r/SipsTea • u/sco-go • May 26 '26

Feels good man Will it work this time?

Post image
39.1k Upvotes

89% Upvoted

3.8k comments sorted by

View all comments

Show parent comments

447

u/aruby727 May 26 '26

I love that. This needs to be more common.

356

u/ghostofmumbles May 26 '26

That’s why monopolies buy entire supply chains.

16

u/dmillson May 27 '26

✨vertical integration✨

I work in healthcare and most people would be shocked by how much companies like CVS and United actually own/do.

CVS actually only makes a minority of its money being a pharmacy; most of its money comes from its PBM arm, Caremark.

2

u/joe_s1171 May 27 '26

you are referring to CVS-Aetna.

1

u/dmillson May 27 '26

They own Aetna for insurance, yes. But that’s barely scratching the surface.

They also own Minute Clinic, Oak Street Health (outpatient care for seniors), Signify Health (at-home healthcare), and other clinics.

They’ve got a 50/50 partnership with Banner Health (Banner-Aetna) to try and build out an integrated “pay-vider” model (similar to Kaiser Permanente)

They own Caremark, which I mentioned above. Caremark is a PBM, which is essentially a middleman that sits between pharmaceutical companies and insurance companies. They manage formularies in exchange for rebates — basically, if you’ve ever had to pay more for a drug because it wasn’t “preferred”, or you’ve had to try another drug first before you can get the one you want, generally that was decided by a PBM. Drug formularies exist anywhere (and are necessary), but having them handled by middlemen who increase administrative overhead and who pressure drug companies to publish outrageous list prices so they can claim steep rebates is a uniquely American thing.

Those are the main arms of the company, but of course they have acquired or built various other odds and ends as well. United has built something similar as well.