A #NewYork state #SupremeCourt judge “permanently” blocked Mayor #EricAdams' administration on Friday from shifting hundreds of thousands of municipal retirees off their #Medicare #insurance onto a privatized version of the plan, but the city immediately vowed to appeal the ruling.

https://gothamist.com/news/judge-permanently-blocks-medicare-advantage-switch-for-nyc-retirees-city-to-appeal

We Can Stop #Drug Price #Gouging. Here’s How

We human beings sometimes do some terrible things in pursuit of the almighty dollar. But to our credit, one moral line most humans don’t cross is to gouge sick people on the price of medicines their lives depend on

Unless, of course, you count executives of giant #pharmaceutical corporations as human beings. Gouging patients is their preferred business model

our #Medicare program can now negotiate drug prices on our behalf.

https://www.counterpunch.org/2023/09/11/we-can-stop-drug-price-gouging-heres-how/

“If there’s a profit in it, then they’ll do it. They’re not going to do a single thing that doesn’t benefit them, first and foremost.”

Excerpt From
These Are the Plunderers p. 268
Gretchen Morgenson & Joshua Rosner

#privateEquity #bookstodon #nonfiction #predatoryCapitalism #hospitals #medicare #healthcare #stewartHealthCare #stewartHealth #nashobaValley

.
<<<Email2Toot ROBOT -- CHECK ACTUAL AUTHOR BELOW:
EMAIL LIST: https://www.clinicians-exchange.org & LEMMY: https://lem.clinicians-exchange.org

-------- Forwarded Message --------

NOTES/ COMMENTS Re., “ROLLING MEDICAID PURGE….LARGEST CONCENTRATION OF
HEALTH INSURANCE LOSS IN US HISTORY"

* The COVID-19 pandemic demonstrated the urgent need for expansion ,
NOT REDUCTION, of the Medicaid health insurance program.
*  In too many states, political decisions by state legislators to
deny health insurance to thousands of their citizens has resulted in
an almost non-existent social and health safety net.

*  Decisions in 2016/2017 by 25 states to reject the expansion of
Medicaid coverage under the Affordable Care Act resulted in an
estimated 7,115 and 17,104 more deaths than had all states opted in,
according to researchers at Harvard Medical School and the City
University of New York.
* The researchers found that because of the states’ “opting out” of
the Medicaid expansion, 7.78 million people who would have gained
coverage remained uninsured.
* To worsen the situation, many states have over the last decade
privatized administration of their Medicaid program into a managed
care program administered by the private profit health insurance
industry.

* The companies are paid by state government, and their profit depends
on spending as little as possible on Medicaid patients.
*  It’s hard to imagine any greater disconnect between public good
and private profit: the interest of private health insurance
companies lies not in the obvious social good of delivering quality
health care to patients but in having as few as possible treated as
cheaply as possible.
* No better example exists of a private capitalist enterprise that
feeds on the misery of man.

* You might think that we learned the lesson of discredited managed
care in the 1990s.
*  The term “managed care” is confusing to many, but really amounts
to managed reimbursement rather than managed care.
* A set prospective annual payment is made by federal/state
governments, as in the case of state Medicaid managed care, to cover
whatever services patients will receive over the coming year.
* There is therefore a built-in incentive for managed care
organizations to skimp on care and pocket more profits.

 Regards,
              Doug Stephenson. LCSW, BCD
              Gainesville, Florida

* ______________________________________________________________________________
*

* LINK: Rolling Medicaid Purge Called 'Largest Concentration of Health
Insurance Loss' in US History

https://www.commondreams.org/news/medicaid-insurance-loss

~~~
 #health #healthcare #medicare #medicareadvantage #medicare-for-all
#medicaid #healthsafetynet #managedcare #ACA #affordablecareact #obamacare>>>
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @PsychResearchBot

.
<<<Email2Toot ROBOT -- CHECK ACTUAL AUTHOR BELOW:
EMAIL LIST: https://www.clinicians-exchange.org & LEMMY: https://lem.clinicians-exchange.org

TITLE: Interesting comments from editor of NAKED CAPITALISM re., "M4A,
NOT MEDICARE ADVANTAGE"

-------- Forwarded Message --------

Hi:

      FYI, very interesting comments from Ms.Yves Smith, editor of the
website, “Naked Capitalism”:

               (Posted on August 24, 2023 by Yves Smith)

"Yves here. This post provides an important, detailed takedown of the
travesty known as Medicare Advantage. If you are in the US and watch
what I call old people TV (syndicated classics and crime shows), you’ll
be bombarded by Medicare Advantage come-ons at this time of year. The
fact that Medicare Advantage is profitable enough to support close to
blanket-level commercials should tell you that not enough of the premium
dollars are going for health care.

Medicare Advantage is serving as a second-tier scheme for
budget-stressed Social Security recipients, since many plans are
nominally “no fee,” as in there is no deduction from Social Security
payments, unlike for Medicare B (doctor coverage) and D (prescription
coverage). But since there is no such thing as a free lunch, the lack of
premiums is recouped via skimpier coverage.

But even worse, the health insurance industry hopes to increase the
market share of Medicare Advantage and eventually displace traditional
Medicare, and it has far too many supporters in Congress and the
Administration.

Please circulate this post widely, particularly to those of Medicare
age. And in particular, exhort recipients to contact their Congress
critters and support legislation (“The Medicare for All Act of 2023”
House Bill, (H.R. 3421, and Senate Bill S. 1655, which would end
Medicare Advantage, as well as the stealth private insurer takeover of
traditional Medicare via Direct Contracting Entities and REACH plans,
described in detail below.

Also note the shout out to Michael Hudson!"

Regards,
                Doug Stephenson, LCSW, BCD
                GNV, FL
__________________________________________

LINK TO NAKED CAPITALISM:

Medicare for All, Not Medicare Advantage

https://www.nakedcapitalism.com/2023/08/medicare-for-all-not-medicare-advantage.html

 #health #healthcare #medicare #medicareadvantage #medicare-for-all
__________________________________________________>>>
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @PsychResearchBot

Exploiting Nursing Homes and Medicare: The Shocking Path to Wealth. How does you mom's nursing home rank? https://thedemlabs.org/2023/09/08/exploiting-nursing-homes-and-medicare-the-shocking-path-to-wealth/
#medicare #nursinghome #youngkin #rickscott

“Private equity–backed health care has been a disaster for patients and for doctors,” said Mark Reiter, residency program director of emergency medicine at the University of Tennessee. “Many decisions are made for what’s going to maximize profits for the private equity company, rather than what is best for the patient, what is best for the community.”

These Are the Plunderers
Morgenson & Rosner

#privateEquity #bookstodon #nonfiction #kkr #predatoryCapitalism #hospitals #medicare #healthcare

“When COVID-19 hit, hospitals owned by private equity firms were among the first to cut their workers’ pay and benefits because their operations could no longer generate profits on elective surgical procedures delayed due to the pandemic.”

Excerpt From
These Are the Plunderers
Gretchen Morgenson & Joshua Rosner

#privateEquity #bookstodon #nonfiction #kkr #predatoryCapitalism #nursingHome #medicare

Yesterday I got my Medicare Summary Notice, a quarterly report documenting services and supplies that Medicare has paid for on my behalf. I usually glance at these to see if there might be an impending bill for me, for something that Medicare and/or the secondary insurance did not fully cover. Imagine my surprise when I discovered that Medicare had been billed for two batches of urinary catheters (total of 400 units) that were supplied to me last April and May by a home-care provider based in Bethel, Connecticut. Grand total for these was $3800, and after Medicare paid what Medicare allowed, I might still be on the hook for almost $700.

So I called the Medicare fraud number, waited on hold and provided copious amounts of information to “verify my identity”, and pointed out that I did not remember getting these catheters in Connecticut, and I was pretty sure that catheterization would have been memorable, at least according to what I have read and heard. The lady on the other end of the line agreed that it probably would be something that I remembered, and initiated a “fraud investigation” process that would get to the bottom of this. So far, so good.

I asked if I should contact the secondary insurance folks, since they had probably been billed for the $700 remainder, and was told that I should definitely do that. Another phone call, another wait on hold, another reciting of information to verify my identity, and the outcome of this one was that the company who allegedly delivered the catheters to me was already known to them as fraudsters. Dunno why the Medicare folks did not have the same information, but apparently, they did not, since they paid most of the bill submitted by the fraudsters. I hope that they can get it back before the GOP accuses Hunter Biden's laptop as a co-conspirator.

So pay attention to your mail, fellow oldsters, and you too could get hours of entertainment like this!

#Medicare #Fraud

Sure millions of people died and more will die, but at least we saved money. <Sarcastic paraphrase>
"Medicare may even wind up saving money because of Covid-19 — because the older Americans who died from the disease tended to have other illnesses that would have been expensive to treat if they had survived, according to an analysis from the Medicare actuary."

Free gifted article #COVID #Medicare

https://www.nytimes.com/interactive/2023/09/05/upshot/medicare-budget-threat-receded.html?unlocked_article_code=hs08LwKchPgR1K-496A-LYXV5hS73LRYxQZccZrM8vfADFtvqv0G2YFnEi81yvbLKFAcWI7UWzRdLUfzWefA8KOOlUu0WHb1fHDM-ySDAZGFYmoDbXy7iKceM47kLuHNe2jR2fDm8iZAz15uFxwOpkC8qOPvBjh0eKyqTgZC2f_B_lA1Jgingu3r3roZbCnq-3vLqiqGaynOI0g6CPGkwJA6lKRYLo5Xh1s_HYEgczLg_CcIW6z3wW4Avpp58qc16aHoRy14yoQLzGOHNe9WQFCSQjK0Ckec34eUSgaaynhWSUSVvO8_mp8I19GZ6QZksN0NhopmfKd-irznRiO3jBwWYQAuIWFUH119OrCsB6a7UTPsspMrbA&smid=url-share

@doot @neil @Crell

It is impossible to use Tor in #Australia to access #socialSecurity and #mediCare. If you try to visit humanservices.gov.au via #TorBrowser you will see how bad the situation is.

People are going without basic social benefits.

#humanServices#inhumanServices #imprisonList #akamai #dotConned

There is too much in the article. #layoffs #healthcare #Medicare #covid #austin

https://www.austinchronicle.com/daily/news/2023-08-17/largest-mental-health-care-provider-in-austin-plans-layoffs/

An unacceptable 3.36% pay cut amid inflation is the headline. Dive into the details and learn how AMA is leading the charge to reform #Medicare pay. https://ama.smh.re/1w-

@MugsysRapSheet

I have bad news for you. Getting in to see a specialist - almost any specialist - frequently takes much, much longer than a month in most of Canada.

Outside the biggest centers, there is a shortage of virtually all specialties. Unless your G.P. refers you on an emergency basis, or you're in an E.R. and the doc there calls for one, a wait of 3-6 months is common enough, depending on the specialty.

Much longer in some cases.

#medicare #SinglePayer

@charlesgaba @BrayingBoozehound Much like #Medicare Advantage, which is also a huge scam.

Negotiations on prices of drugs like Xarelto and Enbrel are set to begin this fall. But this professor of public health has doubts about whether #Medicare and the federal govt can overcome obstacles put up by the pharmaceutical industry. https://medium.com/wise-well/will-medicare-negotiations-with-pharmaceuticals-really-cut-drug-prices-824942e8c90e

#medicine #healthcare #medical

Humana is suing the Biden administration over Medicare Advantage audit rule.

An explanation of what the lawsuit is about:

https://www.statnews.com/2023/09/01/humana-sues-medicare-advantage-audit/

#health #healthcare #medicine #insurance #healthinsurance #medicare #CMS #MedicareAdvantage

How The U.S. Is Finally Taking On Big Pharma

https://www.youtube.com/watch?v=A7VlsQSjhtE&ab_channel=MorePerfectUnion

Biden and the Democrats finally implemented something that's been debated for decades — letting Medicare negotiate down the price of drugs.
Now big pharma is suing, calling it extortion. But they make billions charging Americans 3x what they charge in other countries.

#pharma #bribery #confrontation #medicare #negotiation #pricegouging #greed #suffering #immorality

From @STAT:
"A new paper suggests a simple fix to the primary care physician shortage"

TLDR? Have #medicare ( #CMS ) pay them more. #healthinsurance too

This has been discussed in the media and a big subject of advocacy for decades but apparently you can still publish a paper about it now.

#directprimarycare allows physicians and patients to fix #primarycare without waiting for this.
#internalmedicine #pediatrics #familymedicine #medmastodon #RUC #AMA
@missanabeem
https://www-statnews-com.ezproxy.library.tufts.edu/2023/09/01/primary-care-physician-shortage/

How Health Insurers Have Made Appealing Denials So Complicated
==

"I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals.

"Nearly everyone said the same thing: Great idea. But almost impossible to do."

#Insurance #HealthCare #Health Hospitals #Patients #Doctors #Medicare #Medicaid

https://www.propublica.org/article/how-to-appeal-insurance-denials-too-complicated?utm_medium=social&utm_source=mastodon&utm_campaign=mastodon-post