There is a place for us seasoned people in the system. The ones that watch and improve functions daily. Don't settle for "it will be fine" anymore. The tools are here to protect and move the system forward. The right person needs to do it. Pay Attention.
The version of this thesis that lands hardest is in pharmacy benefits. A pharmacist who has read enough PBM contracts knows where the leakage is, which UM decisions are clinical versus economic, and what a self-funded employer is actually paying for. The same stack you describe plus that domain knowledge is the disruption thesis I find most interesting, because the Big 3 PBMs are not protected by clinical depth. They are protected by network effects and inertia, both softer than they look once a credible alternative shows up. Some of those people are already looking out.
There is a place for us seasoned people in the system. The ones that watch and improve functions daily. Don't settle for "it will be fine" anymore. The tools are here to protect and move the system forward. The right person needs to do it. Pay Attention.
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The version of this thesis that lands hardest is in pharmacy benefits. A pharmacist who has read enough PBM contracts knows where the leakage is, which UM decisions are clinical versus economic, and what a self-funded employer is actually paying for. The same stack you describe plus that domain knowledge is the disruption thesis I find most interesting, because the Big 3 PBMs are not protected by clinical depth. They are protected by network effects and inertia, both softer than they look once a credible alternative shows up. Some of those people are already looking out.
Solid take