For those who don't know about the significant conflict of interest present here:
1. United is a health insurer that has to make payments for people's
2. United owns several physician networks (totaling 90,000 physicians), who then determine what your care should be—no conflict with the fact that they pay the bills...
3. United owns Optum, which determines how much your drugs are going to cost, and of course, who makes them—brand vs. generic, etc.
4. Optum runs its own mail order and specialty pharmacies. Optum also writes your care plans for many chronic diseases and ships medications all over the country.
5. Optum could require their own customers to use their care plans and software in order to receive medications at all, or mark up the price for anyone who doesn't.
Let's step through a workflow.
You, a patient on United, go to a physician for treatment. Later on, you get referred to a specialist, then get diagnosed with a chronic disease and need medication that you receive delivered monthly.
That pans out to:
United pays United, who refers you to United, that forwards you to Optum (owned by United), who gets paid by United. Each and every month.
Let's say you find a better deal for your medication at another pharmacy. Too bad, its not going to be in your network and Optum will no longer cover it.
How is a health system or an independent supposed to compete with that level of integration?
This, of course, does not result in any savings or quality of life improvement for the patient or the physician. United and Optum charge the same prices as everyone else, or more.