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

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

Marketing Medicare Advantage to seniors of color – even when it’s bad for their health

HEALTH CARE un-covered • 659 implied HN points • 03 Jan 24
🏥 Health Politics Healthcare access Medicare Advantage Racial Disparities Insurance policies Patient Advocacy
  1. Many seniors of color, especially Black and Latino seniors, are enrolled in Medicare Advantage plans, but these plans often don't cover necessary care. This can lead to serious health issues and preventable hospitalizations.
  2. The marketing for Medicare Advantage often misleads seniors into believing they will receive good care, but the reality is that many end up facing care denials and complicated processes that are hard to navigate.
  3. There are significant racial disparities in the quality of care provided through Medicare Advantage. This impacts the well-being of seniors of color, who are often targeted by aggressive marketing strategies that don't fully explain the potential downsides.

Elevance Health is denying care for Medicaid patients at high rates, according to Department of Health and Human Services report

HEALTH CARE un-covered • 359 implied HN points • 01 Aug 23
🏥 Health Politics Healthcare access Insurance policies Patient rights Government oversight
  1. Elevance Health is denying a lot of care for Medicaid patients, with one in three requests being turned down. This high denial rate has raised concerns about access to necessary medical treatments.
  2. A big reason Elevance is profitable is that it receives a steady amount of money for each Medicaid beneficiary, which can lead to denying care to keep costs low. This model focuses on profits rather than patient needs.
  3. Federal investigators are calling for more oversight of how these private insurers operate. They found that many states are not closely monitoring the care denials, which could hurt vulnerable patients who rely on Medicaid.

The Unique Hell Unleashed By Each Type of Health Care System

I Might Be Wrong • 11 implied HN points • 10 Dec 24
🏥 Health Politics Healthcare systems Public Health Insurance policies Political Impact Cost management
  1. Different healthcare systems have unique problems. Whether it's private insurance leading to high costs or public systems causing long waits, each has its downsides.
  2. Getting government involved in healthcare doesn't make it free. There's always a cost, either in money or in service quality. It's important to understand that you can't get something for nothing.
  3. Finding the right balance in healthcare is tough. A mix of public and private options might be the best way to give people decent care without breaking the bank.

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.
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