CVS & Aetna are rational actors operating against an irrational set of objectives. Both have a legal (shareholder fiduciary) duty to ensure healthcare costs go up. I know many fine people in these organizations but that can’t change the simple fact that they’re legally obligated to do everything in their power to ensure healthcare costs go up as that’s how they make money — directly and indirectly. Thus, I’m afraid that your bolded, italicized “if” in the last paragraph needs to be in 76 point font to accurately reflect the predicament CVS is in. I empathize with them but empathize even more with our fellow citizens facing cost burdens from healthcare. The math doesn’t work for the majority of the workforce. Consider the following: 20 years of stagnant middle & working class wages due, overwhelmingly, to healthcare costs. 60% of workforce < $20/hr; Avg family of 4 premiums $26k; >50% of households have < $1k savings; >50% of workforce has >$1k deductible.