Congressman Greg Murphy: Even Drug Cartels Are More Ethical Than Health Insurance Companies

In an era when trust in institutions is waning, Congressman Greg Murphy — a practicing urologist and the only current physician in Congress who still sees patients — offers a rare, unfiltered voice on what’s broken in American medicine. In a candid and at times contentious conversation with Offcall co-founder and emergency physician Dr. Graham Walker on the How I Doctor podcast, Murphy didn’t hold back, saying, “Some of our drug cartels are more ethical than our insurance companies.”

That wasn't hyperbole. It was a culmination of decades spent straddling the bedside and the boardroom and seeing how bureaucracy, policy, and profit have eroded the doctor-patient relationship.

Still Scrubbing In

Dr. Murphy continues to perform surgeries and see patients, albeit without pay. "I can't get paid, I have to do it for free," he says. But he insists that practicing medicine keeps him grounded — and gives him credibility in Washington, D.C. "If you're not practicing anymore, you lose a little bit of credibility. That's just a fact."

His medical credentials are extensive: a long-standing surgical career in eastern North Carolina, past leadership roles as president of a urology group and chief of staff at a Level 1 trauma center, and global relief work. But it's his dual identity—as both legislator and physician—that gives his perspective heft.

On the Death of Private Practice

For Murphy, the crisis isn't just about physician burnout or pay cuts. It's existential. “The medical profession as we know it is...on the pathway to extinction,” he warns. He attributes the death of private practice in part to the Affordable Care Act (ACA), which he believes "almost explicitly" pushed doctors into employment models to pave the way for single-payer healthcare.

“When I started, we had one and a half insurance people for our practice,” he recalls. “Toward the end, we could go three out of eight quarters without taking home a paycheck.”

A Generational Divide?

The spark for this podcast episode was a controversial tweet by Murphy critiquing “young doctors complaining about how hard the job is.” Asked whether he believes the greatest threat to medicine is a new generation of physicians unwilling to work hard, Murphy called it a “generational issue” and said: “The first thing they talk about is work-life balance.” By contrast, he says, “When I was coming through, the first thing I talked about was, ‘How many cases can I do?’”

Still, he acknowledges the bureaucracy has worsened: “I get it. The system is broken... but if you throw your hands up and say it’s too hard, guess who gets hurt? The patient.”

Not Just Complaining — Legislating

Murphy isn’t content to shake his fist. He’s using his seat in Congress to push reforms, particularly around physician payment and insurance company overreach.

“I've been told what they [insurers] do is not illegal, but it sure as hell is unethical,” he says. He’s especially critical of UnitedHealthcare, saying, “I think some of those people ought to go to jail.”

He’s also one of the few legislators leading the charge against Medicare cuts, citing a 30% decrease in inflation-adjusted physician payments over 20 years.

A Call for Political Engagement

Murphy urges physicians to get politically involved — not just by voting, but through advocacy and financial support. “Lawyers and businesspeople set aside money to give. Doctors don’t,” he says. “If we’re not engaged, people who have no damn clue will make the decisions for us.”

Though they didn’t agree on everything, both Murphy and Walker share a belief that medicine is more than a job — it’s a calling. “This job nearly killed me,” Walker admits, “but I f***ing love this job.”

Murphy nods. “I care more about your ability to have a life, but also to take care of patients, than anybody. But I’m also not willing to let people off the hook. If you want excuses, that’s not good patient care.”