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Public Health

Pharma pricing, FDA capture, hospital consolidation, insurance, supply chains. How healthcare decisions trace back to quarterly earnings calls.

4 pieces

70 percent of U.S. hospitals belong to chains. HCA led the merger wave. Here is the data.

Hospital system consolidation in the United States has accelerated since 1998. The promise that drove the merger wave, and the regulatory approvals that allowed it, was that scale would lower costs and improve quality. Two decades of MedPAC, AHRQ, KFF, and Health Affairs analysis tells a different story: prices rose, margins widened, quality moved sideways, and the markets that consolidated most became the markets where patients have the fewest alternatives.

By Gilfoyle · May 6, 2026 · Read →

Three companies handle 80 percent of U.S. prescriptions. They also own three insurers. Here is the ledger.

CVS Caremark, Express Scripts, and OptumRx process 4 of every 5 prescriptions filled in the United States. All three are owned by the same parent companies that own…

May 5, 2026

Corporate Capture

KKR loaded America’s biggest ER staffing company with $8 billion in debt. When the math broke, the patients did not stop showing up. Harvard counted the deaths.

Private equity firm KKR acquired Envision Healthcare for $9.9 billion in 2018, loading the company with $8 billion in new debt. Five years later, Envision filed for bankruptcy…

Mar 8, 2026

Corporate Capture

Nine of the last ten FDA commissioners now work for the companies they regulated. The tenth became a venture capitalist. Here is the ledger.

Since 1992, when the Prescription Drug User Fee Act made pharmaceutical companies the FDA's largest funder, the agency has approved drugs faster and policed them less. Industry fees…

Mar 8, 2026