How Pharmacy Benefit Managers Drive Up the Cost of Health Care, by Dr. Joseph Mercola

In a healthy, competitive marketplace, intermediaries drive down costs, providing a benefit to someone, or they go out of business. Once the government befouls a marketplace, it becomes scamming, a grift. From Dr. Joseph Mercola at mercola.com:

• Pharmacy Benefit Managers (PBMs) evolved from simple claims processors into powerful health care intermediaries that control drug pricing and access through their relationships with insurers, pharmacies and drug manufacturers. PBMs engage in “spread pricing” — charging insurers more than they reimburse pharmacies and pocketing the difference — while also steering patients toward higher-cost medications through “rebate pumping” arrangements with drug manufacturers
• The current health care system, influenced by PBMs, underemphasizes preventive care while promoting long-term drug dependency, as ongoing prescription management generates more reliable revenue than prevention or cures
• Independent pharmacies and rural hospitals struggle financially under PBM practices, facing delayed reimbursements, strict audit requirements, and complex negotiation terms that often force them to either close or sell to larger chains
• Three major investment firms — BlackRock, Vanguard, and State Street (the “Big Three”) — have significant financial stakes across PBMs, drug manufacturers, and insurance companies, creating a web of interconnected financial interests
• Solutions include eliminating safe harbor rebate rules, expanding cash-pay health care models, separating PBM services from insurance companies, and implementing stricter regulations to improve pricing transparency

In the featured video, independent journalist Tucker Carlson interviews Brigham Buhler — founder and CEO of Ways2Well, a preventative care and health optimization platform — about how the health insurance industry works to keep us in poor health. Buhler’s career in health care spans over 25 years, during which he gained significant insights into the pharmaceutical and medical device industries.

The rising cost of health care in the United States has become a heavy burden for many families who struggle to pay for essential services. Patients often end up navigating a maze of insurance requirements, denials, and opaque billing practices without understanding why their treatments cost so much. Pharmaceutical prices add another layer of difficulty, with insurers and other entities setting guidelines that determine access.

Pharmacy Benefit Managers, or PBMs, occupy a powerful place in this ecosystem. Initially created to simplify payments and negotiate prices, they have grown into influential brokers controlling which drugs are covered and how they are priced. Critics argue that these corporations operate behind the scenes, orchestrating deals that maximize their profits while pushing more expenses onto patients.

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