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I have personal reasons to distrust the medical establishment, but trying to read this subject article is difficult. Can you summarize the thrust of the argument?

As I understand it, the main idea is that the (U.S.) pharmaceutical industry has been covering up hundreds of thousands of deaths and other adverse effects in their drug trials, using bogus statistical analysis to fool everyone about the efficacy of their drugs, and colluding with government agencies to disallow any alternatives. Thus, we should be immensely distrustful of any and all "evidence-based" medical information, and we should spread this idea in order to convince people to rebuild the medical establishment from the ground up. (I don't personally endorse this argument.)

I don't follow him that closely so maybe he has, but I haven't seen Marinos himself make anywhere near so strong a claim as "covering up hundreds of thousands of deaths, using bogus statistical analysis to fool everyone".

I think his thesis in all this has been "if you judge many accepted findings by the same standards by which plausibly-for-other-reasons-disfavored findings have been dismissed, a lot of it wouldn't hold up".

ie Beware Isolated Demand For Rigor

I don't follow him that closely so maybe he has, but I haven't seen Marinos himself make anywhere near so strong a claim as "covering up hundreds of thousands of deaths, using bogus statistical analysis to fool everyone".

Reading this post, it would appear that Marinos is trying to endorse this viewpoint. He uncritically refers to Gøtzsche "explaining how prescription drugs are the third leading cause of death", which would add up to hundreds of thousands of deaths annually when applied to mainstream leading-cause-of-death tables. Marinos doesn't really add much additional analysis in this post, likely because it was adapted from a Twitter thread. Also, Marinos quotes an author that blames "evidence-based medicine" practitioners for propagating lies that line the pharmaceutical industry's pockets, and he himself blames government agencies for making policy decisions based on "evidence-based medicine" during the COVID-19 pandemic; I'd assume that the pharmacetical companies (and those colluding with them) are to be interpreted as the ultimate liars. Marinos only seems to back off slightly from the accusations in his conclusion.

So Ivermectin Guy is basing his rant on one single source who seems to be an axe-grinder about the medical profession, mostly because it fits in with his biases about Big Pharma and Big Medicine hiding, downplaying or lying about the efficacy of the Miracle Covid Cure Ivermectin?

Colour me surprised at the methodology on display here.

The claims of hidden deaths in particular seem to come entirely from Gøtzsche. The rest of the sources mainly discuss the replication crisis in medical efficacy, alongside their various preferred solutions. Marinos blames the authorities and medical profession for making decisions based on flawed research to further their own ends, against the interest of the public. Personally, I think that Marinos takes his claims of conspiracy much farther than the evidence would justify; if a reader holds Scott's evaluation of orthodox medical information as generally trustworthy (modulo regulatory friction preventing effective drugs from being sold and preventing promising drugs from being tested, and new drugs' efficacy relative to their predecessors being oversold), this post in particular isn't going to change their mind, since beyond the standard replication-crisis stuff it's mostly an appeal to heterodox authorities such as Gøtzsche and Charlton.