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Senat Ishmael
Senat Ishmael
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Region: GH
Wednesday 09 September 2026 05:41:07 GMT
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Mark Cuban came to town to push healthcare policy, so I went to see it. He is backing the Break Up Big Medicine Act, and I want to be fair here: it is aiming at exactly the right target. The target is vertical integration. That is when one company owns every layer of your care at once, the insurer, the PBM, the pharmacy, and the doctor. When the same parent both sets the price and pays the price, it can steer you to its own affiliates and hide where the money goes. Roughly 80% of doctors now work for a corporate parent. Breaking these giants back apart is a genuinely good idea. On the goal, Cuban and I completely agree. Here is my hesitation. Congress built this problem in the first place. Vertical integration existed in smaller forms before, but the Affordable Care Act put it on steroids and helped create the mega-conglomerates we have now. The people proposing the cure are the same ones who wrote the disease. And this is not a one-off. Look at the track record of
Mark Cuban came to town to push healthcare policy, so I went to see it. He is backing the Break Up Big Medicine Act, and I want to be fair here: it is aiming at exactly the right target. The target is vertical integration. That is when one company owns every layer of your care at once, the insurer, the PBM, the pharmacy, and the doctor. When the same parent both sets the price and pays the price, it can steer you to its own affiliates and hide where the money goes. Roughly 80% of doctors now work for a corporate parent. Breaking these giants back apart is a genuinely good idea. On the goal, Cuban and I completely agree. Here is my hesitation. Congress built this problem in the first place. Vertical integration existed in smaller forms before, but the Affordable Care Act put it on steroids and helped create the mega-conglomerates we have now. The people proposing the cure are the same ones who wrote the disease. And this is not a one-off. Look at the track record of "fixes." Your brand-name drug prices trace back to Congress carving out a safe harbor in the anti-kickback statute for PBMs. The theory was that letting them keep a slice of the discount would motivate them to negotiate prices down. Instead, because their cut grows with the size of the discount off a higher list price, it rewarded higher prices. The incentive ran backwards. The American Rescue Plan was supposed to punish drugs whose prices rose too fast. Flovent's maker just discontinued the brand and relaunched it as a higher-priced authorized generic to dodge the penalty entirely. The 340B program was built to help safety-net clinics. It has ballooned into a $100 billion machine, growing about 22% a year while actual drug sales grow a fraction of that. The No Surprises Act, meant to protect patients from surprise bills, has by several analyses added billions in new system costs. That is an ugly track record. A well-aimed law that gets structured badly does not just miss, it usually creates a worse problem than the one it started on. So maybe I am being too harsh. Will this be the time Congress writes the structure right? I want to be wrong here. Let me know in the comments. In the meantime, I am not waiting on legislation. I already broke up big medicine right here. No insurer, no PBM, no parent company skimming a cut. I fired the middleman years ago, and you do not need an act of Congress to get a fair price. Head to forestparkpharmacy.com, look at the price checker, and transfer today to save. See ya.
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