HEALTH CARE un-covered

HEALTH CARE un-covered critically examines the U.S. healthcare system, particularly the impact of Medicare Advantage plans and the practices of major health insurers. It highlights issues like aggressive marketing, profit-driven decision-making, and the effects on patients' access to care and costs. The series advocates for transparency, regulation, and reform.

Medicare Advantage Plans Health Insurance Practices Healthcare Costs Patient Access to Care Healthcare Regulation Political Influence Healthcare Reform

The hottest Substack posts of HEALTH CARE un-covered

And their main takeaways

Universal Primary Care: The Antidote to Health Reform Paralysis?

559 implied HN points • 24 Sep 24
🏥 Health Politics Health care Public Policy Insurance Access Costs
  1. Universal primary care is important because everyone needs it, even healthy people. It helps with routine illnesses and preventive care.
  2. Primary care is cost-effective, making up a small part of total healthcare spending but providing great health benefits. Investing in primary care can save money in the long run.
  3. Starting with universal primary care could be a smart first step toward broader healthcare reform. It might gain more political support and lead to better health outcomes for everyone.

Ten States Have Held Out on Medicaid Expansion. It's Left Millions of Americans Without Health Coverage.

439 implied HN points • 23 Sep 24
🏥 Health Politics Medicaid Legislation Public Health
  1. Ten states have not expanded Medicaid, leaving millions of people without health coverage. These states have some of the highest rates of uninsured residents.
  2. Many people in the coverage gap are working but still can't afford health insurance. Their incomes are too high for Medicaid but too low for ACA subsidies.
  3. The refusal to expand Medicaid often comes from political choices, not a lack of need. Many residents want the expansion, but their state governments are not listening.

Bruised by Government Report, Cigna's Pharmacy Business Sues the Federal Trade Commission

579 implied HN points • 20 Sep 24
🏥 Health Politics Healthcare Reform Insurance Practices Drug Pricing Legal Challenges
  1. Cigna's pharmacy business, Express Scripts, is suing the Federal Trade Commission to challenge a report that claims they inflate drug prices and harm patients.
  2. The FTC's report has raised awareness about the power and practices of big pharmacy benefit managers, which control a large share of the market.
  3. Cigna is trying to protect its financial interests in pharmacy benefits, as they now make up a huge portion of the company's revenues, while also facing potential reforms from lawmakers.

The Dirty Trick Health Insurers Are Playing That You Don’t Know About

1199 implied HN points • 03 Sep 24
🏥 Health Politics Insurance Regulation Consumer Rights Healthcare Costs Health Reform
  1. Health insurers use a measurement called the medical loss ratio (MLR) to determine how much of your premiums go to actual medical care versus overhead costs. They should spend at least 80-85% on care, but many find sneaky ways to get around this.
  2. Big insurance companies manipulate what counts as 'quality improvement' to make it look like they're spending more on healthcare than they actually are. They might include things like software upgrades or marketing instead of just patient care.
  3. By buying up doctors' offices and clinics, insurers can steer patients to their own services without MLR rules applying. This way, they keep more money for themselves instead of lowering premiums or improving coverage for you.

Her Surgeon Said She Needed The Operation. UnitedHealthcare Said No.

899 implied HN points • 06 Sep 24
🏥 Health Politics Health care Insurance Issues Medical Ethics Patient Advocacy Policy Reform
  1. A woman named Robin needed a back surgery that her doctor recommended, but her insurance company, UnitedHealthcare, denied the request multiple times without clear explanations.
  2. The increasing number of denied medical procedures has led to significant financial issues for hospitals and has contributed to rising health care costs and bankruptcies.
  3. Robin's situation highlights a broader problem where insurance companies often prioritize profits over patient care, causing emotional and physical distress for those affected.
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Therapy Patients Stop Treatment After ‘Pre-Payment Reviews’ Swell

319 implied HN points • 18 Sep 24
🏥 Health Politics Healthcare access Insurance Issues Mental health Policy Impact Patient rights
  1. Many therapy patients are stopping their treatment because insurance company UnitedHealthcare is asking for a lot of extra paperwork before paying for services. This makes it hard for patients to get reimbursed and leads to anxiety about continuing their care.
  2. Therapists are feeling overwhelmed by the amount of time and effort needed to process these pre-payment reviews. Some have had to cut back on their schedules to handle the paperwork, which affects both their work and their patients' treatment.
  3. The situation highlights larger issues in mental health care access and billing, particularly for out-of-network providers. It raises concerns about patient privacy and adds unnecessary stress for both patients and therapists.

Important Reads: New Reporting Details Ghost Networks and Fighting Denials

499 implied HN points • 10 Sep 24
🏥 Health Politics Mental health Insurance Issues Patient Advocacy Healthcare access Policy Changes
  1. Many health insurance companies have 'ghost networks,' meaning they list providers that either don't exist or aren't seeing patients. This causes major problems for people needing help.
  2. Health insurers may not fix these ghost networks because it keeps their costs down. Fewer patients finding care means fewer claims they have to pay.
  3. If you're denied care by your health insurer, don't just accept it. It's important to push back and appeal their decisions to get the help you need.

New Netflix Horror Flick “The Deliverance” Tackles Medicaid Troubles, Medical Debt

599 implied HN points • 05 Sep 24
🏥 Health Politics Medicaid Medical Debt Health care Insurance Patient rights
  1. The movie 'The Deliverance' highlights the struggles of a family facing both a demonic presence and real-life issues with the U.S. healthcare system. It shows how complicated and scary healthcare can feel for many families.
  2. Many healthcare providers are dropping Medicaid patients, making it harder for those in need to find care. The film illustrates the true horror of loved ones having to pay medical bills out-of-pocket when Medicaid support is unavailable.
  3. Medical debt is a serious problem in the U.S., affecting countless families. The film ends with the family battling real financial burdens, reminding viewers that there's no easy fix for medical bills.

Project 2025’s Medicare Changes Would Restrict Older Americans’ Access to Care and Imperil the Program’s Financial Health

579 implied HN points • 29 Aug 24
🏥 Health Politics Medicare Healthcare Public Health Policy Insurance
  1. Project 2025 wants to make Medicare Advantage the main choice for people, but this could limit their healthcare options. Instead of giving patients more freedom, it may hand over more control to companies.
  2. Switching from Medicare Advantage back to traditional Medicare could become harder, which may trap people in plans that aren't right for them. This can lead to worse care for those who are sick.
  3. The changes could cost taxpayers billions and weaken Medicare's financial health. Instead of saving money, it might enrich insurance companies while jeopardizing the Medicare program's future.

America’s Seniors Are About to Pay a High Price for Wall Street’s Growing Disenchantment with Medicare Advantage

1139 implied HN points • 08 Aug 24
🏥 Health Politics Healthcare Insurance Medicare Finance Policy
  1. Many seniors using Medicare Advantage may soon face tough choices as big companies like Aetna and Humana say their plans aren't as profitable as expected. This could lead to changes that affect healthcare access and costs for those enrolled.
  2. As these companies look to boost profits, they may increase scrutiny on medical claims and require more approvals for treatments. This means patients could find it harder to get the care they need.
  3. Some seniors might end up losing their Medicare Advantage plans entirely, forcing them into new plans with less coverage and higher costs. This shift could leave many feeling trapped and worried about their healthcare options.

The Most Important Word in The Democratic Party Platform for Health care

659 implied HN points • 23 Aug 24
🏥 Health Politics Health Policy Insurance Medications Affordability Public Health
  1. The Democratic Party wants to expand healthcare benefits so that everyone can afford their medications, even those without insurance.
  2. Many people have gaps in their health coverage, which can be dangerous if they rely on medications like insulin.
  3. Including everyone in cost caps for medications can help prevent medical debt and save lives by ensuring people have access to necessary treatments.

Governor Tim Walz's Track Record on Medical Debt, Public Option, UnitedHealth Group

1059 implied HN points • 07 Aug 24
🇺🇸 U.S. Politics Health Policy Elections Medical Debt Insurance
  1. Governor Tim Walz has worked to make healthcare more accessible in Minnesota, leading to a drop in the uninsured rate. This means more people are getting the healthcare they need.
  2. Walz supports a public option for healthcare which aims to provide more choices and better coverage for citizens. This effort shows his commitment to improving the healthcare system.
  3. He is focused on reducing medical debt and drug costs, making healthcare fairer for everyone. His efforts include laws that help ensure people can access necessary care without financial worry.

Expect a Firehose of Obamacare Misinformation From Bad Actors, Insurance Industry Operatives

679 implied HN points • 19 Aug 24
🇺🇸 U.S. Politics Healthcare Policy Misinformation Legislation Elections
  1. There will be a lot of misinformation about Obamacare as the election approaches, particularly from bad actors and the insurance industry. It's important to stay informed about the truth.
  2. Obamacare has its supporters and critics, with Democrats generally praising it and Republicans trying to repeal it. Understanding both sides can help in making informed opinions.
  3. Many important protections for consumers are tied to Obamacare, like ensuring insurers cover everyone regardless of health. Recognizing these benefits is crucial in the debate over the law.

The New Death Panels: Health Care Rationing Via Delays And Denials

759 implied HN points • 13 Aug 24
🏥 Health Politics Healthcare access Insurance Issues Patient rights Public Health Policy advocacy
  1. Health insurance companies are creating delays and denials that harm patients' ability to receive care. Many people are missing out on necessary treatments because of these issues.
  2. A large number of doctors feel burnt out because of the complicated process of prior authorizations. This adds stress to their jobs and impacts their patients' health.
  3. To improve the situation, legislation and possibly legal action might be necessary. It's important to push for changes in how insurance companies operate to help both patients and doctors.

The U.S. Chamber of Commerce: From Fighting Obamacare to Defending Big Pharma

559 implied HN points • 20 Aug 24
🇺🇸 U.S. Politics Healthcare policy Lobbying Legislation Insurance Industry
  1. The U.S. Chamber of Commerce has a history of opposing health care reforms like Obamacare, fighting to protect the insurance industry's profits. Their actions have often prioritized big business over the needs of everyday people.
  2. Recently, the Chamber has also opposed Medicare's efforts to negotiate lower drug prices. They claim it will harm the pharmaceutical industry, but many seniors could benefit from cheaper medications.
  3. Overall, the Chamber does not represent small businesses or local interests as much as it represents large corporations. Their lobbying efforts highlight how some businesses prioritize profit over the well-being of the public.

UnitedHealth Group – a Real Life Majin Buu: The Art of Absorbing Everything in Sight

679 implied HN points • 14 Aug 24
🏥 Health Politics Healthcare policy Health Insurance Market dominance Corporate strategy Public Health
  1. UnitedHealth Group is a massive company that has grown by buying up other businesses in healthcare. This makes it very influential in many areas of the industry.
  2. Like the Dragon Ball Z character Majin Buu, UnitedHealth absorbs other companies to become stronger and extend its reach. This strategy helps them dominate the healthcare market.
  3. The unchecked power of companies like UnitedHealth can have serious consequences for regular people, leading to higher costs and fewer choices in healthcare.

While Cigna Saddles Patients with Increasing Out-of-Pocket Requirements, the Company Bought Back $5 Billion of Its Own Stock

959 implied HN points • 01 Aug 24
🏥 Health Politics Healthcare system Insurance policies Patient rights Prescription drugs
  1. Cigna spent $5 billion buying back its own stock while customers face rising healthcare costs. This shows a focus on profits over patient care.
  2. Cigna has lost nearly 500,000 health plan members after raising premiums, indicating they prioritize shareholder gains over customer retention.
  3. President Biden wants to limit out-of-pocket drug costs to $2,000 a year, which could help many Americans afford medications better. Insurers like Cigna may resist these changes but it could reduce unfair financial burdens on patients.

Republican Calculation: Don't Support Obama's Affordable Care Act

499 implied HN points • 21 Aug 24
🏥 Health Politics Health Reform Public Policy Misinformation Insurance Industry Bipartisanship
  1. The Affordable Care Act (ACA) was designed to help many people, especially those with preexisting conditions, get health insurance. However, there was a lot of confusion and misinformation surrounding it from the start.
  2. Many Republicans initially rejected working with Democrats on the ACA, believing it would help them in future elections by framing it as a 'government takeover of health care.' This strategy worked, as Democrats faced significant losses in the following elections.
  3. Despite the ACA being based on ideas that once had bipartisan support, misinformation continued to spread, making it harder for people to understand its actual impact and benefits over the years.

Inside The Trump-Affiliated Outfit Trying to Repeal The Affordable Care Act

559 implied HN points • 12 Aug 24
🇺🇸 U.S. Politics Health Policy Public Policy Healthcare Reform
  1. There's a group trying to repeal the Affordable Care Act, led by people connected to Trump. They believe that Obamacare has failed and want to make major changes.
  2. Bobby Jindal, a key figure in this group, argues that patients should have more control over their healthcare choices, but this could risk leaving some people without proper coverage.
  3. Critics say Obamacare has actually helped many Americans get health insurance, and there's evidence suggesting that healthcare costs have not risen as much as claimed by its opponents.

In life, Bill Pascrell Fiercely Bucked Health Insurance Giants During the ACA Debate. Today's Advocates Should See Him as Inspiration.

319 implied HN points • 22 Aug 24
🏥 Health Politics Health care Insurance Legislation Advocacy Public Health
  1. Bill Pascrell was a strong fighter for healthcare reform, especially during the Affordable Care Act debates. He believed everyone deserves access to healthcare.
  2. He worked tirelessly for first responders and survivors after 9/11, making sure they got the medical support they needed. His efforts led to important legislation for their care.
  3. Pascrell's legacy shows us the importance of standing up against powerful interests in healthcare. His commitment inspires others to continue fighting for a fair healthcare system.

Addressing Medical Debt Is Important. Addressing Its Root Causes Is Just As Essential.

679 implied HN points • 26 Jul 24
🏥 Health Politics Medical Debt Health care Policy Reform Political Advocacy Insurance Issues
  1. Medical debt is a serious issue affecting millions of Americans, even those with health insurance. It's important to address the immediate effects of this debt but also look at what causes it.
  2. Many families face the risk of losing their homes and filing for bankruptcy because of medical debt. This situation can have a lasting impact on future generations.
  3. There are calls for reforms, like capping out-of-pocket costs for medical expenses. It's crucial for leaders to support these changes to help reduce the burden of medical debt.

South Park Tackles Prior Authorization. It Would be Funny if It Wasn't so Damn Deadly.

699 implied HN points • 23 Jul 24
🏥 Health Politics Health care Insurance Patient rights Policy Reform
  1. South Park humorously shows how hard it is to get health insurance to pay for needed treatments. This reflects the frustrating challenges many people face with their own health insurance.
  2. Prior authorization is a process where insurance companies require approval before covering treatments or medications. This can delay care and even lead people to give up on getting the help they need.
  3. Many doctors and healthcare workers are overwhelmed by the amount of time spent dealing with insurance approvals. This adds costs to the healthcare system and can negatively impact patient outcomes.

Fifteen Years Ago Today I Became a Whistleblower

1039 implied HN points • 24 Jun 24
🇺🇸 U.S. Politics Health Policy Whistleblowing Insurance Industry Government reform Political Advocacy
  1. Becoming a whistleblower can be a big, brave step. It means standing up for what's right, even when it could hurt your career.
  2. Working in healthcare, some companies mislead the public and lawmakers. This can lead to serious consequences, like denying care to patients who need it.
  3. Transparency and honesty are vital in healthcare. Sharing insider knowledge can help push for important reforms and make the system better for everyone.

As UnitedHealth and Cigna are Sued for AI-Based Claims Denials, Documents Suggest Major AI Expansion

739 implied HN points • 11 Jul 24
🏥 Health Politics Healthcare policy Artificial Intelligence Legal issues Insurance Practices Patient rights
  1. UnitedHealth and Cigna are facing lawsuits for denying medical claims using a flawed AI system, which many believe does not work correctly. This has led to patients not receiving the care they need or having to pay high costs for care.
  2. Despite the lawsuits and public criticism, these companies plan to expand their use of AI in health care decision-making. They are investing more in technology, aiming for efficiency even at the risk of more denied claims.
  3. Experts warn that using AI in health care can leave patients feeling helpless and confused when their claims are denied. They believe that patients under AI-driven systems may struggle to advocate for their own health needs effectively.

Rx Exec on a Mission to Eliminate Unnecessary Middlemen and Slash Generics Spending

519 implied HN points • 25 Jul 24
🏥 Health Politics Healthcare access Insurance Practices
  1. Removing middlemen from the prescription drug process can help lower costs. These middlemen often increase prices unnecessarily, making medications more expensive for everyone.
  2. Generic drugs make up a large portion of prescriptions, yet many people don’t realize they often pay more for them due to the complicated pricing system in healthcare. Focusing on providing generics can make medications more affordable.
  3. There's a need for more transparency in how drug benefits are designed for employers. By simplifying the system and cutting out extra layers, businesses can save money on prescription costs.

Private Medicare Plans and Vertical Integration Yield UnitedHealth $15.8 Billion in Profits Between January and June

619 implied HN points • 16 Jul 24
🏥 Health Politics Healthcare policy Insurance Practices Medicare Advantage Corporate Governance
  1. UnitedHealth made a massive profit of $15.8 billion in just six months by using strategies to boost its income from private Medicare plans. This shows how profitable these plans can be for insurance companies.
  2. The company has been increasing its earnings by owning many of the doctors and clinics its patients visit. This vertical integration gives them more control and helps them profit more from the services they provide.
  3. UnitedHealth has found ways to maximize its Medicare Advantage funding by misreporting patient conditions. This has earned them billions from the government, which has raised questions about their practices.

As it Turns Out, Health Insurance Executives Are Really (Really) Good at Their Jobs

799 implied HN points • 01 Jul 24
🏥 Health Politics Healthcare system Insurance Issues Patient Care Healthcare Costs Corporate Governance
  1. Health insurance executives are focused on making their shareholders happy, which often means keeping costs low for employers, not necessarily improving services for patients.
  2. In health insurance, the customer who pays for the insurance and the consumer who uses it are different, creating conflicts of interest that can harm patients.
  3. Insurance companies often make it difficult for those who need the most care to access it, which is counterproductive for the patients who genuinely need help.

A Former Republican Lawmaker’s Constant Fight with UnitedHealthcare’s Medicare Advantage Plan to Stay Alive

759 implied HN points • 26 Jun 24
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy Chronic Illness Medicare Disability Rights
  1. Healthcare can be a huge struggle, especially when battling a serious illness. Many people might face denied coverage and have to fight tirelessly for the treatments they need to survive.
  2. Financial strain can impact access to necessary medical treatments. Some individuals may even resort to fundraising or selling personal belongings to cover their medical costs.
  3. Certain Medicare Advantage plans can limit access to essential care and providers. This can be frustrating for those who need specialized treatments, forcing them into difficult situations.

While an Insurance Industry Front Group Pushes Against Medicare Advantage Scrutiny, Rural Hospitals Remain Unswayed

599 implied HN points • 08 Jul 24
🏥 Health Politics Healthcare policy Insurance Issues Medicare Patient Care
  1. Medicare Advantage plans are being pushed heavily by some insurance groups, but many rural hospitals are rejecting these plans due to issues like payment delays and limited coverage.
  2. Reports show that people on Medicare Advantage can face higher out-of-pocket costs and less access to necessary care compared to those on traditional Medicare.
  3. Many rural hospitals are opting out of Medicare Advantage altogether, indicating that this choice may leave beneficiaries with fewer options and potentially lead to financial burdens.

FTC: Big Insurance’s PBMs “Profit at the Expense of Patients by Inflating Drug Costs and Squeezing Main Street Pharmacies"

579 implied HN points • 09 Jul 24
🇺🇸 U.S. Politics Healthcare policy Regulatory Affairs Insurance Industry Consumer Advocacy
  1. Big insurance companies and pharmacy benefit managers (PBMs) are making money by increasing drug prices and hurting small pharmacies. This means patients often pay more for their medications.
  2. The FTC found that just six companies control most of the pharmacy benefit market, limiting options for patients and squeezing independent pharmacies.
  3. Many people struggle to afford their medications, with some saying they skip doses because of high costs. This shows the serious impact of PBMs on healthcare access.

Insurers and Private Equity Look to Join Forces to Further Consolidate Control of Americans' Access to Health Care

759 implied HN points • 19 Jun 24
🏥 Health Politics Healthcare system Insurance Private Equity Regulation Bipartisan Politics
  1. Insurance companies and private equity firms are teaming up to gain more control over healthcare access for Americans. This partnership can lead to less competition and more power in deciding patient care.
  2. The trend of private equity buying up medical practices is rising, and this shift could make it harder for independent doctors to operate. Insurance companies are noticing this and are looking to profit from these partnerships.
  3. As more people enroll in Medicare Advantage plans, insurers like CVS/Aetna are pushing to own key healthcare services. This could steer patient referrals to their own facilities, limiting choices for patients.

Confessions of a Recovering Managed Care Executive

839 implied HN points • 10 Jun 24
🏥 Health Politics Healthcare policy Insurance Public Health
  1. Working in managed care, the focus is often on lowering costs rather than ensuring quality care. This can make it hard for executives to feel good about their roles.
  2. A turning point in his career came when a doctor reminded him of the real people affected by profit-driven decisions. It made him reevaluate his path.
  3. Leaving the for-profit insurance world was tough financially, but it became the best career choice for him. He now helps doctors get fair contracts and values the work he does.

Medicare Advantage's $64 Billion Supplemental Benefits Slush Fund

999 implied HN points • 28 May 24
🏥 Health Politics Medicare Health Policy Insurance Health Equity
  1. Medicare is spending around $64 billion on extra benefits for Medicare Advantage plans, like dental and vision care. But we don't really know if people are actually using these benefits.
  2. Many seniors are drawn to Medicare Advantage plans for these added perks, but some end up losing access to their preferred doctors. It's important to understand what you're giving up when switching plans.
  3. There's a growing call to improve how Medicare Advantage plans operate and to provide similar benefits to those in traditional Medicare. Everyone should have access to the same quality of care and benefits.

Medicaid and Medicare Claims Managed by Insurers Are Rising. Why Aren’t They Worried About Their Profits?

819 implied HN points • 11 Jun 24
🏥 Health Politics Healthcare policy Insurance Practices Medicaid Medicare Profit Margins
  1. Insurers are seeing more claims for Medicaid and Medicare, but they aren't worried about profits. This is surprising to many people looking at the rising costs.
  2. Insurance companies can limit patient care by using tactics like prior authorization, which makes it hard for people to get needed treatment. This helps them keep their profits high.
  3. Medicare Advantage plans allow insurers to charge seniors more out-of-pocket costs. Insurers do this to maximize their profits while still getting a steady payment from the government.

IMPACT: After HEALTH CARE un-covered’s Reporting, Medicare Profiteer Shuts Down

659 implied HN points • 17 Jun 24
🏥 Health Politics Health care Medicare Insurance Regulations Fraud
  1. A health insurance company known for misleading advertising has shut down after reports revealed their shady practices. This is good news for Medicare and its beneficiaries.
  2. The government made new rules to protect seniors from aggressive marketing tactics that this company used. These changes likely contributed to the company's downfall.
  3. Even though the company is gone, there's still a problem with how commissions are set up, which may still push seniors towards less beneficial Medicare plans.

Confronting the Dangers of Artificial Intelligence in Health Care is Imperative

359 implied HN points • 17 Jul 24
🏥 Health Politics AI risks Regulation Patient rights Health Equity Privacy
  1. AI in health care needs more rules to keep patients safe. Governments must step up to protect people from potential problems with these technologies.
  2. It's important to make AI decisions clear and understandable for patients. Patients should have the right to ask for a human to review any decision that affects their care.
  3. We need to ensure AI doesn't make health care inequality worse. AI programs should reflect diverse patient groups and focus on fairness, not just existing biases.

Medicare Advantage Insurers Hurt You Because Their Profits Depend On It

739 implied HN points • 05 Jun 24
🏥 Health Politics Healthcare policy Insurance Medicare Patient Care Public Health
  1. Many seniors using Medicare Advantage plans face serious obstacles, like having limited access to doctors. This can lead to long travel times and difficulties in getting proper care.
  2. These plans often require a lot of extra steps to approve treatments, causing frustrating delays for patients in need of immediate attention. It can take weeks or months to get the care they need.
  3. Switching from Medicare Advantage back to traditional Medicare can be tricky and risky. Many people may find they can’t get the additional coverage they need after becoming sick, thus leaving them stuck in a difficult situation.

Nightmare on Wall Street for Medicare Advantage Companies

1498 implied HN points • 05 Apr 24
🏥 Health Politics Medicare Insurance Healthcare Government Finance
  1. Medicare Advantage companies are struggling as Wall Street is disappointed with payment increases from the government. The payment increase for 2025 was lower than what these companies wanted.
  2. Insurers like Humana and UnitedHealth have seen their stock prices drop significantly, losing billions in market value. This fall has been alarming to investors who were used to seeing these companies perform well.
  3. The Medicare Advantage sector may look to influence politics by supporting candidates who favor their interests. Companies are likely to invest heavily in campaigns to get more favorable treatment in the future.

Celebrating Medicare’s 59th Birthday Amidst Troubling Trends

259 implied HN points • 30 Jul 24
🏥 Health Politics Healthcare policy Medicare Insurance Public Health
  1. Medicare has helped millions of seniors access health care since it started 59 years ago. It was created to ensure older people could get medical services without going broke.
  2. Medicare Advantage plans, run by private companies, often cause more problems than they solve. They can lead to higher costs and less access to care for seniors.
  3. Big health insurers are getting extra money from the government through Medicare Advantage, which is hurting the traditional Medicare system. Regulators are now starting to pay attention and could help protect this important program.

CVS CEO to Wall Street: People in Medicare Advantage Are in for a World of Hurt as We Focus on Profits

919 implied HN points • 13 May 24
🏥 Health Politics Healthcare policy Medicare Insurance Patient Advocacy
  1. CVS Health is under pressure to boost profits, which may lead to reduced coverage for Medicare Advantage plans. This means people might not get the treatments their doctors recommend.
  2. Expect higher premiums and limited benefits as CVS plans to adjust its Medicare offerings to make more money. Many seniors could find themselves losing access to necessary care.
  3. The changes happening now in Medicare Advantage could disrupt healthcare for many. Once someone is dropped from these plans, it can be tough for them to find affordable alternatives.