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cover of episode Brigham Buhler: UnitedHealthcare CEO Assassination, & the Mass Monetization of Chronic Illness

Brigham Buhler: UnitedHealthcare CEO Assassination, & the Mass Monetization of Chronic Illness

2024/12/30
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Brigham Buhler
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Tucker Carlson
通过深入调查和批评,卡尔森对美国和全球政治话题产生了显著影响。
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Tucker Carlson: 我对最近发生的联合健康CEO遇刺事件以及公众对此事件的反应感到震惊。虽然我谴责暴力行为,但这反映出人们对医疗保险公司普遍存在的强烈不满情绪。我不太了解这种不满情绪的具体原因,但我想深入探讨这个问题,特别是保险公司如何从慢性病中获利,以及它们在阿片类药物危机中的作用。 Brigham Buhler: 我认为大型保险集团在慢性病危机中扮演着重要的角色。他们从疾病中获利,通过各种手段延缓人们获得医疗保障和护理。这其中涉及到许多不透明的途径和方法,最终导致整个医疗体系变成了一个以利润为导向的系统。我认为公司对机构的掌控是慢性病危机的根本原因,而保险公司是主要贡献者之一。几十年来,他们的行为一直没有受到足够的关注。 我曾在美国参议院作证,向参议员们阐述了公司对机构的掌控以及药房福利管理公司(PBM)的运作方式。PBM最初是为了降低处方药成本,但现在却被五大保险公司控制,成为其利润中心。他们通过抬高药价获得回扣,这部分费用最终由患者承担。例如,Ozempic等GLP-1药物的成本中,约有30%是支付给PBM公司的回扣。这是一种‘付费游戏’机制,制药公司必须向PBM支付回扣才能获得保险公司的优选合同。 UnitedHealthcare公司就是一个典型的例子。他们去年收入3730亿美元,其中60%来自鲜为人知的药房福利管理公司。他们通过各种手段掩盖其盈利能力,但实际上,健康保险公司是鲜为人知的巨头,其收入远高于制药公司。 美国的医疗体系存在严重问题。平均每个美国人服用四种或更多药物,但医疗结果却排名世界第40位。慢性病每年导致近200万美国人死亡,这是一个比任何战争都更严重的问题。制药业、食品业和保险公司是导致美国社会慢性病的三大因素。 保险公司通过各种手段阻碍患者获得及时有效的治疗,例如延误手术、拒绝或延迟MRI等检查。他们从慢性病中获利,而非健康。他们阻碍患者进行手术,因为手术并非其利润来源。他们鼓励患者使用阿片类药物,而不是非成瘾性止痛药,因为阿片类药物可以带来回扣。 保险公司控制患者就医的医生和医院,设置重重障碍,延误患者就医。他们操控医疗体系,导致患者长期服用阿片类药物,甚至手术失败。他们扮演着法官、陪审员和执行者的角色,从慢性病和疾病中获利,延误手术等治疗。 保险公司影响了美国应对COVID-19疫情的方式,HMOs并非真正的医疗保险,而是管理式医疗。他们会从患者的慢性病中获利,医疗保险已变成一种维护计划。医疗体系中的安全网已被公司控制,以季度利润为导向的体系导致医疗体系中缺乏创新。现有的医疗体系将所有医疗行为都变成了创收机会,导致缺乏治愈慢性病的动力。 我认为,要解决这个问题,需要从根本上改变医疗体系,关注预防性医疗,而不是仅仅关注药物治疗。我们需要找到根本原因,并赋予患者对自身健康的自主权。

Deep Dive

Key Insights

Why did 41% of younger people support the assassination of the UnitedHealthcare CEO?

The support reflects deep-seated hostility toward insurance companies, which are seen as profiting from chronic illness and delaying access to care. The incident highlights widespread frustration with a profit-driven healthcare system.

How do health insurance companies contribute to the chronic disease crisis in America?

Insurance companies profit from chronic diseases by delaying coverage and care, prioritizing prescription drugs over surgeries, and creating a system where there is more financial incentive to keep people sick than to help them recover.

What role do Pharmacy Benefit Managers (PBMs) play in the healthcare system?

PBMs, owned by major insurance companies, negotiate drug prices but often inflate costs to receive rebates or kickbacks. They act as profit centers rather than advocates for affordable medication, driving up prescription drug prices for patients.

How much of UnitedHealthcare's revenue comes from its Pharmacy Benefit Manager?

60% of UnitedHealthcare's $373 billion in revenue last year came from its Pharmacy Benefit Manager, Optum, which operates as a hidden profit center within the company.

Why are health insurance companies incentivized to prescribe opioids over non-addictive alternatives?

Insurance companies receive rebates on opioids, making them more profitable than non-addictive pain treatments. This financial incentive has contributed to the opioid crisis by steering patients toward highly addictive medications.

How do insurance companies delay access to surgeries and other critical treatments?

Insurance companies use tactics like denying claims, requiring prior authorizations, and delaying approvals for surgeries. They also restrict patients to in-network providers, often leading to longer wait times and suboptimal care.

What is the impact of insurance companies on preventative care?

Insurance companies discourage preventative care by denying coverage for comprehensive blood work and other early detection measures. This prevents clinicians from identifying and addressing chronic diseases before they become severe.

How do insurance companies profit from Medicare and Medicaid?

Insurance companies negotiate inflated drug prices with Medicare and Medicaid, often receiving rebates that are not disclosed. They then charge the government higher rates, pocketing the difference while taxpayers foot the bill.

Why are doctors increasingly leaving the primary care profession?

Primary care doctors face burnout due to low reimbursement rates, excessive administrative burdens, and limited time with patients. Many are leaving the profession because they feel the system ties their hands and prioritizes profits over patient care.

What is the future of healthcare if insurance companies continue to dominate the system?

If insurance companies continue to dominate, healthcare will remain profit-driven, with a focus on treating chronic diseases rather than preventing them. Patients will face higher costs, limited access to care, and a system that prioritizes financial gain over health outcomes.

Chapters
The podcast starts by discussing the murder of a UnitedHealthcare CEO and the surprising public reaction. It highlights the latent hostility towards insurance companies and their role in the chronic disease crisis.
  • Murder of UnitedHealthcare CEO
  • 41% of young people support the murder
  • Latent hostility towards insurance companies
  • Insurance companies contribute to chronic disease crisis
  • Corporate capture of institutions

Shownotes Transcript

An unhealthy, over-medicated country means record profits for insurance companies. Brigham Buhler explains how they work to keep us sick and monetize chronic illness.

(00:00) The Assassination of the UnitedHealthcare CEO

(13:32) The Opioid Crisis Could Have Been Prevented

(30:28) Monetizing Your Chronic Illness

(35:00) How Health Insurance Companies Are Scamming You

(54:18) How They Profit Off of Cancer

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