Brigham Buhler
speaker
1,533 appearances
6 recordings
5 series
first heard Oct 2024
last heard 27 Feb
Brigham Buhler’s voice in public audio — every appearance, attributed to the second.
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recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Feb 2026 with 1.
Appearances
Like in the state of Texas, Blue Cross Blue Shield is 30% of your revenue. So I'll tell you a real world example. I owned a pharmacy and I still do own pharmacies, but I don't take insurance. Like our model now is we refuse to take insurance because if I don't take insurance, I can tell the patient the real price.
I can get rid of all the games, all the fuzzy numbers, and I can just say, hey, it cost me this. I'm going to sell it to you for that. I'm going to mail it to your doorstep. It's that simple. So, I mean, why aren't there more pharmacies like that? They're springing up. They are coming up. And I think it's taking the American people. So many people think, well, my insurance should cover it.
And I try to explain they're going to cover it. But there's a price to pay. And that price to pay is way more than dollars. They are going to make you chronically ill and make money off you. And oftentimes you're spending more than you would to just pay cash for the compound. Uh, like here's an example.
I also owned labs and I owned a blood lab and I went out and I educated clinicians in the state of Texas on the importance of preventative care. My, my, my pitch, my elevator pitch was the five chronic diseases that are killing so many Americans. How do we stop them? We don't let them develop in the first place. And how do we do that? We do that through getting proactive and predictive.
And how do we do that? We do that by taking a look under the hood. Do you just go out and romp on a car without changing the oil or maintaining it? No, you take care of the vehicle. We have to take care of our bodies. And the only way to do that is to do the deep dive annually and to understand. A basic checkup in America is a lipid panel. They're looking at like four or five things.
They're looking at nothing. You can't get anything out of that. To do a deep dive, you look at over 70 biomarkers. Now I'm looking at your blood work and I can tell, like I said earlier, are you headed towards diabetes? And if you are, we can intervene. We can act now before you become diabetic. But what the insurance model does is they wait for you to become diabetic. Why?
It costs sixfold to keep you alive every year once you're diabetic because they're getting paid off the insulin. there's an incentive for them to let you become diabetic. You show you the incentives, I'll show you the outcomes. We've got to pivot this and shift this. So I would educate doctors on the importance of blood work.
And I would tell them, let's get proactive and predictive and let's prevent chronic disease. Doctors start implementing this in their practice. Within months, clinicians, all of them got letters from the insurance companies. Hey, Dr. So-and-so, we noticed you're pulling a lot of blood work. We don't like this. We don't think there's medical necessity here. Hold on now.
One, where did you go to fucking med school? Two, who are you to tell a clinician what they do with a patient life? Three, that patient paid you their hard-earned money for the right and accessibility to care. Four, you're doing this purely, purely out of evil necessity for profit and greed. That's all this is.
There's no reason not to get a comprehensive blood panel at least once a year to be able to do a deep dive. So clinicians stop pulling the blood work. That's throughout the United States. Doctors are terrified. They are not going to fight the insurance companies because the insurance companies control everything.
And so when we talk about corporate capture, you've got the big pharmaceutical companies that have captured the FDA. You've got the big insurance companies that have captured, included with FBI and DOJ, which I'll get into here in a second. They've also captured our hospital systems and our clinicians.
There are no private primary care practice anymore because insurance cut their reimbursements, forced them to go work as employees of the hospital. Now they've funneled all of the sheep into one location so the wolves can pick them off. And now these doctors are basically fall in line or lose your job. And so doctors fall in line.
There's very few independent primary cares that are in an insurance model anymore. Most of those have gone to work for huge HMOs and like Blue Cross Blue Shield bought Kelsey Siebel, I believe. So the other thing they're doing is they're vertically integrating and capturing our systems. So like when I had where I was going earlier with the blood work is they basically deny the blood work.
Bully the clinician to not pull the blood work so then the doctors don't ever do the deep dive so they can't prevent the chronic disease. So now you are headed towards chronic disease because they don't have the ability to help you prevent it. And so that's just one sliver.
Then the other end is as a pharmacy owner, I would bill and collect and I would ship out hundreds of thousands, millions of dollars in medications a month. Crucial life-saving medications for patients. Blue Cross Blue Shield, true story, came, said, they quit paying me. And I shipped out, I think, over a million dollars in prescription medications in a month in the state of Texas.
You go to negotiate, say, hey, what happened? You guys didn't pay me this month. I have a million dollars that I've shipped to your patients. Yeah, we don't think you collected co-pays and deductibles. Okay, well, we did. We collected 98%. Okay, well, we'll come audit you. Okay, how soon can you be here? Three months. What? I can't ship out $3 million in drugs and float you guys. I'm not a bank.
And they do that throughout the industry. The hospitals are floating the bills. It's 90 days on average to get reimbursed, anywhere from 60 to 90 days to get reimbursed on a surgical procedure. Then when patients say, why do I have such a big copay? It's another method to discourage you from having surgery and to force you back to the drugs that they're making money on.
Yeah. Now there's still a lot of money in surgery, but it is a loss leader for these insurance conglomerates. And so they put obstructions between you, deny, delay, depose, right? So they delay your ability to get the care. They make you jump through all these hurdles before you finally get approval. You know, UnitedHealthcare denied over 30%, one third of claims.
And actually two years ago, they denied 37% of claims. Thirty seven percent. That's not one third. That's almost half. Like, let's let's be honest. And all the meanwhile. And what that means is people are dying. It doesn't mean like, oh, shucks. You know, these aren't aesthetic procedures. These are life changing procedures that people are desperate for, that they paid for.
And you're denying them. And do you know what percentage of people fight the claim? 10%. 10%. People are tired. How do you fight a claim? You have to go to your doctor and write letters and push back and go get second opinions and take time off from your busy job to go try and battle an insurance company.
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