Always On EM - Mayo Clinic Emergency Medicine Grand Rounds - Dr. John Schupbach - Battling big food, big pharma, and big health
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Aug 1, 2025 Dr. John Schupbach, an assistant professor at Mayo Clinic and an MBA graduate from Harvard, dissects the troubling intersection of food, pharma, and health. He highlights the alarming rise in childhood obesity and critiques expensive medications like Liraglutide. Schupbach questions the fairness of healthcare expenses and the dominance of insurance companies. He advocates for patient-centered innovations that disrupt the status quo, urging listeners to challenge misaligned incentives in the healthcare industry.
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Make Price Transparency Truly Usable
- Hospitals must publish machine-readable and consumer-friendly prices per the 2021 rule, but patients rarely use the large files.
- Providers should make prices accessible and usable rather than dropping massive raw files online.
The Payer, Not Patient, Is Often The Customer
- The true customer in U.S. healthcare is usually the insurer, not the patient, so price transparency rarely benefits patients.
- Administrative complexity increases costs; pharmacy cash prices can be far lower than billed insurance prices.
Pharmacy Cash Price Beats Insurance Example
- Schupbach overheard a pharmacy technician offering a patient a $27 cash price or a $92 insurance-billed price, highlighting absurd pricing distortions.
- This example showed administrative overhead and PBM effects can make insured prices much higher than cash payments.
