The sickest patients are dropping private Medicare Advantage plans for traditional Medicare, shifting billions in costs from insurers to taxpayers. “I started freaking out.” wsj.com/health/healthc… via The Wall Street Journal

UnitedHealth pays its own physician groups considerably more than others, driving up consumer costs and its profits statnews.com/2024/11/25/uni… via STAT

Government And Commercial Insurer Payment Rates To Hospitals: A Commentary On Priselac | Health Affairs healthaffairs.org/content/forefr…

Indiana Hospitals Pull Merger Application After Pushback Over Monopoly Concerns kffhealthnews.org/MTk0ODU1Mg via @kffhealthnews

Taxpayers spend 22% more per patient to support Medicare Advantage – the private alternative to Medicare that promised to cost less theconversation.com/taxpayers-spen… via The Conversation U.S.

Looks like a big win for Medicare Advantage insurers. Is this a harbinger of more MA insurer giveaways to come?

from Wendell Potter

Recently spoke with a doc who founded a profitable clinic that was later sold to a large hospital system. But then the nonprofit hospital added a 2nd front desk staffer (5 FTEs for a 24/7 business), added 2nd security guard, hired a dedicated lab tech despite nurses previosuly

Fact check: True This loophole encourages companies to move production and profits offshore even when selling to American consumers at the expense of domestic firms and workers. Closing it would create American jobs and raise $70 billion over 10 years. Here's how it works:

These are some of the new administrative costs generated by the No Surprises Act's unnecessary reliance on arbitration to handle out-of-network payment disputes, which we all end up paying for in higher premiums & taxpayer subsidies.

The report can be found here: arnoldventures.org/resources/redu…

Imagining the counterfactual had DOGE done the job like a turnaround CEO would have: spend the first 100 days on a listening tour and rapid assessment and then come out with a comprehensive plan of reforms, cuts, and vision for the future.

A post on drug patents, exclusivity periods, and Medicare negotiation, and how pharma is trying to use the complexity to pull a fast one to grab $10 billion. A pharma company gets 20 years of patent protection on a drug, starting from date of filing. However, due to lengthy

A note about Medicaid work requirements, false negatives, and a better path forward. There’s an ongoing debate about whether able-bodied adults should be required to engage in productive work to qualify for the social safety net. Most Americans support some level of personal

Medicaid “work requirements” is a catchall phrase for a variety of ways to qualify: work, schooling, caregiving, community service, addiction, and disability. In polls, the majority of Americans support this concept. The challenge isn’t the concept—it’s the implementation. The

This new spending in the OBBB is all nice-to-haves if we were on stable fiscal footing. But we're not. Pushing these while running wartime level deficits, with interest rates near 5% and lingering inflationary pressures, is out of touch with economic reality.

Republicans Are Turning on Medicare Advantage, by Wendell Potter open.substack.com/pub/healthcare…

The most vocal critics of the debt and deficit tend to be people who run successful trading businesses: Dalio, Griffin, Druckenmiller, Singer, Solomon, Gross, Dimon, Gundlach, etc. Here's my theory why... Every successful trading business is grounded in risk management.