BY SALLY NIX

When Congressman Greg Murphy confronted insurance executives during the House Ways and Means Committee hearing on January 22, he did not merely ask tough questions. He pulled back the curtain and dressed down the CEOs. It mattered not because it was dramatic, but because it was overdue.

As a physician, a congressman, a brain surgery patient, and a fellow North Carolinian, Dr. Murphy spoke with a credibility insurance executives could not spin away. He described a healthcare system dominated by massive monopolies that no longer serve patients or physicians, but shareholders and consolidation. Then he made a vow that should echo far beyond that hearing room: to turn these healthcare giants into dust.

As someone who has survived five brain surgeries, I heard something rare in Washington: the truth, spoken plainly.

For those of us who live inside the healthcare system not as executives or lobbyists, but as patients, his words landed with force. We know exactly what he was talking about.

Congressman Murphy named what patients experience every day. Care is delayed not because it is unnecessary, but because it is expensive. Medical judgment is overridden not by doctors, but by algorithms and corporate policies designed to protect profit. Prior authorization has morphed from a safety measure into a business strategy.

This dysfunction is driven by a deeply consolidated system that includes insurers, pharmacy benefit managers, and other corporate intermediaries. PBMs, in particular, operate as powerful and opaque middlemen within massive insurance conglomerates, controlling formularies, influencing pricing, and profiting from delay and denial.

PBMs were created to negotiate lower drug prices. Instead, they have become embedded in vertically integrated healthcare empires that own insurers, pharmacies, and specialty drug distributors. They mark up medications, steer patients toward preferred options, and extract profits at every step, often without patients or employers ever seeing the real numbers.

Patients pay the price. Literally.

I know this system intimately. After fighting serious and complex disease, when time and stability matter most, I have had to fight for medications and treatments my doctors already deemed medically necessary. I have watched denials reverse themselves within hours once public pressure was applied. That alone proves the care could have been approved all along.

That should alarm every American.

If an insurance company can reverse a denial in under 24 hours, then the original denial was never about medical necessity. It was about leverage. It was about power. Congressman Murphy called this out directly. He spoke not only for patients, but for physicians who are drowning in administrative burden, forced to spend precious hours battling insurers

instead of caring for people. Burnout is not a mystery. It is engineered.

What makes this moment different is not just who said it, but how clearly it was said. This was not a partisan attack. It was a diagnosis.

But diagnoses require treatment.

Congress has heard testimony before. Patients have shared their stories for years. Meanwhile, insurance conglomerates grow larger, PBMs grow more powerful, and accountability remains elusive.

Words are no longer enough.

Action must follow. Real, enforceable reform that reins in abusive practices, ends exploitative prior authorization, and restores transparency to a system that thrives on complexity and confusion.

Action means requiring insurers and PBMs to justify denials with clinical evidence.

Action means public reporting of denial and reversal rates.

Action means breaking up vertically integrated healthcare monopolies that profit by standing between patients and care.

Action means consequences when delays cause harm.

Patients should not need media attention, political connections, or public outrage to receive timely, appropriate care. A healthcare system that only works when exposed is not working at all.

Congressman Murphy spoke with the urgency of a doctor who understands what delay can cost, and as a patient who experienced insurance bureaucracy firsthand. Now lawmakers must meet that urgency with courage.

If these giants are to be turned into dust, it will not happen through rhetoric alone. It will happen only when patients, physicians, and policymakers demand a healthcare system that serves people, not monopolies.

Patients like me are watching.

And we are done waiting.

Statesville resident Sally Neely Nix is a co-founder of We The Patients, a national patient-led healthcare advocacy organization. A North Carolina-based volunteer patient advocate and five-time brain surgery patient, she works at the intersection of lived experience and health policy reform, with a focus on insurance practices, prior authorization, and patient protections.