Med students: starting July 2026, new borrowers can take at most $200,000 in federal loans for med school. Grad PLUS is gone. The rest comes from private lenders, with fewer protections. My debt was $300,000. My advice is to go to the cheapest school that accepts you. Debt can really drag your career.

When PBMs like Optum RX, CVS Caremark, and Express Scripts claim that costs have been lowered, ask one simple question: Who benefits? PBMs profit from inflated drug prices through rebates tied to list prices, markups, and other arrangements, even when they negotiate lower acquisition costs. So who sees the benefit: the patient struggling to afford a prescription? The community at risk of losing its local pharmacy? The pharmacist working tirelessly to care for patients while facing unsustainable reimbursement rates? 🎯 👉👉Or the PBM and its shareholders, who benefits financially while everyone else bears the consequences? At the pharmacy counter, a patient arrives to pick up a medication they have taken for years, only to find out that the cost has increased substantially. Many have discovered that it's much cheaper to just pay the cash price, because their pharmacy benefit manager or PBM is requiring them to pay an inflated cost of the generic medication that the PBMs get discounts on. Meanwhile, the pharmacist is left explaining a system they do not control. PBMs can impose reimbursement rates so low that pharmacies struggle to cover the cost of purchasing and dispensing medications. Sometimes, filling a prescription can mean losing money, yet refusing to fill it could leave a patient without essential treatment. This creates moral injury, pharmacy closures, and many pharmacists just leaving the field all together. The patient faces an unaffordable prescription. The pharmacist faces an unsustainable business. The community risks losing access to its local pharmacy while the PBMs and shareholders profit. So when PBMs boast about lowering costs, we must ask whether those savings are actually reaching the people who need them. The truth is easily found in the number of patients who are skipping the use of it their own insurance and choose to pay cash instead. Lower costs for PBMs mean very little if patients still cannot afford their medications and independent pharmacies are forced to close. If PBMs push down the cost of medications but are mostly the only ones to benefit from inflated drug prices while patients struggle, pharmacists lose money, and communities lose access to care, who are these cost savings really serving? (Shareholders, executives, & PBMs.) 🚨The PBMs comments are also major deflection from the pharmacy benefit managers to not answer the question of why are they auditing independent pharmacists at higher rates after the pharmacists spoke up in support of legislation to put an end to the Monopoly power of PBMs.

Let me start with screw the @washingtonpost they are crap journalists. These are hospital-owned clinics. The hospital controls the billing and collects the facility fee. Yet the Washington Post puts “doctors’ offices” in the headline, leaving readers with the impression that their physician is behind the markup. Misleading BS Patients deserve to know who sets these charges and who collects the money. If the hospital is charging the fee, put the hospital in the headline. Physicians shouldn’t have to answer for a billing policy their employer controls.