Austin, TX — Rep. Greg Casar, along with healthcare workers, patient advocates, and healthcare policy experts, reiterated calls to break up Big Medicine at a roundtable hosted by the American Economic Liberties Project in Austin earlier this week. The in-person event brought together various healthcare stakeholders and experts to discuss how vertically-integrated healthcare giants drive up costs and take power away from patients and healthcare professionals across the state and country — and why structural separation is urgently needed.

Rep. Greg Casar (TX-35) kicked off the event by speaking to the broad recognition that our healthcare system, dominated by vertically-integrated giants, is severely broken, saying, “ There is a growing consensus [of lawmakers] who recognize that these middlemen pharmacy benefit managers, that these private equity mergers and that the monopolization of our healthcare system is hurting Texans, no matter who you vote for.”

“People from both sides of the aisle, people all over the country, and providers and patients alike are saying it is time to break up Big Medicine,” Rep. Casar concluded.

“One of the problems with Big Medicine is that healthcare conglomerates are intermediating in a negative way a very trusted, personal relationship that you have with your doctors, with your pharmacist, with your nurse,” added Nidhi Hegde, Executive Director of the American Economic Liberties Project, speaking to the corporate-fueled de-personalization of healthcare thanks to massive healthcare firms.

“They’re taking way all your agency, your liberty to choose who you want to trust your information with, who you want to receive health care from,” Hegde added.

The roundtable conversation spotlighted firsthand accounts from nurses, independent pharmacists, patient advocates, and providers — all of whom detailed how corporate giants now exert control over nearly every facet of care — and underscored the urgent need to unwind those entanglements.

Monica Gonzalez, a Registered Nurse and NNOC-TX nurse representative, said that “[Mega hospitals’] cost-cutting practices have led to historic surges in organizing throughout Austin, throughout the United States — and at a national level we’re seeing more and more people realize how our healthcare corporations are using their monopoly power to gut our healthcare system.”

“We also have seen a lot of steerage, where [the biggest PBMs are] basically telling patients that you cannot fill your prescriptions at the pharmacy you want to go to. You have to use a pharmacy that’s owned by them,” said Rannon Ching, pharmacist and president of Tarrytown Pharmacy.

“We just want a level playing field. We’re not asking for special treatment,” added Ching. “We don’t need special contracts because we’re a small business. And then, if all things are equal, then let the patients choose where they want to go. If they don’t want to use my pharmacy because they feel like I’m not doing a good job, let them choose to go somewhere else.”

“Monopoly and oligopoly, cartels by any other name spell vertical integration,” said Dr. Cliff Porter, managing partner and founder, Texas Direct Medical Care. “It has actually forced people into worse health care, and we have worse outcomes and more healthcare costs, but someone got rich with their gold-plated and shag-carpeted Rolls Royce.”

“It is so disempowering to have a chronic disease,” said Krista Hager, a patient advocate. “Patients feel like something’s been taken away. For them to be re-victimized by a system unnecessarily, it just makes it ridiculous.”

Speaking to the importance and value of independent providers for patients struggling with specialty diseases, Hagar added, “These are lifetime relationships that you build and trust.”

Hayden Rooke-Ley, Senior Fellow for Healthcare at the American Economic Liberties Project concluded by reiterating the need for structural separation policies in healthcare, saying it’s “a tool that is very well known and frankly common to other large regulated industries in the U.S. economy today and historically.”

“This is not a new concept,” Rooke-Ley added. “You can look to banking, you can look to how we regulated railroads in the Gilded Age. The idea of structural separation is not a new one, but it’s very much been missing in the healthcare policy discourse. “

Find photos from the event in Austin here.

Learn more about the fight to Break Up Big Medicine here.

Learn more about Economic Liberties here.

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The American Economic Liberties Project works to ensure America’s system of commerce is structured to advance, rather than undermine, economic liberty, fair commerce, and a secure, inclusive democracy. Economic Liberties believes true economic liberty means entrepreneurs and businesses large and small succeed on the merits of their ideas and hard work; commerce empowers consumers, workers, farmers, and engineers instead of subjecting them to discrimination and abuse from financiers and monopolists; foreign trade arrangements support domestic security and democracy; and wealth is broadly distributed to support equitable political power.