Tag Archives: Healthcare

Coverage denials as reported by the Commonwealth Fund today almost never happened in the past and was a rare occurrence. The insurance companies would concede to the findings of the examining doctors. The methodology being used today is to deny, deny, deny until the insured and the doctor give up. I think it was 1997 when a fictional story “The Rainmaker” became a movie, The issue was a bone marrow transplant which was denied by the healthcare...

r.j. sigmund‘s notes on Covid Metrics It appears all US Covid metrics are now heading down except for deaths, but we can expect deaths to head lower in a week or two as well, as the reduced numbers of those who are newly infected work through the health care system…among the CDC’s “early indicators” “test positivity”, or the percentage of tests for Covid that were positive, fell to 16.3% during the week ending August 31st, after test positivity ...

Much of this is the result of commercial healthcare gaming the system with pricing. Medicare Advantage can not compete head-to-head with Traditional Medicare much less the VA. VA sent me to Barrows (Arizona) for an issue with my back and right leg. I was going numb and it was painful to walk. So to make up for just giving me epidural shots in my spine (surgeon’s suggestions), they decide to work on my blood pressure, cholesterol, and weight. They...

Suppose that you wake up tomorrow and discover that a sadistic alien has turned you into an economist.  You are just getting over your shock at your new predicament (“How will I make friends?  Will anyone ever trust me again?  At least I’m not a lawyer.”) when Kamala Harris, responding to voter concerns about inflation, makes a vague statement in favor of government restrictions on the price of groceries.  It just so happens that you have a...

I found this report on Health Affairs a day or so ago. It was long and I spent the last two days condensing it so it could be presented and read on Angry Bear. Briefly, the author(s) detailed four main prices which consist of a List Price, an Out-of-Pocket Price, Insurer’s responsibility price, and the Negotiated price once all rebates are accounted. Exhibit 1 is a quicky study to understand how the authors arrived at the breakdown. Also detailed is...

Been lucky to have Andrew Sprung of xpostfactoid writing on the topic of perpetrators conceiving, executing, and expanding their carefully planned scheme of large-scale unauthorized plan-switching amongst ACA healthcare insurance subscribers. In the end, people switched over to other plans get lesser healthcare insurance than what they had signed up for initially with a different plan. The plan switch generates a bonus for the person selling a plan...

New Medicaid Rule Adds Fuel to The Fire of Commercial Hospital Price Inflation, Health Affairs Opinion Piece Hospital services prices grew faster than any other sector of the US economy. To address the underpayment of hospitals by Medicaid, the federal government issued a regulation correcting the underpayment of hospitals. However, the issue of higher prices and Medicaid paying more to correct the underpayment does not fit in the opinion of The...

Two in five Americans have outstanding health care bills, according to the Kaiser Foundation. Those with payments overdue are more likely to be uninsured, low-income, and either Black or Hispanic. What’s more, the total amount of outstanding medical debt in the United States is much bigger than people think. ~~~~~~~ Most states have not yet enacted laws preventing the accrual of medical debt, but many have implemented protections for people who...

The university where I was on faculty for 37 years has one of ten NIH-funded vaccine testing and evaluation units in the US. I vividly recall attending a presentation by the clinical director of our vaccine center in January of 2020 on the then-new SARS-CoV-2 virus. By the summer, our vaccine center became a clinical trial site for the Moderna mRNA vaccine. I immediately enrolled, even though I knew I had a 50% chance of being in the placebo arm (in...

Biden-Harris Admin awards $100 Million to navigators to help Americans sign up for healthcare coverage by Charles Gaba ACA Signups ~~~~~~~ The Biden-Harris Administration today continued its historic investment in health care coverage and the Affordable Care Act (ACA) by awarding a new round of $100 million to organizations vital to helping underserved communities, consumers, and small businesses find and enroll in quality, affordable...