Tag Archives: Healthcare

Decoding Medicare Advantage by Andrew Sprung xpostfactoid Can STAT’s exposure of UHC’s exhortations to goose Medicare Advantage enrollees’ risk scores spur action to reduce MA overpayment? Load these Codes It is beyond reasonable doubt that the federal government’s payments to Medicare Advantage plans are grossly inflated by the plans’ gaming of the program’s risk adjustment system, designed to deter plans from cherry-picking health...

– by R.J. Sigmund Most of the demographic indicators of this summer’s Covid wave continued to recede rapidly in this week’s reports, and wastewater levels of the virus, the most definitive indicator of infections, have fallen to “low.” Among the CDC’s “early indicators” “test positivity”, or the percentage of tests for Covid that were positive, fell to 7.7% during the week ending October 5th, down from 9.5% positive during the week ending...

While this is called Medicare, it is Medicare which has been commercialized. Medicare pays additional fees subsidizing the insurance plan companies (United Healthcare, WellCare, Script, etc. offering Medicare Advantage plans Not only have healthcare plans are cutting services, healthcare systems are also pulling out of Medicare Advantage Plans. Both Joel and I discussed twenty-something different healthcare plans dropping Medicare Advance. 34...

If we were to look at the costs of healthcare insurance for families and businesses, it has not remained the same percentage-wise for employers or employees. My initial sentence is a backwards way of saying costs are increasing faster than gains in income for either. Nothing has changed here and the foes to single payer in government and industry keep insisting this is the better way to provide healthcare. Edward Kennedy died too soon to help us...

The old model of a single doc running a practice is disappearing in America. Between the overhead and the reduced compensation, this model of health care delivery looks increasingly anachronistic.When I started as an assistant professor at a medical school in 1987, there was a lot of money sloshing around. Patients and their insurance companies would pay a premium to be seen by docs in an academic health care practice. Managed care put an end to that,...

I’ve posted here before about herd immunity. Prior to inoculation/vaccination, herd immunity was the result of enough people dying or surviving that the transmission of the disease (plague, smallpox, etc) was arrested in that population until the next generation of uninfected people grew up, whereupon the substrate for another round of death appeared.But let’s be clear: the survivors weren’t necessarily healthy. Many polio survivors spent the rest of...

This is just a partial of a much longer commentary by Health Affairs on Employer healthcare insurance for single employees am employees with families. “Health Benefits In 2024: Higher Premiums Persist, Employer Strategies for GLP-1 Coverage and Family-Building Benefits,” Health Affairs. I have used two of the charts to emphasis what is occurring. The first chart will show the variance between single and family coverage 1999-1924. The second chart...

While I was raised Roman Catholic, I had already rejected the RCC teaching on abortion by the time I started high school. That teaching was not grounded in the Bible, nor was it grounded in biological science.Most human conceptuses never make it to term, making God the greatest abortionist of all time. And mammalian stem cells have the potential to develop into a complete animal in every case where it’s been tested, so destroying a “potential” human...

If you must know before you dive in, this is a long read. It is also a presentation of a report. Very little editing has been done to it. Editing which may have been done is to make it clearer in explanation. I believe it presents a clear explanation of healthcare in the US. My own experience with one group of doctors in the Phoenix was rather disheartening. I was there for spinal and back issues. They were more interested in my blood pressure,...

Vaccines are an unalloyed triumph of public health. That Donald Trump is attacking vaccines—any vaccines—is obscene.“ . . . on at least 17 occasions this year, Trump has promised to cut funding to schools that mandate vaccines. Campaign spokespeople have previously said that pledge would apply only to schools with COVID mandates. But speeches reviewed by KFF Health News included no such distinction — raising the possibility Trump would also target...