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  • A Supreme Court decision is expected to hold dramatic consequences for the nation’s health care system

    The U.S. Supreme Court decided in 1984 that judges should defer to federal agencies in interpreting ambiguous parts of statutes. Called the Chevron rule, the court ruled that it should let experts decide how best to handle issues. The U.S. Supreme Court overruled Chevron in June. That may throw health care into chaos. This article is long and a bit wonky but important. It explains the effects possible to our health care . https://kffhealthnews.org/news/article/supreme-court-chevron-deference-doctrine-health-care-policy-shockwaves/?_hsenc=p2ANqtz--dY_Jq2EcD2bTGclbk8g2Tr1Y_G8GmFqyuguxrmcr9CdNpDNMRoV1duOJN6evq_UWYWD2e4jAYhGYZQ2DwkEme8o0zwA&_hsmi=314302999

  • Shrinking drug coverage puts Americans in a medical (and monetary) bind

    Insurers are doing a few things that are making medications more expensive for Americans. Insurers are doing a few things that are making medications more expensive for Americans: Covering 19% fewer medications. In 2010, the average plan covered 73% of prescribed drugs. In 2024, the average plan covered just 54% of prescribed drugs and 25% of Americans have at least one prescription not covered by insurance, leaving consumers to have to pay for the full cost of their medication. Restricting more covered drugs. The average number of drugs with restrictions in Part D plans increased by 23%, from 27% of drugs in 2010 to 50% of drugs in 2024. Restrictions include quantity limits, step therapy which requires patients to try a lower-cost drug before accessing a more expensive prescription medication, prior authorization requirements, and refill-too-soon limits. Patients either “jump through hoops” to get their medications covered, pay for it themselves or delay taking or abandon their medication completely. find out more by reading https://www.usatoday.com/story/money/personalfinance/2024/07/01/shrinking-drug-coverage-insurance-impact/74240289007/

  • The doctor will fee you now

    Many times patients email requests with questions to avoid the cost of a visit. From signing patient documents to emailing responses to patient questions, doctors are increasingly charging fees for these types of administrative tasks. Responding can add hours of unpaid work to a doctor's day for work. https://bit.ly/3z3RIBe

  • Senators Introduce New Bill for Transparency and Oversight in Health Care Transactions and Investment

    On April 3, 2024, Senators Ed Markey (D-Mass) and Elizabeth Warren (D-Mass) released draft legislation titled the “Health Over Wealth Act” (the Proposed Bill). This Proposed Bill is another attempt to regulate private equity’s role in the healthcare sector – attempting to provide corporate transparency, government oversight, and regulation of for-profit investment in healthcare. Tell Senators Markey and Warren, and your state representative you support this Act and want it to pass! https://bit.ly/4c3K9sU

  • U.S. Healthcare is increasingly like a casino

    In the post-pandemic era, having insurance is only the first step toward receiving quality care. Where Americans live, their health status and a range of socioeconomic factors increasingly determine their experience with the health care system, and in many cases that experience appears to be getting worse. https://bit.ly/3KF6bGk

  • Mark Cuban’s Cost Plus Drugs Sparks Others To Change How Rx Meds Are Priced

    The former Shark Tank star offers a transparent way for patients to obtain affordable drugs. The firm now offers prescription drugs—mostly generics—to over 2 million members. Drugs are sold for a fully disclosed price plus a 15% markup, a $5 pharmacy service fee and a $5 shipping fee. It added another 1,000 medicines in December to the list of now 2,200 drugs it sells directly to patients. https://bit.ly/3RiEx63

  • Humana and CVS are downsizing their Medicare Advantage plans for 2025. Which insurers could benefit?

    Humana and CVS, two of the largest Medicare Advantage insurers in the country, are poised to seriously downgrade their plan benefits and drop covering unprofitable counties next year as they chase profits in the privately run Medicare program. This article is fairly wonky, but it's worth reading because it may have serious consequences for you. Mark your calendar with a note to check all available plans during open enrollment in the fall to determine (crystal ball, please) which will cover what you need and want. https://bit.ly/3z0ZM5O

  • A Mom’s $97,000 Question

    How was a two-month old baby’s 86-mile Air-Ambulance Ride Not Medically Necessary? Reach Medical Holdings , which is part of Global Medical Response , an industry giant backed by private equity investors operates in all 50 states. It claims to have 498 helicopters and airplanes. It was out-of-network with the parent's Cigna plan. Cigna declined to cover any part of the bill. Total Bill: $97,599. https://bit.ly/45aA7Uh

  • He went to the ER in Taiwan, then his "Horrors of Socialized Medicine" post went viral

    His total bill was $80. Eighty. American. Dollars. Full cost. At one of the best hospitals in Taiwan. No out-of-pocket, no insurance, no discounts. We live in a country that claims to be the greatest in the world, but where an emergency trip to the hospital can easily bankrupt someone. https://bit.ly/4echIe8

  • Private Equity - Taking Over Health Care

    The private equity business model is incompatible with patient care. Here's why. (click the red arrow to open the video)

  • Nursing Homes Wield Pandemic Immunity Laws To Duck Wrongful Death Suits

    More than 172,000 nursing home residents died of Covid. H undreds of lawsuits blaming patient deaths on negligent care have been tossed out or languished in the courts amid contentious legal battles, citing a New York state law hastily passed early in the pandemic. It granted immunity to medical providers for “harm or damages” from an “act or omission” in treating or arranging care for Covid. https://bit.ly/4cb4hJU

  • Prescription drug ads should soon start looking noticeably different

    A federal transparency rule takes effect in June 2024 requiring commercials to clearly spell out potential side effects and when a person should avoid the medicine. The effort, more than a decade in the making, could demystify those rapid-fire disclaimers at the end of TV and radio ads through steps like simultaneous text that is displayed long enough to be read easily. Now to stop them from being so loud. DID YOU KNOW? The FDA approval process includes testing only for safety and effectiveness. It does not approve other claims made in advertisements. BEWARE. https://bit.ly/3Vx9ENv

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