Comment from Thomas Martin III (Consumer)

Subject: Public Comment – Healthcare Fragmentation, Competition, and Patient Harm I am submitting this comment based on direct patient experience with a fragmented healthcare system that lacks real-time coordination across providers. Despite seeing multiple primary care providers, specialists, and pharmacies, there is no requirement or incentive for real-time communication. This results in siloed decision-making, repeated or conflicting treatments, and a system that often prioritizes prescriptions and procedures over identifying root causes. From an antitrust perspective, this raises serious concerns. When healthcare entities—including provider networks, insurers, and pharmaceutical suppliers—operate without interoperability or transparency, it creates functional barriers to competition and better care. Patients are left navigating disconnected systems while taxpayer-funded programs absorb the cost of inefficiency, duplication, and preventable harm. In my case, documented patterns—such as blood pressure spikes tied to nerve pain and environmental triggers—were not fully integrated into care decisions. Instead, treatment pathways focused on symptom suppression, which could have led to unnecessary complications. Patients should have: • Real-time access to and verification of their full medical data • Visibility into how decisions are made across providers • Assurance that all contributing factors are evaluated before medications or procedures are prescribed The Agencies should consider guidance that: • Encourages real-time data sharing and coordination across healthcare entities • Promotes transparency and accountability in prescribing and treatment decisions • Removes structural barriers that discourage integrated, prevention-focused care Without these changes, fragmentation will continue to drive higher costs, poorer outcomes, and reduced trust in the system. This is not just a healthcare issue—it is a competition and accountability issue