Pharma Whistleblower Reveals Who Really Runs American Healthcare - Transcript

Brigham Buhler
It's not freedom if you're gonna hide and mislead the American people. If you're expecting the insurance companies or the big pharmaceutical companies to look out for you, you're in trouble. Pharma whistleblower Brigham Bueller now exposes the industry's broken incentives and fights to put patients back in control.

Dr. Mark Hyman
How does it look like behind the scenes in terms of what's happening in our agencies that govern our health and health care?

Brigham Buhler
We are really, really bad at stopping chronic disease from developing.

Dr. Mark Hyman
You only really succeed when people are not well.

Brigham Buhler
And it's because there's so much money being made on chronic disease. This is to me, it's not a political thing. This is

Dr. Mark Hyman
a humanity. Is there hope that it's just not fixable?

Brigham Buhler
I think we have to.

Dr. Mark Hyman
So, Brigham, welcome to the podcast. We had a chance to get together at a dinner at my house with a number of state senators talking about how we fix our problem of chronic disease in America. We got to testify the next day at the, Texas Health and Human Services Committee talking about what needs to be done to address some of these issues. And background, you're you're not a practicing physician or a practitioner, but you've been involved with insurance, with pharmacies, with delivering health care, and you have a very unique perspective on our healthcare system. And we all know it's broken.

Like, there isn't anybody who goes, Wow, healthcare in is just rocking. It is the best healthcare system in the world. And in some ways, is, right? The best doctors are here for the most part. You can get access to extraordinary treatments and surgeries and interventional treatments.

And yet, we're suffering and the whole country is sick. I mean, six out of ten Americans have a chronic disease, ninety three percent are metabolic and healthy, seventy five percent overweight. We've got kids struggling with obesity and depression. The whole system is just kinda not working. You spent your life really deep in the weeds in it, understanding it, understanding the challenges of it, how it's just kinda messed up.

And we're getting poor health despite spending more than double any other industrialized nation or fortieth in life expectancy. And something's wrong. So the question we're going talk about today is, what's wrong? And not just that we have a crappy food system and all those things that I talked about forever, but in the health care system itself. And you talk about that FDA and NIH and many other regulatory agencies are really not impartial, but they're influenced by corporate interests.

And there's this concept going around in the ether called corporate capture, you know? Mhmm. I've also heard of this concept of corp you know, corporate kleptocracy, you know, which means, you know, our our basically government has been taken over by corporations.

Brigham Buhler
That's so true. I love

Dr. Mark Hyman
that. The people, by the people, of the people. It's for the corporations, of the corporations, by the corporations. You know, and I was, working on emergency policy issues for a long time and I met with someone who'd been in in the Obama administration who was working on the food program and food systems program issues. And he says, look, Mark, everybody who came to us was from industry.

No one came to us talking about how we need to improve our food supply and food food system or what we could do or with ideas or policies or regulations. Yet, you know, when the food industry comes or they come with stacks of and insurance industry and farm industry and you name it, they come with literally stacks of quote scientific evidence to back their point. They come up with the written legislation that they want to have passed. They come up with the written regulations that they want implemented. And for the most part, with some tweaks, it gets done because they're so compelling at what they do and they have such a clear strategy.

So how does it look like behind the scenes in terms of what's happening in our in our agencies that govern our health and health care?

Brigham Buhler
I think you did a great job of laying the groundwork because it's it's a deep, deep, dark sinister hole and and and being in it. So my experience is right out of college, I got hired to be a drug rep for Eli Lilly. And, you know, this was twenty five years ago, not to date You're with a drug dealer. But yeah. And I thought, oh my gosh, this is gonna be amazing.

I'm gonna help people. This is like I get a company car, an expense account, like this was a really good job right out of college. And it took me probably eighteen months to really start to see, oh, man. I was a little blinded because I launched Cialis, which was the Viagra competitor. So that was a little different because everyone loved that, and it was fun and all that.

But as soon as, after about eighteen months, I did well, and they moved me to antidepressants. I remember distinctly going to training and asking at one point when this doctor, who's a paid consultant for the company, is going over the placebo trials versus the non placebo control and versus the control, and it was literally like a fractional difference.

Dr. Mark Hyman
Yeah.

Brigham Buhler
I can't remember just it was like a four or 5% difference. I remember asking, wait, placebo was this high, this close? And they had their talk track to talk you out of why that wasn't a big deal. But then now we look at that, what, twenty five years later, and we see the data and the statistics, deaths of despair at an all time high, depression at an all time high, anxiety at an all time high, all of these things, what we were doing is not working. And you used the words corporate capture.

That's what I used in front of my Senate testimony. I I quoted Eisenhower's speech where he he talked about the military industrial complex, but the second half of the speech, he does talk about the scientific industrial complex. And what happens if we allow the capture of our institutions? We would lose the garage tinkerer, the innovator, the creator. Before we went on air, you and I were just talking about products like HCG that have been off patent forever, but they're getting charged $809,100 dollars a month, and big pharma is still trying to find a way to keep a stranglehold on these life changing treatment modalities for people who are trying to have children or have fertility issues.

So my experience was going from a drug rep to then a med device rep. I worked in the Operating Room with some of the best and brightest surgeons in the world. You also had alluded to we have some of the greatest practitioners, and I agree with that. I think we are really, really good at treating and triaging major catastrophic events.

Dr. Mark Hyman
Yeah.

Brigham Buhler
We are really, really bad at proactive, predictive, preventative care, at stopping chronic disease from developing.

Dr. Mark Hyman
Or even reversing it once it occurs, right?

Brigham Buhler
Absolutely. And it's because there's so much money being made off chronic disease. Yeah. And and people will try and argue that that's a conspiracy theory. I lived it.

I saw it firsthand.

Dr. Mark Hyman
Well, unpack that. Like, how how is how is sickness a a profit making enterprise? It doesn't seem like that's right. There's something wrong just conceptually with the idea that companies are going all the way to the bank with giant bags of cash.

Brigham Buhler
Yep.

Dr. Mark Hyman
And basically, the more sickness we have, the better they do. Whether you're a pharmacy company or a pharmaceutical company or an insurance company or a hospital or a healthcare company, you only really succeed when people are not well.

Brigham Buhler
And the problem is everything pivoted from you know, I talked about this on Joe's podcast. Originally, doctors knew the family. You know, they came out with their little bag, leather bag, they knew the mom, the dad I have one of those. Yeah. It's awesome.

And that was healthcare. You took pride and had ownership and accountability of your patient population. And as we pivoted to an insurance model and HMOs, clinicians' ability to make decisions and autonomous choices alongside their patients and those families were severed. And clinicians are now in a system where they have six minutes on average with a patient. And so everything is so siloed, and even the way we've become so specific and niche in the way we practice medicine Casey Means talks about this and does an eloquent job of laying it out, but we don't look at a person holistically anymore.

You know, a primary care has six minutes, and they're just looking at what prescription drugs you're on, and they reach for the tool in the tool belt. So I'm not trying to make it as sinister as they're implicitly conspiring

Dr. Mark Hyman
They wanna do the right thing. Mean, I remember coming out of medical school and thinking that I knew everything that there was to know about medicine, that anything that wasn't included in medical school wasn't actually real medicine. It was fringe or or whatever. And, you know, we kind of gave lip service to diet and exercise, but it was more like eat well and exercise less. And that was about the only thing or have a balanced diet, whatever that means.

And I remember just realizing, you know, I was just handing out prescriptions. You know, I was really good at matching, diagnosing and then matching the drug to the disease. I never once did I go, Is this the right treatment for this particular problem? Is this dealing with the root cause or am I just putting a band aid on it?

Brigham Buhler
Bingo. And that's the challenge with primary care because the way the model's built now, a primary care has a hard time getting to the root cause of chronic disease. And I think I've heard you say this, I've heard a bunch of clinicians say if you really want to treat the root cause, if you really want to treat and prevent chronic disease, you first have to uncover the root cause. You don't treat the symptomology, but we built an ecosystem that incentivizes profiteers and makes an exorbitant amount of money off of treating symptomology. How does that work?

And I can give you real world examples, like if we look at the opioid crisis. How I pivoted to becoming an entrepreneur in health care and broke away from being a med device rep was I lost my brother during the opioid crisis. It was crazy, because I had already spun up a pharmacy and was working on my first project where I was going out and educating clinicians on how catastrophic opioids were. And there were so many options that could have prevented these catastrophic deaths. If we look at the failure of our three letter alphabet organizations like the FDA, people have gone through this a million times, so I'll make it fast, but the FDA allowed Purdue Pharma to ramrod a dangerous drug into the market.

Not only ramrod, but it gave them the goose that laid the golden egg, met with Purdue Pharma in a private hotel room. And the head of the FDA signed off saying this is a less likely to be addictive opioid. Wow. Which was a fallacy, because oxy was eight times more addictive than hydrocodone, and we moved them to oxy. Why did that happen?

Because the shell game of big pharma, people say big pharma innovates, and they create all these drugs, and that's why we pay so much. America innovates for the world. We do, but it's through

Dr. Mark Hyman
taxpayer And they pay they spend more for marketing than they do for R and D. Bingo. So when you look at the dollars spent by pharma, there's a disproportionate amount spent on marketing both on television ads, on marketing your doctors and continuing medical education conferences which I would call continuing pharmaceutical education conferences that are basically funded by by I remember I was on a chairlift and skiing once and I and I was sitting next to someone, you're a random person, so what do you do? And we started chatting. I'm a You know, put on continuing medical education conferences.

I'm like, oh, really? You work for it? I'm oh, I work for, you know, Pfizer or Pfizer Lilly. Yeah.

Brigham Buhler
They were

Dr. Mark Hyman
one of those pharma companies. I'm like, wait, wait a minute. These are medical conferences and you basically set them up, run them, pick the doctors, give them the slides. I literally remember like, going to a conference and seeing these slides, and I'm like, wow, how did you and I went up to the presenter, these slides are amazing. How did you create these incredible PowerPoints and these slides?

Oh, the pharma companies give them to us. And I'm like, what?

Brigham Buhler
And then they they when they say they innovate, what they'll do, and I've saw this a lot, when a patent's about to expire, pharma finagles ways to extend the patent, and you can do that a couple of ways. You can find a new indication on the drug, so now all of a sudden it's gonna be good for anxiety versus depression, and you apply for that new indication a year before to make sure you get it to extend the patent to protect the revenue stream. The other thing you do is you slightly shift the compound. And so like with Oxy and Purdue Pharma, they were gonna lose their goose that laid the golden egg, hydrocodone. They push Oxy into the market knowing it's eight times more addictive.

The head of the FDA at a time gives them that golden goose label. Eighteen months later, the head of the FDA went to go work for Purdue Pharma. So that was step one. The system failed. Step two.

What are the checks and balances? We would go out and educate clinicians. At the time, Obama's team had guidelines for opioids, and those guidelines said, You should pharmacogenetic test. You should do a test to identify, Is this patient a slow, fast, or moderate metabolizer? Are they at an increased risk of addiction?

Which cytochrome P450 pathway is this molecule going to take in this unique individual? Insurance quit covering that. So that safety net was removed. You were also supposed to toxicology screen, meaning let's make sure this patient is not diverting or transferring the medication somewhere else or abusing the medication. Let's make sure we're not prescribing an opioid to a cocaine addict.

Insurance quit covering that. That was gone. So now you're left with one more lifeline, the final lifeline, non abusive, non addictive, topical, or any orthopedic related injury, which is a lot of where opioids start, if somebody gets an ACL tear or hurts their back, and they're waiting to get in with the doctor, and they go on a pain pill. A topical was a solution to avoid that. Insurance quit covering that.

Topicals like what? Yeah. Like a ketamine based pain cream that could help with an orthopedic knee injury or anything like that. So all those safety nets were gone. The three letter organization that was supposed to protect us colluded with industry.

Now let's go to the final piece of the puzzle that nobody is talking about, the insurance companies themselves. This isn't me telling you this. This article came out, I think, in December when Trump was talking about the PBMs and the pharmacy benefit managers. One of these articles released showed that almost 30% of the profitability of the opioid crisis ended up in the hands of the insurance company's pharmacy benefit managers, because they negotiate rebate deals with the pharmaceutical supply companies. And so that's the thing I've been ringing the bell on for years because somehow

Dr. Mark Hyman
So in other words, this is a backup so I don't understand what you're talking about. PBMs or pharmacy benefit managers gonna decide on what the formulary of drugs that you're allowed to prescribe are, whatever your insurance company is. You got it. And then they'll push the ones that they wanna push and then they'll get rebates from the drug companies when they prescribe those drugs.

Brigham Buhler
Bingo. The challenge with that is it's tier placement, right?

Dr. Mark Hyman
And they're a middleman. They're kind of

Brigham Buhler
They were supposed to negotiate on behalf of you and me. The average American who is trying to make our prescription medications affordable for our grandmas and grandpas, and at some point they got corporately captured, the buzzword you used earlier, by who? The five big insurance companies. People don't understand. United, Cigna, Aetna, Blue Cross Blue Shield, CVS Caremark, they control 90% of the prescription drug care in our country.

You're going through one of those big five insurance companies to get any prescription

Dr. Mark Hyman
Oh, you're saying is insurance companies own the pharmacy benefit management.

Brigham Buhler
You got it. And they went from negotiating down the cost of drugs to negotiating up the cost of drugs, which sounds insane, but you'd go, why? Because they wanted rebates. So they go to, let's just say, a big pharmaceutical supplier and they say, hey, rather than charging me the $130 for a vial of insulin, charge me $300 for a vial of insulin and give me a $150 rebate, and we'll hold it at our pharmacy benefit manager company. Does that make sense?

Dr. Mark Hyman
Yeah.

Brigham Buhler
And so now what we've done is we've aligned the incentives of the insurance companies to profiteer and monetize prescription drug care in chronic disease. So if I'm an executive at an insurance company, and a big chunk of my revenue is you being on prescription drugs, and I look at a pain cream that's compounded that I don't get a rebate on versus an opioid that I do get a rebate on, or we can go down dozens of drugs, peptides, you know, like any of these different things, GLP ones. Why is there this GLP one boom? Why would insurance companies want us to support GLP ones too? Right?

There's a massive amount of revenue. And so the last puzzle piece, just so people understand the flow of the money, because a lot of people listening will go, wait a second, The insurance company still paid for it because even if they paid the markup, that's the final fallacy. Most Americans are employed, and their insurance coverage comes from their employer. I employ almost 300 people. At the end of each year, I have to sit down with the insurance companies and renegotiate our contracts Yeah.

For all of our employees. And they say, well, Joe Bob was on a GLP one all year. It cost us $12,000 We're gonna

Dr. Mark Hyman
your premiums.

Brigham Buhler
We're gonna raise your premiums, your co pays, your deductibles, your out of pocket expenses, we can't afford this. But they paid a fraction of what they're showing you on the balance sheet.

Dr. Mark Hyman
So they're basically lying.

Brigham Buhler
And anywhere else, we call it a kickback. And any if a clinician gets remuneration directly

Dr. Mark Hyman
It's illegal.

Brigham Buhler
Indirectly, yes, overtly or covertly Totally

Dr. Mark Hyman
Stark law.

Brigham Buhler
You go to prison.

Dr. Mark Hyman
If you have a lab and you recommend someone to go to that lab or a imaging center you recommend someone to go there, then that's called a violation of the Stark Law and it's illegal.

Brigham Buhler
They're doing this every day. Like And legalized now the average American's on four or more prescription drugs, right, chronically riddled with disease and sickness, depressed, anxiety ridden, and you look through the system and it's like, from our food that you've done such a good job of educating people on, to regulatory organizations, to the clinicians, Unfortunately, the clinicians are hogtied. They want to help, even covering orthopedic surgery. They're good guys. Like, I worked with some of the best guys in the country for orthopedic surgery, and they would say, What am I supposed to do?

You know, I come out of med school, and then I go to residency, and then I go to fellowship, and now I'm in my mid-30s, finally getting a paycheck, and I'm working at an institution where I'm an employee, and I got to do surgeries. That's how I make my living. And I gotta justify my role at this hospital system. And so I'm not saying they're doing surgeries they shouldn't, but I'm saying people will absolutely show me the incentives, I'll show you the outcomes. To a hammer, everything's a nail.

Dr. Mark Hyman
In gastroenterology, we used to call it scoping for dollars, you know. You need another colonoscopy, you need another exam. It's like, you know, doctors are humans too and if incentives are misaligned, they're not gonna act always, you know, they might think they are, but they might not always act in the best interest of the patient because, you know, it's like they'll get a little extra.

Brigham Buhler
And it also puts almost builds an obstructionist mindset, the age old additive that science evolves one funeral at a time. I really did see that. If something new came out that was innovative, let's say a new orthopedic group opened up across town and they're doing something unique that's cash pay. The rest of the community would candidly shit on them. And they'd go, oh, that's pseudoscience, or oh, those guys are a bunch of whack jobs.

Because what they're doing was innovative and didn't fit into the insurance model, and it challenged your status quo because you are making decisions off what insurance will cover. Right? And so in so many parts of health care, we're doing not what's best for the patient, but what we can get the insurance company to approve. The problem with that is the insurance company doesn't give a crap about the they care about that quarterly earning, that quarterly profit, hitting that number for Wall Street.

Dr. Mark Hyman
And they're getting it coming and going, right? So you're assuming they're getting it through these kind of backroom deals with kickbacks from pharma. They inflate their profits. And they're also saying, oh, we can't afford to take care of your cohort of population because, you know, they're sick and they're using all these drugs so then they basically have to raise the premiums which is pure profit.

Brigham Buhler
Yep.

Dr. Mark Hyman
And so, you know, it's like the more healthcare costs, the better they do because they make a percentage, there's a fixed percentage that they can get as their profit.

Brigham Buhler
Got it. And there's no money in diet, lifestyle, nutrition, sunshine, grounding, being outdoors, taking care of yourself, spending time with your family. The basic bread and butters that And my thing is knowledge is power, that's one of things I appreciate about what you're doing at Function Health, and what we do at our company is we try to look at you and say, Hey, let's give you the knowledge and the tools to drive your own health. Yeah. Take you out of this broken system, take you out of this insurance model.

Dr. Mark Hyman
It's such a screwed up system. I mean, you know, I had UnitedHealthcare, now Medicare, but I had surgery last fall. And I just was sort of stunned at the way in which they handled it. First of all, I needed rehab after. I really needed rehab and physical therapy and I couldn't walk.

It quite a serious back surgery. You know, they paid for the surgery and they paid for the hospitalization, but they wouldn't pay for me to go to a rehab center to do rehab for three hours a day for a week or two to kind of get back on my feet. And I was like, wow, you really you're gonna make me pay $7,000 a day to go to a place where I'm doing physical therapy for three hours a day and staying in a hospital bed and eating crappy food. I'm like, this didn't make any sense. Thankfully, I I could afford to stay in a hotel and hire a private physical therapist to come to me, which was far cheaper Yep.

To stay in that place. So it worked out in some ways for me but, you know, I just also got a bill for my surgery and I was looking at it and it didn't make any sense to me. And I think, you know, this is where healthcare is so screwed up. You know, I get a bill for $140,000 for my surgery and my procedure, you know, dollars 61,000 for the surgery, dollars 11,000 for pharmacy. I don't know what the hell they gave me, what kind of drugs they gave me but in like two days, that's a lot of drugs.

But they didn't get that many Then drugs, trust they the insurance discount was like a $129,000 and the final bill was 11,000 down from a 140 and then I had to pay a thousand whatever co pay but it just was like, this whole system is so messed up. Yeah. And then, you know, what you get in one place is different than another place. I Previous surgery where I wanted to hyperbaric oxygen after the surgery to heal my wound and to repair faster and recover. And I found a hyperbaric center and they said, Well, yeah, we can come in.

I said, How much is it? He says, dollars 5,000 a session. Like, dollars 5,000 a session? That's insane.

Brigham Buhler
That's crazy.

Dr. Mark Hyman
He's like, Can I talk to the medical director? And he says, Yeah, yeah, that's what we charge Medicare, but you're paying cash, it's a $175. So imagine a $175 cash versus 5,000 that they bill insurance of which they'll pay 30%.

Brigham Buhler
You got it.

Dr. Mark Hyman
Right? And so the whole incentive system, the whole payment system, it's so opaque. It's not transparent. Even though I've been in healthcare for forty years, it's still fuzzy and most doctors have no clue how things work. Yeah.

And you've gotten on the inside and see the inside bulb, what happens when you have misaligned incentives across pharma, across insurance companies, across hospital systems, insurers. It's like it's like really a problem. So how do we start to think about dealing with this? Because, you know, there's really no accountability, there's no checks and balances. I mean, the price of healthcare keeps going up and up.

Mhmm. And it's true, spend more than twice as much as any other nation, sometimes three or four, five times as much, and we get far worse outcomes. You know, Cuba, I think, has better life expectancy than we do. Albania does, you know, like, it's what?

Brigham Buhler
Yeah. Yeah. Cali talks about Italy Yeah. You know, where you drink a lot of wine and eat a lot of carbs and, you know, he's like, are the Italians healthier than us, or is there something wrong in our system? I think one of the things you do is you get proactive, predictive, and personalized.

You've got to take sovereignty and accountability over your health, and realize that nobody's gonna do it but you. If you're expecting the insurance companies or the big pharmaceutical companies to look out for you, you're in trouble. I've said this on a bunch of different podcasts, but if you live the average American lifestyle, you eat the average American diet, you go to the average American doctor, don't be surprised when you get diagnosed with the average American chronic disease. And if we really want to drive health span, it starts with taking a look under the hood and doing the deep dive and understanding what's going on with you so you can make those lifestyle changes. But unfortunately, the system's not built to do that.

And so if we could get rid of a lot of the things that you and I have fought for with with the MAHA movement, you know, I know Bobby's talking about, you know, pushing back on the PBMs. Like, we should not allow the insurance companies to profiteer off of prescription drug care.

Dr. 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?

Brigham Buhler
I agree. I mean, it's insanity. And I understand, you know, the saying the highway to hell was paved 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 seems 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

Dr. Mark Hyman
Yeah.

Brigham Buhler
And so again, we go back to the insurance companies

Dr. Mark Hyman
Push it off to the taxpayer.

Brigham Buhler
They just wait. And so if if I knew that, you know, again, Joe Bob is pre diabetic, it's gonna 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 prediabetes to diabetes? Because I know in twenty four months, when he reaches diabetes, he's gonna switch employers and be somebody else's problem.

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

Dr. 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 take 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. And Yeah.

Right? And then Yeah. So we need we need a system where and I don't I I don't know if anybody's really solved this. I've heard some different theories and ideas but, you know, if we could somehow have a shared risk pool where it didn't matter if you're United or Cigna or Aetna or any of the other big insurance companies that you would actually kind of collectively share the risk and 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 through a benefits manager for employers who helps advise them on which programs to use and which things to do. And and they were like, yeah, you know, they they they're following the American affordable I mean, the Affordable Care Act guidelines which is almost no screening and almost no prevention and and really reducing I mean, like reducing what you're allowed to do. And and they're frustrated because the employers wanna have more productive employees, they don't wanna pay these high premiums, but they're also stuck in this vicious cycle. So is is there any way out of that?

Brigham Buhler
I think there is. One of the things that, in my talks with Callie is how do you with his company, TrueMed, how do you increase HSA amounts? Right? If we could give the power back to the patient, or the patient or even the insurance company, there's got to be a way to incentivize being healthy. Yeah.

Rather than incentivizing chronic disease, can we give tax incentives or quality care incentives that allow patients accessibility to being predictive, proactive, and preventative. And what I mean, like if we had a, let's just say, $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 nutritionists

Dr. Mark Hyman
Yeah.

Brigham Buhler
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. Yeah. And we've gotta give that sovereignty on autonomy back to the patient.

And so many times I've heard clinicians go, well, my patients don't give a shit. They just wanna just wanna med.

Dr. Mark Hyman
Not true.

Brigham Buhler
And it infuriated me. It's because they just want help.

Dr. Mark Hyman
Yeah.

Brigham Buhler
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

Dr. Mark Hyman
Yeah, health savings accounts.

Brigham Buhler
Yes. If somebody could have $300 to sit with their clinician for an hour and really talk.

Dr. 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 the old, you know, Chinese doctors used to get paid when their patients were well, but when they were sick, they wouldn't get We might want to think about something

Brigham Buhler
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? So you can't get that MRI if the insurance company doesn't approve it. The insurance company's not gonna 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.

Dr. Mark Hyman
Would take a medication where I was super expensive and I had totally legitimate reasons for taking it. And I had to work with, you know, my doctor and with writing up long, you know, scientific reports on why I need this and why the indications were there and what my genetics were and why. I mean, it was like a whole thing. Mhmm. And it was recommended.

The letter was written by the physician and 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. I was like, they said I'd have to do these things, I did these things, and they still said no. Yeah. So the denial of claims is a huge business.

Brigham Buhler
Oh, it's it's and and what's happened is now these denials have climbed

Dr. Mark Hyman
The Ponzi's keeping in mind.

Brigham Buhler
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 their their, like, game plan is deny, delay, depose. Like, what what that kid Luigi wrote, like, 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 why?

Dr. Mark Hyman
Yeah. And while I needed rehab after my surgery with UnitedHealthcare, they made $22,000,000,000 in profit, and I couldn't get paid for a week of rehab after my surgery, which Yeah. Just didn't didn't make any sense to me.

Brigham Buhler
It'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.

Dr. Mark Hyman
Yeah. We hope that change is coming. We hope that train's coming on the station. You know, but the the forces that are raid against it are pretty big. You're talking about, you know, a humongous industry with so much at stake and so much to lose unless the incentives get aligned and they're get 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 and there are 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. But their incentives are aligned. But that's not most of health care.

That's where we were moving towards in terms of Obamacare. Value based health care, 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 business 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 You're a hospital system like Cleveland Clinic, you get $20,000,000 a year to take care diabetic patients.

If it costs you 30, you lose money. If it costs you 10, you make money. Right?

Brigham Buhler
Yeah.

Dr. Mark Hyman
And so what are you gonna do in that situation? You're gonna 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.

Brigham Buhler
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 thirty five 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. And 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?

Dr. Mark Hyman
Yeah, of course. But that's not what health care is.

Brigham Buhler
In their model, there's no 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 gonna reimburse me more for a better joint, and every year they're gonna cut my reimbursements by 8%, I'm gonna go back to the manufacturer and say, You need to cut my joint price by 8%. And then the manufacturer's gonna say, Why am I gonna 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.

Dr. Mark Hyman
And we know that things work that aren't paid for, like medically tailored meals for chronic illness, you know, five percent of the Medicare population accounts for fifty percent 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

Brigham Buhler
Mhmm.

Dr. Mark Hyman
That you would save thousands of dollars. In 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 a cost. It's a cost to give people, how much is it to give them the medication? You know?

And I think people just don't even realize that. I mean I have one patient whose copay was $20,000 a year.

Brigham Buhler
Yes.

Dr. Mark Hyman
I don't know what her actual pharmacy bill was but that 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?

Brigham Buhler
Yep.

Dr. Mark Hyman
And so we know what to do and there are initiatives out there that work but, you know, 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 treated 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. But 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 health care 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?

Brigham Buhler
And if you're an executive at one of those companies Yeah. And you try. I think you said this at the dinner. I wanna say you brought this up at the dinner. One of your buddies at a food company attempted to drive meaningful change.

Dr. Mark Hyman
Yeah.

Brigham Buhler
And good luck keeping your job.

Dr. Mark Hyman
Yeah. Yeah.

Brigham Buhler
Because if meaningful change doesn't you're on such a short timeline and leash to produce for the organization

Dr. Mark Hyman
Yeah.

Brigham Buhler
That if profits take a dip at all, chances of you getting to the finish line are slim to none.

Dr. Mark Hyman
Yeah. Right. There's no long term thinking. Right? Yeah.

No ten year plan or five year plan. It's like next quarter, what are our earnings? Are we gonna make our shareholders happy? Yeah. 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 this? They're not perpetuating the cycle of of sickness and the cycle of perverse incentives.

Brigham Buhler
You and I just did that testimony, I guess, what, two weeks ago. And it and I 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, 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.

Dr. Mark Hyman
Yeah, there is.

Brigham Buhler
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. And 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 gotta find the root cause.

Yeah. And you gotta start treating the root cause and not the symptoms. Yeah. Because otherwise, we're just playing whack a mole.

Dr. Mark Hyman
Well, that speaks to the whole food industry and also how they're they're profiting from millions. In fact, what really struck me was when I learned that insurance companies invest in fast food and junk food companies I didn't know that. As they had 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?

Brigham Buhler
It's so

Dr. Mark Hyman
So so, you know, back in the in the seventies, there was the big big tobacco companies were starting to buy the food companies like Philip Morris, Kraft, you know, and or Argyra Nabisco, which was, you know, another one. And they basically designed these food products to become biologically addictive. And the there are these these significant tactics they use to infuse, to obfuscate, to muddy the waters, to put out fake science, to deny and deflect. And I mean, it's pretty amazing and 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. And it's I mean, I think today or tomorrow that there's the testimony in Arizona on bills that are gonna get rid of soda and snap and junk food and snap which

Brigham Buhler
Mhmm.

Dr. Mark Hyman
I I think is gonna be hard doing at state level. But it's coming from the this 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 will the states be able to kinda leverage this momentum? Will that drive the change in Washington?

Even though you've got someone like, you know, R. F. K. Jr, whether you like him or not, you know, he's he's beginning to address these issues. You know?

Mhmm. The problems with the FDA, the problems with the NIH, problems with Medicare, Medicaid, the problems with our food companies, the problem with, you know, these 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 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.

Yeah. 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.

Brigham Buhler
It's jarring. Like, I I knew there would be a counter punch. I didn't know it would be that big of a counter punch. Like, even when you and I testified in front of the Texas State Senate, you know, they're 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 labeled 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, I don't wanna quote the wrong One of these organizations is supposed to be supportive of, you know, health and wellness is testifying against these bills. Like, what part of that makes any sense?

Dr. Mark Hyman
Well, it makes sense because they're funded by the companies. Right? Yeah. I mean, American Heart Association gets a $192,000,000 from food and pharma companies, right, a year.

Brigham Buhler
Yeah. And then I go back to show me the incentives and I'll show you the outcomes. Right. And so it almost goes back to we have to realign and cut the head of the snake off. And that's gonna 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.

Dr. Mark Hyman
Explain what you mean by that.

Brigham Buhler
These companies are ramrodding your choices down your throat and pretending to tell you that you have the choice. In reality, know, 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 gonna hide and mislead the American people on what you're feeding them and their children. Yeah. That's not freedom.

Dr. Mark Hyman
No. It's I mean, there's such a lack of transparency and, you know, many other countries have front of package labeling. And in my nonprofit Food Fix, it's one of our key efforts is to try to get transparent, honest, clear Mhmm. 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 gonna promote health? Is it gonna promote disease?

It shouldn't have to be a PhD in nutrition science to figure this out. Yeah. And the way in which the food industry regulates these things is concerning to me. I heard, you know, second hand, but from someone who talked to Robert Caleb who was a former FDA commissioner under Biden, who said, you know, we're working on these front of package labeling guidelines, but don't don't get your hopes up. You know, it's not gonna be what it really should be.

Even though he was an advocate for real change.

Brigham Buhler
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 you don't see people smoking everywhere like when I was a kid in the eighties.

In the eighties, people smoked on planes. Like, they were there was everywhere you went, people were chains

Dr. Mark Hyman
smoking smoking section. It didn't make any sense to me. Got like a little curtain with a smoking section and non smoking section on a plane.

Brigham Buhler
And 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.

Dr. Mark Hyman
Now there's nowhere to put your gum because in the you don't have the ashtray in the airplanes anymore.

Brigham Buhler
And it's But that's 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.

Dr. Mark Hyman
Yeah. And I think 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. It's saying if you eat this, these are the known harms. And you choose for yourself whether you want to do it or not. I know ice cream gives me runny nose and I my stomach and I suddenly get pimples.

But will I eat it occasionally? Yeah, because I like it. And I know it's gonna 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 and I I think, you know, for most of American public, this is true.

I You know, I'm 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. 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. You go to South America, you know, there's like big stop signs on the front of food packages.

You know, 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. And you can buy a two liter bottle for a buck or 2, you know.

It's like insane how cheap it can be in some place. When you look at the true cost of that, what is the true cost of that? 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 Wow. 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 atmospheric carbon. The nitric oxide, it 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. It sucks all the oxygen out of the water and kills all the fish.

And Mhmm. We have dead zones the size of New Jersey and the Gulf Of Mexico or Gulf Of America, whatever we wanna call it now. And and 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? That's the society pays for that. We pay for that. Then 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.

They're paying a $125,000,000,000 a year for food stamp or food assistance programs. Most of that is for junk food, 10% soda and 75% is 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 And food if we actually put a price on the Coke, it probably would be $100 when you count it all for all those things.

Brigham Buhler
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. It'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.

Dr. Mark Hyman
Yeah.

Brigham Buhler
And once a molecule reaches a certain point that it has a lot of promise, it's then licensed off and commercialized for pennies

Dr. Mark Hyman
Yeah.

Brigham Buhler
To a big pharmaceutical company, like the GLP ones, you know?

Dr. Mark Hyman
Who make billions. Right?

Brigham Buhler
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, so 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.

Dr. Mark Hyman
It's quite crazy. And the FDA is 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. They're personally not getting the money, but they're reviewing the science. But it's a little muddy.

Brigham Buhler
It's definitely hard because 10 out of the last 11 heads of the FDA went to go work for industry.

Dr. Mark Hyman
That's right.

Brigham Buhler
And that's a problem. Revolving door syndrome and went

Dr. Mark Hyman
to work for Pfizer who was the commissioner of the FDA, was under Trump. So then you have other problems where things that should be approved, that have profound benefit, 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. So you're basically taking a compound that's off patent, MDMA, you're pairing it with therapy, it's not just prescribing the drug, but you're actually making sure you have a licensed trained therapist to guide people to the experience and healing. It's dramatically more effective for depression, for PTSD, for anxiety than any existing medication.

Brigham Buhler
In the stats on Ibogaine and the future of all this stuff, it's like

Dr. 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 your risk of heart attack by twenty percent to thirty percent And then you have another therapy that reduces the risk by five hundred percent or a thousand percent. Yeah. And it's safe.

And there's no side effects. Yeah. And it works better than anything else ever discovered and yet you're not gonna approve it. That that to me is just the ultimate in corporate capture. Yeah.

Do you think that's why?

Brigham Buhler
Oh, a 100%. And we

Dr. Mark Hyman
And the people on the commission were didn't really understand this drug. They also were very much had been involved with pharma and were conflicted.

Brigham Buhler
Oh, and and and you see all of that time and time and time again, like with psilocybin, all these different it 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, a or even what I mentioned when I started with ibogaine, it's it was around eight thousand 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 eight thousand years. And when you look at the compelling data that that Doctor. Nolan's seen at Stanford University, and the two, do your credit, the MDMA trials and all of it, it's If 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's ramrodding down our throats. It's the same thing with peptides.

You know, 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. We were making BPC for the last five years. To my knowledge, we never had a single side effect other than injection site agitation. Like, there's not a big catastrophic this isn't an opioid crisis.

What are you talking about?

Dr. Mark Hyman
It is a bit strange, you know. Seemed also strange that it seemed to coincide with one of the biggest success stories in pharmaceutical, which was a peptide. Yeah. GOP-one. Ozempic.

Yeah. Right?

Brigham Buhler
That's a peptide. They insulin is a peptide. For those listeners They're lot of money here.

Dr. Mark Hyman
That's right.

Brigham Buhler
We gotta block it off.

Dr. Mark Hyman
Yeah. Do think it was that pernicious? Do you think that that that's my, you know, kinda conspiracy theory in my head. But that that all of a sudden, there was a realization that there's thousands of peptides that could be turned into drugs. 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? It's literally pennies.

Brigham Buhler
And and, you know, we compound GLP-1s 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 ones from big pharmaceutical institutions, which are thousands of dollars a month. Compounding pharmacies were compounding Like

Dr. Mark Hyman
$20 a year or less. Yeah.

Brigham Buhler
Dirt cheap. Like a whole vial for $250 mailed dude, 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.

Dr. Mark Hyman
That's

Brigham Buhler
right. 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.

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

Dr. Mark Hyman
And there are thousands, 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, which we're talking about, is a peptide that's been around for a long time.

And it's part of what your body makes to regulate your normal functions. I mean, GLP one is something your body makes. Yeah. But because of the food we eat and because of how we live, it's in many of us. Our appetite is not properly regulated.

So a lot of these things, you're you're you're just enhancing your body's own system, right? It's like, think about if you're if you're going through menopause, you might need a little hormones. If you're an older guy, you might need little testosterone to optimize your level. It's kinda like that. I think they're incredibly powerful compounds.

And you think under this new administration that they're gonna come back and be able to be deregulated like they were?

Brigham Buhler
I hope. I'm I'm actually very optimistic on that because I and and we know that, you know, Marty's doctor Makari's taken over the as the head of the FDA. Well, if he get if he procures the nomination, I guess, at 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

Dr. Mark Hyman
I saw that.

Brigham Buhler
Red light

Dr. Mark Hyman
I saw that.

Brigham Buhler
Is over. Right. And I have a message for you. Save your records and pack your bag.

Dr. Mark Hyman
Yeah. Right.

Brigham Buhler
Which is that's a bold statement. It was. And so 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? Again, 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.

Dr. Mark Hyman
That's right. Mean, insulin is the original peptide. Right? It's a mini protein. Peptides are just less than 20 amino acids.

Brigham Buhler
Yep.

Dr. Mark Hyman
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 they they regulate they're like the super highway communication system of your body. It regulates so many of your biological functions from your sex hormones, growth hormone, to sex drive, to immune function, to tissue repair, the nerve function.

I mean, there's just so many that do so many things. We never learned about them in medical school. Mean, going about insulin, we kind of learned it was a peptide, but it was like it was a drug. Right?

Brigham Buhler
And if you go back to the system, like what we were saying earlier, at WaysToWell, we use a ton of BPC, and we also compound it. 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 you, it does a phenomenal 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? This 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 study where BPC regrew spine damaged spines in mice, you know? Mean, I provided a dozen plus articles on Rogan when we went through it. We did a deep dive into VPC because I was such and this is like four years ago. Yeah. Yeah.

But I was like, this is a really powerful compound with really compelling data. And China's done a lot of studies in humans. There's fascinating data there. And what we saw anecdotally through our clinicians in our clinician network was phenomenal feedback with minimal to no side effect profile. So it's disappointing when the FDA makes choices, and you got to 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 monetize them themselves.

Dr. 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 in 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 give them overdose of Tylenol, the treatment to save them from their liver basically dying and them dying was giving them something called Mucamist, which I thought was a drug.

You know, I didn't know when I was in 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 function. And I'm like, why are they putting this on the kind of not approved list for the FDA? Didn't make any sense to me.

So I think there's some weird forces at work and that we Mhmm. 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 gonna work. Right?

Brigham Buhler
No, you're spot on.

Dr. Mark Hyman
Yeah, I'm spot on. That's gonna be the challenge. How do we incentivize health versus disease? 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 like 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 the disease and to not just manage it with a bunch of drugs or surgery, but truly reverse diabetes and heart disease, the 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. Mhmm. 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 gonna 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. 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 that's problematic, you know? Mean, you got the Dairy Council, 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. Politically, not from a medical perspective. Yeah. And and the two two time secretary of agriculture under, Obama and under Biden, Billsack, Tom Billsack, worked for the dairy council in between his agriculture jobs.

And the dairy council was the one that put out those ads Got Milk Mhmm. With the government. There's this program called the checkout program.

Brigham Buhler
I didn't know it was with the government.

Dr. Mark Hyman
Oh, The government the government everywhere. 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. Oh, no.

Or the the white mustache ads, which claimed all these health benefits for dairy that weren't scientifically validated. It was a complete scam and got everybody to drink milk

Brigham Buhler
Yeah.

Dr. Mark Hyman
Where there was no evidence. 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 down to Shalala under Clinton, she actually also had one of these mustaches on and plus athletes, 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 now you don't you don't see the Got Milk ads anymore. Yeah. It's not it's not because they they didn't work.

Brigham Buhler
I didn't know any

Dr. Mark Hyman
of It's

Brigham Buhler
because it was illegal. Just saw they went away.

Dr. Mark Hyman
Yeah. No. Wild. It's so bad. And so and and and the idea wasn't for the government to support and to get money from industry and then 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 I think how do you see us going forward as this new administration sort of gets its 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?

Brigham Buhler
I mean, always think I always have hope. And 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.

We can drive change with policymakers, I think we are. And I think RFK is going to try and he's gonna fight, but it's going to require the American people standing behind and fighting for it as well. And we can also fight with our pocketbooks. Yeah. Look at what happened to Kellogg's after the Senate testimony

Dr. Mark Hyman
when he stock got went down pretty bad. Yeah.

Brigham Buhler
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.

Dr. 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 Yeah. It it hit them where it hurts in their pocketbook. Yeah. And they're gonna have to change.

Now they're not gonna wanna change. It's gonna take them a little time. And and we see this starting to happen where, you know, around the country there are bills being introduced to get these additives out of food and chemicals out of food. I And think that's gonna be helpful. It still could be ultra processed foods.

If there's not any focus on the starch and sugar content, I think it's gonna fall short. Yep. But but at least there's some shifts happening where where these these lawmakers are starting to stand up and go, wait a minute. You know, we one third of our state budget is Medicaid. You know, governors know this.

Yeah. This isn't hurting our our state. We can be doing so many other things with this money if we didn't have to pay all these health care bills. And and so there's this 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, when whenever I, you know, talk to lawmakers about what actually moves the needle on what they're gonna do, they're gonna say, calls to my office. Yeah. You know, that's how RFK got confirmed. Yeah.

Brigham Buhler
I remember Cali's They got a flood of calls.

Dr. Mark Hyman
There were 200,000 phone calls to Cassidy's office to to confirm him for the the HHS secretary whether you, you know, want him to be secretary or not, whether you agree with him or not. What I'm I'm I'm making a point here is that your voice matters. Yes. And that your if you 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.

You know, it it doesn't start in Washington. It ends in Washington. You know, when you look at whether it's abolition or civil rights or women's rights or the women's vote or, you know, gay rights, whatever it is that were massive cataclysmic changes in society that we all accepted as the norm, right? They changed because people were like, enough already, you know? Yeah.

And I think Cory Booker once said to me, it feels like 1959 in the civil rights movement in terms of what was happening in health care and food systems. And I hope that's true and I hope we're gonna see in the next four or five years some big shifts. Because I think they 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 $5,000,000,000,000 industry and it's not gonna go down lightly.

Brigham Buhler
No. You know? No. And that's where it's gotta be a unified effort. It's gotta 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. Yeah.

This is to me, it's not a political thing. This is a humanity thing. Yeah. Yeah. And so everything you said resonates with me, and hopefully, we can keep driving change.

Dr. Mark Hyman
Let's go. Let's go. 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 health care system that you're bringing light to, pharmacy benefit managers, how insurance companies work, the problems with the, you know, the the food industry, the cost of our broken health care 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.

Brigham Buhler
Thank you for having me, for giving me a voice. I appreciate it.

Dr. Mark Hyman
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 Doctor Mark Hyman. Please reach out, I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the doctor Hyman show wherever you get your podcasts.

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