The hottest Health Insurance Substack posts right now

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RFK Jr. guts the U.S. vaccine policy committee

Your Local Epidemiologist • 2249 implied HN points • 10 Jun 25
🏥 Health Politics Vaccines Public Health Policy Epidemiology Health Insurance
  1. Robert F. Kennedy Jr. has removed all members of the U.S. vaccine policy committee, which has been a trusted part of vaccine safety and recommendations for decades.
  2. The change raises concerns about who will be appointed next and whether they will rely on scientific evidence or personal beliefs to guide vaccine policy.
  3. If vaccine recommendations change or lose credibility, it could affect insurance coverage, access to vaccines for children, and create inconsistent state policies that may risk public health.

The Hidden Cost Of Unreliable Insurance

An Educated Guess • 290 implied HN points • 29 Jan 25
🏥 Health Politics Health Insurance Public Health Mental health Healthcare policy
  1. Profit-driven health insurance can harm people's health instead of helping them. When companies prioritize making money, they can exploit their customers.
  2. Trust is really important in health insurance. If people feel taken advantage of, they won't believe their insurance will truly support them when they need it.
  3. Having health insurance can provide peace of mind and improve mental health. Just knowing you're covered can help reduce anxiety and depression, but many profit-driven plans don't offer this sense of security.

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

HEALTH CARE un-covered • 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.

Secrets From a Hospital CEO: How Big Hospital Chains Suck Money Out of Your Local Community

HEALTH CARE un-covered • 779 implied HN points • 15 May 24
🏥 Health Politics Healthcare system Medical Debt Corporate Practices Community Impact Health Insurance
  1. Big hospital chains often prioritize profits over patient care, leading to high salaries for executives while many people struggle with medical debt. This focus on money can hurt local communities by draining resources that could have been used for patient care.
  2. Health insurance companies have complicated systems that sometimes make it hard for patients to get the care they need. Instead of focusing on helping people, they often get caught up in making profits and managing money.
  3. Employers and patients should educate themselves about the healthcare system. Understanding how it works can help them make better choices and potentially reduce costs in healthcare.

The Dose (December 13)

Your Local Epidemiologist • 953 implied HN points • 13 Dec 24
🏥 Health Politics Healthcare policy Vaccines Public Health Disease Prevention Health Insurance
  1. There's a national discussion happening about the U.S. healthcare system, revealing mixed feelings among Americans. Even though many like their insurance, dissatisfaction rises when they actually need to use it.
  2. H5N1 testing in milk is finally being implemented, which is important for tracking its spread. This change comes after significant public health concern and other testing efforts at local levels.
  3. Moderna's RSV vaccine trial for infants was stopped because some babies became sicker after receiving it. This shows the ongoing challenge of developing safe vaccines for young children.
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Where Does Medicare Go From Here: Profit-Driven Chaos or Patient-Centered Community?

HEALTH CARE un-covered • 679 implied HN points • 17 Apr 24
🏥 Health Politics Medicare Health Insurance Healthcare Reform Patient Care Policy Analysis
  1. Medicare is facing serious issues due to privatization, which could harm millions of seniors and disabled people who rely on it for health care.
  2. Insurance companies are overcharging the government for Medicare Advantage plans, leading to higher costs for both the program and patients.
  3. There are two possible futures for Medicare: one that could focus on patient care without profit motives, or one that could worsen access and services for people who need care.

The great Medicare Advantage marketing scam: How for-profit health insurers convince seniors to enroll in private Medicare plans

HEALTH CARE un-covered • 1338 implied HN points • 10 Jan 24
🏥 Health Politics Medicare Health Insurance Health Advocacy Healthcare policy
  1. Seniors receive a lot of ads for Medicare Advantage plans that often oversell the benefits and don't mention the downsides, like limited networks and requiring approvals for care.
  2. More than half of seniors are now enrolled in Medicare Advantage, a shift that many believe is driven by aggressive marketing tactics from insurance companies.
  3. Complaints about how Medicare Advantage is marketed have doubled recently, highlighting the need for stricter regulations on these advertising practices.

More than half of every dollar spent by Medicare drug plans goes to private health insurers' pharmacy benefit managers and wholesalers

HEALTH CARE un-covered • 1318 implied HN points • 05 Jan 24
🏥 Health Politics Health Insurance Medicare Drug Pricing Pharmacy Benefits Healthcare Reform
  1. More than half of the money spent on Medicare drug plans goes to middlemen like pharmacy benefit managers (PBMs) and wholesalers, not to the actual drugs.
  2. These PBMs are making huge profits, taking over 40% of the funds while people often end up paying more for their medications.
  3. Lawmakers need to act on this issue because if they can reduce PBM profits, there could be funds to support important health programs for low-income Americans.

As Medicare Advantage's shortcomings echo in the press, key legislators still push to privatize traditional Medicare

HEALTH CARE un-covered • 639 implied HN points • 07 Mar 24
🏥 Health Politics Health Insurance Medicare Policy Analysis Legislation Healthcare access
  1. There are concerns about the move to privatize Medicare, especially with more seniors being pushed towards Medicare Advantage plans. Many seniors might not know the downsides of these plans, which can include delays in care and unexpected out-of-pocket costs.
  2. Medicare Advantage plans often have strict rules that can limit care for patients, and these plans are favored because they make profits for private insurance companies. Some patients have difficulty getting necessary treatments due to these limitations.
  3. There's a push from certain lawmakers to make Medicare Advantage the default option for new Medicare recipients, which could make traditional Medicare less accessible. This raises worries that Medicare as we know it could disappear in favor of profit-driven plans.

As executive compensation at big automakers soars, so does health care costs for the companies, workers

HEALTH CARE un-covered • 759 implied HN points • 18 Sep 23
💼 Business Corporate Governance Executive Compensation Labor relations Health Insurance Economic Inequality
  1. CEO pay at big automakers is very high, while worker pay has stayed low, causing frustration among workers. This gap in pay creates issues in labor negotiations and workers' struggles for fair wages.
  2. Healthcare costs for companies like GM are increasing significantly, which takes away funds that could be used for paying workers better. This trend is leading to workers facing higher deductibles and premiums.
  3. Despite the high pay for CEOs, the stock performance of companies is often underwhelming, raising questions about whether these leaders are meeting their performance goals.

The choice between traditional Medicare and Medicare Advantage? It’s easier than you think. (PART 2)

HEALTH CARE un-covered • 419 implied HN points • 07 Mar 23
🏥 Health Politics Medicare Health Insurance Healthcare Costs Policy Analysis Patient rights
  1. Traditional Medicare can be expensive upfront due to high out-of-pocket costs, especially if you need supplemental coverage. Many people choose Medicare Advantage for its lower immediate costs and out-of-pocket limits.
  2. Companies often push retirees into Medicare Advantage plans because they save money and get better benefits for these groups. However, retirees might lose important access to doctors and hospitals by switching.
  3. Medicare Advantage plans may advertise extra benefits, but these can come with hidden costs. People often struggle to access the care they need due to strict rules and limited provider networks.

Why Health Insurance Systems are Mismanaged

In My Tribe • 455 implied HN points • 01 Jul 23
🏥 Health Politics Health Insurance Incentives Costs Government Market
  1. Incentives in health insurance systems can be misaligned, leading to issues like services being rationed for those with expensive illnesses.
  2. Government can create artificial pools within health insurance to avoid selection games, but challenges in insurer-provider conflicts may persist.
  3. Integrating health insurance with health care, like in HMOs, can help manage costs, but compensation methods for HMOs and providers remain contentious.

"Confessions of a Former Carrier Executive": my keynote address at the 2023 YOU Powered Symposium

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

Big insurer Anthem took in $38 billion in the first 3 months of 2022. Most of it by far came from taxpayers.

HEALTH CARE un-covered • 199 implied HN points • 28 Apr 22
🏥 Health Politics Health Insurance Public funding Medicare Medicaid
  1. Anthem's revenue has shifted significantly, with most of its income now coming from taxpayer-funded programs like Medicare and Medicaid rather than private-paying customers.
  2. The employer-based health insurance system is declining rapidly as many employers can no longer afford to provide coverage, affecting the number of private-paying customers.
  3. Despite growing profits largely from private-paying clients, many of Anthem's customers are struggling to afford out-of-pocket costs, leading to increased financial hardships.

[VIDEO] My advice as you pick a health insurance plan for 2023

HEALTH CARE un-covered • 99 implied HN points • 07 Dec 22
🏥 Health Politics Health Insurance Public Health Policy advocacy
  1. When choosing a health insurance plan, look beyond just the monthly premium. Consider the total out-of-pocket costs before your benefits start.
  2. It's important to compare different plans and understand what you'll have to pay for services and prescriptions.
  3. Be mindful of enrollment deadlines so you don't miss out on getting the coverage you need.

Big insurer Cigna took in $44 billion in the first 3 months of 2022. 75% came from its drug business.

HEALTH CARE un-covered • 139 implied HN points • 06 May 22
💰 Finance Health Insurance Corporate Earnings Pharmacy Benefits Profit Margins Market Trends
  1. Cigna's huge revenue of $44 billion in just three months shows they are making a lot of money, mainly from their drug business. This means health insurers can earn a lot just from selling medications.
  2. Cigna's profits rose by 12% compared to last year, and they expect even more profits moving forward. This makes investors happy and boosts the company's stock value.
  3. Many Cigna customers face high deductibles and out-of-pocket costs, making it hard for them to afford care. This highlights a problem in the healthcare system where profits might come at the expense of customers' financial wellbeing.

My video comment letter on FTC meeting today regarding PBM business practices

HEALTH CARE un-covered • 159 implied HN points • 17 Feb 22
🏥 Health Politics Healthcare policy Health Insurance Pharmaceuticals Public Health Consumer Advocacy
  1. Pharmacy Benefit Managers (PBMs) are having a big impact on drug prices and people's ability to afford medications. Many Americans are struggling with high out-of-pocket costs and can't pick up their prescriptions.
  2. Big companies like UnitedHealth, CVS Health, and Cigna dominate the PBM market and have merged with health insurers. This has led to higher deductibles and premiums, putting families in financial trouble, even as these companies are making huge profits.
  3. The practices of these large PBMs can hurt independent pharmacies and might not benefit consumers. There is a call to investigate how these companies operate and how their actions affect patients and healthcare costs.

Millions of Americans can't afford their out-of-pocket costs. We want to tell those stories.

HEALTH CARE un-covered • 99 implied HN points • 21 Sep 22
🏥 Health Politics Health Insurance Patient Advocacy Legislation Healthcare Reform
  1. Many Americans struggle to afford their out-of-pocket healthcare costs, often leading them to delay necessary medical care. High-deductible health plans are making it harder for people to afford the care they need.
  2. The Affordable Care Act has a flaw, with high out-of-pocket costs causing many insured individuals to feel like they are 'functionally uninsured'. This means they have insurance but can’t afford to use it.
  3. Insurance companies continue to raise costs, which puts more financial pressure on families. Without action, more people will find themselves unable to afford their healthcare, even if they have insurance.

A link to my piece in The Nation – with some added context.

HEALTH CARE un-covered • 0 implied HN points • 08 Jul 21
🏥 Health Politics Healthcare Reform Public Health Policy advocacy Health Insurance Pandemic response
  1. America's health care system, based on employers, is failing and needs a change. The pandemic showed that this model is not working well for many people.
  2. There is a call for President Biden to deliver on his promises for health care reform, especially after the challenges revealed by the pandemic.
  3. A Medicare for All system could be better for both individuals and businesses, and it's important to think about new solutions for health care.