Let me say something that makes the pharmaceutical industry, its lobbyists, and their enablers in Washington very nervous: America does not have a healthcare system designed to heal people; it has a system designed to protect profits. The outrage over healthcare costs is not manufactured—it is earned. The reason families are drowning in medical bills has less to do with science and everything to do with power: power concentrated in the hands of Big Pharma, insurance giants, and the shadowy middlemen known as pharmaceutical benefit managers, all of whom have turned illness into a revenue stream and public programs like Medicaid into a blank check.
For decades, Americans were told that rising healthcare costs were unavoidable, that innovation was expensive, and that we should be grateful for a system that charges more than any other nation on earth. Yet somehow, those same corporations manage to spend billions on lobbying, stock buybacks, and executive compensation while insisting they cannot lower prices. A routine blood test can cost hundreds—or even thousands—of dollars when run through a legacy laboratory and billed to Medicaid, not because it costs that much to perform, but because the system allows it. Prices are inflated, codes are manipulated, and taxpayers are left holding the bag. This is not healthcare; it is legalized plunder.
That is why the hysteria surrounding Elizabeth Holmes and Theranos deserves more scrutiny than it gets. This is not a declaration of innocence, nor a dismissal of accountability. It is a demand for consistency. Holmes proposed a model that threatened the established order by dramatically lowering the cost of lab testing, reportedly to around ten percent of what traditional labs were charging. For patients, that meant access. For taxpayers, that meant savings. For the healthcare cartel, that meant danger. When innovation challenges entrenched interests, the reaction is rarely fair competition—it is annihilation.
Ask yourself who stood to lose if low-cost diagnostics became the norm. It wasn’t the patient on Medicaid waiting weeks for results. It wasn’t the working family rationing care. It was the legacy labs and pharmaceutical interests that have grown fat off opaque pricing and government reimbursement schemes. Meanwhile, the same corporations that quietly settle billion-dollar lawsuits over price fixing, opioid distribution, and Medicaid fraud are treated as indispensable partners. Their executives walk away wealthy, their companies write fines off as business expenses, and the cycle continues. The selective outrage should concern anyone who believes justice ought to be blind.
What makes this system truly perverse is the role of pharmaceutical benefit managers. PBMs were sold to the public as cost savers, but they have become some of the most powerful and least accountable actors in healthcare. They decide which drugs patients can access, manipulate formularies, extract rebates that inflate list prices, and pocket the spread between what insurers pay and what pharmacies receive. Patients never see these deals. Doctors don’t control them. Voters never approved them. Yet they siphon billions from Medicare and Medicaid while independent pharmacies close and drug prices soar. That is not market efficiency; it is cartel behavior hiding behind complexity.
Obamacare was supposed to rein in this madness. Instead, it cemented it. Premiums rose, deductibles exploded, and choice evaporated. The law did not dismantle the profit centers that drive high costs; it guaranteed their participation. Americans were forced into plans dominated by the same insurers and PBMs that benefit from inflated prices, all while being told this was reform. It wasn’t. It was consolidation masquerading as compassion.
Replacing Obamacare is not about politics; it is about reality. A system that mandates participation in overpriced plans while shielding middlemen from accountability cannot be fixed with more bureaucracy. It must be rebuilt with transparency, competition, and patient choice at the center. Healthcare should operate on the same principle as every other service in America: you should know the price before you buy it. Direct pricing for diagnostics, routine care, and medications would expose how artificial today’s costs truly are.
The real threat to Big Pharma has never been regulation; it has been competition. Someone asking why a blood test costs $1,200 when it could cost $100. Someone questioning why Medicaid is treated like a bottomless well. Someone daring to disrupt a system that depends on confusion to survive. That is why innovators are treated as existential threats while corporate giants are treated as too big to challenge.
Whenever Washington stages a performance about protecting patients, the first thing you should do is follow the money. When companies that repeatedly overbill taxpayers are rewarded with influence and access, while those who threaten the pricing model are vilified, it is fair to ask whether the system is being defended or exposed. Lowering healthcare costs will not come from more speeches or more panels. It will come from confronting Big Pharma, dismantling PBMs, ending the fiction that Obamacare worked, and asking uncomfortable questions about why certain people are crushed while others are protected.
The American people deserve healthcare that serves patients, not profits—and a government brave enough to stand up to the cartel that has turned sickness into one of the most lucrative industries on Earth.