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Neil Floch MD Profile picture
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Jan 2 • 5 tweets • 4 min read
I know it’s hard for you to believe but many insurance companies have purchased pharmacies:
1. @Aetna bought @CVSHealth
2. @Cigna bought @ExpressScripts
3. @UHC owns @OptumRx
1/
Mergers of medical insurance companies and pharmacy chains is creating a #verticalintegration - many would consider this a monopoly nytimes.com/2018/10/10/hea… 2/
#Verticleintegration drives up cost to the consumer and increases profitability for the industry 3/ Image
Medical insurance companies now have their own Pharmacy Benefit Managers that set the pricing and and profit off the cost of the drugs 4/
80% of the #US drug market is controlled by pharmacy benefit managers:

“According to a report released earlier this year, the three largest pharmacy benefit managers — CVS Caremark, Express Scripts and OptumRx — control 80% of the prescription drug market in the U.S.” 5/

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More from @NeilFlochMD

Neil Floch MD Profile picture
Jan 3
A very interesting thread on @Reddit with @Walgreens employees and others discussing the rules made by @LillyPad to only place through prescriptions with the diagnosis of #diabetes - #Mounjaro is NOT YET indicated by the @US_FDA for #obesity as a diagnosis
The stigma for #obesity is directed at those with the disease. Unfortunately our society perceives that obesity is a “second class” disease and should be treated as such. Here @Walgreens employees are admitting to discriminating against patients 1/
The patients have been prescribed #Mounjaro “off-label” for the treatment of #obesity (because this medication has been shown to result in the highest weight loss of any medication at 22% total body weight lost) 2/
Read 4 tweets
Neil Floch MD Profile picture
Dec 9, 2022
About 5 years ago I had 150 new people following me every day. My tweets were seen by many then one day it all stopped…. A website in Europe detected that I was #shadowbanned by @twitter 1/
Clearly my tweets and retweets were not getting the same impact - I had gained notoriety from my social media presence and I had no answers. I had no recourse. No one at #twitter would respond to my texts, emails, or calls. So… I just worked harder… 2/
I worked on influencing others on and off social media to advocate for fair treatment of those with #obesity and access to care for treatment- others became involved in social medi and #twitter 3/
Read 13 tweets
Neil Floch MD Profile picture
Dec 6, 2022
This is incredible on so many fronts:
1. Brendan Fraser BOLDLY took on the role@of #TheWhale
2. He is discussing the unfair treatment of people who need #obesity care
3. He is endorsed by @AdamSandler
We have broken New Ground
I cannot remember a public figure advocating for the improvement of access to bariatric surgery so openly
Brendan Fraser is courageous and a champion of the movement to treat obesity

Thank you sir!
Read 4 tweets
Neil Floch MD Profile picture
Nov 12, 2022
Ten myths of weight and weightloss
1. Myth: Our current weight only depends on how much we eat and how much we exercise

Reality: Our weight depends on genetic, environmental factors and behavior as well as what and how much we eat, exercise accounts for little weight loss but can help maintain our weight
2. Myth: Any weight can be lost by anyone who eats less food and healthy food

Reality: People with obesity have a very small chance of being able to lose all their weight and keep it off by diet change alone
Read 12 tweets
Neil Floch MD Profile picture
Apr 18, 2021
#Obesity is killing Americans
#Obesity increases risk for death from #covid #covid19
#Obesity is a disease
#Obesity is associated with over 200 other medical conditions
#Obesity is usually & eventually unhealthy
#Obesity & those with it should never be shamed or stigmatized
#Obesity is mostly dictated by #genetics & environment
#Obesity is ignored by politicians
#Obesity occurs in 42% of Americans
#Obesity and people with it are ignored, shamed, humiliated, and discriminated against
#Obesity may occur after psychological trauma 2/
#Obesity is worse because we do not address it as a society
#Obesity is worse from eating unhealthy #food
#Obesity is worse because we exercise too little
#Obesity is worse because we create an environment that propagates obesity
#Obesity is a political issue 3/
Read 11 tweets
Neil Floch MD Profile picture
Apr 17, 2021
When the #ACA was implemented: there was no mandate established to ensure that #emr #ehr electronic medical records could communicate and physicians could obtain medical records from #doctors caring for the same patients at other offices or hospitals. 1/
What ensued was that the government forces practices to an incur most of the cost of buying expensive electronic medical records and forced them to use them or incur more financial penalties. In retrospect those who did not use #emr and #ehr benefitted 2/
It became impossible to afford an #emr #ehr in a private practice
costs include:
1. Computers
2. Network maintenance
3. Wi-Fi
4. Back-up systems
5. #emr #ehr Licenses
6. Cost of repairs
7. Reduction of time with patients
8. Increase typing-dictating time
9. Longer notes 3/
Read 6 tweets

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