Catering To Thoughts

Stop Catering to People’s Thoughts! Once you see it, you can’t unsee it! Enjoy life coaching, helping others access meds & healthcare

[Forest Park Pharmacy @ForestParkPharm]

My wife and I own a pharmacy. Last month we spent days trying to pry one prescription loose from a company that did everything it could to hold onto it.

The drug was everolimus. A generic. It treats cancer and protects transplant patients from rejecting their new organ. Not exotic. Not rare. A pill.

The patient wanted it filled with us because we're cash-pay and cost-plus. No insurance. No PBM. No secret markups, no games. Our price was $318. That's not cheap by our standards — most of what we fill runs under $20 — but it was honest.

Here's what that same prescription looked like on the other side of the counter.

In 2023, Medicare was paying about $6,645 for it. That's roughly 21 times our price for the identical medication. Medicare spent around $240 million on everolimus alone that year. If they'd paid our price, they'd have saved roughly $230 million. On one generic drug.

So how does an insurance company profit off a drug that expensive? Don't they pay for it?

No. You pay for it. In your premiums. Their job isn't to spend less — it's to keep your healthcare dollars circulating inside their own companies. And the tool they use is called spread pricing.

Spread pricing works like this: the middleman bills the health plan one price, pays the pharmacy a lower one, and keeps the difference. You never see it. On TRICARE, they pay an independent pharmacy like mine about $311 to fill everolimus. That barely covers our cost of the drug. Meanwhile the plan gets billed thousands. That gap — north of $6,000 on a single fill — is pure margin the middleman pockets.

Now here's the part they'd rather you not think about.

The pharmacy we were fighting was Accredo. Accredo is owned by Express Scripts. Express Scripts is the pharmacy benefit manager owned by Cigna. Same company, three masks. That nesting-doll structure isn't an accident — it's the whole design. When the pharmacy, the PBM, and the insurer are all one entity, they can shuffle money between their own pockets and call it whatever they want. The confusion is the product.

And this isn't a story about one weird drug. It's the business model.

The FTC has been digging into exactly this. In its January 2025 report on the three biggest PBMs — CVS Caremark, Express Scripts, and OptumRx — staff found those companies marked up specialty generic drugs by hundreds and thousands of percent when dispensing through their own affiliated pharmacies. Just those markups generated more than $7.3 billion above what the drugs actually cost to acquire, from 2017 to 2022. One in five of the specialty generics they studied was marked up over 1,000%. Some cancer generics: over 3,000%. On top of that, the FTC pegged spread pricing on those same drugs at another $1.4 billion.

One example straight from the FTC's files: dimethyl fumarate, a multiple sclerosis drug. Costs about $177 to acquire. The PBMs paid their own pharmacies close to $4,000 for a 30-day supply. Same trick. Different drug.

And they steer the profitable ones to themselves on purpose. Pharmacies affiliated with the big three took in 68% of specialty dispensing revenue in 2023 — up from 54% in 2016. The prescriptions marked up more than $1,000 disproportionately end up at their own pharmacies, not independents like mine.

So when we called to transfer this patient's everolimus to be filled without insurance, it landed like we were asking them to set $6,000 on fire. Of course they stonewalled us.

That's why we fired them.

No insurance means no invisible $6,000 charge buried in a premium you can't itemize. It means the price you see is the price. Ours was $318. Theirs was thousands. Same pill.

[Larry Elder @larryelder]

“Democrats think they're using Muslims to usher in socialism. The truth is Muslims are using Democrats to usher in Islam.”
—@GuntherEagleman

[Catering To Thoughts @CaterToThoughts]

@noahkaufmanmd This is the type of care everyone who seeks urgent care can only hope to receive. Patients in your area are very fortunate to have you.

[Isaac @isaacrrr7]

Polonia se negó a acoger inmigrantes musulmanes.

Polonia fue acusada de «islamofobia».

Hoy en día, Polonia es más segura que cualquier país de Europa.

Polonia no tiene bandas de violadores ni manifestaciones diarias en apoyo de Hamás.

Polonia tenía razón.

[Gunther Eagleman™ @GuntherEagleman]

We CANNOT let America turn into Europe.

Stop the Islamic invasion.

[Jeremy @jeremyct]

Just got off the phone with my college roommate.

His daughter was diagnosed with leukemia in January.

He has insurance. Good insurance. The kind you feel safe having.

7 months later:
Savings: wiped out. 401k: cashed early. Penalties and all. House: refinanced to cover the gaps insurance decided weren’t their problem.

He told me he’s not the same person anymore.

Said watching your child fight for her life while simultaneously fighting an insurance company over coverage codes does something to you that doesn’t go away.

They did everything right.
Two incomes. No debt. Responsible their whole lives.

One diagnosis undid all of it in 7 months.

And somewhere a health insurance CEO is getting a $30 million bonus this quarter.

I don’t know how people defend this system with a straight face.

I really don’t.

[Tommy Robinson 🇬🇧 @TRobinsonNewEra]

A retired police sergeant in Plano Texas warns about the Mosque command and control centre in the Muslim only community they have built thyere.

They are getting armed and ready for their 'sharia compliant' life in the USA, which also means not just building a segregated and parallel community, but also an economy.

USA please wake up before its too late!!!!

[Catering To Thoughts @CaterToThoughts]

@mhdksafa He took away the money you raked in through USAID fraud and now you’re crying

[Joel Webbon @JoelWebbon]

Who lives in India?

1.4 billion future Americans.

250 years.

We had a good run.

But at least we’re not racist.

[Joe Rogan Podcast News @joeroganhq]

Combat veteran Nick Tran: "I am tired of white Americans being told that they should feel like strangers in their own country, and I'm saying that as an immigrant."

[Wall Street Apes @WallStreetApes]

Almost every major country on earth bans birthright citizenship because they aren’t idiots. Here’s a list of major countries who don’t allow birthright citizenship

- China
- Germany
- United Kingdom
- France
- Italy
- Russia
- Japan
- India
- South Korea
- Indonesia
- Turkey
- Iran
- Saudi Arabia
- Egypt
- Spain
- Netherlands
- Poland
- Australia
- Pakistan
- Thailand
- Malaysia
- Vietnam
- Philippines
- Bangladesh
- Nigeria

Btw this image is of a real caravan of illegals headed into America under the Biden Admin

[Sassafrass84 @Sassafrass_84]

She's not wrong.

A republic if you can keep it.

[ThePatrioticBlonde™🇺🇸 @ImBreckWorsham]

Anybody else just not feeling this July 4th.

It's hard to celebrate America's "independence" when you're living in occupied territory.

Everything is a lie.

[Derrick Evans @DerrickEvans4WV]

After this Supreme Court ruling I truly have to ask:

At this point, what does it even mean to be an American?

[Andrew Kolvet @AndrewKolvet]

Official transcript from the US Senate on May 30, 1866. Senator Jacob Howard, who introduced the 14th Amendment:

"This will not, of course, include persons born in the United States who are foreigners, aliens...”

SCOTUS got this ruling 100% wrong. A total travesty.

[Gunther Eagleman™ @GuntherEagleman]

He’s right.

[Elon Musk @elonmusk]

Extremely troubling

[ThePersistence @ScottPresler]

How to Kill a Country:

Open the border
Allow illegal aliens in by the millions
Give out visas
Don’t enforce overstayed visas
Pause deportations
Allow birthright citizenship
Demonize opposition
Provide free housing
Provide government benefits
Give illegal aliens Driver’s Licenses
Automate voter registration
Mail every voter a mail-in ballot
Install Secretaries of State
Refuse to clean the voter rolls
Install judges
Accept ballots after Election Day

[Catering To Thoughts @CaterToThoughts]

@mhdksafa You are Evil with an agenda. I pray it fails🙏

[Catering To Thoughts @CaterToThoughts]

@DutchRojas Exactly right. Nothing has been done to change it and letting it drag on for more than three decades now. Clearly deep pockets are being lined like the rest of fraud happening in our government.