Summit Lens

AI is helping pharmaceutical companies develop drugs. Now, the FDA has an AI assistant to help review the evidence. But that's just the beginning. Across American healthcare, government agencies are increasingly using AI to review medical payments, document patient visits, and support biomedical research. So what happens when the institutions responsible for regulating, paying for, and deliver...

AI can predict protein structures, search enormous chemical spaces, identify drug targets, and help design new molecules. But building a molecule is only the beginning. In this episode, we follow one fictional cancer drug, SL-101, through the modern R&D pipeline—from target discovery and medicinal chemistry to Phase II, biomarker selection, clinical trials, and one of the hardest decisions in...

AI can already read scans, flag high-risk patients, guide ultrasound exams, and even make some autonomous diagnostic decisions. But that raises a more important question: does a better model actually lead to better care? In this episode, we follow what happens after the algorithm gives an answer. We look at why GPT-4 did not automatically make physicians better diagnosticians, how AI cut mammograp...

You may know your doctor. But do you know who owns the business around your doctor? Private equity usually does not show up in healthcare with a Wall Street label. It shows up more quietly, in the local practice that keeps its old name, the specialist group inside a hospital, or the clinic that suddenly feels more optimized than before. The care may look familiar. The ownership may not be. In this...

Why can the same care cost more when the doctor, the room, and the service have not changed? In this episode, we look at how hospitals became some of the most powerful price setters in American healthcare. We start with a routine cardiology visit that suddenly costs almost three times more after the practice becomes part of a hospital system. From there, we unpack the larger structure behind that...

What does it actually mean to have health insurance in America? In this episode, we look at the Affordable Care Act not as a partisan debate, but as a systems story. The ACA changed who could enter the insurance market. It made it harder for insurers to deny coverage because of pre-existing conditions, removed annual and lifetime limits, expanded Medicaid in many states, and created subsidized mar...

What happens when Medicare stops only paying for drugs and starts naming the price? In this episode, we look at the Inflation Reduction Act and Medicare drug price negotiation, not as a policy explainer, but as a shift in power inside the U.S. drug market. For nearly two decades, Medicare Part D relied on private plans, PBMs, formularies, and rebates to negotiate drug costs. The IRA changed that a...

GLP-1 proved the science could work. The harder test began once patients tried to get it. In this episode, we follow GLP-1 from the pharmacy counter into the real world of American healthcare: insurance coverage, compounding pharmacies, PBM formulary decisions, employer benefit design, cash pay pathways, TrumpRx, and public policy. The question is no longer only whether these drugs work. It is how...

How did a gut hormone that disappeared in seconds become one of the biggest drug classes in the world? In this episode, I walk through the story of GLP-1, from early scientific discovery and the Gila monster breakthrough to Novo Nordisk’s drug design strategy, Eli Lilly’s competitive push, and the shift that turned GLP-1 from a diabetes treatment into something much bigger. This is a story about h...

What does it actually take to turn a scientific breakthrough into a drug patients can access? In this episode, I look at the manufacturer side of the healthcare system, the part that absorbs scientific failure, funds long-shot bets, and then enters a second battle after the science succeeds. Because FDA approval is not the finish line. It is the point where a therapy enters the real commercial sys...

If your doctor writes a prescription, who actually decides whether you get it, where you fill it, and what you pay? In this episode, I unpack the hidden role of pharmacy benefit managers, or PBMs, the intermediaries that sit between drugmakers, insurers, employers, pharmacies, and patients. PBMs do not invent drugs or prescribe them, but they often control formularies, prior authorization, special...

What happens when an insurance company stops acting like a payer and starts acting like infrastructure? In this episode, I explore how private insurers became some of the most powerful actors in American healthcare. Using UnitedHealth Group as a central case study, I trace the shift from passive bill payer to managed care gatekeeper to vertically integrated healthcare empire. From Medicare Advanta...

Why does getting care in America so often feel like navigating a maze? In this episode, I unpack the hidden architecture behind that confusion. U.S. healthcare is not one coherent system. It is a patchwork of rulebooks built over time through employer-sponsored insurance, Medicare, Medicaid, the ACA Marketplace, ERISA, and decades of political compromise. The result is a system where your job, age...

Why does the United States spend more on healthcare than any other country in the world, and still underperform on many basic health outcomes? In this episode, I unpack the machinery behind the high cost of American healthcare. From employer-sponsored insurance and tax policy to hospital consolidation, administrative complexity, and market power, this is a story about how the U.S. built a system t...