Doctor Mike

Specifically surrounding pricing and with middlemen, specifically pharmacy benefit managers.

This is...

basically a coupon company that was started as a way to be the middleman between pharmacies and insurance companies to say, well, look, if we're going to prescribe this many or dispense this many medications for you, give us a better deal.

And they acted as this middleman to get us patients a better deal.

And it was kind of a win.

But then insurers were like, oh, let's start our own coupon company where it looks like we're saving people money, but when we make a $2 savings, we'll keep 50 cents of it.

So then they just started moving around money from one pocket to another, acting like they're spending more money, when in reality, they're just paying a subsidy of themselves the money.

And now those coupon companies are worth billions of dollars.

So there's, and there's no transparency of how they negotiate the deal, why they're covering one type of medication versus another type.

It's all very shady and transparency needs to happen there.

Second, the transparency that needs to improve is if I have an elective procedure, I need to take out my gallbladder and it's not an emergency.

Let's use hernia procedure, because that's really not an emergency.

Unless you have incarcerated bowel where the intestine is actually stuck and is being choked out, that's an emergency.

But let's say you're aware you have a hernia, there's nothing stuck and you want to get it fixed.

You should be able to call multiple surgeons or hospitals and find out what that price is.

That's like near impossible right now.

If a patient asks me, doctor, like you ordered this MRI for my shoulder, how much does it cost?

I have no idea.

It depends where they go.

It depends which insurance kicks in.