The hottest Healthcare Reform Substack posts right now

And their main takeaways
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Top Health Politics Topics

NHS Reform - big gains from small moves

Rory’s Always On Newsletter • 575 implied HN points • 24 Oct 24
🏥 Health Politics Healthcare Reform Patient Care Healthcare system Public Health Policy Solutions
  1. Small changes can lead to big improvements in the NHS, like having administrators handle tasks normally done by doctors, which can cut waiting times significantly.
  2. Many missed hospital appointments could be avoided by improving text reminders and allowing patients to choose their own appointment times, which leads to better attendance rates.
  3. Using simple tech solutions or AI to remind patients about appointments can really help reduce the number of people who don't show up, making the system work better for everyone.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

Focusing on Healthcare’s Administrative Costs Is Misguided

Cremieux Recueil • 610 implied HN points • 07 Dec 24
🏥 Health Politics Healthcare Reform Policy Analysis Economic Impact Public Health
  1. The idea that administrative costs in healthcare are the main issue is often wrong. Many studies show the key costs come from provider payments, not just administration.
  2. Comparing U.S. administrative spending to other countries shows Americans spend similar percentages on administration, but overall higher costs are mostly due to higher payments to healthcare providers.
  3. Improving how healthcare is managed, especially through better corporate governance, can help reduce administrative costs, but we need broader reforms to really lower healthcare prices.

Wall Street Yawned as Congress Grilled UnitedHealth’s CEO but Went Ballistic on CVS/Aetna Over Medicare Advantage Claims

HEALTH CARE un-covered • 739 implied HN points • 07 May 24
🏥 Health Politics Healthcare Reform Insurance Issues Corporate Influence Patient Care
  1. Congress questioned UnitedHealth's CEO, but it seems unlikely that real changes will happen to how big insurance companies operate.
  2. Wall Street reacted differently to the news, raising UnitedHealth's stock while CVS's stock dropped sharply due to their Medicare Advantage claims.
  3. The speaker highlights that money in politics plays a big role in healthcare issues, making it hard for patients to get the care they need.
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DEATH PANELS ABROAD: Cigna Whistleblower Reveals How Employees in the Philippines Play a Key Roll in Denying Care for American Beneficiaries

HEALTH CARE un-covered • 759 implied HN points • 29 Apr 24
🏥 Health Politics Insurance Whistleblowing Patient Care Healthcare Reform Ethics
  1. Cigna employees in the Philippines are involved in deciding whether American patients can receive the care they need. This raises concerns about how patient care is managed far away from the actual doctors.
  2. Cigna medical directors spend an average of just four minutes reviewing complex medical cases. This quick decision-making means important health choices may not get the attention they deserve.
  3. There is pressure within Cigna to deny treatment requests quickly, which can put patients at risk. Employees feel forced to prioritize speed over the quality of care.

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.

BIG INSURANCE 2023: Revenues reached $1.39 trillion thanks to taxpayer-funded Medicaid and Medicare Advantage businesses

HEALTH CARE un-covered • 779 implied HN points • 02 Apr 24
🏥 Health Politics Insurance Policy Medicaid Medicare Healthcare Reform Corporate Influence
  1. Health insurance companies in the U.S. made $1.39 trillion in revenue last year. A lot of this money came from government programs like Medicaid and Medicare Advantage.
  2. The Affordable Care Act (ACA) helped many people get insurance but also allowed insurers to profit tremendously. This has led to higher out-of-pocket costs for consumers and medical debts for many families.
  3. Big insurance companies have grown a lot over the last decade, and their executives are making huge salaries. Reform is needed to control these companies and make healthcare more affordable for everyday people.

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.

A simple suggestion for RFK Jr to end corruption in medicine

Vinay Prasad's Observations and Thoughts • 189 implied HN points • 23 Nov 24
🏥 Health Politics Medical Ethics Pharmaceuticals Public Health Government Policy Healthcare Reform
  1. RFK Jr. wants to fight corruption in medicine, especially the money doctors take from pharmaceutical companies. It's important to have honest practices to benefit patients.
  2. A proposed change is to limit the number of doctors in advisory groups who have received money from drug companies. This could start at no more than 60% in 2025 and end with 0% by 2028.
  3. By having fewer conflicts of interest, doctors might focus more on what's best for patients rather than just following drug company interests. This could lead to better healthcare decisions.

The PBM-insurer mafia comes for community pharmacies

HEALTH CARE un-covered • 579 implied HN points • 20 Mar 24
🏥 Health Politics Pharmaceuticals Healthcare Reform Insurance Regulations Public Health
  1. Big Pharmacy Benefit Managers (PBMs) like UnitedHealth and Cigna are pushing independent pharmacies out of business. They drop reimbursement rates, making it harder for these smaller pharmacies to survive.
  2. The financial troubles for independent pharmacies are linked to complex fees and lack of transparency from PBMs. Many pharmacies are struggling with fees that keep rising unexpectedly.
  3. Without independent pharmacies, people might face longer waits for medications and less personalized care. It's important for lawmakers to step in and make changes to support these community pharmacies.

UnitedHealth Group: vulnerable and ill-equipped to defend against modern threats like cyberattacks

HEALTH CARE un-covered • 599 implied HN points • 05 Mar 24
🏥 Health Politics Healthcare Reform Cybersecurity Patient Safety Corporate Influence Regulation
  1. UnitedHealth faced a serious cyberattack, showing that even big companies can be vulnerable to cybercrime. This situation highlights the risks of having too much sensitive data controlled by a few large corporations.
  2. The healthcare system is focused more on profit than patient care. This has left it weak against modern threats like cyberattacks, which can disrupt services and harm patients.
  3. To fix these issues, we need stronger rules to protect patient data and make sure healthcare companies prioritize patient safety over making money. It's important to shift our focus from profits to genuine care for patients.

I’m hosting a free webinar on Thursday. Here’s why you should tune in and how to register.

HEALTH CARE un-covered • 459 implied HN points • 18 Mar 24
🏥 Health Politics Healthcare Reform Insurance Market Public Health Health Policy Webinars
  1. A free webinar titled 'Safeguarding Health Care's Runaway Train' is happening on March 21, 2024, at 2 PM EST. It'll cover important changes in health care and why you should be interested.
  2. The health insurance industry is facing possible changes, as some employers are starting to find ways to bypass big insurance companies to offer better benefits.
  3. This webinar is part of a series aimed at providing insights into the U.S. health care system, helping people understand the ongoing issues and proposed reforms.

Strange bedfellows agree: PBM pricing reform cannot stop at Medicare, Medicaid

HEALTH CARE un-covered • 679 implied HN points • 24 Jan 24
🏥 Health Politics Healthcare Reform Pharmacy Benefits Bipartisan Politics Insurance Market
  1. Pharmacy benefit managers (PBMs) make a lot of money, often taking nearly half of all spending on drugs for Medicare and Medicaid. This needs to change so that more money goes directly to patients and their care.
  2. There is growing bipartisan support for reforming PBMs, but it’s important that these changes don’t only apply to Medicare and Medicaid. They should also include employer-based insurance plans, as many Americans still rely on them.
  3. Reforming PBMs could lower drug costs for both companies and their employees. It's a move that could save money for everyone and cut out unnecessary profits made by these middlemen.

Bi-partisan pharmacy benefit manager (PBM) reform bill gets endorsement from AARP

HEALTH CARE un-covered • 439 implied HN points • 26 Feb 24
🏥 Health Politics Healthcare Reform Legislation Medicare
  1. A new bill to reform pharmacy benefit managers (PBMs) is getting support from AARP, which is important for many Medicare beneficiaries.
  2. The bill aims to change how PBMs are paid, moving away from linking their fees to drug prices, which can lead to higher costs for patients.
  3. Bipartisan support for this reform shows that both political sides agree on the need to address high prescription drug prices.

The top 10 recipients of campaign cash from seven health insurance industry PACs

HEALTH CARE un-covered • 639 implied HN points • 03 Nov 23
🏥 Health Politics Healthcare Reform Insurance Industry Campaign Finance Medicare Advantage Political Influence
  1. Health insurance companies are heavily funding politicians, especially those in powerful positions. This gives them influence over healthcare policies, especially Medicare.
  2. A lot of Medicare-eligible people are being pushed towards private insurance plans called Medicare Advantage, which can lead to worse care for patients.
  3. There's a lot of money involved in keeping the status quo for insurance companies, including political campaign contributions and lobbyists working to protect their interests.

Dr. Daniel Hurley, advocate for health insurance reform, dies at 50

HEALTH CARE un-covered • 759 implied HN points • 16 Aug 23
🏥 Health Politics Healthcare Reform Medical Ethics Insurance Policy Patient Advocacy Chronic Illness
  1. Dr. Daniel Hurley was a strong advocate for health insurance reform. He wanted to bring more transparency to the insurance industry.
  2. Even while battling cancer, he worked hard to fight against insurance companies that denied necessary medical treatments. He was determined to make changes that would help patients.
  3. His passing at 50 is a big loss, but his family and friends plan to continue his mission for better healthcare practices.

Sanders' Senate committee report puts nonprofit hospitals on notice while bi-partisan appetite for reforms intensifies.

HEALTH CARE un-covered • 319 implied HN points • 27 Oct 23
🇺🇸 U.S. Politics Health Policy Legislation Public Health Healthcare Reform
  1. Nonprofit hospitals are under scrutiny for not doing enough to help low-income patients afford care. Many have been accused of taking advantage of their tax-exempt status.
  2. A recent Senate report highlighted stories like that of Carrie Barrett, who faced huge medical bills from a nonprofit hospital despite her low income. This shows how unfair practices can lead to unbearable debt for patients.
  3. There's a growing push from Congress to make sure nonprofit hospitals meet their obligations to provide charity care. Lawmakers want to ensure these hospitals aren't just focused on profits.

What RFK Jr. can do as Secretary of Health and Human Services

Unreported Truths • 91 implied HN points • 20 Nov 24
🏥 Health Politics Healthcare Reform Public Health Health Policy Drug policy Vaccine Policy
  1. Limit how often drugs can be advertised to help patients make better choices. It’s important to make sure medicine is about health, not just selling products.
  2. Open up information about COVID-19 and vaccine safety to the public. This means sharing everything from lab investigations to side effects so people can trust what they’re getting.
  3. Make healthcare more affordable by promoting cheaper generic options and limiting hospital executive pay. This can help more people access the care they need without high costs.

Former PBM chief medical officer: ‘Our motives were murky at best’

HEALTH CARE un-covered • 399 implied HN points • 08 Mar 23
🏥 Health Politics Healthcare Reform Public Health Insurance Issues Advocacy
  1. The claims by pharmacy benefits managers (PBMs) about making prescription drugs safer and more affordable are often misleading. Even though they say they help, the reality is much more complicated.
  2. PBMs profit from selling more drugs, not necessarily from helping patients save money. Instead of focusing on what’s best for patients, their main goal can be to keep their own profits high.
  3. The healthcare system in the U.S. is fragmented and expensive, leading to a push for universal coverage. There is a belief that a single-payer system could make healthcare more inclusive and affordable for everyone.

The U.S. Disease Epidemic and MAHA

Who is Robert Malone • 20 implied HN points • 14 Nov 24
🏥 Health Politics Public Health Pharmaceuticals Chronic Illness Healthcare Reform Nutrition
  1. Many Americans are suffering from serious health issues, with a high number living with chronic illnesses. This shows that despite advances in healthcare, people's health is getting worse.
  2. The current medical system heavily favors pharmaceutical companies over patient care. This creates a cycle where dangerous drugs can be approved while underlying health problems are ignored.
  3. Environmental factors, like toxins in food and other products, are major contributors to health issues. A reevaluation of health policies and standards is needed to protect people's well-being.

In New York, the left and right are united in a fight against the corporate takeover of Medicare

HEALTH CARE un-covered • 419 implied HN points • 11 Jan 23
🏥 Health Politics Healthcare Reform Medicare Corporate Influence Public Policy Political Opposition
  1. People from different political sides are coming together in New York to oppose a plan to move retirees from traditional Medicare to a private insurance plan. This shows that healthcare issues can unite folks regardless of their politics.
  2. The mayor's proposal could harm retirees financially, pushing them to a private plan with higher costs and less freedom in choosing doctors. Many might not truly have a choice once they face increased costs to stay in their current Medicare plan.
  3. There's growing awareness about how private insurers are negatively affecting Medicare. More people, including those in government, are recognizing the problem and starting to speak out against it.

Trump's top healthcare priority must be repealing Big Pharma's legal immunity for vaccines

Unreported Truths • 60 implied HN points • 06 Nov 24
🏥 Health Politics Vaccine Safety Public Health Healthcare Reform
  1. Big Pharma currently has legal immunity for vaccines, which makes it hard for people to sue them for injuries caused by vaccines. This immunity creates a system where companies might not feel responsible for ensuring their products are safe.
  2. The law that protects vaccine manufacturers was made for simpler and cheaper vaccines, not today's advanced and costly ones. This means that the rules should change to hold companies accountable for the newer, more complex vaccines.
  3. Removing this legal protection would help ensure that vaccines are treated like regular products. It would make sure that they are evaluated for risk and safety properly, just like any other medical product.

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

HEALTH CARE un-covered • 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.

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.

We launched a coalition to lower out-of-pocket costs and help end medical bankruptcies

HEALTH CARE un-covered • 59 implied HN points • 15 Sep 21
🏥 Health Politics Healthcare Reform Social justice Public Health
  1. A new coalition called Lower Out-of-Pockets NOW aims to reduce the high costs people pay out-of-pocket for medical care. This is to help stop families from going into debt because of medical bills.
  2. High out-of-pocket costs are a big reason why many people in the U.S. face bankruptcy, even if they have health insurance. Many are skipping necessary treatments or medications because they can't afford them.
  3. The coalition wants Congress to prioritize insurance reforms to lower these costs, especially for Medicare beneficiaries and those with low incomes or chronic conditions.

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.