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Great piece Wendell. It highlights IMHO how these companies have become too big and diversified to simply be put out of business under Medicare for All. As you said, their businesses have changed dramatically over the past 10 years. I'm quite sure we'd wind up with "Medicare Advantage For All" and that's what they're positioning themselves for.

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The role of PBMs in the rising cost of healthcare is finally becoming understood by many Americans. It confirms my suspicions since I first heard the term a decade ago. In 2022, the Kroger corporation decided to no longer do business with ExpressScripts, my PBM. All my prescriptions were handled by this PBM through pharmacies in Kroger's Fred Meyer stores, located here in the Pacific NW. I've attempted to determine who is the more evil culprit in this clusterfart, and my money's on the PBM for demanding higher fees than its competitors. I wouldn't bet any of that money on Congress doing a damn thing about PBMs anytime soon.

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