Pharma Whistleblower Reveals Who Really Runs American Healthcare w/ Brigham Buhler

25:00Dr. Mark Hyman:Why do there have to be PBMs? Why can't you just get a prescription from your doctor and go to the pharmacy and get it and not have to go through a middleman? I agree. I mean, it's insanity. And I understand, you know, the saying, the highway to hell was paid with the best of intentions. I do think when they started this, the thought was, hey, these middlemen will help us negotiate down the price. But where that gets even more sinister, just like when we look at when does mega chronic disease happen? Like when do the big ticket items happen? It's as we age, right? And so after the age of 65, when you're the taxpayer's problem.

25:33Yeah. And so again, we go back to the insurance companies. Push it off to the taxpayer. They just wait. and so if I knew that, you know, again, Joe Bob is pre-diabetic, it's going to be a seven to eight fold increase in the cost of care. If we let him transition to diabetes, why would we not pay for him to see a nutritionist? Why would we not encourage him and treat him with even something as simple as metformin that's been on the market forever and prevent him from transitioning from pre-diabetes to diabetes? Because I know in 24 months when he reaches diabetes, he's going to switch employers and be somebody else's problem.

26:07And then when he has that catastrophic heart attack or the cascade effect that follows, he's going to be the taxpayer problem. And I'm just worried about hitting my quarterly earnings.

26:25Dr. Mark Hyman:I mean, this is really a key problem you're hitting on, which is that there's a lack of of transferability of risk. In other words, there's not a collective risk sharing. And when you have an insurance company, like you said, you negotiate with your insurance company. They're not doing the right things for patients because they're incentivized not to. Because if I pay for a health program where I reverse a disease or I improve people's health or whatever, I mean, I got the benefit because next year you might switch insurance companies. Yeah. Right? And then... So we need a system where, and I don't know if anybody's really solved this.

27:05Dr. Mark Hyman:I've heard some different theories and ideas, but if we could somehow have a shared risk pool where it didn't matter if you were United or Cigna or Aetna or any of the other big insurance companies that you would actually kind of collectively share the risk and the reward of getting people healthy. Because right now you're right. there's no incentive for doing anything proactive or preventive. And I was just, you know, kind of talking this morning to a benefits manager for employers who helps advise them on which programs to use and which things to do. And they were like, yeah, you know, they're following the American Affordable Care Act guidelines, which is almost no screening and almost no prevention and really reducing what you're allowed to do.

27:59Dr. Mark Hyman:And they're frustrated because the employers want to have more productive employees. They don't want to pay high premiums, but they're also stuck in this vicious cycle. So is there any way out of that? I think there is. One of the things that in my talks with Callie is with his company, TruMed, how do you increase HSA amounts, right? If we could give the power back to the patient, where the patient or even the insurance company, there's got to be a way to incentivize being healthy. Rather than incentivizing chronic disease, can we give tax incentives or quality care incentives that allow patients accessibility to being predictive, proactive, and preventative?

28:41And what I mean, like if we had a, let's just say a$15 ,000 a year HSA, right? Or whatever the number is that you get a tax benefit on, how much chronic disease could we prevent if it gave somebody accessibility to quarterly blood work, to a nutritionist, to the ability to go to a gym. And then you have all the other items like red light and all these other things. It would choose your own adventure to each their own. We do know definitively that diet, lifestyle, and exercise are the biggest leading opportunities for us to fix. And we've got to give that solventry on autonomy back to the patient.

29:19And so many times I've heard clinicians go, well, my patients don't give a shit. They just want to, they just want to met. And I, it infuriated me. It's because they just want help. Yeah. They want help. And they view you as the thought leader and they're asking you for help. You hear, they're asking me for medication. They're asking you for a cure. Yeah. And if you took the time to talk to this patient and have empathy, if the insurance company would allow you to do this. And that's where HSA... Yeah, health savings accounts. Yes, if somebody could have$300 to sit with their clinician for an hour and really talk.

29:57Dr. Mark Hyman:I think we have this incredible moment to think about this all again and to change what's happening and to educate the American public about some of the challenges with these systems that are filled with perverse incentives and to realign those economic incentives so people do the right thing. You know, the old Chinese doctors used to get paid when their patients were well, but when they were sick, they wouldn't get paid. We might want to think about something like that. And there's got to be some sort of insurance reform that would allow patients to drive their choice. Because right now, patients are driven by the insurance company's selection, right?

30:33So you can't get that MRI if the insurance company doesn't approve it. The insurance company is not going to approve it. Somebody made a joke, it's like doing a rain dance, jump on one leg, shake a stick in the air and hope that it rains. that's what it's like trying to get anything approved through an insurance company.

30:48Dr. Mark Hyman:No, no, I had to take a medication where it was super expensive, and I had totally legitimate reasons for taking it. And I had to work with my doctor with writing up long scientific reports on why I need this and why the indications were there and what my genetics were and why. And it was like a whole thing. And it was recommended, and the letter was written by the physician. And I still got denied. And I even met their criteria, which they say I needed to meet in order to actually get paid for this drug. So I was like, they said I'd have to do these things. I did these things. And they still said no.

31:23Yeah.

31:23Dr. Mark Hyman:So the denial of claims is a huge business. Oh, and what happened is now those denials have climbed and climbed and climbed. And the reason the insurance companies do it is they have all these algorithms. They know. They know if they deny a claim that less than 10 % of people will dispute it. So now their game plan is deny, delay, depose. Like what that kid Luigi wrote. Like terrible message, terrible delivery. What he did was horrible. But it was an example of the frustration of these patients in this country saying, I can't get the care I'm paying for. I can't, like why? Yeah. And while I needed rehab after my surgery with UnitedHealthcare, they made$22 billion in profit and I couldn't get paid for a week of rehab after my surgery, which just didn't make any sense to me.

32:15It's sad. It's sad. And that's, that is literally, it's not the exception. It's the rule, which is sad to say, but you're spot on. Like that's, that's just the ecosystem we live in. And there's gotta be a way to improve it. And that's where I hope that, you know, with everything that you're fighting for and all these folks are fighting for that, there will be that change coming.

32:33Dr. Mark Hyman:Uh, yeah, we hope that change is coming. We hope that train's coming on the station, you know, but the, the forces are right against it that are pretty big. You're talking about a humongous industry with so much at stake and so much to lose unless the incentives get aligned and they make more money when they do the right thing. I mean, that's what has to happen. When you do the right thing, you should get paid more. And there are systems like that, like Geisinger, Kaiser, which are essentially HMOs or accountable care organizations where they're internally kind of covering their own patients, both the payer and the provider.

33:13Dr. Mark Hyman:But their incentives are aligned. But that's not most of healthcare. That's where we were moving towards in terms of Obamacare, value-based healthcare, which is getting paid on results, not getting paid on doing more stuff. Right now doctors and everybody gets paid hospitals. The more surgeries you do, the more procedures you do, the more visits you have, the more things you do, the more you get paid, as opposed to incentives that are changing that, where you get, let's say you get your hospital system, like Cleveland Clinic, you get$20 million a year to take your diabetic patients. If it costs you 30, you lose money.

33:45Dr. Mark Hyman:If it costs you 10, you make money. And so what are you going to do in that situation? You're going to make sure your diabetic patients are extremely well cared for, that their diets are great, that their exercise is great, that their medications are properly monitored and tracked, that they're involved in good primary care. I mean, it's not hard to solve these problems we know how to solve them and you can see it in every aspect of health like another example i can give you is my years as an orthopedic rep why do joints have the life cycle they have you're telling me over freaking 35 years we haven't evolved a joint that's going to last more than seven eight years it's because it's a race to the bottom every year the insurance companies pay the hospitals less and less for joint surgery So every year the hospitals do more and more joint surgeries to keep up with their overhead and their expenses because they're going to make less off the joint surgery.

34:38And then if you were to ask an executive at a hospital, why wouldn't you buy a joint that's, if we were to innovate a joint that lasts longer, would you use it?

34:45Dr. Mark Hyman:Yeah, of course. But that's not what healthcare is. In their model, there's no incentive now because they'll go, well, I'll get a new joint in eight years and that's another revenue stream for us. And if the insurance isn't going to reimburse me more for a better joint and every year they're going to cut my reimbursements by 8%, I'm going to go back to the manufacturer and say, you need to cut my joint price by 8%. And then the manufacturer is going to say, why am I going to innovate a joint that nobody will buy? And so we go back to that Eisenhower speech. If we allow the corporate capture of our healthcare and scientific institutions, it's essentially a race to the bottom.

35:22Dr. Mark Hyman:And we know that things work that aren't paid for, like medically tailored meals for chronic illness. You know, 5 % of the Medicare population accounts for 50 % of the cost. And if you take those people with heart failure and diabetes and kidney issues and all the chronic things that they pay for, and you provided them meals that were designed to treat or reverse or optimize their health, that you would save thousands of dollars. And one study in Cleveland Clinic, they saved$12 ,000 just in a small cohort that was given free food, and people say that's a cost over cost. It's a cost to give people.

35:58Dr. Mark Hyman:How much is it to give them the medication? And I think people just don't even realize that. I mean, I have one patient whose copay was$20 ,000 a year. I don't know what her actual pharmacy bill was, but if you gave her$20 ,000 of food a year to reverse her diabetes and heart failure, well, guess what? That would be a net savings, right? Yep. And so we know what to do, and there are initiatives out there that work, but they're not being paid for. I mean, we found out that group shared medical visits worked three times as well for the same disease, free by the same doctor at far less cost. And we actually had to use a physician in the process, even though I think it would be equally effective if it was delivered by a health coach who wasn't paid a fraction of what a doctor repaid.

36:44Dr. Mark Hyman:Well, we had to do it because we had to game the system. In order to get reimbursed from Medicare, from insurance, we had to bill for a shared medical visit, which wasn't even necessary. And we could have achieved the same outcome. So we know that these models are out there. Most of the healthcare system is not incentivized to use these or doesn't leverage them because it's sort of against their own interest. And it makes sense. Why would you act against your own interest if you were a pharmacy company or a pharmaceutical company? And if you're an executive at one of those companies and you try, I think you said this at the dinner.

37:16I want to say you brought this up at the dinner. One of your buddies at a food company attempted to drive meaningful change. Yeah. And good luck keeping your job. Yeah. Yeah. Because if meaningful change doesn't, you're on such a short timeline and leash to produce for the organization that if profits take a dip at all, chances of you getting to the finish line are slim to none.

37:40Dr. Mark Hyman:Yeah. Right. There's no long-term thinking, right? Yeah. No 10 year plan or five year plan. It's like next quarter, what are our earnings? are we going to make our share holders happy? Who cares if people are sicker and dying? It's like, it's a whole fucked up system. How do we hold these corporations accountable? How do we hold policymakers accountable to us that do not perpetuate the cycle of sickness and the cycle of perverse incentives? You and I just did that testimony, I guess, what, two weeks ago. And I thought the whole time, one of the things that resonated with me, because I've never been political, is is Tulsi Gabbard told me at one point uh Brigham people think that politicians drive change people drive change yeah and it starts with people having a voice you have to use your voice because if the people will speak up the policymakers will act but it takes people fighting for what they think is right and you look at what's happened with the health movement and the food movement these are things you've been preaching for how long how long i mean it's been a while and there is meaningful momentum right now yeah there is and and politicians may get the credit and and they they are this they are the tip of the spear that are driving this forward but it's people people like you podcasts people having discussions and open forums and being honest and having integrity and calling people out and asking, why are we not doing these things better?

39:10And that's how we start change. It starts with a little spark that becomes a fire, that becomes a movement that's unstoppable. And so I am optimistic that we can drive change. But like we said, with medicine, you got to find the root cause and you got to start treating the root cause and not the symptoms. Because otherwise we're just playing whack-a-mole.

39:30Dr. Mark Hyman:Well, that speaks to the whole food industry and also how they're profiting from illness. In fact, what really struck me was when I learned that insurance companies invest in fast food and junk food companies as a hedge against their profits. Because if people get sicker, maybe they think they won't make as much money, but they'll make more money if people are eating more junk food. The whole thing is crazy, right? It's so good. So back in the 70s, the big tobacco companies were starting to buy the food companies like Philip Morris Kraft, you know, and called Altria or R.J.R. Nabisco, which was, you know, another one.

40:08Dr. Mark Hyman:And they basically designed these food products to become biologically addictive. And there are these significant tactics they use to confuse, to obfuscate, to muddy the waters, to put out fake science, to kind of deny and deflect. And I mean, it's pretty amazing. And it makes the lawmakers confused because they're hearing all this, quote, I would say, pseudoscience about how these products are not harmful, how there's no evidence, how we need to provide safe, affordable food that's convenient for people who are discriminating and racist and being bad people if we don't offer all this crap to everybody.

40:47Dr. Mark Hyman:and it's, I mean, I think today or tomorrow there's a testimony in Arizona on bills that are going to get rid of soda and SNAP and junk food and SNAP, which I think is going to be hard to do on a state level, but it's coming from the periphery. Now, I think there's, you know, 30 or more states that have bills that are directionally toward fixing these problems. I'm curious to hear what your thinking is about this because I think, you know, will the states be able to kind of leverage this momentum? Will that drive the change in Washington? Even though you've got someone like, you know, Marv Gay Jr., whether you like him or not, you know, he's beginning to address these issues.

41:26Dr. Mark Hyman:You know, the problems with the FDA, the problems with the NIH, the problems with Medicare, Medicaid, the problems with our food companies, the problem with, you know, these regulating compounds in food that shouldn't even be there. We have 10 ,000 chemicals in the US, there's 400 in Europe. And you could say, well, you know, some of those 10 ,000 are lumped together, and maybe it's not 10 ,000, maybe it's 5 ,000. but still 5 ,000 versus 4 ,000 or whatever it is. It's a lot. And so how do we sort of kind of move forward? Because I feel like we're at this critical time, but it's really fraught with danger, but it's full of possibility.

41:59It's jarring. Like I knew there would be a counterpunch. I didn't know it would be that big of a counterpunch. Like even when you and I testified in front of the Texas State Senate, they were telling us that big conglomerates like Buc-ee's and H-E-B, which are legends here in Texas. I grew up in Texas. This is my home state. I love Buc-ee's. I love H-E-B. It's very disheartening and disappointing to know that they're working behind the scenes to block something as simple as label disclosure, just label disclosure. And then who testified with us, Grace, brilliant young girl. I don't know if you remember Grace, but she posted about how the American, I think it was the American Heart Association.

42:38I don't want to quote the wrong. One of these organizations is supposed to be supportive of health and wellness is, is testifying against these bills. Like what part of that makes any sense?

42:51Dr. Mark Hyman:Well, it makes sense because they're funded by the companies, right? I mean, American Heart Association gets$192 million from food and pharma companies, right? A year. Yeah. And then I go back to show me the incentives and I'll show you the outcomes. And so it almost goes back to, we have to realign and cut the head of the snake off. And that's going to be policymakers changing the rules. Like I'm all for a free market. This is America. We should have a free market and free choice. What we have today though, is the illusion of a free market. Explain what you mean by that. These companies are ramrodding your choices down your throat and pretending to tell you that you have the choice.

43:31In reality, you know, you don't, if you don't have the knowledge and the accessibility to know what they're feeding you, then how can you make an educated choice? That's not freedom. Freedom would be, tell me what you're putting in my food. Tell me, give me like the real story here so I can make the better choice for my family. To me, it's not freedom if you're going to hide and mislead the American people on what you're feeding them and their children. That's not freedom. No, it's true.

44:02Dr. Mark Hyman:I mean, there's such a lack of transparency and many other countries have front of package labeling. In my nonprofit Food Fix, it's one of our key efforts is to try to get transparent, honest, clear labeling on the front of your food. You can tell what the heck it is you're eating. Is it good for you? Is it bad for you? Is it okay to eat? Is it good to promote health? Is it going to promote disease? It shouldn't have to be a PhD in nutrition science to figure this out. And the way in which the food industry regulates these things is concerning to me. And I heard secondhand, but from someone who talked to Robert Califf, who was the former FDA commissioner under Biden, who said, you know, we're working on these front of package labeling guidelines, but don't get your hopes up.

44:47Dr. Mark Hyman:You know, it's not going to be what it really should be. Even though he was an advocate for real change. I mean, look at what he did. You mentioned that they acquired that big tobacco, went up and bought big food. Look at how impactful it was to put a warning label on the front of a pack of cigarettes. It changed that industry. people looked at that and you don't see people smoking everywhere. Like when I was a kid in the eighties, the eighties people smoked on planes. Like there was everywhere you went, people were chain smoking. There's a smoking section. That didn't make sense to me. You got like a little curtain, the smoking section and non-smoking section on a plane.

45:21And now that's a thing of the past because most, I don't know what percentage of Americans smoke, but it's way less than it was in the eighties. I promise you that.

45:28Dr. Mark Hyman:Now there's nowhere to put your gum because in the, you don't have the ashtray in the airplanes anymore. but that to me, nobody's telling Americans what to do and not to do. And I think that's where they start to misunderstand. And that's where these lobbyists in these big food industries try to trick the American people. What we're trying to say is let's make you aware of your choices so that you have true accountability and solventry over yours and your family's health. And you know when you're being bamboozled. Yeah, and I think front of package labeling is a huge opportunity because it's really not about saying, don't eat this, don't eat that, saying, if you eat this, these are the known harm.

46:07Dr. Mark Hyman:And you choose for yourself whether you want to do it or not. I know ice cream gives me runny nose and I mess up my stomach and I sometimes get pimples, but will I eat it occasionally? Yeah, because I like it. And I know what's going to have an adverse impact on my biology, but I'll do it. And I won't do it all the time. If you don't know that something's causing a disease. And I think, you know, for most of the American public, like this is true. You know, I'm shocked at how even educated people, highly educated people, don't understand what's in their food, don't know how to make the right food choices, feed themselves and their kids crap, and think it's fine.

46:41Dr. Mark Hyman:Because, you know, it's part of our food supply and the government regulated if it wasn't healthy. And in other countries, they don't do that. They have warning labels. If you go to South America, there's like big stop signs on the front of food packages. You know, and I've talked a lot about this in my book Food Fix and other places, but you look, for example, at a Coke, right, or any soda. It's filled with high fructose corn syrup. It's cheap. You know, you can buy a two liter bottle for a buck or two. You know, it's like insane how cheap it can be in some places. When you look at the true cost of that, what is the true cost of that?

47:13Dr. Mark Hyman:The Rockefeller Foundation did a report called The True Cost of Food, which says that for every dollar we spend on food, there's$3 that's spent in collateral damage. So just take soda, for example. Wow. You grow the corn, the government pays for that through crop subsidies and basically crop insurance in different schemes. That growing of the corn in that way with the use of pesticides, herbicides, and fertilizer cause environmental damage, kill the pollinators, lower biodiversity, destroy the soil organic matter, cause that to be released in the atmosphere, increasing the atmosphere of carbon, the nitric Dioxide gets released from the nitrogen fertilizer, also causes climate effects, as well as running off into the rivers and streams, causing eutrophication, which is the overgrowth of algae because of too much fertilizer.

48:04Dr. Mark Hyman:It sucks all the oxygen out of the water and kills all the fish. And we have dead zones the size of New Jersey and the Gulf of Mexico or Gulf of America, whatever you want to call it now. And there's 400 dead zones like that around the world. And it's like, that's just one piece, right? So who's paying for all of that environmental damage? The society pays for that. We pay for that. Then you have those cheap calories that are artificially cheap getting put into processed food by the big food companies into fast food foods. And then the government is paying for that again through the SNAP program.

48:41Dr. Mark Hyman:So they're paying$125 billion a year for food stamp or food assistance programs. Most of that is for junk food, 10 % soda and 75 % junk food. And then we pay for it again when those people who are eating those foods on Medicaid or Medicare get sick and they get chronic illnesses because they're eating that food. We pay again. So the taxpayer is paying four or five times for the same food product. And if we actually put a price on the Coke, it probably would be$100 when you account for all those things. It's so wild that you're saying that Because you're literally describing the same offense that I try to articulate to people with prescription drugs.

49:23It's the same thing where most of the drugs innovated and molecules are innovated at the Human Health Services NIH. And so those come from taxpayer dollars. And once a molecule reaches a certain point that it has a lot of promise, it's then licensed off and commercialized for pennies to a big pharmaceutical company like the GLP-1s. Who make billions. And then they mark it up. Then they've got to give their cut to the insurance company. Then we, the people who funded the molecule in the first place, who already paid for it once, now have to pay for it not only at the pharmaceutical level but the insurance level.

50:02So we're marked up twice. Now we finally have accessibility to these medications. And it's like, but we're paying for it three times over. And then the rest of the world just gets to have accessibility to those compounds for pennies on the dollar.

50:17Dr. Mark Hyman:It's quite crazy. And the FDA is problematic in my view because, you know, some of their funding comes from pharma. And the rationale behind that is that, you know, in order to hire the best talent and to expedite the approval processes for devices and pharmaceuticals, we need high quality talent. We need a lot of it to be able to deal with the volume. And so they're offsetting that cost by providing that money, pharma is, to the FDA. You can say, well, that's pretty conflicted. And it is. But you can also say that the scientists within the FDA hopefully be independent. and they're personally not getting the money, but they're reviewing the science.

50:55Dr. Mark Hyman:But it's a little muddy. It's definitely hard, because 10 out of the last 11 heads of the FDA went to go work for industry. That's right. And that's a problem. Right. Revolving door syndrome. Yes, Scott Gottlieb went to work for Pfizer, who was the commissioner of the FDA, who was under Trump. So then you have other problems where things that should be approved, that have profound benefits, that don't cost a lot, that can solve problems that nothing else can solve, that have gone through phase three trials and shown better outcomes by orders of magnitude greater than existing treatments. And I'm talking here specifically about MDMA-assisted therapy.

51:35Dr. Mark Hyman:So you're basically taking a compound that's off-patent, MDMA, you're pairing it with therapy, so you're not just prescribing the drug, but you're actually making sure you have a licensed, trained therapist to guide people to experience them healing. it's dramatically more effective for depression, for PTSD, for anxiety than any existing medication.

52:06In the stats on Ibogaine and the future of all this stuff, it's like...

52:11Dr. Mark Hyman:Pretty impressive. But the point I'm making here is that the FDA denied the approval of MDMA-assisted therapy and it didn't make any sense to me because the data was so strong. I mean, imagine if you have Lipitor that reduces the risk of heart attack by 20 to 30 % and then you have another therapy that reduces the risk by 500 % or 1 ,000 % and it's safe and there's no side effects and it works better than anything else ever discovered and yet you're not going to approve it. that to me is just the ultimate in corporate capture. Yeah. Do you think that's why? Oh, 100%. And the people on the commission didn't really understand this drug.

52:57Dr. Mark Hyman:They also were very much, had been involved with pharma and were conflicted. Oh, and you see all of that time and time and time again, with psilocybin, all these different, it shouldn't be this difficult to bring a life-changing molecule that's available in nature to the marketplace. you know it's it's pretty asinine to think like or even what i mentioned when i started with ibogaine it was around 8 000 years ago used on the plains of africa you know these are these are available by we call it god nature whatever it is there's not a pharmaceutical drug on the market that's been researched for 8 000 years and when you look at the compelling data that that dr nolan's seen at Stanford University, and the two, do your credit, the MDMA trials and all of it.

53:47If we build a system where everybody's incentivized to shut down and prevent accessibility to alternative treatments that are honestly more efficacious than what big pharma is ramrodding down our throats, it's the same thing with peptides. People go, well, what happened with these peptides? Why did they get put on a dangerous list? Were there a bunch of side? There were not a bunch of side effects. What happened is Merck has applied for a patent on 200 different peptides. Peptides are the future of big pharma. They are attempting to capture and monetize peptides, and they are using their ability to influence and impress upon the FDA to shut down pathways where patients were already utilizing these compounds.

54:28We were making BPC for the last five years. To my knowledge, we never had a single side of it other than injection site agitation, Like there's not a big catastrophic, this isn't an opioid crisis. What are you talking about?

54:43Dr. Mark Hyman:It is a bit strange. You know, it seemed to, it also strange that it seemed to coincide with the, that one of the biggest success stories in pharmaceutical, which was a peptide. Yeah. GLP one. Oh, Zempic. Yeah. Right. Yeah. That's a peptide. And they go, oh my God, there's a lot of money here. That's right. We got to block it off. Yeah. We got to build a moan. Do you think it was that pernicious? Do you think that, that, that that's my, you know, kind of conspiracy theory in my head, but that all of a sudden there was a realization that there's thousands of peptides that could be turned into drugs.

55:15Dr. Mark Hyman:And the reason Ozempic is so expensive or these injectables are so expensive is because of the delivery mechanism, because they have a preloaded auto syringe. But if you actually just look at the peptide itself, it's pennies, right? Yes. It's literally pennies. And we compound GLP-1 for pennies on the dollar. You know, and that's a pathway that rapidly big pharma is trying to shut off. Actually, today, I think, is the day that the D-Day that if the FDA doesn't make a statement, you will be forced to buy GLP-1s from big pharmaceutical institutions, which are thousands of dollars a month. Compounding pharmacies were compounding these for$200.

55:53Like$20 a year or less. Yeah. Dirt cheap. Like a whole vial for$250, which allowed you to titrate up and titrate down. It allowed you to customize your treatment plan. It wasn't a one-size-fits-all approach. It was an ability to take the pros of the drug and minimize the cons of the drug. And it allowed patients to have accessibility because in reality, those compounds were meant for sick, diabetic people. That's what they're meant for. And they got captured because Big Pharma does what it does. And they go out and they grow the brand. How do you grow the brand? You grow the patient population.

56:30And how do you do that? you start having every mom in Malibu take it for spring break. And that's not what that compound was meant for.

56:38Dr. Mark Hyman:And there are thousands of these peptides and the dosage that are used in the pharmaceutical versions are far, far higher and potentially with much more side effects than the ones that are used just for therapeutic prevention or for optimization or for other things. And I've used them. I mean, I've had various injuries and it's amazing, BP-157, and what you're talking about, is a peptide that's been around for a long time and is part of what your body makes to regulate your normal functions. I mean, GLP-1 is something your body makes. Yeah. But because of the food we eat and because of how we live, it's decreased in many of us.

57:16Dr. Mark Hyman:Our appetite's not properly regulated. So a lot of these things, you're just enhancing your body's own system, right? It's like, think about if you're going through menopause, you might need a little hormones. If you're an older guy, you might need a little testosterone to optimize your level. It's kind of like that. And I think they're incredibly powerful compounds. And you think under this new administration that they're going to come back and be able to be deregulated like they were? I hope. I'm actually very optimistic on that because we know that Marty's, Dr. Macari's taken over as the head of the FDA.

57:50Well, if he procures the nomination, I guess is the right nomenclature. And then you've got Bobby, who's RFK, who's a big proponent of peptides. He's posted about it. I don't know if you saw his tweet. This was when he was running. He said, FDA, your war on peptides, stem cells, red light is over. I have a message for you. Save your records and pack your bag. That's a bold statement. I think the expectation is that we're going to free up and give the power back to the people to have those sovereignty and accountability over their health again. Why should a clinician not be able to talk to a patient, discuss the risk reward?

58:33Again, these are short chain amino acids. They've been around since the dawn of time. That's why Big Pharma is so interested. They're realizing there was a whole article about how Big Pharma is attempting to capture the peptide market because the risk profile versus the reward profile is way more beneficial than pharmaceutical compounds because you just have a much safer pathway. That's right.

58:58Dr. Mark Hyman:I mean, insulin is the original peptide, right? It's a mini protein. Peptides are just less than 20 amino acids. That's just how we define them. And if it's bigger than 20 amino acids, it's a protein versus a peptide. It's just a mini protein. And they regulate, they're like the super highway communication system of your body that regulates so many of your biological functions from your sex hormones to your growth hormone to sex drive to immune function to tissue repair. So the nerve function, I mean, there's just so many that do so many things. And we never learned about them in medical school.

59:31Dr. Mark Hyman:I've been going about insulin, but we kind of learned it was a peptide, but it was like, it was a drug, right? And if you go back to the system, like what we were saying earlier, this is at Ways to Well, we use a ton of BPC and we also compound. It was phenomenal. Like it really, it is phenomenal. It's a phenomenal compound. For an orthopedic injury, a knee, shoulder, elbow, you know, something that's been bothering you for years, it does a phenomenal job. And what I saw is even my orthopedic buddies, they were all like, oh, it's pseudoscience. It's not real. Okay. The hammer, everything's a nail, right?

1:00:04This is a threat to your revenue stream. You're pressured to do these surgeries. You need to be doing these knee, shoulder, elbow surgeries. Anything that comes into the marketplace that's a disruptor is immediately met. with hostility. And you have to ask yourself, is it because it impacts my practice adversely, or is it because I really believe what I'm telling these patients? Because the data's there. People say there's no studies, there's no this, there's all sorts of studies. BPC regrew spine damaged spines in mice. I mean, I provided a dozen plus articles on Rogan. When we went through it we did a deep dive into bpc because i was such this is like four years ago but i was like this is a really powerful compound with really compelling data and china's done a lot of studies in humans um there's fascinating data there and what we saw anecdotally at you know through our clinicians in our clinician network was phenomenal feedback with no minimal to no side effect profile so it's disappointing when the fda makes choices and you gotta scratch your head and go, are those choices, I hate to be conspiratorial, but I just go, there's no way this choice wasn't made for anything other than the pressure the pharmaceutical companies are putting on you and the data that they're providing that's skewed to twist your arm to go this way, because at the same time, they're attempting to patent all these things and monetize them themselves.

1:01:36Dr. Mark Hyman:Yeah, it's interesting. Even N-acetylcysteine was considered to be something that should be regulated, which is a supplement that otherwise known as NAC, but it helps to boost glutathione, the body's main detoxifying compound. And yet it's something we use all the time in the emergency room for people who had overdoses. You'd give them, you know, overdose of Tylenol. The treatment to save them from their liver basically dying and them dying was giving them something called Mucomis, which I thought was a drug. You know, I didn't know when I was training, but it's a natural compound. It's a biological compound made of three amino acids, and it's incredibly important for the body's biological functioning.

1:02:15Dr. Mark Hyman:And I'm like, why are they putting this on the kind of not approved list for the FDA? Doesn't make any sense to me? So I think there's some weird forces at work, and we can't always see what they are. Some of them, you know, the incentives that are misaligned are obvious, like insurance companies or PBMs or sometimes the FDA, but it's, you know, it's like this Gordian Knot has to get unraveled because if we don't realign incentives to make it profitable to be healthy, then the system's never going to work, right? No, you're spot on. Yeah, and so that's going to be the challenge. How do we incentivize health versus disease?

1:02:49Dr. Mark Hyman:And there was an attempt through the Affordable Care Act to do that with value-based care, but it really didn't catch on. And it really didn't kind of work that well because of how it was implemented. And because, honestly, because even if you're a traditional healthcare system, all you know how to do is traditional drugs and surgery. And so it's hard to create real value, really truly to reverse disease and to not just manage it with a bunch of drugs or surgery, but truly reverse diabetes and heart disease, they're big cost drivers. I mean, Cleveland Clinic, there was a woman who was a nephrologist who was running a program on reversing kidney failure using lifestyle approaches, which was amazing, because that's something, again, we ever learned we could do, and she was seeing it all the time.

1:03:30Dr. Mark Hyman:And yet that wasn't reimbursed. you know, she had to do research, she had to get funding, she had to try to get, you know, donors. And it was just, it was just a hard slog. And yet that's what we should be paying for. So until somehow those incentives get changed through the government actually funding the kind of research that needs to get funded to show these are not only more effective, but cost effective, that I don't think things are going to shift. Or until we put up guardrails where there's, you know, insulation from conflicts of interest on the dietary guidelines and the FDA and on insurance, you know, regulators.

1:04:05Dr. Mark Hyman:I mean, the revolving door in government is so big and so wide and it's used sort of like a, you know, just a super high way for people to go back and forth between government and industry. That's problematic, you know? I mean, you got the Dairy Council, which basically has recommended us to have three glasses of milk a day as adults and two as kids. there's no scientific data to support that at all. And when scientists, friends of mine from Harvard, challenged the Dietary Guidelines Committee on this, because they were friends with some of the committee members, they said, you know, you're right, and politically we have to do this.

1:04:41Dr. Mark Hyman:Politically, not from a medical perspective. And the two-time Secretary of Agriculture under Obama and under Biden, Vilsack, Tom Vilsack, worked for the Dairy Council in between his agriculture jobs. and the dairy council was the one that put out those ads got milk with the government there's this program called the checkoff program i didn't know it was with the government oh yeah the government the government has these programs to support at the usda support industry and agricultural products so the other white meat or right that that was a joint program between the government paid for by taxpayers and by the pork industry or the the white mustache ads which claimed all all these health benefits for dairy that weren't scientifically validated was a complete scam and got everybody to drink milk where there was no evidence.

1:05:34Dr. Mark Hyman:And it was the government colluding with industry and the dairy council to come up with these things and promote them. Even the former secretary of health and human services, Donna Shalala under Clinton, she actually also had one of these mustaches on and plus athletes. And they were getting paid a lot of money to do these ads, but there was no evidence. And finally, the FTC said, no, this is not truth in advertising. You can't do this. This is illegal. You have to take these ads down. And you don't see the Got Milk ads anymore. It's not because they didn't work. I didn't know any of that. It's because it was illegal.

1:06:05Dr. Mark Hyman:Yeah, I just saw they went away. Yeah, no, no. That's wild. It's so bad. And so, and the idea wasn't for the government to support, to get money from industry and to use its own money to actually promote things that aren't scientifically true, even though that's what they did. Like pork, the other white meat, really? Yeah. So I think, how do you see us going forward as this new administration sort of gets its foot on the ground? Is there hope? Are we still gonna be stuck in this perverse incentive system? Is it so intractable and difficult that it's just not fixable? I mean, I always think, I always have hope.

1:06:39And I think there's the fact we're having the conversation, the fact all these podcasts are talking about it, all the things that you've discussed historically, you know, we're moving the right direction. We're uncovering the root cause. Now we've got to treat the root cause so we can stop the symptoms. And that's going to take consistent, persistent action. And us as the people talking and acting with our pocketbooks, you know, we can drive change with policymakers. And I think we are. And I think RFK is going to try and he's going to fight, but it's going to require the American people standing behind and fighting for it as well.

1:07:15And we can also fight with our pocketbooks. look at what happened to Kellogg's after the Senate testimony. The stock went down pretty bad. Yeah. And that, those eventually, if we, the people drive change through our pocketbooks, it resonates with these big industries. And at some point they're going to change their behaviors. But part of that is giving the knowledge to the people. And that's where I think platforms like yours and podcasts are so important because if we can educate the public, they can fight for themselves. They can protect themselves. They can defend their families while hopefully putting pressure on policymakers to drive policy change.

1:07:52Dr. Mark Hyman:It reminds me of the quote from Margaret Mead, which is, don't believe this small group of highly committed people can't change the world. In fact, it's the only thing that ever has, right? I love that. And I think you see this with Kellogg's. I mean, 400 ,000 signatures marching on their headquarters in Battle Creek, Michigan, demanding change in the Froot Loops and other cereals they make to match the same type of cereal they produce in Europe without all the toxic chemicals, it worked because it hit them where it hurts in their pocketbook. And they're gonna have to change. Now they're not gonna wanna change, it's gonna take them a little time.

1:08:31Dr. Mark Hyman:And we see this starting to happen where around the country there are bills being introduced to get these additives out of food and chemicals out of food. And I think that's gonna be helpful. It still could be ultra-processed food. So if there's not any focus on the starch and sugar content, I think it's going to fall short. But at least there's some shifts happening where these lawmakers are starting to stand up and go, wait a minute. One third of our state budget is Medicaid. Governors know this. This isn't hurting our state. We could be doing so many other things with this money if we didn't have to pay all this health care bills.

1:09:09Dr. Mark Hyman:And so there's this moment where I think there's some shift happening, and I see it around the country, and that needs to get accelerated. The fans need to get flamed. People need to call their congressmen, call their senators, call their state lawmakers, advocate for these ideas, ask them to solve them, tell your stories. It matters. I mean, you know, whenever I, you know, talk to lawmakers about what actually moves the needle and what they're going to do, they're going to say, call us to my office. Yeah. You know, that's how RFK got confirmed. Yeah, I remember Cali saying they said they got a flood of calls.

1:09:44Dr. Mark Hyman:There were 200 ,000 phone calls to Cassidy's office to confirm him for the HHS secretary. Whether you, you know, want him to be secretary or not, whether you agree with him or not, what I'm making a point here is that your voice matters. Yes. And that your, if you, your, our collective voice is very powerful. And that things change through these powerful grassroots efforts that then move to the center. and I always say change doesn't happen in Washington. It doesn't start in Washington, it ends in Washington. When you look at whether it's abolition or civil rights or women's rights or the women's vote or gay rights, whatever it is that were massive cataclysmic changes in society that we all accepted as the norm, right?

1:10:29Dr. Mark Hyman:They changed because people were like, enough already. And I think Cory Booker once said to me, it feels like 1959 in the Civil Rights Movement in terms of what's happening in healthcare and food systems. And I hope that's true. And I hope we're going to see in the next four or five years, some big shifts. Because I think they have to happen. We can't keep doing the same thing. People understand the emperor has no clothes, that we're in this really cataclysmic situation with our health and the economic impact of it. But, you know, it's a$5 trillion industry and it's not going to go down lightly.

1:10:59No, and that's where it's got to be a unified effort. It's got to be a unified effort. People have to realize chronic disease doesn't care if you're a Republican or a Democrat. It's killing all of us. Like we have to work together and extend the olive branch and not let big industry divide us. They'd love nothing more than for us to be divided as people and fighting each other. This is, to me, it's not a political thing. This is a humanity thing. And so everything you said resonates with me and hopefully we can keep driving change. Let's go. Let's go.

1:11:29Dr. Mark Hyman:Well, Brigham, thank you for your work. Thank you for being such a clear voice for some of the challenges and problems in the dark alleys of our healthcare system that you're bringing light to, like pharmacy benefit managers, how insurance companies work, the problems with the food industry, the cost of our broken healthcare system, the things that you really have sort of highlighted. It's so important to get these ideas out there, to get people to hear about them, to get them incensed and do something about it. So thanks so much for your work and being who you are. Thank you for having me and for giving me a voice.

1:12:01Dr. Mark Hyman:I appreciate it. Anytime. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer.

1:12:34Dr. Mark Hyman:This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help, in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient.

1:13:06Dr. Mark Hyman:It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.