The largest U.S. health insurance companies aren’t just insurers anymore. They own hospitals, employ doctors, run clinics, operate pharmacies, and control pharmacy benefit managers (PBMs) that decide which drugs you can get and how much you pay. In one revealing moment at a Senate hearing, executives were asked to raise their hands if their company: - Owns/controls a health insurance division - Employs providers or owns clinics/specialty pharmacies - Owns/controls a PBM - Has a legal duty to maximize shareholder value Almost every major hand stayed up. They diagnose, treat, dispense drugs, set prices, and decide coverage—all while legally obligated to prioritize profits over patients. One entity now controls almost every step of your healthcare journey. That’s not competition. That’s consolidation.