I spent over two decades watching this system get built from the inside, so to many of us, the recent class action lawsuit against Express Scripts isn't a surprise, it's a reckoning that's been a long time coming.

The Break Up Big Medicine Act — introduced by the unlikely bipartisan pairing of Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) — is designed to dismantle vertical integration in healthcare. And while the bill will cause significant disruption for the investors and executives who've built these vast healthcare empires, the case for it is hard to ignore.

If we are serious about prevention, clean and nutritious food access should be treated as a core health policy priority — not a peripheral social concern. That means examining agricultural incentives, transportation systems, zoning decisions, and insurance benefit design through a health lens.

Wouldn’t it be amazing if a patient struggling to find care due to their MA plans restrictions was simply advised by a friend or their physicians’ office that they could simply switch to traditional Medicare and avoid all of the games the private insurers play? Well, here’s the playbook.

I read the administration’s Great Healthcare Plan with both interest and a healthy dose of realism. Trying to find a way to fix our system is one of the top priorities our legislators should be focused on right now. Healthcare costs too much, insurance feels opaque, and patients are often the last to understand what something will actually cost until the bill shows up.

Insurers are under the spotlight. Hospitals are watching. And Washington is sending a clear message: if you profit from public programs, we will eventually hold you accountable.

If we actually want to lower what people pay at the pharmacy counter, we need transparency, accountability, and real guardrails on the gatekeepers who control access to medicines. I negotiated inside this system for years. The math doesn’t lie — and until we fix how the money flows, patients will keep paying the price.

Between skyrocketing premiums, narrower provider networks, and rising employee frustration, many organizations are finding themselves caught in a perfect storm. And when your team is struggling with denied claims, delayed care, or medical debt, that stress inevitably shows up at work — in morale, in performance, and in retention. The good news? You’re not powerless here. In fact, your leadership and your employees’ experiences together can be a real force for change.

Here is why there will be little impact, even if many more manufacturers agree to negotiate. Most patients will not see an impact from the price concessions since these agreements are for Medicaid patients and patients without insurance. Medicaid patients comprise around 24% of the US population and the uninsured comprise around 9%. These two deals do not impact the two largest healthcare populations in the US: insured and Medicare patients.