What happens when you run health care like a fast-food chain? You get America’s largest for-profit hospital system: HCA Healthcare. This is the story of how a pitch for Kentucky Roast Beef—KFC’s roast beef expansion—ends with a few billionaires and a broken health care system.

Today HCA operates 182 hospitals nationwide, many of which are the only health care provider in their locality–so in lots of cases, if you want to live you must trust HCA.

But even if you don’t rely on an HCA hospital, your life is deeply affected by what the Frist family has done in the name of enriching themselves and their shareholders: manipulating American health care policy in a way that helps them and hurts everyone else.

We dug into how the Frists, and their pitch for Kentucky Roast Beef, broke the American health care system.