Shield.
My hope is that the Bill becomes law as testimony that Congress actually wants to repair more than a few broken systems that negatively impact the lives of Americans daily. Healthcare, immigration, the limits of AI and data centers, free speech, and online privacy are waiting to be addressed while the clock is ticking. This would require, however, a level of cooperation, commitment and political bravery that the majority of elected officials haven’t shown for decades. Instead we see the usual yielding to their big funders, favored industries, rampant corruption, and their personal love of power and avarice.
It’s not the size of the dog in the fight; it’s the size of the fight in the dog. ~ Mark Twain
Photo credits: Murder hornet – Gardening Journal, Light at the End of the Tunnel – claudia-soraya, Up arrow – Getty images, Bull dog – curated lifestyle.
Thank you for this, Barbara. I certainly support this legislation.
Locally, the Family Care Network has left United Health Care–I think because of the short visit times it mandated–and, of course, Hoagland Pharmacy is independent. So we have choices.