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

Insurers using AI and algorithms to deny claims; Sen. Elizabeth Warren calls on Biden to address Medicare Advantage profiteering

299 implied HN points • 04 Apr 23
🇺🇸 U.S. Politics Health Policy Insurance Reform Technology impact Government Action
  1. Insurance companies are using AI to deny a lot of claims quickly without human checks. This means many people might not get the coverage they need.
  2. Senator Elizabeth Warren is pushing for action against Medicare Advantage plans that are making huge profits while not providing necessary care. She's highlighting the need for better oversight.
  3. The healthcare system can be very confusing and stressful, especially for those who are sick. Navigating it feels even tougher when you’re not feeling well.

Doctors and patients raise alarm about prior authorization

319 implied HN points • 01 Feb 23
🏥 Health Politics Healthcare Insurance Patient Care Policy Medical Ethics
  1. Prior authorization can cause major problems for patients, leading to delays or denials of necessary treatments. This can sometimes result in serious health issues or even death.
  2. A lot of doctors believe that the prior authorization process actually worsens care for patients. Most doctors say these requirements can make patients abandon their treatment plans.
  3. Insurance companies aren't really cooperating with doctors to fix these issues. This makes it hard for patients to access the care they really need.

The American Health Care System is on the Brink of Collapse: How the Center for Health & Democracy Will Help Us Fix It

319 implied HN points • 31 Jan 23
🏥 Health Politics Health care Insurance Health Reform Medical Debt Legislation
  1. The American healthcare system is failing, with many people struggling to get the care they need while insurance companies make huge profits.
  2. The Center for Health & Democracy aims to expose issues in the insurance industry and work for meaningful reforms to help improve healthcare access and affordability.
  3. Many Americans are dealing with high medical costs and debt, and there is a growing need for significant changes to ensure everyone gets proper healthcare without financial burden.

Big Insurance in-fighting: why it's so important that Cigna is suing CVS

319 implied HN points • 30 Jan 23
🏥 Health Politics Insurance Healthcare Lawsuit Regulation
  1. Cigna is suing CVS to stop them from hiring a former executive, citing a non-compete agreement. This shows how competitive the big insurance companies are over valuable staff.
  2. Pharmacy benefit managers (PBMs) are key players in health insurance, making more money than some health plans. They act as middlemen between patients and drug companies, but their operations are often unclear.
  3. Both political parties are focusing on reforming PBMs because they're seen as raising drug costs. There's growing legal pressure and proposed bills aimed at improving transparency and fairness in their practices.

Welcome to HEALTH CARE un-covered (formerly Wendell Potter NOW)

319 implied HN points • 27 Jan 23
🏥 Health Politics Health care Insurance Policy Reform Medical Debt Patient Advocacy
  1. Many patients are struggling with high medical costs and debt, making it hard for them to get the care they need. Even those with insurance often end up underinsured and facing high out-of-pocket expenses.
  2. Big insurance companies are reporting record profits while many people still lack proper coverage or are pushed into bankruptcy due to healthcare costs. This shows a big gap in the current healthcare system.
  3. There's a push for more transparency in healthcare costs and a call for reforms to create a fairer system. The aim is to educate both the public and lawmakers about the issues and to find better solutions together.
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"Confessions of a Former Carrier Executive": my keynote address at the 2023 YOU Powered Symposium

279 implied HN points • 17 Feb 23
🏥 Health Politics Health Insurance Policy Making Public Health Healthcare Costs Corporate ethics
  1. Big health insurance companies mainly focus on making their shareholders richer, often at the expense of patients.
  2. The speaker shared personal experiences from a career in the industry, highlighting the luxury lifestyle financed by policyholders and taxpayers.
  3. Despite record profits for insurance companies, many American families remain uninsured or underinsured.

UnitedHealth, CVS/Aetna, Cigna pulled in close to a trillion dollars last year, mostly as drug middlemen

279 implied HN points • 09 Feb 23
🏥 Health Politics Pharmaceuticals Insurance Healthcare Costs Market Dynamics Public Policy
  1. Three major companies, UnitedHealth, CVS/Aetna, and Cigna, are now making most of their money from being middlemen in the prescription drug market rather than from selling health insurance. This means they control a big part of how much patients pay for their medications.
  2. In 2022, these companies earned over $492 billion from their pharmacy benefit management (PBM) services, showing that this part of their business is growing much faster than their health insurance offerings.
  3. These companies are expanding into primary care services, like buying healthcare centers, as they face slower growth in their health insurance segments. This shift suggests they are looking for new ways to make profits amid tougher competition.

LIFE AND DOLLARS: a health care insider's account of how prior authorization really works.

239 implied HN points • 07 Feb 23
🏥 Health Politics Healthcare system Insurance Issues Patient Advocacy Cost management Policy Impact
  1. Prior authorization was meant to reduce unnecessary medical procedures, but it's often causing more problems than it solves. Patients and doctors face delays and frustrations, and the process doesn't save as much money as expected.
  2. Health insurers are spending a lot on middlemen and outsourcing prior authorization, which drives up health care costs. These companies often prioritize profits over patient care.
  3. Many patients don't understand how prior authorization affects their care, leading to confusion. It's important for employers and patients to be informed and communicate better about these requirements to avoid frustrations.

U.S. women enrolled in high-deductible health insurance plans are at risk of dying younger

199 implied HN points • 13 Mar 23
🏥 Health Politics Healthcare access Women's Health Racial Disparities Policy Impact
  1. Women with high-deductible health insurance plans face a greater risk of dying younger because they may not afford the care they need. This is especially true for those diagnosed with serious illnesses like breast cancer.
  2. Studies show that women in high-deductible plans are less likely to stick to their treatment due to high out-of-pocket costs, which can lead to worse health outcomes.
  3. There's a significant racial disparity in health outcomes for women with cancer in high-deductible plans, particularly affecting Black women who are less likely to receive necessary treatment compared to other groups.

NYC Mayor Adam wants to move retirees into so-called Medicare Advantage plans. See my testimony against it.

239 implied HN points • 10 Jan 23
🏥 Health Politics Healthcare policy Medicare Public Health Political Advocacy
  1. Medicare Advantage plans are not truly Medicare, and they don't really benefit many people. These plans are designed more for profit than for helping retirees.
  2. Insurers are making a lot of money by making Medicare Advantage plans look better than they really are. They're getting extra tax dollars because they claim people are sicker than they are.
  3. The move to push retirees into these plans will primarily help insurance companies earn more money, not improve the health of retirees. This decision can hurt many people financially.

How prior authorization can kill: a 2-year-old with cancer; a young woman needing chemo; and a 17-year-old in need of a transplant

219 implied HN points • 02 Feb 23
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy Medical treatment Government Policy
  1. Prior authorization is a process where insurance companies must approve treatments before they happen. This can delay or deny care, leading to serious health consequences.
  2. Patients and their advocates should not accept a denial as the final answer. Speaking out or getting media attention often leads to faster approvals for necessary treatments.
  3. The system is flawed, as people need to fight for coverage, and even then, unexpected bills can still arise. It's important to be proactive and challenge initial denials.

Consolidations and profiteering: the relentless rise of hospital expenditures

199 implied HN points • 02 Mar 23
🏥 Health Politics Healthcare Costs Health Policy Pharmaceuticals
  1. Hospital expenditures are rising quickly, with costs expected to reach $2.2 trillion by 2030. This growth is leading to financial burden on patients and families.
  2. Many factors contribute to these rising costs, including wasteful administrative expenses and high-priced medicines. Administrative costs alone can make up 15-30% of the health-care spending.
  3. One big reason for higher hospital prices is consolidation through mergers, which leads to less competition and price increases. Most areas now have only a few hospital options which can drive prices up by over 20%.

The price of health insurance has increased 24% over the last year

299 implied HN points • 04 Oct 22
🏥 Health Politics Insurance Costs Policy Healthcare Inflation
  1. Health insurance prices went up by 24% over the last year, which is a much bigger increase than most other expenses like food or gas.
  2. While the cost of medical services only rose by around 5.6%, health insurance continues to climb, indicating issues with insurers' pricing.
  3. Deductibles and out-of-pocket costs have also significantly increased, and future premium hikes are expected, putting more financial pressure on families.

NYC mayor’s misguided and dangerous plan to move city retirees into a private Medicare replacement plan dealt another blow

219 implied HN points • 18 Jan 23
🏥 Health Politics Health Policy Medicare Public Health Healthcare Costs
  1. New York City retirees are fighting against a plan to move them to a private Medicare replacement that could limit their healthcare options. Many retirees feel this plan is risky and unnecessary.
  2. Recent opposition resulted in the city council not voting on the mayor's proposal, showing that collective action can influence decision-makers. The retirees are determined to continue their fight, even if it means taking legal action.
  3. The mayor's plan could lead to increased healthcare costs and less choice for retirees. There are suggested ways for the city to save money without cutting benefits, like conducting audits and improving its own systems.

I just caused a long line at the pharmacy counter. And still paid $141 for an inhaler.

399 implied HN points • 18 May 22
🏥 Health Politics Healthcare access Insurance Policy
  1. Healthcare costs in the U.S. can be confusing and expensive, even for generics that are supposed to be cheaper. Sometimes, you end up paying more for generics than for brand-name drugs.
  2. Many people don’t realize they might get cheaper medication prices through services like GoodRx instead of their insurance. This can lead to significant savings on prescriptions.
  3. The Medicare Modernization Act has complicated Medicare drug coverage and prevents Medicare from negotiating drug prices, leading to greater financial burdens for many Americans.

The health care injustices that Dr. King spoke about are still here. And growing.

219 implied HN points • 16 Jan 23
🏥 Health Politics Health Inequality Healthcare access Public Health Social justice
  1. Healthcare inequalities that Dr. King talked about are still a big problem today. Many people, especially in low-income areas, can't get the medical care they need.
  2. Emergency departments are becoming overcrowded because people can't find regular doctors. This leads to dire situations where even minor issues turn into urgent needs.
  3. Despite the suffering in poorer neighborhoods, big health insurance companies are making huge profits. This creates a larger gap in healthcare access for those who need it most.

What I'm Reading: Cigna's 2022 earnings; ProPublica's prior authorization series

199 implied HN points • 03 Feb 23
🏥 Health Politics Healthcare Insurance Policy Profits Investigations
  1. Insurance companies like Cigna are making a lot of money by acting as middlemen in the drug supply chain, especially after acquiring pharmacy benefit managers.
  2. Cigna's profits increased significantly in 2022, partly because they paid out less for medical claims compared to previous years.
  3. Instead of lowering costs for customers, Cigna is using its profits to buy back its own stock, which primarily benefits shareholders.

Elevance Health's 2022 earnings are in, outperforms Wall Street expectations

199 implied HN points • 25 Jan 23
💰 Finance Earnings Investments Health Insurance Stock Market Government programs
  1. Elevance Health did really well in 2022, exceeding what Wall Street expected for their earnings. Their stock prices went up, even when many other companies were struggling.
  2. Most of Elevance's profit came from government programs like Medicaid and Medicare Advantage, not from selling insurance to individuals or businesses. These programs are where they made the most money.
  3. The company's pharmacy business, CarelonRX, also saw significant profit growth. This shows that owning a pharmacy service is becoming very important for insurance companies.

A decade-long look at how Big Insurance profiteers American taxpayers and the sick.

399 implied HN points • 04 Apr 22
🏥 Health Politics Insurance Healthcare Policy Profit Regulation
  1. Big insurance companies have grown a lot in size and profit over the last decade, primarily through mergers and getting more government contracts. They now make a lot of money, with profits reaching over $60 billion last year.
  2. Most of the increase in people under these insurance companies comes from government programs like Medicare and Medicaid, not from private insurance. Taxpayers are indirectly supporting these companies even if they don't use their plans.
  3. Insurance companies are shifting more costs onto patients, leading to higher out-of-pocket expenses and making it hard for many to afford care. This is resulting in more people being underinsured and potentially struggling with medical debt.

NYC's call to move retirees to a Medicare Advantage plan is being opposed by a 9/11 hero. She's backed by hundreds of retirees.

199 implied HN points • 17 Jan 23
🏥 Health Politics Healthcare Medicare Policy Retirement Insurance
  1. A retired EMT, Marianne Pizzitola, is fighting against NYC's plan to move retirees to a Medicare Advantage plan. This change could hurt many retirees and reduce their healthcare coverage.
  2. Retirees are concerned that Medicare Advantage plans may limit the care they receive. These plans can require approvals for necessary treatments, which can delay or deny important medical care.
  3. The fight against the Medicare Advantage plan is uniting many retirees from different backgrounds and political views. They all agree that retirees deserve better healthcare options and shouldn't be forced into a plan that may not serve their needs.

The majority of big insurers' health plan revenues are subsidized by American taxpayers

279 implied HN points • 07 Sep 22
🏥 Health Politics Insurance Medicare Subsidies Policy Government
  1. Most big health insurers, like UnitedHealth, get a large part of their money from taxpayer funds, not from private customers. This shows how our tax dollars support these companies.
  2. Many insurers focus on getting more Medicare Advantage enrollments because the government pays them good money for it. This has become a major source of profit for them.
  3. Despite receiving big subsidies, many people using ACA marketplace plans still face high out-of-pocket costs, making them effectively under-insured. This means they might struggle to afford healthcare even with insurance.

UnitedHealth Group's 2022 Earnings are in, PBM Optum outperforms health insurance division

199 implied HN points • 13 Jan 23
🏥 Health Politics Healthcare policy Insurance Industry Pharmacy Benefits Profit Margins
  1. UnitedHealth Group's pharmacy benefit manager, Optum, is now making more profits than its health insurance division. This shows a big shift in how these companies are making money.
  2. Over the past decade, Optum has seen huge growth in both revenue and profits, while the health insurance side has not grown as fast. This tells us where the real money is for these companies now.
  3. Many major companies, like Cigna and CVS, are also finding their profits mainly from managing drug supplies instead of just selling health insurance. This shows a trend in the healthcare industry where drug supply roles are becoming more profitable.

As health insurance premiums and out-of-pocket obligations increase, so does the number of Americans who are “functionally uninsured”

239 implied HN points • 03 Nov 22
🏥 Health Politics Insurance Costs Policies Coverage
  1. Health insurance costs are rising quickly, with family premiums increasing by 43% over the last decade. This makes healthcare harder to afford for many families.
  2. More people have to pay larger out-of-pocket expenses before their insurance starts helping. On average, these costs have gone up by 61% in the past 10 years.
  3. Small businesses struggle the most with these high costs and many are no longer offering health insurance benefits to their employees, leaving more people without proper coverage.

Hospital megasystems join insurers in a pattern of mergers and acquisitions, patients pay the price.

239 implied HN points • 27 Sep 22
🏥 Health Politics Healthcare system Medical Debt Health Insurance Patient rights Policy Reform
  1. Many hospital systems are merging with insurers, making healthcare more expensive for patients. This means folks often end up paying out-of-pocket costs that can be shockingly high.
  2. Patients with insurance are still struggling financially due to high deductibles. Even insured people can find themselves unable to afford medical bills, leading some to sell their homes or declare bankruptcy.
  3. There is a growing concern that hospital mergers are not improving care or lowering costs. Policymakers are being urged to look at how these changes are affecting patients and the overall healthcare system.

Sen. Blackburn (R-TN) used the "socialism" trope. It proves she doesn't know her history about Tennessee.

239 implied HN points • 31 Aug 22
🇺🇸 U.S. Politics Political History Government programs Political criticism Public Policy
  1. Senator Blackburn claims Tennesseans don't want socialism, but many benefit from government programs like the Tennessee Valley Authority. This program has provided jobs and improved living standards in Tennessee.
  2. The Tennessee Valley Authority (TVA), created during the New Deal, was seen as 'socialism' but has had a positive impact on the community for many years. It helped people get jobs and electricity.
  3. The history of programs like the TVA shows that what some label as 'socialism' can actually lead to progress and improve lives. It's important to consider the benefits of such programs.

A closer look: what you need to know about insurance companies' and PBMs' "copay accumulator" scheme

159 implied HN points • 20 Jan 23
🏥 Health Politics Insurance Issues Patient Advocacy Legislation Pharmaceuticals Chronic Illness
  1. Copay accumulators are a practice where insurance companies and pharmacy benefit managers (PBMs) do not count patient discounts towards their deductible. This forces patients to pay more out of pocket for expensive medications later in the year.
  2. Many patients, especially those with chronic illnesses, are impacted by these accumulators, facing higher healthcare costs that can lead to stress and difficult financial choices. Advocacy groups are working to raise awareness and ban this practice.
  3. Insurance companies argue copay accumulators help control drug costs, but many believe it's just a way to make more money at patients' expense. Some states are taking steps to ban it, but many patients still lack protection.

CVS/Aetna's $9 billion in profits paid for a lavish party and stock buybacks. Not patients' medical claims.

239 implied HN points • 10 Aug 22
🏥 Health Politics Healthcare access Corporate Profits Patient Advocacy Medical Debt Insurance Industry
  1. CVS/Aetna made $9 billion in profits, which they used for parties and buying back stocks, not helping patients with their medical costs.
  2. Many patients are struggling with high out-of-pocket medical expenses, leading them to seek help through crowdfunding platforms like GoFundMe.
  3. Executives at CVS/Aetna are making huge salaries, while the company is spending less on actual patient care, raising concerns about corporate priorities in healthcare.

Biden is continuing Trump's privatization of Medicare. Here's what you need to know.

259 implied HN points • 29 Jun 22
🇺🇸 U.S. Politics Health care Health Policy Medicare Privatization Government programs
  1. Biden is following Trump's lead by continuing a program that privatizes Medicare. This shift is concerning because it can affect seniors' healthcare options.
  2. Many seniors might be moved into profit-driven Medicare plans without realizing it. This could limit their access to care and services.
  3. Critics argue that allowing private equity and insurance companies into Medicare will make them more focused on profits than on providing quality healthcare to seniors.

EXCLUSIVE: UnitedHealth Group made $81 billion in revenues during Q3 2022, billions subsidized by American tax dollars

199 implied HN points • 14 Oct 22
🇺🇸 U.S. Politics Health Policy Corporate Influence Insurance Industry Economic Impact
  1. UnitedHealth Group's revenues hit $81 billion in just one quarter of 2022, showing a huge profit increase over the last decade. Despite this, they have fewer people enrolled in private health plans compared to ten years ago.
  2. Many Americans are facing higher medical costs, including premiums and out-of-pocket expenses, with UnitedHealth contributing to this inflation. This means more financial strain on people, especially those with employer-sponsored insurance.
  3. The growth of UnitedHealth's Medicare and Medicaid plans highlights how private insurers are benefiting from government-funded healthcare. This creates concerns about fairness and access to care for low- and middle-income Americans.

Here is what you need to know in healthcare this week.

279 implied HN points • 20 May 22
🏥 Health Politics Healthcare Costs Insurance Issues Medicare Policy Impact Public Health
  1. Insulin prices have skyrocketed, and many diabetics are struggling to afford it. In fact, out-of-pocket spending for insulin doubled from 2007 to 2019 for those on Medicare.
  2. High-deductible health plans are making it harder for low-income workers to get preventative care. People earning less than $75,000 a year often avoid necessary medical check-ups due to high costs.
  3. Private insurers are paying much more for healthcare services than Medicare, which leads to higher premiums for consumers. This shows that privatizing healthcare isn't necessarily better for controlling costs.

What I'm Reading: PBM front groups, Biden on prior authorization and American's $88 billion medical debt problem

139 implied HN points • 15 Feb 23
🏥 Health Politics Healthcare Reform Medical Debt Insurance policies
  1. Pharmacy Benefit Managers (PBMs) have a big impact on drug prices, often leading to high out-of-pocket costs for patients. Many people don't know much about PBMs, and there's a push to educate more on their role in the healthcare system.
  2. Big insurance companies are under scrutiny for using front groups to lobby against healthcare reforms. These groups aim to protect their profits, especially in areas like Medicare Advantage plans, while avoiding direct public backlash.
  3. Prior authorization is increasingly being criticized for delaying medical care due to insurance companies denying necessary treatments. Both the Biden administration and many states are looking to reform this process to improve access to care.

A CLOSER LOOK: The Mid Year Earnings of 7 Big For-Profit Insurance Companies

219 implied HN points • 16 Aug 22
🏥 Health Politics Insurance Medicare Medicaid Profitability Government funding
  1. The largest for-profit insurance companies made $43.8 billion in profits and had $620.6 billion in revenue, mostly from taxpayer money. This shows how much they benefit financially from government programs.
  2. Three major insurers control 80% of the pharmacy benefit market. This means they have a huge influence over how prescription medications are managed and priced.
  3. A large number of Americans are underinsured, with 43.4% lacking sufficient coverage. This highlights a growing issue in healthcare, where many people struggle to afford medical care despite having insurance.

Wall Street to Elevance (formerly Anthem) Executives: Stop paying medical claims... or else.

219 implied HN points • 22 Jul 22
🏥 Health Politics Healthcare system Insurance Issues Healthcare Costs
  1. Insurance companies are increasing out-of-pocket costs to avoid paying medical claims. This means patients end up paying more, making healthcare less affordable.
  2. Wall Street puts pressure on insurers to keep profits high, which can lead to practices like denying claims or raising premiums. This can hurt many people who need insurance.
  3. Many Americans with insurance are still in medical debt because of high out-of-pocket expenses. Even those with coverage can find it hard to get the care they need without facing huge bills.

Interested in the U.S. health care system? Here's what you need to know going into 2023.

139 implied HN points • 12 Jan 23
🏥 Health Politics Health care Insurance Policy Advocacy Medicare
  1. Pharmacy Benefit Managers (PBMs) are under scrutiny in Congress, with both political parties examining their roles in rising healthcare costs. It's important for patient advocates to educate lawmakers on the real impacts of PBMs.
  2. Health insurance benefits have been decreasing over the years, making care less affordable for many Americans, especially women. People are paying higher premiums but getting less coverage now than in the past.
  3. Rural areas face significant challenges in accessing healthcare, especially with transportation. Lack of options for medical transport can make it hard for patients in these regions to attend necessary appointments.

NEW: Rep. Khanna, Rep. Pocan and I go after Medicare Advantage in The Nation

139 implied HN points • 28 Dec 22
🇺🇸 U.S. Politics Healthcare Legislation Fraud Insurance Advocacy
  1. Medicare Advantage plans are designed to benefit insurance company shareholders rather than patients. This means they may prioritize profit over providing quality care.
  2. Patients on Medicare Advantage often need prior approval from insurers before getting treatment. This can delay care and make it harder to get necessary services.
  3. Real Medicare allows patients to see almost any doctor or hospital without needing referrals. In contrast, Medicare Advantage plans have stricter networks that can limit choices.

High deductibles helped UnitedHealth reach $7 billion in profits in Q2 as a 14-year-old begs for deductible assistance on GoFundMe.

199 implied HN points • 15 Jul 22
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy
  1. UnitedHealth made $7 billion in profits during the second quarter, thanks in part to high deductibles in health insurance plans. This means they are doing really well financially.
  2. A 14-year-old named Ava Hope has health insurance but cannot afford the high out-of-pocket costs and is asking for help on GoFundMe. Her story highlights the struggles many face even with insurance.
  3. Many people in the U.S. are suffering and going into debt due to insurance costs while companies like UnitedHealth focus on profits. There's a call for Congress to lower costs so people can actually use their insurance when they need it.

I spoke with GOP Rep. Buddy Carter. He thinks Republicans and Democrats can find common ground on PBMs, high out-of-pocket costs

139 implied HN points • 06 Dec 22
🏥 Health Politics Healthcare access Pharmaceuticals Cost reduction Legislation Bipartisanship
  1. Rep. Buddy Carter believes both Republicans and Democrats can work together to tackle high drug costs and the role of Pharmacy Benefit Managers (PBMs).
  2. Many patients struggle with getting necessary medications due to high out-of-pocket costs and complicated insurance processes, leading to significant stress and hardship.
  3. Carter advocates for breaking up the power of large PBMs and pushing for more transparency in drug pricing to make healthcare more affordable for everyone.

Dr. Oz wants to force Pennsylvania seniors into Wall Street-run health insurance plans

179 implied HN points • 18 Aug 22
🇺🇸 U.S. Politics Health Policy Insurance Government Elections Corporate Influence
  1. Dr. Oz wants to push seniors in Pennsylvania into private health insurance plans that may cost them more than traditional Medicare. These private plans can limit their choices for doctors and hospitals.
  2. If this change happens, Dr. Oz could benefit financially because he owns a lot of stock in a big company that runs these plans. It would make him richer while seniors may end up with less coverage.
  3. Many seniors prefer sticking with original Medicare and avoid these private plans, but changes could force them to switch. This could lead to a lot of taxpayer money being spent without good coverage.

What I’m reading in health care this week.

119 implied HN points • 19 Jan 23
🏥 Health Politics Health care Medicare Insurance Legislation Public Policy
  1. Restaurant workers' money is being used for lobbying instead of improving their wages and healthcare. This is hurting low-wage workers who really need better support.
  2. More seniors are signing up for Medicare Advantage plans, which may not be as beneficial as they seem. It's important for legislators and the public to be cautious about these private plans.
  3. The process for getting medical approvals is becoming a huge hassle for doctors and patients. There are calls for reforms to make it easier and less burdensome to access necessary healthcare services.

In 2021, 72% of UnitedHealth’s $222.9 billion revenue came from taxpayers.

259 implied HN points • 27 Jan 22
🏥 Health Politics Healthcare system Insurance Industry Government programs Public funding Health economics
  1. In 2021, most of UnitedHealth's revenue, about 72%, came from taxpayer money, highlighting their dependence on government programs.
  2. The majority of UnitedHealth's growth in the last decade came from government programs like Medicare and Medicaid, not from private insurance.
  3. Healthcare costs for families are rising, with premiums and deductibles taking a larger slice of their income compared to a decade ago.