1. United States
2. Pa.
3. Letter

I am a practicing physician on the front lines of a collapsing healthcare system, and I am demanding that you co-sponsor and pass the bipartisan Break Up Big Medicine Act. We took an oath to advocate for our patients, but our hands are tied by vertically integrated cartels like UnitedHealth Group. These conglomerates do not exist to facilitate care; their entire business model depends on delaying, denying, and gaming it for profit. By simultaneously owning the health insurer, the physician practices through Optum, the pharmacy benefit manager (Optum Rx), and the clearinghouses, they sit on every side of the transaction. They bypass statutory profit caps by paying themselves, while using unaccountable algorithms to unilaterally overturn physician orders and cut off sick patients from critical therapies. Independent practices are being systematically crushed and bought out, while employed clinicians are forced to act like factory piece-workers—pressured to upcode charts for inflated Medicare payouts and see patients in assembly-line slots. Meanwhile, PBM arms manipulate drug formularies to extract manufacturer rebates, leaving vulnerable patients to ration basic, life-saving medications or die because they cannot afford sudden hundreds-of-dollars price hikes. This isn't a free market. It is an unmitigated conflict of interest that harms patients, burns out clinicians, and bleeds public trust. The Break Up Big Medicine Act directly tackles this corporate rot by outlawing the simultaneous ownership of insurers/PBMs and medical providers. It forces these monopolies to divest, separates the payer from the provider, and ends the predatory self-dealing that is bankrupting our patients and destroying clinical medicine. Voluntary compliance is a farce. The public is furious, doctors have had enough, and the line has been drawn. Stop protecting insurance conglomerates over the people you represent: pass the Break Up Big Medicine Act and dismantle these healthcare monopolies.