Dr. Makary,

Thank you for writing The Price We Pay - it was the best book I read this year [my notes]. Before reading it, I had an average understanding of US healthcare and had trouble understanding the real problems. Your book was insightful and gave me a firm opinion beyond the political dialogue.

You mentioned ways that both the market and the government could fix the system. I have a question on each side.

On government policy:
You provided many examples of how the government is already stepping in. Your work with the White House and the Florida pricing transparency law is exciting. Do you think real progress can be made here with the massive amount of lobbying power that the healthcare industry has?

On private markets:
You mentioned market disruptors like Iora Health, but it doesn’t seem like this is possible in all areas of healthcare. Do you think real disruptors can thrive in verticals that appear to be run by oligopolies (e.g. PBMs, GPOs)? If not, is fixing those verticals dependent on government policy?

I suspect you have an insanely busy schedule, but if I could suggest one thing: please be more active on Twitter. You have an amazing perspective and Twitter can help spread your message further. Not everyone will read your book, but tweeting a core idea could get many thousands of people aware.

Thank you again,

Andrew Hess

PS: I live in San Francisco and assume you will be at the JP Morgan Healthcare Conference. Can I buy you a coffee during a break? No pressure, just an offer.