The hottest Insurance Substack posts right now

And their main takeaways
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Economics Links, 12/19/2025

In My Tribe • 227 implied HN points • 19 Dec 25
💰 Finance Insurance
  1. Annuities give guaranteed lifetime income by shifting market and longevity risk to insurers, but they also mean your heirs won't inherit those assets and many people dislike losing control. Inflation protection is crucial because fixed nominal payouts can leave retirees worse off.
  2. A large part of residential real estate value may be rent extraction from limits on new construction rather than true productive wealth. Still, location-specific advantages like access to jobs and amenities also create genuine value beyond supply constraints.
  3. GDP isn't a perfect measure of wellbeing, but it reliably captures economic development by measuring market transactions, specialization, and trade. Economic growth as measured by GDP often lays the foundation for progress on other social and wellbeing goals.

Here are the Five Areas the New DOJ Task Force on Monopolies in Health Care Should Focus On

HEALTH CARE un-covered • 499 implied HN points • 23 May 24
🏥 Health Politics Insurance
  1. Insurers buying doctor practices is a big problem. When insurance companies own the doctors, it creates a conflict of interest and can limit patient choices.
  2. The connection between insurance companies and pharmacy benefit managers (PBMs) is concerning. This merger can hurt small pharmacies and affect how patients access medications.
  3. Prior authorization is making it harder for patients to get necessary care. Insurance companies use this process to delay or deny treatments, which can lead to serious health risks.

Getting Even

Tigerfeathers! • 24 implied HN points • 27 Feb 26
💼 Business Insurance
  1. India’s healthcare incentives are misaligned: fee‑for‑service and fragmented delivery reward more procedures while payers try to limit payouts, which drives opaque pricing, catastrophic out‑of‑pocket bills, and inefficient care.
  2. Vertically integrating care (telehealth → salaried primary care → in‑house diagnostics → lean secondary hospitals) aligns incentives, captures provider margins, lowers claims, and improves retention by making prevention and appropriate care financially sensible.
  3. Existing hospitals and insurers find this integration hard to copy because it cannibalises incumbent economics or requires new capabilities, so startups can build a durable advantage — but the model must guard against new risks like under‑treatment and needs long time horizons and smart regulation.

Medicare Advantage gets walloped in the press as the federal government's rate notice looms

HEALTH CARE un-covered • 779 implied HN points • 25 Mar 24
🏥 Health Politics Insurance
  1. The federal government will soon decide how much money to give private health insurers running Medicare Advantage, affecting millions of seniors' healthcare options.
  2. Many reports are showing that Medicare Advantage plans may not be as beneficial as claimed, often leading to overcharging taxpayers.
  3. More groups are speaking out against the industry's tactics this year, pushing back against pressures to increase funds for these insurance companies.

UnitedHealth Group, the Biggest Private Health Insurer on the Planet, Made $8.5 Billion in Profits in Q1 2024

HEALTH CARE un-covered • 619 implied HN points • 16 Apr 24
🏥 Health Politics Insurance
  1. UnitedHealth Group made $8.5 billion in profits in the first quarter of 2024, showing strong financial growth despite recent challenges. Their revenues have tripled over the last decade, indicating a significant increase in business.
  2. A big part of their success comes from government programs like Medicare and Medicaid, where enrollment has jumped in recent years. This growth has helped them dominate the market alongside a few other large competitors.
  3. Despite their financial success, many healthcare providers are struggling due to a cyberattack on a subsidiary. Advocates are concerned that profit-focused practices may lead to patients not receiving necessary care.
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Chartbook 391 How to predict a 1 in 1,000 year riot: the insurance expertise gearing up to commodify America's agony.

Chartbook • 1344 implied HN points • 13 Jun 25
🇺🇸 U.S. Politics Insurance
  1. The rise of protests in America has led to the insurance industry developing new ways to predict and analyze civil unrest. They are focusing on how to manage the risks and losses from these events.
  2. Big data and statistical models are now used to assess the likelihood and impact of riots and protests across various locations in the US. This helps identify high-risk areas for potential damage.
  3. Recent protests like those seen in 2020 are changing how insurance companies view risks. They see political unrest as a serious threat that may lead to significant losses, prompting them to adjust their policies accordingly.

"Climate Change is Showing its Claws"

The Honest Broker Newsletter • 2718 implied HN points • 12 Jan 25
🌞 Climate & Environment Insurance
  1. In 2024, global weather-related disaster losses reached $298 billion, with a significant portion occurring in the U.S., mainly due to hurricanes. This shows that while climate change impacts us, other factors like economic growth also play a big role.
  2. Today, disaster losses as a percentage of global GDP are less than they were 30 years ago. This suggests that despite increasing losses in dollars, extreme weather is not as devastating to the economy as it used to be.
  3. The rising insured losses are largely driven by construction in risky areas and inflation, rather than just climate change. It's important to consider these factors when looking at why disaster losses are increasing.

The Ackman Complex

Net Interest • 27 implied HN points • 13 Feb 26
💰 Finance Insurance
  1. Pershing Square is now a widely accessible, London-listed fund concentrated in a handful of large, liquid mega-cap stocks, and it buys into these names when short-term selling creates mispricing.
  2. High management and performance fees have materially reduced net returns for investors, so the firm has moved to create alternatives that can offer capital on cheaper terms.
  3. By acquiring an insurance company to generate investable float, Ackman is building a Buffett-style vehicle to scale capital without extra performance fees, but the strategy adds complexity and its success is not guaranteed.

The federal government will soon announce its payment rates and policy changes for the Medicare Advantage program. Here's how you can influence their decision.

HEALTH CARE un-covered • 599 implied HN points • 26 Mar 24
🏥 Health Politics Insurance
  1. The government will soon decide how much money to give to private Medicare Advantage insurers for 2025. People are encouraged to voice their opinions to influence this decision.
  2. Many Medicare Advantage plans cost taxpayers more money and often provide worse care than traditional Medicare. There's a call to demand better use of tax dollars.
  3. The marketing of Medicare Advantage plans can be misleading, impacting vulnerable seniors. It's important to push the government to avoid giving more funds to these insurers.

Hospitals across the country are dumping Medicare Advantage plans and canceling their contracts with insurers

HEALTH CARE un-covered • 1238 implied HN points • 07 Dec 23
🏥 Health Politics Insurance
  1. Many hospitals are canceling their contracts with Medicare Advantage plans due to lower payments and extra work to get approvals. This creates difficulties for both hospitals and patients.
  2. Patients on Medicare Advantage plans may face delays in receiving care and might get stuck with high medical bills. This is because these plans often deny or delay necessary services.
  3. There's a growing concern about whether Medicare Advantage plans are good for seniors. People are questioning if these plans truly provide the best care or if they profit from denying treatments.

The PBM-insurer mafia comes for community pharmacies

HEALTH CARE un-covered • 579 implied HN points • 20 Mar 24
🏥 Health Politics Insurance
  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.

DEATH BY PAPERWORK: Watch NYT Opinion video on health insurers' "prior authorization" practices

HEALTH CARE un-covered • 579 implied HN points • 15 Mar 24
🏥 Health Politics Insurance
  1. Prior authorization is a process where patients and doctors must get approval from insurance companies before certain treatments can be covered. This often causes delays and can lead to worsening health issues for patients.
  2. The process can be very frustrating and complicated, leading some patients to skip necessary care altogether. This can increase stress and harm their health further.
  3. Doctors and their staff spend a lot of time dealing with the paperwork required for prior authorization, which takes away from actual patient care and can lead to burnout among healthcare providers.

UnitedHealth’s self-dealing is accelerating

HEALTH CARE un-covered • 899 implied HN points • 12 Jan 24
🏥 Health Politics Insurance
  1. UnitedHealth is increasingly making money through its own subsidiaries, which means it's doing more business with itself. This raises concerns about whether patients are getting the best options and quality of care.
  2. A significant portion of UnitedHealth's revenue comes from internal transactions with its subsidiary, Optum. This could limit competition and hurt other healthcare providers.
  3. Using its own doctors and services helps UnitedHealth avoid spending obligations meant for patient care, potentially leading to reduced quality for patients.

Have insurance? Good luck finding an in-network mental health professional.

HEALTH CARE un-covered • 659 implied HN points • 22 Feb 24
🏥 Health Politics Insurance
  1. Finding an in-network mental health professional is really hard for people with insurance. Many providers are not actually accepting new patients or have left the network, making it feel like a waste of time for those seeking help.
  2. Even with insurance, many patients face high out-of-pocket costs. The average cost for therapy sessions can be over $174, creating a barrier for those who need mental health care.
  3. Insurance companies often make it tough to get claims approved by imposing complicated processes. This frustrates providers and leaves patients without the care they deserve.

President Biden proposes $2,000-a-year limit on prescription drugs

HEALTH CARE un-covered • 519 implied HN points • 08 Mar 24
🇺🇸 U.S. Politics Insurance
  1. President Biden wants a yearly cap of $2,000 on prescription drug costs for everyone, not just seniors. This could help many people afford their necessary medications.
  2. This proposal builds on a previous law that already caps costs for Medicare recipients, showing a commitment to reducing healthcare expenses for all.
  3. The success of this plan relies on public support and overcoming resistance from insurance companies, who may argue it could lead to higher costs elsewhere.

The crisis in American medicine runs DEEP

Unreported Truths • 57 implied HN points • 23 Jan 26
🏥 Health Politics Insurance
  1. The American health system is hugely overpriced and depends on hidden cross‑subsidies where the healthy, young, and less demanding patients pay for heavy users and corporate profits. Insurance hides real prices, so a lot of care of marginal value is funded by others.
  2. If many healthy people and doctors shift to concierge or fee‑for‑service care, they can opt out of those subsidies and expose how unsustainable current prices are. That exodus could destabilize or even collapse the broader system.
  3. Decades of consolidation, bureaucracy, and insurer/hospital rules have locked people into the expensive system and made meaningful opt‑out or reform difficult. Breaking the system to fix it would be painful for patients and providers alike.

BETWEEN YOU AND YOUR DOCTOR: How Medicare Advantage care denials affect patients

HEALTH CARE un-covered • 499 implied HN points • 04 Mar 24
🏥 Health Politics Insurance
  1. Medicare Advantage plans are often denying care for patients, which can lead to serious health issues. Insurers like UnitedHealth prioritize profits over patient care, creating barriers for those who need treatment.
  2. The process of 'prior authorization' used by these insurers causes significant delays in receiving necessary medical care. This system can sometimes result in life-threatening situations for patients who are waiting for approval.
  3. Organizations like People’s Action are working to help patients navigate the complicated insurance system and advocate for fair treatment. They aim to expose the challenges faced by patients and push for changes to the healthcare system.

Mapping UnitedHealth’s consumption of our health care system – from the ‘70s to today

HEALTH CARE un-covered • 759 implied HN points • 20 Dec 23
🏥 Health Politics Insurance
  1. UnitedHealth has grown significantly by acquiring many health companies since the 1970s. This has made it one of the biggest and most influential health care companies in the U.S.
  2. Their acquisitions have changed how health care is managed, often focusing more on profit rather than patient care. Some companies they've bought have faced criticism for denying necessary treatments.
  3. UnitedHealth's size allows it to impact many areas of health care, from insurance to the providers of medical services. This has raised concerns about its influence over patient care and competition in the market.

How Employers Can Easily Bend the Rx Cost Curve

HEALTH CARE un-covered • 259 implied HN points • 24 Apr 24
🏥 Health Politics Insurance
  1. Employers can save money on prescription drugs by creating a competitive environment for pharmacy benefit management (PBM) contracts. This means they should compare prices from various PBMs to find the best deal.
  2. Using objective pricing metrics helps employers understand exactly how much they are paying for drugs. By focusing on all costs including fees and ensuring transparency, they can cut down unnecessary expenses.
  3. Employers should keep track of their spending regularly and adjust as needed. This ongoing management can lead to significant savings for both the employer and employees without limiting access to necessary medications.

Disaffected, Episode 154

Disaffected Newsletter • 499 implied HN points • 15 Jan 24
🎙 Podcasts Insurance
  1. There is a real difference between bipolar disorder and borderline personality disorder, and understanding this can help clarify some public misconceptions.
  2. An update on a recent shooting shows that the shooter, who was initially labeled a right-wing hate criminal, had a different background and mental health issues, challenging assumptions about such incidents.
  3. Infrastructure issues are more than just physical repairs; applying for health insurance can be frustrating and complicated, highlighting the broader problems in the system.

Reports and lawsuits allege UnitedHealth uses AI algorithms to cut off care for the elderly and disabled

HEALTH CARE un-covered • 699 implied HN points • 15 Nov 23
🏥 Health Politics Insurance
  1. UnitedHealth is accused of using AI to deny necessary care for elderly and disabled patients. Some families have filed lawsuits claiming that these algorithms lead to severe treatment cut-offs.
  2. Employees at UnitedHealth face pressure to deny care based on algorithmic targets, which can lead to risky patient outcomes. Many fear losing their jobs if they do not comply.
  3. There is concern about the partnership between UnitedHealth and AARP, especially during Medicare open enrollment. Ads promoting these plans often do not mention the potential dangers of enrolling in private Medicare plans.

Why Insurance Companies Are Rationally Failing Their Social Purpose

Software Design: Tidy First? • 1391 implied HN points • 25 Oct 24
💼 Business Insurance
  1. Insurance is meant to convert risks into opportunities, allowing people to buy homes and start businesses by protecting lenders against losses. But it's complicated when companies only want to insure low-risk customers.
  2. Insurance companies often cut back on the risks they cover to stay competitive and offer lower prices, which means they might not support those in need, like entrepreneurs with health issues.
  3. For insurance to work as it should, companies need to stop focusing solely on low-risk clients. They should start covering real people, including those who are a bit riskier, to provide the societal benefits that insurance was originally designed for.

When MAHA Forgets the Working Class

Common Sense with Bari Weiss • 955 implied HN points • 29 Jan 25
🏥 Health Politics Insurance
  1. Health advice that seems extreme or unattainable can push regular people away. It's important to give advice that feels realistic and achievable.
  2. Personal experiences with illness can be heavily influenced by socioeconomic status. Financial worries about healthcare can be a barrier to education and opportunities.
  3. Policies like the Affordable Care Act can make a big difference for people with preexisting conditions. They can open doors for education and better health insurance options.

Top Links 773 How a private equity titan became an insurance-backed quasi-bank. Narrating the AI boom & rethinking the "fall of Rome".

Chartbook • 443 implied HN points • 18 Jun 25
💼 Business Insurance
  1. Apollo, a big player in private equity, became like a bank by adding insurance services to its business. This change was led by its CEO in 2009.
  2. The rise of artificial intelligence is a hot topic, drawing attention to its impact and potential in today's economy.
  3. There's a need to rethink historical perspectives, like the fall of Rome, to better understand how current events and trends affect us today.

The Real Cause of Health Care Dysfunction

In My Tribe • 1002 implied HN points • 17 Dec 24
🏥 Health Politics Insurance
  1. A big reason we spend so much on healthcare is that we often get expensive tests and procedures that don't help us much.
  2. Simply making more people eligible for Medicare won't fix the problem of overspending in healthcare.
  3. Many people like to think that healthcare costs are high because of greedy doctors or insurance companies, but that's not the main reason.

Cigna said to be going after Humana to buy its way into Medicare Advantage

HEALTH CARE un-covered • 519 implied HN points • 28 Nov 23
💼 Business Insurance
  1. Cigna is looking to acquire Humana to strengthen its position in the Medicare Advantage market. This is important because Medicare Advantage is a growing and profitable area in health insurance.
  2. If the deal goes through, Cigna and Humana together would have around 30 million health plan enrollees in the U.S., but they would still be smaller than their main competitor, UnitedHealthcare.
  3. Cigna's focus on this acquisition shows that they see it as a strategic move to grow, especially since both companies are shifting away from their commercial insurance businesses.

You should get a pre-nuptial agreement

Something to Consider • 79 implied HN points • 18 Jun 24
💰 Finance Insurance
  1. Getting a pre-nuptial agreement is like buying insurance for your marriage. It protects both partners in case things don't go as planned.
  2. Many people think a prenup shows distrust, but it actually helps avoid messy court battles later. It's about planning for the future.
  3. Not having a prenup means accepting a default contract from the state. It's better to negotiate your own terms when you both feel good about each other.

Private Medicare blitz: for-profit health insurers are pressing hard for new enrollees in their taxpayer-supported Medicare businesses in 2024

HEALTH CARE un-covered • 519 implied HN points • 20 Nov 23
🏥 Health Politics Insurance
  1. Private Medicare plans are trying hard to gain new members, often using appealing offers like gym memberships and grocery cards to entice seniors.
  2. Many seniors who switch to these plans may face unexpected costs, like high deductibles, and risk being denied coverage for essential medical services.
  3. It's important for seniors to carefully consider the long-term impact of switching to private Medicare plans, especially if they have serious health needs.

Ticker Take: a weekly newsletter on investing.

Jon’s Newsletter • 119 implied HN points • 19 May 24
💰 Finance Insurance
  1. Investing in utilities could be a smart move as demand for power grows due to the rise of AI and data centers.
  2. The stock market has shown strong recent performance, with predictions of further gains this year based on solid earnings and market momentum.
  3. There's a noticeable trend in retail investors participating in meme stocks, indicating a lasting shift in how a generation approaches investing in the stock market.

First half of 2023: 7 big health insurers pulled in $683 billion in revenues – largely through taxpayer-supported programs and the pharmacy supply chain

HEALTH CARE un-covered • 619 implied HN points • 06 Sep 23
🏥 Health Politics Insurance
  1. In the first half of 2023, seven major health insurance companies made over $683 billion in revenue, mainly from government programs like Medicare and Medicaid. This shows a lot of reliance on taxpayer-supported programs.
  2. Despite these huge profits, Wall Street is not satisfied with the health insurers. Investors believe the companies are not raising premiums enough to keep up with demand for healthcare after pandemic delays.
  3. To please investors, these insurers may increase premiums for customers and limit coverage for medical care. This trend highlights the struggle between corporate profit motives and patient care.

The LOOP NOW Coalition sent a letter to Congressional leaders asking them to introduce bipartisan legislation to begin reducing Americans’ exposure to absurdly high out-of-pocket requirements.

HEALTH CARE un-covered • 719 implied HN points • 21 Jul 23
🏥 Health Politics Insurance
  1. Many Americans, even those with health insurance, are struggling with high medical debt. This situation affects around 100 million people.
  2. The LOOP NOW Coalition is urging Congress to pass laws that lower out-of-pocket costs for healthcare. They want to limit annual expenses for medications and treatments.
  3. Currently, out-of-pocket health costs can reach over $9,000 for individuals, which makes it tough for families to afford necessary care. The coalition is working with lawmakers from both parties to tackle this issue.

An epidemic of medical debt is devastating American families as health insurers ratchet up out-of-pocket demands

HEALTH CARE un-covered • 439 implied HN points • 20 Oct 23
🏥 Health Politics Insurance
  1. Many American families are struggling with medical debt because health insurance companies are making them pay more out of pocket before they get any help. This leaves lots of people feeling like they don't have any insurance for most of the year.
  2. The rise in medical costs is leading to serious financial problems, with a large number of people owing money due to health care expenses. This debt crisis affects millions, and many people feel they might never fully pay it off.
  3. The way healthcare is organized forces people to pay higher costs for their care, often putting them in tough situations where they can't afford necessary treatments. Despite promises of affordable care, the system still seems to favor higher spending on healthcare.

Health insurers find new way to drain the bank accounts of Americans with chronic conditions

HEALTH CARE un-covered • 459 implied HN points • 26 Sep 23
🏥 Health Politics Insurance
  1. Health insurers are changing rules that make it harder for people with chronic illnesses to pay for their medications. This is causing patients to spend much more money out-of-pocket.
  2. Copay accumulators are a new tactic where insurance companies do not count discounts from drug manufacturers towards patients' out-of-pocket limits, making medications even more expensive.
  3. Legislation is being introduced to help protect patients. Bills are being considered at both state and federal levels to ensure that all payments count towards out-of-pocket expenses.

The Killing of Brian Thompson

The Chris Hedges Report • 719 implied HN points • 05 Dec 24
🇺🇸 U.S. Politics Insurance
  1. The CEO of UnitedHealthcare, Brian Thompson, was recently killed, sparking questions about possible motives related to healthcare policies and insurance denials.
  2. In the U.S., healthcare spending is highest among wealthy countries, but health outcomes are among the worst, with many people facing financial ruin due to medical bills.
  3. The business practices of health insurance companies are criticized for prioritizing profits over patient care, which can lead to unnecessary suffering and death.