September 27, 2025 • 30 mins
The mysterious world behind your healthcare bills just got a whole lot clearer. Rachel Strauss, dubbed the "PBM Princess" and CEO of her eponymous healthcare consulting firm, pulls back the curtain on the complex systems determining what treatments you can access and how much you'll pay.
Drawing from over two decades in pharmacy benefit management, Rachel delivers eye-opening insights into why certain medications are covered while others aren't, and sometimes why more expensive drugs are preferred over cheaper alternatives. Her mission? Making healthcare more affordable, accessible, and collaborative by bridging the gap between patients, providers, and payers.
The conversation takes a compelling turn when Rachel shares a recent success story—sourcing growth hormone medication from Israel at a 70% discount for a child whose treatment was capped by insurance. This exemplifies her approach to healthcare advocacy: finding creative, legal solutions when traditional systems fall short. She's also partnering with innovative companies like Leafwell Health to integrate cannabis consultations as alternatives to opioids, legitimizing treatments that insurance companies have been slow to embrace.
Rachel's perspective is refreshingly human-centered in an industry dominated by corporate interests and complex systems. When evaluating potential partners, she looks beyond buzzwords to understand the story behind the company and ensures their revenue model aligns with patient outcomes rather than exploitation. Her prediction that AI will transform healthcare through more precise risk assessment offers hope for a future where healthcare dollars are allocated more effectively.
Whether you're struggling with medical bills, denied treatments, or simply trying to understand your insurance options, Rachel's insights provide valuable guidance for navigating the healthcare maze. Connect with her on LinkedIn as Rachel Strauss, PBM Princess, or find her on Instagram and TikTok to learn how to become your own healthcare advocate in a system designed to be difficult to navigate.
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SPEAKER_00 (00:02):
Well, hello, and welcome back to the Healthy
Living Podcast.
I'm your host, Joe Grumbine, andtoday we've got a very special
guest.
Her name is Rachel Strauss, andshe's the CEO of PBM Princess
LLC.
She's a healthcare consultingfirm on a mission to build an
ecosystem of clients aroundthree core goals making
(00:24):
healthcare more affordable,accessible, and collaborative.
And I think that that's where Iwant to start the conversation.
I think that's really important.
And I'll let you shareeverything else about yourself
and your system and everything.
But Rachel, welcome to the show.
So great to have you here today.
SPEAKER_01 (00:41):
So great to be here, John.
Thank you for having me.
SPEAKER_00 (00:44):
Now, as we were talking before, you know, a lot
of the guests on the show arepractitioners or patients or
people that have developed aproduct or a resource or some
technique to find some way tohelp.
But I think something thatpeople don't think about or
don't know or don't realize, ormaybe they are very aware of as
myself, um, insurance is such aparamount influencer in the kind
(01:12):
of health that you have accessto.
And um, you know, we talk aboutinfluencers.
People think about somebodydoing a dog and pony show on
TikTok.
But the truth is when you need atreatment and you submit it to
your insurance company, if youhave one, and they say whatever
they say, you know, they mightsay, Yeah, we'll do it, or it
might be a$4,000 copay, or wecan do it, but you got only one
(01:37):
option and it's you know 50miles from your house and you
can't travel that far.
Um, it seems like what you offerbrings a beautiful bridge to
this.
What's your thoughts?
SPEAKER_01 (01:48):
Yeah, I mean, it's it it's it's no question.
So my passion really has alwaysbeen Joe in helping people.
Um, I'm the daughter of aphysician, I'm the granddaughter
of a pharmacist.
I've always grown up in a worldwhere you just help people.
And unfortunately, the payerside of you know helping people
hasn't really done its job.
(02:09):
Um, you know, I hear oftenhealthcare is broken.
And I would argue, um, and and Ido give Dr.
Jonathan Weasen, who lives inIsrael, he's the founder of a
telemedicine company.
I always give him credit becausehe always comes back at me and
says, healthcare's not broken.
How we pay for it is what isbroken.
SPEAKER_00 (02:26):
Absolutely.
SPEAKER_01 (02:27):
And, you know, with science and advancements in
technology, he's 100% correct.
And we really are not designedto do that.
And so I spent, you know, thefirst 20 plus years of my career
uh working on the payer side,specifically in what's called
the pharmacy benefit managerside of the world.
So I was behind the scenes.
(02:48):
Um, you know, people don't oftenthink about how prescription
drugs are paid for.
They go to the pharmacy, if theyhave insurance, they pay a copay
and nobody gives it muchthought.
How much is the other side ofthat medication?
SPEAKER_02 (03:00):
Right.
SPEAKER_01 (03:00):
And I was on the other side.
I understand why drugs arecovered, why certain drugs are
excluded.
Um, even when more expensivedrugs are covered over less
expensive medications, whichsounds backwards.
And it's not necessarily becausethe more expensive drug is
better.
It's just we are heavilyinfluenced here by
pharmaceutical companies.
(03:22):
And, you know, when I, you know,because I wear a lot of pink and
I'm not shy, Joe, as you'll getto know in our limited time
together.
Um, I be I was once introducedas the PBM princess.
Um, because I I happen to wearpink and, you know, and and I
kind of laughed when I was giventhat nickname.
But when you're given a nicknameand you're in an industry you
(03:44):
want to stand out, I'm like, youknow what?
I'm gonna roll with it.
So I left um, I left my 23-yearcorporate job and watched PBM
Princess LLC as an attempt togive a voice to a very difficult
side of the industry.
And unfortunately, if you'regetting healthcare bills,
they're complicated and peopledon't understand what to do with
(04:06):
them.
SPEAKER_00 (04:06):
And so the the influence so many of them like
they just keep rolling in, andyou're like, do I open this one
or do I just let it go?
SPEAKER_01 (04:13):
You know, and in fact, I have one right behind
me, you know, from a doctorvisit from my daughter, and I'm
looking at it and it shows whatI owe.
And the funny thing most peoplerealize is just because it says
what I owe, yeah, you know, youdo have the opportunity to
negotiate that.
SPEAKER_02 (04:28):
Right.
SPEAKER_01 (04:29):
And you have the opportunity to reach out.
And so, you know, for theconsumer, you know, really I've
done this more altruistically.
My business was not um today isnot necessarily set up just to
help the individual, but throughTikTok and Instagram and you
know, other social mediachannels, I am building out what
I hope to be a whole library ofways to help people and
(04:52):
understand how they cannegotiate their bill.
SPEAKER_00 (04:55):
Nice.
SPEAKER_01 (04:56):
Where I have built um several thousand followers is
on the business side, which ison LinkedIn.
And, you know, really what I'vefocused on and how I earn a
living, quite honestly, isworking with companies that are
determined to help the patientside.
SPEAKER_00 (05:14):
Wow.
SPEAKER_01 (05:14):
That's where I will refer individuals that call me,
but really business owners, youknow, trying to help them,
whether it's with telemedicineor a fun side is I'm very
getting heavily involved in thecannabis side of healthcare.
And cannabis as an alternativethat employers can actually
sponsor for their patients,utilizing physicians.
(05:37):
You know, even our alternativemedicine space is so
complicated, even, you know,where it's legal in our country,
which is 38 states.
You know, you don't tell apatient they have high blood
pressure, go take a bloodpressure pill.
SPEAKER_02 (05:48):
Right.
SPEAKER_01 (05:49):
In the cannabis industry, a doctor writes a
script, but then patients haveno guidance.
They just walk into adispensary.
And so we need to connect thedots.
We need patient advocates, weneed physicians to understand
how their bills are going to bepaid when they send these bills
out to patients and to care andto really work together.
SPEAKER_00 (06:07):
Well, in case you didn't know, which you probably
didn't, I've been involved withcannabis medicine for over 40
years.
And I've developed products,worked with doctors, and been in
and out of the quote unquotelegal side of things.
And um, that was always sort ofthe big I was more involved
before we passed ourrecreational law here in
(06:28):
California, which really kind ofundermined everything.
But it, you know, who knowswhere it's gonna go.
But the problem was alwayscouldn't get insurance to look
at it, you know.
And every once in a while, therewas like somebody come to me and
said, Oh, we've got aworkaround, we got this thing,
but I never actually saw itwork.
And that's what I'm here to tellyou.
SPEAKER_01 (06:48):
So at PBM Princess, I work with a company called
Leafwell Health.
SPEAKER_00 (06:52):
Nice.
SPEAKER_01 (06:52):
Um, I'll give them a shout out.
They were originally direct toconsumer, but Leafwell, that is
what they are.
They are a physiciantelemedicine platform to discuss
cannabis options and to movepeople off of opioids and
rheumatoid arthritis.
Um, the founder herself is acan't is a cancer survivor, so
understands you know just howbeneficial it can be.
(07:14):
And so the employer and gettinginsurance to pay for it is when
you link the physician's eye.
SPEAKER_00 (07:19):
And we've got at least while they have a
dispensing anything, it's reallya consulting, which is the big
piece that's missing, you know.
As a dispensary operator at thetime, you know, 15 years ago, I
was taking clients, patientsinto a consultation and sharing
with them, you know, what Ilearned and said, well, you
know, and I helped dozens anddozens of people get off opiates
(07:43):
and you know, find their waythrough the, you know, 15 years
ago, it was a lot more clumsythan it is today.
And still, uh, I watched, youknow, these people that were 50,
60, 70 years old that were, youknow, running out of their
oxycotton script, you know, fouror five days before it could get
renewed, and they were in miseryfor that time and had to go
(08:05):
through withdrawals and got itto the point where they threw
the script out.
SPEAKER_01 (08:11):
So you get it.
I mean, and so that is reallywhat I'm about is just helping
people navigate and giving avoice to these really cool
startups, or you know, Leafall'snot a startup.
They've been, they've servedover half a million patients
since they started, I believe,seven years ago.
But other, there's just so manyexciting evolutions in the payer
space.
And, you know, and you know,we're living in a world where
(08:31):
the relic insurance companieslike Blue Cross, Blue Shield,
United, Cigna, you know, you'rein California, um, Kaiser,
they're just not evolving withyou know where this is at.
And, you know, and if this isn'tmaking accusations, but you
start to wonder, you know, atwhat point is it profit over
patience?
SPEAKER_00 (08:51):
Well, and I think, you know, part of it, I think
there is an inherent issue withthe system, with an institution
so big as a Kaiser or a BlueCross, because things don't
change quickly or easily orinexpensively.
And that's one of the reasonswhy, you know, standard of care
is many years behind thescience.
(09:12):
And even though they're, youknow, updating it quick as can,
I'm sure there's huge gapsbetween what's available and
what is approved and whatthey'll a doctor will even
recommend because they don'tknow about it.
SPEAKER_01 (09:26):
I mean, it's amazing.
And I know on a previous podcastyou've had menopause as a topic.
I think that was released today.
And it's it's wild, even inwomen's health issues, how many
treatments and things are thereare out there, yet the lack of
education the physicians aregiven and the lack of approval
you see from the insurance side.
(09:47):
You know, we're so quick to putwomen on antidepressants and
things that really just be herown.
SPEAKER_00 (09:52):
No, right?
Yeah.
unknown (09:53):
Yes.
SPEAKER_00 (09:54):
And and I think that's part of the issue is like
they have evidence that says ifyou do this, there's a this much
chance that that'll happen.
But there's also all thispotential for negative, but they
seem to be willing to acceptthat negative uh, you know,
whatever you want to call it,collateral damage, if you will,
(10:16):
because they've got some kind ofstuff they can count on.
I know, you know, with my cancertreatment, I've I've been around
the world with doctors, and I'vebeen, you know, taking the
matter into my own hands andresearching and meeting with all
sorts of, you know, modern andand old and you know, just
learning everything I can onmost of the things I present to
a doctor that is covered by theinsurance, they look at me and
(10:39):
say, I just don't know aboutthat.
SPEAKER_01 (10:42):
I mean, it's it's sad, and you know, I'm happy
you're here today and uh, youknow, really being your own
advocate.
And that's really what we getto.
Um, you know, is is having to beour own advocate and working a
system that's not designed to beeasy.
You know, I was on a I made apost yesterday on LinkedIn.
I saw it right before this, Ihad almost almost 250,000
(11:06):
impressions on it on LinkedIn.
I think my largest.
And all I said was, yeah, I goton the plane yesterday to fly
home from Phoenix, and theflight attendant, it was a full
Southwest flight, and they saidwe only have 60 overhead bins
for 170 passengers.
I felt to myself, you know, likethat work, it doesn't work, and
(11:27):
what they're banking on.
I mean, people don't typicallyday do day trips when they take
an airplane.
And in fact, with all of theextra charges, even Southwest
charging for baggage, it's gonnahave to happen.
And yet they don't have classes,first class, second class, you
know, they or first class and umnot second class, first class,
and you know, priority oranything like that.
(11:48):
So, you know, it's it's reallythey're wanting you not to use
it, and that is how healthcareis designed on the payer side.
And if we don't use a servicethat we're buying, we are going
to get a lot sicker, and that iswhat is going to be exhaustive
on the system.
SPEAKER_00 (12:04):
Well, and that's something that I always thought
like Kaiser kind of had a goodthought about, like they always
talk about, you know, we weadvocate for preventative
healthcare and all these things.
But really, you know, I don'tsee that in action the way that
that, you know, it could.
I think healthcare could focuson things like, you know, diet
and weight loss and and um youknow disease prevention.
(12:27):
So much of our disease ispreventable simply, you know, by
a few health corrections thatcost very little, if anything.
SPEAKER_01 (12:38):
I mean, correct.
I mean, even if something isbasic as an aspirin a day,
right?
I mean, things that we've beenwe've learned, you know, baby
aspirin, I think was somethingthat came out years ago for um
heart disease and just you know,just even some of the
alternative therapies likecannabis, as we mentioned, but
you know, outside of cannabis,there's there's an entire
industry, the wellness industry.
(12:59):
Oh yeah, you know, I mean, asI'm sure you're familiar with
other podcasts and things thatpeople are coming out with.
We've got to have, you know, adifferent way um for this to
happen.
And I apologize, we are on apodcast and I have an I know
it's all good, it's good to seeit.
Um and audio file anyway.
SPEAKER_00 (13:18):
I'm filming, so it's all good.
SPEAKER_01 (13:21):
I'm so sorry, Leah.
You have to get out.
This is my okay, all right.
Sorry about that.
I sent my kids.
Well, for those potentialworking mothers who are
listening out there, um, I sentto you know, it's purple day.
My kids have teams they're onall year, and um, I read the
email that today was purple day,but for our my kids are on the
(13:41):
purple team for their school.
Yeah, okay, and he's closing thedoor, but I just that I was
wrong.
The purple day is tomorrow, nottoday.
So I send my kids in the wrongclothes for spirit day.
SPEAKER_00 (13:54):
You are evidence that self-employed people are
the hardest working people outthere, so I think self-employed
or even employed, period.
SPEAKER_01 (14:02):
Because it is, you know, when you're a mom and you
have elementary kids, kids theycan't necessarily always be
responsible for themselves.
The emails are crazy.
SPEAKER_00 (14:10):
Yeah, I can only imagine.
It's I'm fortunately past thatpoint in my life.
So the grandkids don't come witha lot of emails.
I love it.
SPEAKER_01 (14:17):
No, just fun.
SPEAKER_00 (14:18):
Yep, exactly.
So this sounds like you'rereally jumping into um a gap in
the system that really needs tobe bridged.
And why don't you kind of sharewith us a little bit about how
it actually works?
Like you are out there in thecommunity, you're listening to
(14:42):
various sources of information,but how do you come across a
company or a doctor or an entitythat is providing something that
you want to include in yourtoolbox?
SPEAKER_01 (14:54):
Sure.
So I attend probably seven oreight conferences a year.
Um, I do speak at a lot of them,but I'm also always willing to
meet with somebody who saysthey're doing something out of
the box.
And when I engage, when PBMPrincess engages formally with
an entity, it's because I fullysupport what they're doing and
the mission of how they helppatients.
(15:15):
And then on the other side, it'sjust watching the trends,
learning and listening.
Um, I don't want you to get a PG13 rating on this podcast.
So I'll use uh less colorfullanguage, but I have jokingly
become the oh poop girl, and Idon't need poop, for many
employers and health insuranceconsultants out there because
(15:37):
they know that if they havesomething that somebody can't
afford, they call me and theysay, Hey, can you help this
person?
Right.
That is, you know, BrandyGlanville with somebody that I'm
in the process of helping as Icontinue to get her medical
bills that she's so publiclyspoken about, and helping
negotiate with her with a clientof mine that I work with called
Highlight Health.
Um, but you know, I'll give youone right before this call uh
(16:00):
was a mother with a child who'son growth hormones.
And her growth hormones, youknow, were capped at how much
her plan was willing to pay forthem.
SPEAKER_02 (16:09):
Of course.
SPEAKER_01 (16:09):
The child is still on those growth hormones because
that's part of the treatment.
And so what I did is I alignedher.
Um, we looked at sourcing thosemedications from another
country, um, Israel, in fact,for this one.
And I was just on the other callearlier than this podcast, and
we found them for her for 70%less coming from Israel.
It is the exact same drug, Joe.
(16:30):
In fact, it's manufactured umout that way, and it's taking
out one less shipping cost forthem.
And now they can, you know, nowtheir health insurance plan did
agree to pay for it at a 70%reduction.
And so the call I had beforethis was setting up the pharmacy
that is fulfilling the claimlegally.
The member is allowed to importthis claim.
(16:52):
Um, under, you know, our laws,we do allow individual
importation of medication, uh,meaning anybody can resort,
research their medications andcomplying with the laws in that
country to meet with aphysician, etc.
And we're getting thatmedication shipped tomorrow, and
she'll have it early next week.
And we found 70% savings on it.
SPEAKER_00 (17:12):
Wow.
I I never had any idea that thatwas even a possibility or an
option.
I love that.
SPEAKER_01 (17:18):
So, you know, and that's really why the majority
of the people who I, you know,talk to are employers, because
what we just did is we just tooksomething that would have been
unaffordable for them and theirpremiums would have gone through
the roof next year, and we founda manageable way for them to pay
for it so that that patient canget what they need and it's at a
reasonable price that doesn'tbreak the system and and you
(17:41):
know, channel of risk.
I often joke, you know, ifyou've had to buy a car for a
16-year-old, you're also havingto buy them car insurance.
SPEAKER_00 (17:50):
Right.
Can you imagine if probablygasoline too and maintenance?
SPEAKER_01 (17:54):
And can you imagine if every American's health
premiums were that of a16-year-old driver, we would be
in big trouble.
SPEAKER_02 (18:00):
Horrible.
SPEAKER_01 (18:00):
So it's right.
And so what we're trying to dois level the risk so that people
who are really sick can affordwhat they're getting, but keep
the healthy people healthy.
SPEAKER_00 (18:11):
Nice.
So what are the um I don't know,the characteristics or the
qualities of a client?
I mean, it sounds to me like theway you get out there, you're
just out there, you're talkingto these people, you're in that
world.
So you're when it's likeanything, you know, you want to
get into a world, you you meet aperson and then you meet their
friends, and you you you becomein that world.
(18:34):
And so it sounds like you'veintegrated that well enough that
you have access to kind ofreal-time information.
So when new things are comingyour way, like there's got to be
some sort of a checklist thatsays, oh, this is somebody I'm
maybe interested.
Oh, this is somebody I'mdefinitely interested in, or
this is somebody I got to dropwhat I'm doing to go talk to.
(18:55):
How does it work like that foryou?
SPEAKER_01 (18:56):
Sure.
So first and foremost, I want toknow how they're differentiating
themselves in the space.
I want to make sure that it'snot something in a sea of
buzzwords.
Um, just I think every industryhas their own buzzword, whether
it's health, automotive,anything.
Um, and we also in the payerside, there are a lot of
buzzwords.
So it's first figuring out howyou get past that.
(19:18):
And then it's understanding whatmotivates for me, it's the story
that built the company.
I want to hear not thesalesperson's pitch.
I want to hear why that companybuilt what they built.
Um, almost the the human side ofthe story, the need they saw and
why they saw it, and you know,how they're gonna make it
better.
(19:38):
And then ultimately I like toknow how their revenue works.
Is it aligned with patientoutcome?
Is it a lot?
Everybody deserves to makemoney.
Um I get hired and I'm paid aconsulting fee, and that's how I
get paid.
Um, but to me, I want to knowthat I'm not making money
charging somebody more for aproduct.
That's not gonna feel good andhelp me sleep at night.
SPEAKER_00 (19:58):
It's a difference between equitable and
exploitative.
SPEAKER_01 (20:03):
Correct.
And so I just really want tofind those types of partners.
And then when I get reallyexcited, I'll tell you the most
exciting company I'm contractedwork with doesn't actually
charge at all to be put on ahealth plan.
SPEAKER_03 (20:17):
Wow.
SPEAKER_01 (20:18):
Um it's a it's a father of a child of a child who
has a um cebral seizuredisorder.
And when they were going throughthe diagnosis, this is his
story, by the way.
The catches that caught me.
He was explaining that you know,he went to all these doctors,
and you know, by the time he gotto Dr.
Seven, Dr.
Seven said, Oh, you went to Dr.
(20:38):
Two and Four.
Somebody should have known youdidn't need five or six.
SPEAKER_00 (20:42):
You could have probably I'm well aware of that.
Yeah.
SPEAKER_01 (20:45):
So he built a system that literally can take data
from an from the medicalcarrier, and it looks at all of
these different physician visitsand codes.
And when certain criteria arehit, it immediately says, We've
got one.
We got a patient here that'sgonna doesn't need to go have
this or this test.
We already know that if they hadthose two, you you're wasting
(21:07):
time continuing.
And so he doesn't charge to puthis analytics into a health
plan.
He charges when he engages thepatient and then goes from
there, rightfully so.
Um, but you would be amazed athow hard it is to just get his
data into the system.
SPEAKER_00 (21:22):
Right.
SPEAKER_01 (21:22):
Um, I thought it'd be simple, but I'm like, yeah,
but they don't know how to plugit in.
And so to me, that'sunacceptable.
We have technology, we have theways to help people live better.
And, you know, that to me iswhat I drop everything for, and
I go I go to bat for them.
SPEAKER_00 (21:39):
Nice.
SPEAKER_01 (21:39):
And my, you know, my final thought is, you know, I'm
I am very heavily known in myspace um just because I've spent
two decades getting beingfriendly, if you will.
SPEAKER_02 (21:48):
Sure.
SPEAKER_01 (21:48):
But where I'm really focused on this next 10 years of
my career is getting employersand people who are insured,
whether it's through anindividual plan or through their
employer, how their programworks and before they have to
use it.
SPEAKER_00 (22:05):
I love it.
I love it.
That I mean, you know, I thinkone of the biggest problems with
insurance is it doesn't comewith any kind of a training
manual.
And you know, you sign upbecause you have to, usually for
some reason, whether it's yourown health or or maybe you get
an offer through a company youwork for or whatever it is, but
then you just get this policyand then a card.
(22:27):
And if you need it, you go tothe doctor and you hand them
your card and you just kind offollow what they say.
Like there's never um there'snever a training manual that
says, Oh, well, you're here, youhave these choices, you know,
and I think that what you'reoffering would present some
semblance of that, which wouldchange everything, really.
SPEAKER_01 (22:48):
That's what that's my goal.
That's what I'm trying to do.
SPEAKER_00 (22:51):
I love it.
So we're running low on time,but I always want to hear like
two things.
One, you know, you're looking atthe cutting edge of healthcare,
and I I I have a lot of gueststhat come on and they talk about
things that are involved with AIand and software, and um,
there's a lot of conversationabout telemedicine.
Those are two majortransformations I see in
(23:15):
healthcare and everything elsein in life right now.
But are there any other major umfactors that you see that are
gonna be influencing, you know,the the I'm gonna say two
letters.
SPEAKER_01 (23:30):
You want to take a guess?
SPEAKER_00 (23:31):
Yeah, I don't know.
SPEAKER_01 (23:33):
First letter is the start of the alphabet.
SPEAKER_00 (23:35):
Okay.
SPEAKER_01 (23:36):
And then I'll let you buy another vowel.
SPEAKER_00 (23:38):
AI.
SPEAKER_01 (23:39):
Boom.
That is going to be, I hope,what truly changes the
trajectory of healthcare.
Um we on the healthcare payerside are using AI in ways that
are um, I think just amazing.
It's now not just about, youknow, predicting risk.
You know, we've used actuariesfor years, and that's all
(24:00):
insurance, right?
Whether it's flood insurance,life insurance, there's factors
that go in.
But now with AI, we can drill inso much more specifically onto
what the risk actually is,because the better you can
handle and manage risk and getso fine and so nitty-gritty, you
can start lowering the premiumsand using it to do more things
(24:22):
with those dollars.
SPEAKER_02 (24:23):
Right.
SPEAKER_01 (24:24):
So AI that is from the paying for the healthcare
side, right down to what I wastalking about before, is putting
in AI to start likeunderstanding, you know, the the
automation side of healthcare.
And, you know, like we talkedabout with cannabis and
understanding data and puttingit into you know learning
machines that can actually startlooking at prescribing patterns
(24:47):
of physicians and where we helpthe opioid crisis in this
country.
And I'm I'm so thrilled that I'mat this phase of my career where
I'm not fully exhausted.
I have young kids.
So I am tired, Joe.
But that you know, I've I I I'vegot 20 years behind me, God
willing, I'll have 30 or 40 moreahead of me.
SPEAKER_00 (25:07):
There you go.
SPEAKER_01 (25:07):
And I will get to see where we are with
technology.
SPEAKER_00 (25:11):
Well, I I I think you're right.
I think that um it'll be veryinteresting and exciting to see
uh a few years from now when AIhas a chance to examine all the
data it's collected over thelast several years.
Like right now, it's looking atmultiple sources of information
and sometimes it messes thingsup.
But I think as it looks more atactual submitted, you know,
(25:36):
cases and facts, I think it'llbecome a lot more accurate,
reliable, and and valuable.
SPEAKER_01 (25:42):
I I couldn't agree more.
SPEAKER_00 (25:47):
So on a final note, I know that you know your
experience has uh afforded youso many different uh people that
you've affected, influenced inmany different ways.
I always like to hear about atleast one just incident that
just captures you as like, wow,I helped this person in a really
uh traumatic way.
SPEAKER_01 (26:08):
Um, you know, I think this growth hormone
example right before this callis the one so fresh of mind.
Um I think the first time I gotto talk to Brandy was also
really amazing because she is soshe's so public and her health,
which she doesn't need to makepublic, she has made public.
SPEAKER_02 (26:27):
Yeah.
SPEAKER_01 (26:28):
And, you know, kind of knowing that this could
happen to somebody in such ahigh profile case.
SPEAKER_02 (26:34):
Right.
SPEAKER_01 (26:35):
That to me, um, and knowing that I'm I haven't
helped her yet.
We're in process of getting thebills and we're getting ready to
go to bat for her.
SPEAKER_00 (26:42):
You're well on your way.
SPEAKER_01 (26:43):
We do have a lot of HIPAA laws in this country, so
things have to be put in placeso that we can.
Um, but I'm excited to have goodnews for her, but just the
potential of hope andunderstanding that it's so hard
and frustrating when you getthose bills um to have resources
out there that can advocate.
So that would I would say that'sanother another recent one.
SPEAKER_00 (27:04):
I love it.
Um, so this is a place where Igive you a place to sum up your
thoughts or give us a partingshot, and most importantly, how
somebody can get a hold of youand and access your resources.
SPEAKER_01 (27:15):
Parting shot, I will say this is a wellness podcast.
Um, be your biggest advocate.
SPEAKER_00 (27:21):
Yes.
SPEAKER_01 (27:21):
Something isn't right, talk about it, research
it.
Don't just Google or chat GPTit, but do the research on who
else you can talk to.
Um I am not a physician, I justknow how to pay for one.
Um, but please reach out at anytime.
I am my largest social channel,it is definitely LinkedIn.
Um, Rachel Strauss, PBMprincess.
(27:42):
You can't miss me if you Googlethose few words.
SPEAKER_00 (27:45):
Um, but I can't PBM princesses out there with uh a
business carrying that name,right?
SPEAKER_01 (27:50):
Yeah, I know.
It's it was it was uh it wassomething I had to think about
because it does make it kind ofsound silly.
But at the end of the day, theprincess part to me is that I
have a voice and I'm giving it aplatform and I'm gonna use it to
take care of people.
And that's my parting shot.
I'm on Instagram, Rachel Straussor the real Rachel Strauss on
TikTok.
SPEAKER_00 (28:08):
I love it.
Well, thank you so much forjoining us and always like to
extend the offer.
Um, we had a great conversation.
There's always more to talkabout.
Feel free to reach back.
And uh, you know, as I suspect alot of these cutting-edge um
guests, they're they're pavingthe way.
So I'm sure there will come apoint where you've got a lot of
new information to share withus.
(28:30):
And uh yeah, just grateful youwere here with us today.
SPEAKER_01 (28:33):
Thanks, Joe.
Keep fighting.
You look amazing.
SPEAKER_00 (28:35):
Oh, you bet.
Thank you.
All right, this has been anotherepisode of the Healthy Living
Podcast.
I'm your host, Joe Grumba, and Iwant to thank all the supporters
that make the show possible, andwe will see you next time.
Well, hello, and welcome back to the Healthy
Living Podcast.
I'm your host, Joe Grumbine, andtoday we've got a very special
guest.
Her name is Rachel Strauss, andshe's the CEO of PBM Princess
LLC.
She's a healthcare consultingfirm on a mission to build an
ecosystem of clients aroundthree core goals making
(00:24):
healthcare more affordable,accessible, and collaborative.
And I think that that's where Iwant to start the conversation.
I think that's really important.
And I'll let you shareeverything else about yourself
and your system and everything.
But Rachel, welcome to the show.
So great to have you here today.
SPEAKER_01 (00:41):
So great to be here, John.
Thank you for having me.
SPEAKER_00 (00:44):
Now, as we were talking before, you know, a lot
of the guests on the show arepractitioners or patients or
people that have developed aproduct or a resource or some
technique to find some way tohelp.
But I think something thatpeople don't think about or
don't know or don't realize, ormaybe they are very aware of as
myself, um, insurance is such aparamount influencer in the kind
(01:12):
of health that you have accessto.
And um, you know, we talk aboutinfluencers.
People think about somebodydoing a dog and pony show on
TikTok.
But the truth is when you need atreatment and you submit it to
your insurance company, if youhave one, and they say whatever
they say, you know, they mightsay, Yeah, we'll do it, or it
might be a$4,000 copay, or wecan do it, but you got only one
(01:37):
option and it's you know 50miles from your house and you
can't travel that far.
Um, it seems like what you offerbrings a beautiful bridge to
this.
What's your thoughts?
SPEAKER_01 (01:48):
Yeah, I mean, it's it it's it's no question.
So my passion really has alwaysbeen Joe in helping people.
Um, I'm the daughter of aphysician, I'm the granddaughter
of a pharmacist.
I've always grown up in a worldwhere you just help people.
And unfortunately, the payerside of you know helping people
hasn't really done its job.
(02:09):
Um, you know, I hear oftenhealthcare is broken.
And I would argue, um, and and Ido give Dr.
Jonathan Weasen, who lives inIsrael, he's the founder of a
telemedicine company.
I always give him credit becausehe always comes back at me and
says, healthcare's not broken.
How we pay for it is what isbroken.
SPEAKER_00 (02:26):
Absolutely.
SPEAKER_01 (02:27):
And, you know, with science and advancements in
technology, he's 100% correct.
And we really are not designedto do that.
And so I spent, you know, thefirst 20 plus years of my career
uh working on the payer side,specifically in what's called
the pharmacy benefit managerside of the world.
So I was behind the scenes.
(02:48):
Um, you know, people don't oftenthink about how prescription
drugs are paid for.
They go to the pharmacy, if theyhave insurance, they pay a copay
and nobody gives it muchthought.
How much is the other side ofthat medication?
SPEAKER_02 (03:00):
Right.
SPEAKER_01 (03:00):
And I was on the other side.
I understand why drugs arecovered, why certain drugs are
excluded.
Um, even when more expensivedrugs are covered over less
expensive medications, whichsounds backwards.
And it's not necessarily becausethe more expensive drug is
better.
It's just we are heavilyinfluenced here by
pharmaceutical companies.
(03:22):
And, you know, when I, you know,because I wear a lot of pink and
I'm not shy, Joe, as you'll getto know in our limited time
together.
Um, I be I was once introducedas the PBM princess.
Um, because I I happen to wearpink and, you know, and and I
kind of laughed when I was giventhat nickname.
But when you're given a nicknameand you're in an industry you
(03:44):
want to stand out, I'm like, youknow what?
I'm gonna roll with it.
So I left um, I left my 23-yearcorporate job and watched PBM
Princess LLC as an attempt togive a voice to a very difficult
side of the industry.
And unfortunately, if you'regetting healthcare bills,
they're complicated and peopledon't understand what to do with
(04:06):
them.
SPEAKER_00 (04:06):
And so the the influence so many of them like
they just keep rolling in, andyou're like, do I open this one
or do I just let it go?
SPEAKER_01 (04:13):
You know, and in fact, I have one right behind
me, you know, from a doctorvisit from my daughter, and I'm
looking at it and it shows whatI owe.
And the funny thing most peoplerealize is just because it says
what I owe, yeah, you know, youdo have the opportunity to
negotiate that.
SPEAKER_02 (04:28):
Right.
SPEAKER_01 (04:29):
And you have the opportunity to reach out.
And so, you know, for theconsumer, you know, really I've
done this more altruistically.
My business was not um today isnot necessarily set up just to
help the individual, but throughTikTok and Instagram and you
know, other social mediachannels, I am building out what
I hope to be a whole library ofways to help people and
(04:52):
understand how they cannegotiate their bill.
SPEAKER_00 (04:55):
Nice.
SPEAKER_01 (04:56):
Where I have built um several thousand followers is
on the business side, which ison LinkedIn.
And, you know, really what I'vefocused on and how I earn a
living, quite honestly, isworking with companies that are
determined to help the patientside.
SPEAKER_00 (05:14):
Wow.
SPEAKER_01 (05:14):
That's where I will refer individuals that call me,
but really business owners, youknow, trying to help them,
whether it's with telemedicineor a fun side is I'm very
getting heavily involved in thecannabis side of healthcare.
And cannabis as an alternativethat employers can actually
sponsor for their patients,utilizing physicians.
(05:37):
You know, even our alternativemedicine space is so
complicated, even, you know,where it's legal in our country,
which is 38 states.
You know, you don't tell apatient they have high blood
pressure, go take a bloodpressure pill.
SPEAKER_02 (05:48):
Right.
SPEAKER_01 (05:49):
In the cannabis industry, a doctor writes a
script, but then patients haveno guidance.
They just walk into adispensary.
And so we need to connect thedots.
We need patient advocates, weneed physicians to understand
how their bills are going to bepaid when they send these bills
out to patients and to care andto really work together.
SPEAKER_00 (06:07):
Well, in case you didn't know, which you probably
didn't, I've been involved withcannabis medicine for over 40
years.
And I've developed products,worked with doctors, and been in
and out of the quote unquotelegal side of things.
And um, that was always sort ofthe big I was more involved
before we passed ourrecreational law here in
(06:28):
California, which really kind ofundermined everything.
But it, you know, who knowswhere it's gonna go.
But the problem was alwayscouldn't get insurance to look
at it, you know.
And every once in a while, therewas like somebody come to me and
said, Oh, we've got aworkaround, we got this thing,
but I never actually saw itwork.
And that's what I'm here to tellyou.
SPEAKER_01 (06:48):
So at PBM Princess, I work with a company called
Leafwell Health.
SPEAKER_00 (06:52):
Nice.
SPEAKER_01 (06:52):
Um, I'll give them a shout out.
They were originally direct toconsumer, but Leafwell, that is
what they are.
They are a physiciantelemedicine platform to discuss
cannabis options and to movepeople off of opioids and
rheumatoid arthritis.
Um, the founder herself is acan't is a cancer survivor, so
understands you know just howbeneficial it can be.
(07:14):
And so the employer and gettinginsurance to pay for it is when
you link the physician's eye.
SPEAKER_00 (07:19):
And we've got at least while they have a
dispensing anything, it's reallya consulting, which is the big
piece that's missing, you know.
As a dispensary operator at thetime, you know, 15 years ago, I
was taking clients, patientsinto a consultation and sharing
with them, you know, what Ilearned and said, well, you
know, and I helped dozens anddozens of people get off opiates
(07:43):
and you know, find their waythrough the, you know, 15 years
ago, it was a lot more clumsythan it is today.
And still, uh, I watched, youknow, these people that were 50,
60, 70 years old that were, youknow, running out of their
oxycotton script, you know, fouror five days before it could get
renewed, and they were in miseryfor that time and had to go
(08:05):
through withdrawals and got itto the point where they threw
the script out.
SPEAKER_01 (08:11):
So you get it.
I mean, and so that is reallywhat I'm about is just helping
people navigate and giving avoice to these really cool
startups, or you know, Leafall'snot a startup.
They've been, they've servedover half a million patients
since they started, I believe,seven years ago.
But other, there's just so manyexciting evolutions in the payer
space.
And, you know, and you know,we're living in a world where
(08:31):
the relic insurance companieslike Blue Cross, Blue Shield,
United, Cigna, you know, you'rein California, um, Kaiser,
they're just not evolving withyou know where this is at.
And, you know, and if this isn'tmaking accusations, but you
start to wonder, you know, atwhat point is it profit over
patience?
SPEAKER_00 (08:51):
Well, and I think, you know, part of it, I think
there is an inherent issue withthe system, with an institution
so big as a Kaiser or a BlueCross, because things don't
change quickly or easily orinexpensively.
And that's one of the reasonswhy, you know, standard of care
is many years behind thescience.
(09:12):
And even though they're, youknow, updating it quick as can,
I'm sure there's huge gapsbetween what's available and
what is approved and whatthey'll a doctor will even
recommend because they don'tknow about it.
SPEAKER_01 (09:26):
I mean, it's amazing.
And I know on a previous podcastyou've had menopause as a topic.
I think that was released today.
And it's it's wild, even inwomen's health issues, how many
treatments and things are thereare out there, yet the lack of
education the physicians aregiven and the lack of approval
you see from the insurance side.
(09:47):
You know, we're so quick to putwomen on antidepressants and
things that really just be herown.
SPEAKER_00 (09:52):
No, right?
Yeah.
unknown (09:53):
Yes.
SPEAKER_00 (09:54):
And and I think that's part of the issue is like
they have evidence that says ifyou do this, there's a this much
chance that that'll happen.
But there's also all thispotential for negative, but they
seem to be willing to acceptthat negative uh, you know,
whatever you want to call it,collateral damage, if you will,
(10:16):
because they've got some kind ofstuff they can count on.
I know, you know, with my cancertreatment, I've I've been around
the world with doctors, and I'vebeen, you know, taking the
matter into my own hands andresearching and meeting with all
sorts of, you know, modern andand old and you know, just
learning everything I can onmost of the things I present to
a doctor that is covered by theinsurance, they look at me and
(10:39):
say, I just don't know aboutthat.
SPEAKER_01 (10:42):
I mean, it's it's sad, and you know, I'm happy
you're here today and uh, youknow, really being your own
advocate.
And that's really what we getto.
Um, you know, is is having to beour own advocate and working a
system that's not designed to beeasy.
You know, I was on a I made apost yesterday on LinkedIn.
I saw it right before this, Ihad almost almost 250,000
(11:06):
impressions on it on LinkedIn.
I think my largest.
And all I said was, yeah, I goton the plane yesterday to fly
home from Phoenix, and theflight attendant, it was a full
Southwest flight, and they saidwe only have 60 overhead bins
for 170 passengers.
I felt to myself, you know, likethat work, it doesn't work, and
(11:27):
what they're banking on.
I mean, people don't typicallyday do day trips when they take
an airplane.
And in fact, with all of theextra charges, even Southwest
charging for baggage, it's gonnahave to happen.
And yet they don't have classes,first class, second class, you
know, they or first class and umnot second class, first class,
and you know, priority oranything like that.
(11:48):
So, you know, it's it's reallythey're wanting you not to use
it, and that is how healthcareis designed on the payer side.
And if we don't use a servicethat we're buying, we are going
to get a lot sicker, and that iswhat is going to be exhaustive
on the system.
SPEAKER_00 (12:04):
Well, and that's something that I always thought
like Kaiser kind of had a goodthought about, like they always
talk about, you know, we weadvocate for preventative
healthcare and all these things.
But really, you know, I don'tsee that in action the way that
that, you know, it could.
I think healthcare could focuson things like, you know, diet
and weight loss and and um youknow disease prevention.
(12:27):
So much of our disease ispreventable simply, you know, by
a few health corrections thatcost very little, if anything.
SPEAKER_01 (12:38):
I mean, correct.
I mean, even if something isbasic as an aspirin a day,
right?
I mean, things that we've beenwe've learned, you know, baby
aspirin, I think was somethingthat came out years ago for um
heart disease and just you know,just even some of the
alternative therapies likecannabis, as we mentioned, but
you know, outside of cannabis,there's there's an entire
industry, the wellness industry.
(12:59):
Oh yeah, you know, I mean, asI'm sure you're familiar with
other podcasts and things thatpeople are coming out with.
We've got to have, you know, adifferent way um for this to
happen.
And I apologize, we are on apodcast and I have an I know
it's all good, it's good to seeit.
Um and audio file anyway.
SPEAKER_00 (13:18):
I'm filming, so it's all good.
SPEAKER_01 (13:21):
I'm so sorry, Leah.
You have to get out.
This is my okay, all right.
Sorry about that.
I sent my kids.
Well, for those potentialworking mothers who are
listening out there, um, I sentto you know, it's purple day.
My kids have teams they're onall year, and um, I read the
email that today was purple day,but for our my kids are on the
(13:41):
purple team for their school.
Yeah, okay, and he's closing thedoor, but I just that I was
wrong.
The purple day is tomorrow, nottoday.
So I send my kids in the wrongclothes for spirit day.
SPEAKER_00 (13:54):
You are evidence that self-employed people are
the hardest working people outthere, so I think self-employed
or even employed, period.
SPEAKER_01 (14:02):
Because it is, you know, when you're a mom and you
have elementary kids, kids theycan't necessarily always be
responsible for themselves.
The emails are crazy.
SPEAKER_00 (14:10):
Yeah, I can only imagine.
It's I'm fortunately past thatpoint in my life.
So the grandkids don't come witha lot of emails.
I love it.
SPEAKER_01 (14:17):
No, just fun.
SPEAKER_00 (14:18):
Yep, exactly.
So this sounds like you'rereally jumping into um a gap in
the system that really needs tobe bridged.
And why don't you kind of sharewith us a little bit about how
it actually works?
Like you are out there in thecommunity, you're listening to
(14:42):
various sources of information,but how do you come across a
company or a doctor or an entitythat is providing something that
you want to include in yourtoolbox?
SPEAKER_01 (14:54):
Sure.
So I attend probably seven oreight conferences a year.
Um, I do speak at a lot of them,but I'm also always willing to
meet with somebody who saysthey're doing something out of
the box.
And when I engage, when PBMPrincess engages formally with
an entity, it's because I fullysupport what they're doing and
the mission of how they helppatients.
(15:15):
And then on the other side, it'sjust watching the trends,
learning and listening.
Um, I don't want you to get a PG13 rating on this podcast.
So I'll use uh less colorfullanguage, but I have jokingly
become the oh poop girl, and Idon't need poop, for many
employers and health insuranceconsultants out there because
(15:37):
they know that if they havesomething that somebody can't
afford, they call me and theysay, Hey, can you help this
person?
Right.
That is, you know, BrandyGlanville with somebody that I'm
in the process of helping as Icontinue to get her medical
bills that she's so publiclyspoken about, and helping
negotiate with her with a clientof mine that I work with called
Highlight Health.
Um, but you know, I'll give youone right before this call uh
(16:00):
was a mother with a child who'son growth hormones.
And her growth hormones, youknow, were capped at how much
her plan was willing to pay forthem.
SPEAKER_02 (16:09):
Of course.
SPEAKER_01 (16:09):
The child is still on those growth hormones because
that's part of the treatment.
And so what I did is I alignedher.
Um, we looked at sourcing thosemedications from another
country, um, Israel, in fact,for this one.
And I was just on the other callearlier than this podcast, and
we found them for her for 70%less coming from Israel.
It is the exact same drug, Joe.
(16:30):
In fact, it's manufactured umout that way, and it's taking
out one less shipping cost forthem.
And now they can, you know, nowtheir health insurance plan did
agree to pay for it at a 70%reduction.
And so the call I had beforethis was setting up the pharmacy
that is fulfilling the claimlegally.
The member is allowed to importthis claim.
(16:52):
Um, under, you know, our laws,we do allow individual
importation of medication, uh,meaning anybody can resort,
research their medications andcomplying with the laws in that
country to meet with aphysician, etc.
And we're getting thatmedication shipped tomorrow, and
she'll have it early next week.
And we found 70% savings on it.
SPEAKER_00 (17:12):
Wow.
I I never had any idea that thatwas even a possibility or an
option.
I love that.
SPEAKER_01 (17:18):
So, you know, and that's really why the majority
of the people who I, you know,talk to are employers, because
what we just did is we just tooksomething that would have been
unaffordable for them and theirpremiums would have gone through
the roof next year, and we founda manageable way for them to pay
for it so that that patient canget what they need and it's at a
reasonable price that doesn'tbreak the system and and you
(17:41):
know, channel of risk.
I often joke, you know, ifyou've had to buy a car for a
16-year-old, you're also havingto buy them car insurance.
SPEAKER_00 (17:50):
Right.
Can you imagine if probablygasoline too and maintenance?
SPEAKER_01 (17:54):
And can you imagine if every American's health
premiums were that of a16-year-old driver, we would be
in big trouble.
SPEAKER_02 (18:00):
Horrible.
SPEAKER_01 (18:00):
So it's right.
And so what we're trying to dois level the risk so that people
who are really sick can affordwhat they're getting, but keep
the healthy people healthy.
SPEAKER_00 (18:11):
Nice.
So what are the um I don't know,the characteristics or the
qualities of a client?
I mean, it sounds to me like theway you get out there, you're
just out there, you're talkingto these people, you're in that
world.
So you're when it's likeanything, you know, you want to
get into a world, you you meet aperson and then you meet their
friends, and you you you becomein that world.
(18:34):
And so it sounds like you'veintegrated that well enough that
you have access to kind ofreal-time information.
So when new things are comingyour way, like there's got to be
some sort of a checklist thatsays, oh, this is somebody I'm
maybe interested.
Oh, this is somebody I'mdefinitely interested in, or
this is somebody I got to dropwhat I'm doing to go talk to.
(18:55):
How does it work like that foryou?
SPEAKER_01 (18:56):
Sure.
So first and foremost, I want toknow how they're differentiating
themselves in the space.
I want to make sure that it'snot something in a sea of
buzzwords.
Um, just I think every industryhas their own buzzword, whether
it's health, automotive,anything.
Um, and we also in the payerside, there are a lot of
buzzwords.
So it's first figuring out howyou get past that.
(19:18):
And then it's understanding whatmotivates for me, it's the story
that built the company.
I want to hear not thesalesperson's pitch.
I want to hear why that companybuilt what they built.
Um, almost the the human side ofthe story, the need they saw and
why they saw it, and you know,how they're gonna make it
better.
(19:38):
And then ultimately I like toknow how their revenue works.
Is it aligned with patientoutcome?
Is it a lot?
Everybody deserves to makemoney.
Um I get hired and I'm paid aconsulting fee, and that's how I
get paid.
Um, but to me, I want to knowthat I'm not making money
charging somebody more for aproduct.
That's not gonna feel good andhelp me sleep at night.
SPEAKER_00 (19:58):
It's a difference between equitable and
exploitative.
SPEAKER_01 (20:03):
Correct.
And so I just really want tofind those types of partners.
And then when I get reallyexcited, I'll tell you the most
exciting company I'm contractedwork with doesn't actually
charge at all to be put on ahealth plan.
SPEAKER_03 (20:17):
Wow.
SPEAKER_01 (20:18):
Um it's a it's a father of a child of a child who
has a um cebral seizuredisorder.
And when they were going throughthe diagnosis, this is his
story, by the way.
The catches that caught me.
He was explaining that you know,he went to all these doctors,
and you know, by the time he gotto Dr.
Seven, Dr.
Seven said, Oh, you went to Dr.
(20:38):
Two and Four.
Somebody should have known youdidn't need five or six.
SPEAKER_00 (20:42):
You could have probably I'm well aware of that.
Yeah.
SPEAKER_01 (20:45):
So he built a system that literally can take data
from an from the medicalcarrier, and it looks at all of
these different physician visitsand codes.
And when certain criteria arehit, it immediately says, We've
got one.
We got a patient here that'sgonna doesn't need to go have
this or this test.
We already know that if they hadthose two, you you're wasting
(21:07):
time continuing.
And so he doesn't charge to puthis analytics into a health
plan.
He charges when he engages thepatient and then goes from
there, rightfully so.
Um, but you would be amazed athow hard it is to just get his
data into the system.
SPEAKER_00 (21:22):
Right.
SPEAKER_01 (21:22):
Um, I thought it'd be simple, but I'm like, yeah,
but they don't know how to plugit in.
And so to me, that'sunacceptable.
We have technology, we have theways to help people live better.
And, you know, that to me iswhat I drop everything for, and
I go I go to bat for them.
SPEAKER_00 (21:39):
Nice.
SPEAKER_01 (21:39):
And my, you know, my final thought is, you know, I'm
I am very heavily known in myspace um just because I've spent
two decades getting beingfriendly, if you will.
SPEAKER_02 (21:48):
Sure.
SPEAKER_01 (21:48):
But where I'm really focused on this next 10 years of
my career is getting employersand people who are insured,
whether it's through anindividual plan or through their
employer, how their programworks and before they have to
use it.
SPEAKER_00 (22:05):
I love it.
I love it.
That I mean, you know, I thinkone of the biggest problems with
insurance is it doesn't comewith any kind of a training
manual.
And you know, you sign upbecause you have to, usually for
some reason, whether it's yourown health or or maybe you get
an offer through a company youwork for or whatever it is, but
then you just get this policyand then a card.
(22:27):
And if you need it, you go tothe doctor and you hand them
your card and you just kind offollow what they say.
Like there's never um there'snever a training manual that
says, Oh, well, you're here, youhave these choices, you know,
and I think that what you'reoffering would present some
semblance of that, which wouldchange everything, really.
SPEAKER_01 (22:48):
That's what that's my goal.
That's what I'm trying to do.
SPEAKER_00 (22:51):
I love it.
So we're running low on time,but I always want to hear like
two things.
One, you know, you're looking atthe cutting edge of healthcare,
and I I I have a lot of gueststhat come on and they talk about
things that are involved with AIand and software, and um,
there's a lot of conversationabout telemedicine.
Those are two majortransformations I see in
(23:15):
healthcare and everything elsein in life right now.
But are there any other major umfactors that you see that are
gonna be influencing, you know,the the I'm gonna say two
letters.
SPEAKER_01 (23:30):
You want to take a guess?
SPEAKER_00 (23:31):
Yeah, I don't know.
SPEAKER_01 (23:33):
First letter is the start of the alphabet.
SPEAKER_00 (23:35):
Okay.
SPEAKER_01 (23:36):
And then I'll let you buy another vowel.
SPEAKER_00 (23:38):
AI.
SPEAKER_01 (23:39):
Boom.
That is going to be, I hope,what truly changes the
trajectory of healthcare.
Um we on the healthcare payerside are using AI in ways that
are um, I think just amazing.
It's now not just about, youknow, predicting risk.
You know, we've used actuariesfor years, and that's all
(24:00):
insurance, right?
Whether it's flood insurance,life insurance, there's factors
that go in.
But now with AI, we can drill inso much more specifically onto
what the risk actually is,because the better you can
handle and manage risk and getso fine and so nitty-gritty, you
can start lowering the premiumsand using it to do more things
(24:22):
with those dollars.
SPEAKER_02 (24:23):
Right.
SPEAKER_01 (24:24):
So AI that is from the paying for the healthcare
side, right down to what I wastalking about before, is putting
in AI to start likeunderstanding, you know, the the
automation side of healthcare.
And, you know, like we talkedabout with cannabis and
understanding data and puttingit into you know learning
machines that can actually startlooking at prescribing patterns
(24:47):
of physicians and where we helpthe opioid crisis in this
country.
And I'm I'm so thrilled that I'mat this phase of my career where
I'm not fully exhausted.
I have young kids.
So I am tired, Joe.
But that you know, I've I I I'vegot 20 years behind me, God
willing, I'll have 30 or 40 moreahead of me.
SPEAKER_00 (25:07):
There you go.
SPEAKER_01 (25:07):
And I will get to see where we are with
technology.
SPEAKER_00 (25:11):
Well, I I I think you're right.
I think that um it'll be veryinteresting and exciting to see
uh a few years from now when AIhas a chance to examine all the
data it's collected over thelast several years.
Like right now, it's looking atmultiple sources of information
and sometimes it messes thingsup.
But I think as it looks more atactual submitted, you know,
(25:36):
cases and facts, I think it'llbecome a lot more accurate,
reliable, and and valuable.
SPEAKER_01 (25:42):
I I couldn't agree more.
SPEAKER_00 (25:47):
So on a final note, I know that you know your
experience has uh afforded youso many different uh people that
you've affected, influenced inmany different ways.
I always like to hear about atleast one just incident that
just captures you as like, wow,I helped this person in a really
uh traumatic way.
SPEAKER_01 (26:08):
Um, you know, I think this growth hormone
example right before this callis the one so fresh of mind.
Um I think the first time I gotto talk to Brandy was also
really amazing because she is soshe's so public and her health,
which she doesn't need to makepublic, she has made public.
SPEAKER_02 (26:27):
Yeah.
SPEAKER_01 (26:28):
And, you know, kind of knowing that this could
happen to somebody in such ahigh profile case.
SPEAKER_02 (26:34):
Right.
SPEAKER_01 (26:35):
That to me, um, and knowing that I'm I haven't
helped her yet.
We're in process of getting thebills and we're getting ready to
go to bat for her.
SPEAKER_00 (26:42):
You're well on your way.
SPEAKER_01 (26:43):
We do have a lot of HIPAA laws in this country, so
things have to be put in placeso that we can.
Um, but I'm excited to have goodnews for her, but just the
potential of hope andunderstanding that it's so hard
and frustrating when you getthose bills um to have resources
out there that can advocate.
So that would I would say that'sanother another recent one.
SPEAKER_00 (27:04):
I love it.
Um, so this is a place where Igive you a place to sum up your
thoughts or give us a partingshot, and most importantly, how
somebody can get a hold of youand and access your resources.
SPEAKER_01 (27:15):
Parting shot, I will say this is a wellness podcast.
Um, be your biggest advocate.
SPEAKER_00 (27:21):
Yes.
SPEAKER_01 (27:21):
Something isn't right, talk about it, research
it.
Don't just Google or chat GPTit, but do the research on who
else you can talk to.
Um I am not a physician, I justknow how to pay for one.
Um, but please reach out at anytime.
I am my largest social channel,it is definitely LinkedIn.
Um, Rachel Strauss, PBMprincess.
(27:42):
You can't miss me if you Googlethose few words.
SPEAKER_00 (27:45):
Um, but I can't PBM princesses out there with uh a
business carrying that name,right?
SPEAKER_01 (27:50):
Yeah, I know.
It's it was it was uh it wassomething I had to think about
because it does make it kind ofsound silly.
But at the end of the day, theprincess part to me is that I
have a voice and I'm giving it aplatform and I'm gonna use it to
take care of people.
And that's my parting shot.
I'm on Instagram, Rachel Straussor the real Rachel Strauss on
TikTok.
SPEAKER_00 (28:08):
I love it.
Well, thank you so much forjoining us and always like to
extend the offer.
Um, we had a great conversation.
There's always more to talkabout.
Feel free to reach back.
And uh, you know, as I suspect alot of these cutting-edge um
guests, they're they're pavingthe way.
So I'm sure there will come apoint where you've got a lot of
new information to share withus.
(28:30):
And uh yeah, just grateful youwere here with us today.
SPEAKER_01 (28:33):
Thanks, Joe.
Keep fighting.
You look amazing.
SPEAKER_00 (28:35):
Oh, you bet.
Thank you.
All right, this has been anotherepisode of the Healthy Living
Podcast.
I'm your host, Joe Grumba, and Iwant to thank all the supporters
that make the show possible, andwe will see you next time.
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