15 Comments

“And much like it’s pink counterpart, UnitedHealth’s aggressive vertical integration is leaving plenty of dead and broke earthlings in it’s path towards complete health care market dominance.“

Fantastic!

Expand full comment

It seems as though antitrust laws/regulations would (or should) come into play here, at some point. It appears that United Health is trying to create a monopoly, or at least a duopoly with BCBS. When the public's so-called choices are all actually under just one or two corporate umbrellas, that fits the definition. Wherefore art thou, AG Merrick Garland?

Expand full comment

You’re right Squid! It’s a corporate oligarchy! Aetna/Cigna/BCBS/Humana&United…. and they are under scrutiny of FTC’s Lina Khan. They are all doing the vertical consolidation from doctor to PBM to INSCO, and I hope they all go down.

We can look for more strong work from FTC after Harris/Walz are elected, because if these guys aren’t guilty of violation of America’s trust, I’ll eat my hat!🧢

Expand full comment

Hi Doc! Thanks for that information, and let's hope that "under scrutiny" turns into "under indictment" sometime in the near future. Seems like this consolidation-trajectory has gone on for literally decades, with no one being held accountable . . . as these conglomerates squeeze consumers more and more, to the point of financial suffocation.

Expand full comment

Thank you for more clarification Dr. Fake Smile. My head is exploding over the fuckery this huge, bloated corporation gets away with.

Expand full comment

Huge fuckery.

I can’t believe they employ >10% of our doctors. That is such a bad thing for patients.

Expand full comment

I just found out one of Optum’s middlemen had a huge data breach. They are offering two, count ‘em 2 years worth of data monitoring on top of their oh so sincere apology.

W

T

F

?

!

Who the hell is tracking this shit? These corporations are grifting the Medicare seniors for BILLIONS. Who wants to bet UHC also owns the data monitoring service?

Expand full comment

BmG- that middleman part of UHGs vertical chain is called ChangeHealthcare, another Orwellian title. It sure did change healthcare for 6 weeks this spring! Brought health care economy to its knees. The entire process from electronic medical records to prescriptions to billing to payment was interrupted and doctors did not get bills paid for months. Patients data was highjacked and is on the cloud.

The weird thing is that ChangeHealthcare is a relay switch that UHG “rents” to other insurers too, so it affected all players- even their competitors.

They even tried to say it was doctors responsibility to inform patients of the data breach. That was squelched, and now there’s more awareness of our vulnerability to this monopoly. UHG/ChangeHealthcare controls ~80% of all electronic filing.

Its just so obscure, detailed and frankly boring to talk about, so wasn’t covered by the media as well as it should have been.

I hope Substack writers will keep writing about this!

It’s unbelievable.

Expand full comment

Excellent article! I love the analogy with Majin Buu!

Think y’all- some people’s doctors are actually employees of the insurer. How can a doctor advocate for her patients against her own employer ?

America needs to hear more of your voices!

Expand full comment

This was all predicted when the ACA was proposed and passed. The ACA has created many distortions in healthcare. I shake my head every time government bureaucrats and politicians pass laws and formulate new regulations then cry foul when entities find ways around. Then these same people in government propose new laws and regs which result in more distortions and greater costs to the American public. Consolidation has also been taking place with hospital systems. Many now dominate smaller metropolitan areas. Not surprising UHC decided is was the best option. when are we going to learn that uncontrolled government is not the answer is not the answer. IT IS THE PROBLEM!

Expand full comment

Timothy- Look at Germany. Now there’s a government for the people. They pay taxes, they get health insurance and long term care insurance for life. We pay taxes too, and really high premiums, and yet we have no safety nets.

The problem here in our country is unchecked capitalism by a corporate oligarchy, not government intervention.

Expand full comment

Ah yes . . . the dreaded boogeyman "socialism." Certain elements in America say that like it's a bad thing - ha! -- without even being able to give an accurate definition. At any given time, that approach is decried as anything from "communism" to "fascism," with no understanding that those two labels constitute opposite ends of the political spectrum.

Expand full comment

Government was forced to create Medicare in about 1965 because private for profit health insurance corporations dropped people as they aged. Government has to pass laws to battle the real problem of corporate greed.

Expand full comment

great article Joey!

Expand full comment

Orwellian indeed.

Expand full comment