Ever wonder why it feels like you’re fighting a giant machine just to get basic healthcare?
Let’s break it down.
One Corporation Owns Your Entire Healthcare Journey
In the U.S., the same corporation can own every single step of your healthcare journey:
- They own the insurance company that decides if your care is “medically necessary.”
- They own the PBM that negotiates drug prices behind closed doors.
- They own the pharmacy where you’re required to fill your prescriptions.
- They buy up the doctor’s practices that write those prescriptions.
- And they’re publicly traded, which means the bottom line comes first — not your health.
The Part Most People Never Hear
And here’s the part most people never hear:
- PBMs get rebates from drug manufacturers to put certain drugs on the “preferred” list — meaning the machine makes even more money by steering you toward the products that pay them the most.
- These same companies can force you into their pharmacies and their provider networks, even if it’s not what’s best for you.
- They can deny claims or refuse to cover therapies they can’t profit from — including over-the-counter options that don’t require a doctor’s approval.
It Doesn’t Stop There
When the Affordable Care Act rolled in, heavy lobbying successfully removed the ability to use HSA and FSA accounts to buy basic vitamins and supplements — the very things that actually support your health and help prevent disease. Why? Because healthier people don’t feed the machine.
Now Add AI to the Mix
And now imagine all of this being run through AI systems designed to automate decisions even faster — faster denials, tighter control, fewer human eyes, and algorithms trained to protect profit, not people.
If they don’t make money on it, it magically becomes “not covered.”
This Would Never Stand in Any Other Industry
In any other industry, this level of vertical control would never stand.
In healthcare, it’s just another Tuesday.
So if you’re not getting the coverage you deserve… maybe the problem isn’t you. Maybe it’s the system that was never designed with your health in mind.