TVC Top 3: The AMA’s Code Monopoly, a Whistleblower Walks Free, and Why Trust is Fraying

In this episode of The Voyage Cast Top Three, Eddie breaks down the stories shaping mental health care in America — where headlines, codes, and cash collide.

• Why federal prosecutors dropped charges against AMA whistleblower Dr. Eithan Haim, and what his case reveals about silencing dissent.
• How the hidden CPT Editorial Panel — stacked with insurance executives — decides which therapy and psychiatric treatments “count” for coverage.
• What the AMA’s latest annual report shows about its true financial engine, and why that raises questions about who they really serve.

At the center of all three stories is one fragile thread: trust. Trust in science, in clinicians, and in the healthcare system itself. Without it, patients delay care, turn to social media for answers, and mental health outcomes suffer.

🎙️ The Voyage Cast Top Three — bringing you the headlines that shape your headspace, because mental health doesn’t stop at the therapy door.

👉 Don’t miss an episode — hit Follow and leave a ⭐⭐⭐⭐⭐ review so more listeners can find the show.

Transcript

This is The Voyage Cast Top Three — bringing you the headlines that shape your headspace, because mental health doesn’t stop at the therapy door. I’m Eddie, your host.

Today we’re pulling back the curtain on American healthcare — where policies, codes, and money quietly shape what kind of treatment patients receive, and what insurers actually pay for.

We’ll cover three interconnected stories:

1. A whistleblower whose federal case was dropped,
2. The hidden panel that defines every therapy session and psychiatric visit,
3. And the financial backbone of the American Medical Association — which raises some uncomfortable questions about who they really serve.

Story One: A Whistleblower Walks Free

In May 2024, Dallas surgeon Dr. Eithan Haim was indicted by federal prosecutors. His alleged crime? Violating HIPAA after leaking documents about pediatric gender care at Texas Children’s Hospital.

Fast-forward to January 2025 — the case was dismissed with prejudice. That means it cannot be refiled.

By June, Haim was testifying before the U.S. House Judiciary Committee, describing what he saw as systemic problems in gender medicine. And by late August, the Daily Wire released leaked video of a private call between AMA president Dr. Bobby Mukkamala, Michigan Representative Brad Paquette, and Haim himself.

In the clip, the AMA defended its stance on gender-affirming care. Critics argued they were leaning on experts without seriously engaging dissenting voices.

So why does this matter?

Because whistleblowers, whether you like them or not, are a symptom of a system under stress. If a physician can be prosecuted for speaking out — only to later be vindicated — other clinicians may think twice about raising red flags. That chilling effect reaches mental health too.

Guidelines for depression, ADHD, PTSD, gender care — they all rest on evidence. But if doctors fear reprisal for questioning policy, those guidelines risk becoming echo chambers.

And for patients, the deeper question is trust. Can you trust that your therapist or psychiatrist is following the science? Or are their hands tied by politics and financial pressure? Without trust, people delay care, turn to TikTok or Reddit for answers, and outcomes suffer.

Story Two: Who Really Owns the Codes That Run Medicine?

Every therapy session, every psychiatric evaluation, every family counseling visit — it all gets boiled down to a billing code. If you’ve ever seen numbers like 90837 or 90791 on an invoice, that’s what those are.

Here’s the kicker: those codes aren’t government property. They’re owned and copyrighted by the American Medical Association. Licensed to Medicare and Medicaid. Sold to every private insurer.

The committee that writes and updates them is called the CPT Editorial Panel. As of July 2025, it has 21 members. Some are physicians. But several seats are held by executives from insurance companies — people whose job is literally to minimize payouts.

Blue Cross Blue Shield has multiple representatives. Healthfirst has a vice president on the panel. And one executive committee seat must always be filled by a third-party payer. Federal agencies like CMS, CDC, and FDA? They’re in the room — but only as non-voting guests.

So, why does this matter?

Because CPT codes aren’t just paperwork — they’re gatekeepers. If there’s no code, there’s no coverage.

That means the future of mental health coverage — therapy, telehealth, maybe even AI-assisted treatments — isn’t being decided purely by clinical evidence. It’s shaped by the financial interests of insurers.

So when your claim gets denied and you feel like your therapist dropped the ball? The real issue may be structural: the code doesn’t exist, or it was defined to limit reimbursement. That disconnect feeds frustration, and fuels the growing mistrust of the system itself.

Story Three: Follow the Money

The AMA often presents itself as the voice of American physicians. But the money tells a different story.

According to the AMA’s own 2024 Annual Report:

• Total revenue: $513 million.
• Royalties and credentialing products: $326 million — that’s more than 63 percent of the total.
• Of that, CPT coding products alone brought in $281 million, with a $252 million margin.
• Membership dues? Just a sliver by comparison.

So why does this matter?

Because the AMA is now more financially dependent on selling code licenses and credentialing products to insurers and hospitals than on dues from actual physicians. That changes the incentive structure.

For mental health providers, it raises doubts: is the AMA fighting for fair reimbursement, or protecting lucrative licensing deals?

And for patients, it deepens the suspicion that medical policy isn’t shaped by clinicians on the ground — but by revenue streams at the top.

When therapy and psychiatric care are already difficult to access, this perception of profit-first medicine becomes another barrier. Stigma keeps many from seeking help. Add a system that feels conflicted, and more people just walk away from care altogether.

Closing

So what ties these three stories together?

A whistleblower asking if the AMA is following science.

Insurers sitting at the table that defines what counts as real treatment.

And an association whose financial backbone is selling those very definitions to the insurers.

The common thread is trust. Trust in evidence. Trust in clinicians. Trust in the system itself. And right now, that trust is frayed.

For mental health especially, trust is the difference between showing up or staying home. Between getting care or slipping further into silence.

That’s your Top Three in Mental Health News. I’m Eddie with The Voyage Cast — bringing you the headlines that shape your headspace, because mental health doesn’t stop at the therapy door.

If today’s episode gave you something to think about, make sure to hit subscribe and leave a five-star rating. It helps more people find the show, and it tells the algorithm that mental health news actually matters.

Thanks for listening — I’ll see you next time.