Trickle down economics

Are we being to near-sighted by focusing our anger at the MBA’s at the chain stores? I think that we need to look at the larger picture.. The dollars in the healthcare system is neither finite nor infinite and we have so many entities trying to get a “unequal share” of those dollars.

We have:

The Pharmas

The Insurance companies & PBM’s & companies that negotiate discounts/rebates/kickbacks from the Pharmas


Laboratory services and other ancillary diagnostic services



Most of these are public corporations and they all are headed by a handful of narcissistic, myopic execs running them… many of these execs .. are like professional athletes… the length of their careers are often very limited.. so like professional athletes .. they focus on getting as much money as they can in the shortest period of time.

But all of these executives have a common master… THE STOCK MARKET…  one week they can love you and the stock price goes up and the next week.. one piece of bad news and the market will trash the stock price.

Each one of these entities have a layer of  MBA’s working on increasing the company’s bottom line and keeping those execs at the top of the pile happy.

Unfortunately, those insurance companies and PBM’s are working under an exemption to the Sherman Antitrust Act by the Mc Carren/Ferguson Act..  If you remember your history, the Sherman Antitrust Act was passed because of the actions of Standard Oil.. how they would run competitors out of business market by market.. by selling products below cost until the competition in a particular market was gone.

So.. IMO .. those MBA’s working for the corporate chains.. are just doing their job.. like the rest of are trying to do.. they probably get no fewer threats from above than we do.

Yes.. they don’t understand pharmacy and yes they don’t have much idea of the consequences to the Rx dept staff and the patients that we serve… but the slave drivers above them – remember that handful of  narcissistic execs .. and THE MARKET that they are enslaved to.. only know one thing… more money .. is the only answer.. remember the 1987 Hollywood movie  WALL STREET …. GREED IS GOOD!!!

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