Danny Jones

And so here's how that worked.

Yeah, this is where this gets crazy.

It's a little nuanced, but it's the truth.

And this is one of the things I've testified at the state level, at the federal level.

This is one of the things that they're talking about trying to fix, but they've been talking about trying to fix it for 20 years.

so they in the 80s the government said oh my god we need to develop an advocate for the average american we've got to protect these consumers so they came up with the idea of developing what's called a pharmacy benefit manager the pharmacy benefit manager's job was to go out and negotiate with the big pharmaceutical companies to drive down the cost of a prescription medication to make it affordable for me and you and our grandparents and our loved ones

In the 90s, in late 80s, the big five insurance companies went out and it worked for a little bit, but like everything, no good deed goes unpunished.

So then in the late 80s and early 90s, the insurance companies went out and acquired these middlemen.

So now the middlemen don't exist at all.

All of the major PBMs in America are owned by either United, Cigna, Aetna, Blue Cross Blue Shield, or CVS Caramark.

And that's an important differentiator because as soon as they captured those entities, they stopped negotiating down the price of drugs and started negotiating up the price of drugs.

And so you go, wait, how does that make sense?

If I'm Blue Cross Blue Shield and Brigham goes on insulin, don't I have to pay for that insulin?

Isn't it me paying for that insulin?

And this is where the shell game begins.

They put insulin on a balance sheet saying that it costs them $600 a month.

And that's what they show at United.

But what you don't know is their middleman negotiated a $300 rebate that goes to the PBM.

So they go to Eli Lilly and they say, rather than selling me insulin for the $300 you were selling it for, sell it to me for 700 and give me a $300 rebate.

And so then at the end of the year, well, they go, well, that doesn't make sense because they still paid for it.