Tag: health insurance

Hospitals stunned by Senate GOP’s Medicaid plan

Posted on by Lone Candle

““No senator wants to be the reason their local hospital shutters its doors, and now is their opportunity to stop that from happening,” said a source familiar with hospital industry thinking, granted anonymity to speak freely on strategy.

More than 250 hospital leaders flew into Washington on Tuesday to urge senators to preserve Medicaid as part of an American Hospital Association lobbying campaign. The association spent almost $8.5 million on lobbying in the first quarter of the year, a high water mark dating back almost two decades.

“There are aggressive conversations ongoing … to make sure that all senators recognize the vulnerability that it is going to potentially put all of our hospitals in,” said one stakeholder granted anonymity to speak on strategy”

https://www.politico.com/news/2025/06/17/hospitals-senate-medicaid-megabill-taxes-00410769

Republicans Are Lying To You And They Don’t Care

Posted on by Lone Candle

The Republican claim that their bill’s Medicaid cuts won’t take away people’s health insurance because people will get employer health insurance is either spoken out of dishonesty or ignorance. Many people on Medicaid will not be able to get a full time job that supplies benefits like health insurance. They will be paid little and not receive health insurance. Medicaid expansion has not shown to increase unemployment.

https://www.youtube.com/watch?v=x99Dk844qZY

Exposing UnitedHealth’s Greed | George Joseph | TMR

Posted on by Lone Candle

Medicare Advantage private health insurance companies have a strong say in whether someone gets elevated medical care. They have the incentive to see you as healthier than you are so they don’t have to pay for Medical care. Whistleblowers say that United Healthcare has said something like ‘they are old anyways, so maybe no one will notice’.

United Healthcare apparently illegally incentivized nursing homes to give United Healthcare leads so the insurance company can sell old people products. Families have complained that their loved ones were sold products when the elderly family member was not capable of making such a decision.

https://www.youtube.com/watch?v=5ikJ9t2OVis

Insurers Failed to Comply With Mental Health Coverage Law, Department of Labor Report Finds

Posted on by Lone Candle

“Health plans, and the companies that administer them, have excluded key behavioral treatments, such as therapies for substance use and autism, and offered inadequate networks of mental health providers, according to a 142-page report released Jan. 17 in conjunction with the Treasury and Health and Human Services departments.

The report, which the agencies are required to file regularly to Congress, also detailed the results of secret shopper surveys of more than 4,300 mental health providers listed in insurance directories and found an “alarming proportion” were “unresponsive or unreachable.” Such error-ridden plans, commonly known as ghost networks, make it harder for patients to get the treatment they need, ProPublica has previously found.

Since 2021, the Labor Department has addressed violations in health plans that serve more than 7 million people, according to the report. The agency has worked to remedy the problems by seeking changes to plan provisions, policies and procedures, as well as working to ensure wrongly denied claims were paid.

But the report acknowledged that while plans and insurers have made some progress, they continue to fall short.”

https://www.propublica.org/article/department-labor-investigation-health-insurance-doctors-healthcare

A big insurer backed off its plan to pay less for anesthesia. That’s bad.

Posted on by Lone Candle

“this particular fight was not actually about putting the interests of patients against those of rapacious corporations. Anthem’s policy would not have increased costs for their enrollees. Rather, it would have reduced payments for some of the most overpaid physicians in America. And when millionaire doctors beat back cost controls — as they have here — patients pay the price through higher premiums.”

…

“the avarice and inefficiencies of private insurers are not the sole — or even primary — reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America’s health care providers — hospitals, physicians, and drug companies — charge much higher rates than their peers in other wealthy nations.”

…

“In 2023, the average physician salary in the United States was $352,000. In Germany, that figure was $160,000; in the United Kingdom, it was $122,000; in France, it was $93,000.
This discrepancy is partly explained by the fact that those European nations have more socialized health care systems, in which the government imposes more cost controls on medical providers. In the past, progressives have emphasized that a Medicare-for-all system would reduce overall health care costs by forcing providers to accept lower payments.

With its new policy, Anthem was attempting to do precisely this: force anesthesiologists to accept lower rates of reimbursement.

And the case for forcing down payment rates for anesthesiologists is especially strong. According to Medscape’s 2024 Anesthesiologist Salary Report, the average salary for an American anesthesiologist in 2023 was $472,000. This represented a $70,000 increase over the field’s average salary in 2022. This puts anesthesiology in the top 10 highest-paid physician specialties in the United States.

If we want America’s health care system to treat more patients — while charging us all less money for coverage — then there is no alternative to forcing myriad specialists to accept lower payment rates.”

https://www.vox.com/policy/390031/anthem-blue-cross-blue-shield-anesthesia-limits-insurance