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

HEALTH CARE un-covered • 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.

Therapy Patients Stop Treatment After ‘Pre-Payment Reviews’ Swell

HEALTH CARE un-covered • 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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.
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As it Turns Out, Health Insurance Executives Are Really (Really) Good at Their Jobs

HEALTH CARE un-covered • 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

HEALTH CARE un-covered • 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

HEALTH CARE un-covered • 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.

We Could Have Much Better, Stronger Homes. We'll Need Them.

OK Doomer • 91 implied HN points • 27 Jan 25
🌞 Climate & Environment Disaster Preparedness Climate Impact Insurance Issues
  1. We need stronger homes to protect against natural disasters like tornadoes. Many people have experienced damage and loss during such events, which shows how important it is to be prepared.
  2. Other countries build homes that are better equipped to handle storms. It's about using smart designs and materials instead of relying on temporary solutions.
  3. Homeowners should consider making upgrades to their homes to improve safety. There are practical steps that can be taken, like reinforcing structures or creating safe spaces.

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.

“Senator, Saying It Doesn't Make It True”

HEALTH CARE un-covered • 599 implied HN points • 19 Apr 24
🇺🇸 U.S. Politics Health Policy Insurance Issues Political Discourse Government Accountability
  1. The health insurance industry often uses certain lawmakers to protect their profits when faced with regulatory changes. This means politicians sometimes reinforce misleading talking points to serve big insurance companies.
  2. Senator Kennedy challenged Health and Human Services Secretary Becerra with claims about Medicare Advantage savings that are based on questionable research. These figures have been promoted by the insurance industry to create a positive image of their plans.
  3. Becerra pushed back against Kennedy's claims, stating that funding for Medicare Advantage has increased, countering the argument that the administration is cutting funds. This highlights the ongoing debate over the true costs and benefits of these healthcare plans.

Health Insurer Admits “Mistake” – and Still Sticks Disabled Veteran With $110,000 in Medical Bills

HEALTH CARE un-covered • 519 implied HN points • 25 Apr 24
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy
  1. Health insurers can make big mistakes that leave patients with hefty bills, as seen with a disabled veteran who faced $110,000 in medical expenses after an insurance error.
  2. Even when companies admit to their mistakes, they may not take responsibility to fix the situation, often leaving vulnerable people to deal with the consequences.
  3. Finding help through patient advocates can make a huge difference, showing the importance of community support in navigating medical billing issues.

Company behind Joe Namath Medicare Advantage ads has long rap sheet of misconduct

HEALTH CARE un-covered • 599 implied HN points • 20 Feb 24
🏥 Health Politics Healthcare policy Insurance Issues Regulatory Affairs
  1. The company behind Joe Namath's Medicare Advantage ads has a history of legal troubles and misconduct. This includes past penalties from federal agencies and a recent bankruptcy that some say was a way to avoid paying off legal liabilities.
  2. Over 31 million seniors are enrolled in Medicare Advantage plans, which can limit their access to doctors and hospitals. Many don't realize that signing up might mean losing their preferred healthcare providers, despite potential perks like gym memberships.
  3. Private equity firms play a big role in the Medicare Advantage market. They invest heavily in companies that often prioritize profits over genuine patient care, which can lead to misleading advertising and poor service for seniors.

Your Money or Your Life

HEALTH CARE un-covered • 599 implied HN points • 31 Jan 24
🏥 Health Politics Healthcare system Insurance Issues Patient rights Medical Ethics
  1. Patients with insurance are sometimes asked to pay the full cost of treatment upfront, which can be very high, making healthcare access difficult.
  2. Many healthcare providers may refuse treatment to insured patients if they can't pay large amounts in cash before receiving care, creating ethical concerns.
  3. Patients can protect themselves by understanding their insurance, confirming costs beforehand, and knowing their options if they face payment demands at appointments.

Is the No Surprises Act backfiring on patients?

HEALTH CARE un-covered • 439 implied HN points • 14 Feb 24
🏥 Health Politics Health Policy Insurance Issues Patient Advocacy
  1. The No Surprises Act was created to protect patients from surprise medical bills, but it may not be working as intended. Insurers have found ways to manipulate the system, negatively impacting patients.
  2. Insurers can set the rates for out-of-network services and use that power to push down payments to doctors, which may lead to less availability of medical care.
  3. The government has not enforced the law properly, allowing insurers to profit while leaving patients with longer wait times and less access to doctors.

Cigna denied a double lung transplant after a donor was found, leaving a mother scrambling for answers

HEALTH CARE un-covered • 679 implied HN points • 27 Nov 23
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy Medical Ethics Public Health
  1. Cigna denied a double lung transplant even after a donor was found, leaving the patient and her family in a tough situation. This shows how insurance companies can impact life-saving medical decisions.
  2. In some cases, insurance companies take a long time to approve necessary surgeries, which can be life-threatening. Quick action is critical for patients needing urgent medical care.
  3. This isn't just an isolated incident; many patients face similar issues with insurance companies. More awareness and action are needed to protect patients from such denials.

Allopathic Violence

The Carousel • 51 implied HN points • 10 Dec 24
🏥 Health Politics Healthcare system Pharmaceuticals Mental health Public Health Insurance Issues
  1. The American health and pharmaceutical system is viewed as harmful and profit-driven, often prioritizing financial gain over patient well-being. This can lead to unnecessary medical treatments and a cycle of dependency on medications.
  2. Many medical issues, especially chronic pain, can be rooted in psychological factors rather than purely physical ones. This shows a need for a more holistic approach to health instead of just treating symptoms with drugs and surgeries.
  3. When dealing with health insurance like UnitedHealthcare, it's important to understand that their role is complex. They can be a part of the problem, but often the real issue lies with healthcare providers and pharmaceutical companies who create unnecessary treatments.

Meet Dr. Hurley – a physician (and now a patient) bent on righting the wrongs of insurance denials

HEALTH CARE un-covered • 1218 implied HN points • 05 Jun 23
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy Chronic Illness
  1. Dr. Hurley, a physician turned patient, fights against health insurance denials that affect patients' access to care. His own experience with his son's surgery denial opened his eyes to the struggles many face with insurance companies.
  2. He wants to reform the medical claims process, aiming for fairness and accountability from insurers. By using his legal education and experience, he hopes to help others navigate the complicated system and advocate for their healthcare rights.
  3. Dr. Hurley emphasizes the importance of having qualified specialists review insurance claims. He believes that having doctors without the right expertise making decisions harms patients and wants to see changes that hold these reviewers accountable.

How two very motivated women are helping patients fight their health insurers and get the care they need

HEALTH CARE un-covered • 499 implied HN points • 12 Oct 23
🏥 Health Politics Patient Advocacy Insurance Issues
  1. Two women are helping patients fight against health insurance companies to get the care they deserve. They believe that everyone should advocate for themselves to ensure they receive the benefits they are paying for.
  2. They created resources that explain complex insurance terms and processes. These tools help patients understand how to deal with denials and other challenges in the healthcare system.
  3. Education is key for patients navigating healthcare issues. Many people don't know how to appeal denied claims or ask for urgent care, and there's a need for more knowledge in schools about health insurance.

Six annoying steps that reduced my prescription drug costs by $2000 per year

Neeloy’s Substack • 59 implied HN points • 21 Jun 24
🏥 Health Politics Healthcare Costs Prescription drugs Insurance Issues Patient Advocacy Health economics
  1. You can save money on prescription drugs by asking for generic versions. A simple request to your doctor might cut costs significantly.
  2. Checking websites like goodrx.com for coupons can make a big difference. It's worth taking the time to search for discounts at different pharmacies.
  3. Don't hesitate to communicate with your pharmacist and doctor. Asking questions and exploring alternatives can lead to much lower medication costs.

Cigna’s Q2 earnings put Wall Street on edge despite huge PBM business revenues

HEALTH CARE un-covered • 599 implied HN points • 08 Aug 23
🏥 Health Politics Insurance Issues Healthcare Costs Profit Margins Corporate Practices Market Trends
  1. Cigna plans to raise health insurance premiums for many customers by about 23% next year, which could leave small businesses and individuals struggling to afford their coverage.
  2. Despite earning more money overall, Cigna's profits fell due to higher medical costs and this disappointed investors, causing their stock price to drop.
  3. Cigna is focusing on its pharmacy benefit manager business, which now accounts for a large share of its revenue, even while prioritizing stock buybacks over customer relief.

[VIDEO] Poor Americans to feel the burn from health insurer Elevence's decision in Medicaid dispute

HEALTH CARE un-covered • 519 implied HN points • 28 Aug 23
🏥 Health Politics Healthcare access Insurance Issues Medicaid Public Health Policy advocacy
  1. Elevance is a health insurer with high denial rates for claims, affecting patients' access to necessary treatments. Many poor Americans are struggling because of this.
  2. In Ohio and Virginia, there's a conflict between Elevance and a major hospital system, leading to unpaid claims amounting to $100 million. This dispute means Medicaid patients may need to find different hospitals for care.
  3. Lawmakers need to step in and address the unfair practices of health insurers like Elevance. This is crucial for protecting low-income Americans who rely on Medicaid services.

Hospitals' latest "innovation": "patient-centric payment capabilities"

HEALTH CARE un-covered • 399 implied HN points • 07 Jul 23
🏥 Health Politics Healthcare system Patient rights Insurance Issues
  1. Hospitals are focusing more on getting paid upfront from patients, even before care is provided. This shift is partly due to more people facing high medical costs because of their insurance plans.
  2. Many hospitals are using technology to remind patients of their bills and to ask for payments in advance. This creates a situation where financial discussions happen at the same time as medical care.
  3. The emphasis on collecting money may lead to less compassion in healthcare. Patients often feel pressured about their bills instead of receiving the support they need during tough times.

Doctors said "it was a matter of life or death." But their health insurer denied the claim.

HEALTH CARE un-covered • 399 implied HN points • 15 Jun 23
🏥 Health Politics Healthcare access Insurance Issues Patient Advocacy Policy Reform Public Health
  1. Health insurance companies often deny crucial medical claims, even when doctors say treatment is a matter of life or death. This can leave patients in distress, struggling to access the care they desperately need.
  2. Many people don't know they have the right to challenge claim denials. Even if they do, insurers often make it difficult to win these appeals.
  3. Campaigns like Care Over Cost show that collective action can help patients get the care they deserve. By uniting and raising awareness, patients can hold insurers accountable and fight for their rights.

NEWS UN-COVERED: health insurer rate hikes and Medicare Advantage ads in 2024

HEALTH CARE un-covered • 239 implied HN points • 27 Sep 23
🏥 Health Politics Healthcare Costs Insurance Issues Government Policy Consumer Rights
  1. Medicare Advantage ads are misleading, and there is an effort by the government to make them more transparent. Consumers need to be careful and do their research before signing up for these plans.
  2. In 2024, health insurers are planning significant rate hikes that could affect employers and consumers. This could lead to higher overall healthcare costs and impact inflation.
  3. There is increasing pushback from employers against these rate hikes. They are using new transparency rules to negotiate better deals with health insurers.

URGENT: The killer of UnitedHealthcare CEO Brian Thompson left an anti-insurance company message at the scene of Thompson's murder

Unreported Truths • 74 implied HN points • 05 Dec 24
🇺🇸 U.S. Politics Health Policy Public Safety Insurance Issues Social media
  1. The murder of the UnitedHealthcare CEO suggests a deep anger towards insurance companies in America. Many people feel frustrated with the healthcare system and this anger may have contributed to the tragic event.
  2. The words found on the bullet casings indicate a connection to the tactics used by insurance companies to deny claims. This points to a critical view of the industry and its practices.
  3. There seems to be a troubling support for the killer from some online communities. This reflects a growing dissatisfaction with the healthcare system and raises concerns about the public's response to such violence.

State and local governments are acting to unburden millions in medical debt but federal action is still needed

HEALTH CARE un-covered • 299 implied HN points • 03 Aug 23
🏥 Health Politics Healthcare access Medical Debt Policy Reform Insurance Issues
  1. Many people, even with health insurance, struggle to pay medical bills. High deductibles and out-of-pocket costs can make accessing healthcare really stressful.
  2. State and local governments are starting to help by abolishing medical debt for residents, providing immediate relief. This makes a huge difference in people's lives and encourages them to seek necessary healthcare.
  3. While local actions are positive, more federal support is needed to truly tackle medical debt. There’s a call for Congress to lower out-of-pocket costs and improve insurance protections so that medical debt doesn't become a lasting issue for many families.

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.

16 years ago, my story was told in Michael Moore's documentary "Sicko." I still struggle for the health care I need

HEALTH CARE un-covered • 339 implied HN points • 16 Mar 23
🏥 Health Politics Health care Medical Debt Insurance Issues Policy Reform Advocacy
  1. Having health insurance isn't always enough. Many people still face huge costs and hardships despite having coverage.
  2. Medical bills can lead to severe financial strain and even bankruptcy, impacting people's lives deeply.
  3. Advocacy for better healthcare systems is crucial, and personal stories highlight the struggles that many individuals endure with the current system.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

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

HEALTH CARE un-covered • 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.

HOW IRONIC: Corporate health insurance consultants blame high medical costs on our "bad habits" and "overuse" of system.

HEALTH CARE un-covered • 139 implied HN points • 21 Oct 22
🏥 Health Politics Healthcare Costs Insurance Issues Medical Debt Patient Advocacy
  1. Health insurance consultants often blame people's bad habits for rising medical costs, while huge insurance companies are making record profits. This seems very unfair to the average person trying to access affordable care.
  2. Many insured Americans are still struggling with medical debt and high out-of-pocket expenses. It's tough when even people with insurance can't afford their medications or treatments.
  3. The focus should be on the greed of insurance companies rather than blaming individuals. Insurers could help lower costs, but they often choose profit over patient care, leaving many people in financial trouble.

Interested in health care? This is what you should be reading.

HEALTH CARE un-covered • 199 implied HN points • 13 May 22
🏥 Health Politics Healthcare system Insurance Issues Policy Analysis Patient Advocacy
  1. Healthcare in the U.S. can be very expensive, even for people who have insurance. Many are struggling to pay out-of-pocket costs and are skipping necessary doctor visits or medications.
  2. People often turn to GoFundMe pages to raise money for their medical expenses. Sadly, those who are most likely to succeed in this fundraising are usually the privileged ones, making the problem worse for those in need.
  3. There are serious flaws in Medicare's prescription drug coverage, leading to high costs for many older Americans. Some can face over $10,000 a year on medications, which highlights the need for better healthcare solutions.

Judge halts New York City's plan to redirect tax dollars to private health insurance companies

HEALTH CARE un-covered • 119 implied HN points • 29 Nov 22
🏥 Health Politics Healthcare policy Insurance Issues Medicare Public Health
  1. A judge stopped New York City's plan to move municipal retirees into private Medicare Advantage plans. This decision allows them to stay in traditional Medicare without facing penalties.
  2. The city's plan aimed to save $600 million by pushing retirees into private insurance options, but this would have burdened taxpayers across the country. The plan depended on federal subsidies to work.
  3. There are concerns about Medicare Advantage plans, as they can limit access to necessary care and lead to higher out-of-pocket costs for retirees. Many believe that staying in traditional Medicare is safer and more reliable for their health needs.

What I'm reading in health care this week.

HEALTH CARE un-covered • 99 implied HN points • 30 Jan 23
🏥 Health Politics Healthcare policy Medicare Insurance Issues Patient Care
  1. Doctors are facing a lot more claim denials this year, which is making their jobs harder and causing burnout. There's a push from healthcare providers for the government to change the rules around prior authorizations to help ease this burden.
  2. Patients with diabetes are struggling when companies switch them to high-deductible health plans. These plans can increase the chances of serious health issues and financial troubles for patients who need regular care.
  3. The government is looking closely at Medicare Advantage plans due to concerns about overpayments to insurers. Changes could be on the way that would affect how these plans operate and the money insurers can make from them.

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

HEALTH CARE un-covered • 119 implied HN points • 27 May 22
🏥 Health Politics Healthcare policy Insurance Issues Pharmaceuticals Patient Advocacy Medicare
  1. Big Insurance companies have gotten very powerful and can make it hard for patients to get the care they need. They create many barriers, like high costs and complex approvals.
  2. Some healthcare organizations that once supported Big Insurance are now worried about its growing power and are asking the government to step in. They realize their previous choices contributed to the problem.
  3. Legislation is being introduced to limit the influence of Pharmacy Benefit Managers (PBMs) and ensure patients have better access to medications. More people are speaking out about the negative impacts of PBMs on drug costs.