Image By Sidney Haitoff

Sidney’s Image is proof a picture is worth a thousand words. Sidney’s Image explains the difference between the failed legacy health plans of the past 40 years and all the value draining third party baggage it brings versus New Era Healthcare that’s disrupting healthcare delivery, finance and access in far better and more cost effective ways than proponents of more government control have ever dreamed about in deep sleep stupor.

SOURCE: ActivityCovered.com

Salvasen Health burst onto the health insurance scene in 2020 with big promises of affordable, comprehensive health coverage. However, behind the glossy marketing was an illegal operation that left thousands of customers without the coverage they paid for.

“Insurance is designed for catastrophic events, not for low-cost events. We don’t buy Flat Tire Insurance, or Fan Belt Insurance. So why do we buy Primary Care Visit Insurance? – Don Pedro

Hospital’s cost saving discharge strategy hinges upon patient attaining room temperature

By Jeff Evans

DO WE HAVE THE STOMACH TO CUT HEALTHCARE COSTS?

Everyone complains about the high cost of healthcare and health insurance. But can you really complain if you’re not willing to do something about it.

“Why do something today when it can be done tomorrow!” – Don Pedro

Revenue: $3.9m – Contracted Members: 19,450 – Clinic Count: 9 – Medical Staff Count: 52

Getting A Second Bite At The Apple: When you win but lose, keep fighting until you win and don’t lose…..

By Dutch Rojas

The Physician Shortage: Arithmetic, Incentives, and the American Delusion

“If a large employer sponsors a defined contribution plan such as an ICHRA to all full-time employees and contributes $362.50 per participating employee per month the employer’s cost will be never more than $362.50 per employee whether the employee’s share of the cost is affordable or not.”

Jeremy Bentham (1748–1832)

A 450 life self-funded health plan spends more than $1.5 million GLP-1 drugs, or about $300 pepm benefiting 20% of plan members. A majority of plan members don’t benefit at all.

Insuring worker’s paychecks has never been easier. Field quoting rate estimation is not rocket science.

Back in the day when delivering health insurance renewals I would always ask “Mr. Employer, do you insure your employee’s paycheck?”

When the answer was invariably “No” I would say “We can insure all your employee’s paycheck that will pay them 2/3 of their income all the way to age 65 after a 90 day waiting period for less than 1% of your payroll.”

Why Some People Are Microdosing Popular Weight-Loss Drugs

San Antonio is a mature Reference Based Pricing market. The first group adopting RBP did so in 2007. More followed over time as word spread throughout the business community of savings to be achieved.

A letter to his children by Col. E. Rusteberg dated 28 September, 1989

There it was, on his cap, the “Death Head” of the SS Toten Kopf, the dreaded and most feared of Hitler’s ruthless legions.

Lt. Col. E. Rusteberg – West Point 1934 – Two Silver Stars, One Bronze Star, Presidential Unit Citation (Battle of Hatten), Purple Heart. 

You are a third party beneficiary to provider contracts someone else you’ve never met negotiated. You have no clue what you have agreed to pay for care………… and no one tells you…… until you pay for care.

Your group health insurance costs go up double digits every year, year after year. You think there is nothing you can do to bring health care costs down because your broker thinks the same. You are mistaken………….and so is your broker. (Read on, it gets better)……

Katie Keith – May 22, 2025

If enacted, the House bill would severely cut federal health care spending—including the most significant cut to the Medicaid program in its 60-year history—and highly restrict eligibility for marketplace coverage. Those proposed changes are summarized here.

By Leon Wiesnieski

Yesterday I had to schedule a MRI on knee for my son. I call the hospital outpatient services and schedule. They ask “what insurance do you have”. I said none, I’m self-pay. They schedule me and tell me another person will call me to tell me the price. 1hr later I get a phone call telling me the price is $242.

Everything you need to know to save health insurance in the United States and the world

By Monte K. Jennings

By Liie Jarrouge, MD

Got high blood pressure? Here’s a pill.

Recently we looked at the rebates a mid-size group received from their PBM. We found about 45% of their total health plan spend was for prescription drugs. Of that they were consistently getting back 12% in commission (rebate) kickbacks. In the insurance industry this is called rebating.

The 340b Rx program is a government program that sets the amount of manufacturer’s rebates at better than average discounts for certain entities that qualify.

By Chris Deacon

BREAKING Litigation Alert: Major ERISA Win for Employers as 6th Circuit Blows the Lid Off TPA “Savings” Schemes

92% of all ACA Marketplace enrollees received some form of premium subsidy in 2024, with many paying significantly reduced premiums.

The ECO – Mar 21, 2025

Whistleblower Lawsuit Exposes Alleged Drug Rebate Scheme at AssuredPartners

A recent lawsuit has brought serious allegations against Evolution Healthcare and its parent company, AssuredPartners, Inc., that could have major implications for employers relying on their brokerage services.

“Employees who want you to pay for them to take weight off should be willing to commit to learning how to keep weight off.”

“what happens to people who don’t know enough to say no?”

Juanito just got started in the business and is doing great.

Years ago while flying on Braniff Airlines I reached into the seat pocket in front of me and pulled out the airline’s flight magazine. I’ll never forget the lead article as it made a big impression on me at the time.

By: Molly Gamble

Wednesday, May 14th, 2025

Below are the adjusted expenses per inpatient day in 2023 for nonprofit, for-profit, and government hospitals in every U.S. state, based on the latest estimates provided by Kaiser State Health Facts. 

Why insure office visits? That’s kind of stupid isn’t it? Insurance is for catastrophic events, not common everyday events.

“So when they continued asking him, he lifted up himself, and said unto them, He that is without sin among you, let him first cast a stone at her.” – John 8:7

The Mercedes Independent School District superintendent has been arrested on a charge of driving while intoxicated on Friday, according to Cameron County jail records.

The following is an old DPC Agreement we used in 2015. Notice the capitated rate. A large South Texas primary care clinic was the first to approve this direct to employer Agreement at the capitated rate shown which their business manager deemed “fair and reasonable.”

By Brian Gilmore | Published May 13, 2025

The House Ways & Means Committee has released its much-anticipated initial draft of the tax provisions in the reconciliation bill, which is now being referred to as “The One, Big, Beautiful Bill.”  The bill includes several significant proposed changes to health savings accounts (HSAs) and individual coverage HRAs (ICHRAs). 

By Janet Smartipants

The “One, Big, Beautiful Bill,” advanced by the U.S. House Ways and Means Committee on May 14, 2025, proposes significant reforms to Individual Coverage Health Reimbursement Arrangements (ICHRAs). These reforms aim to enhance flexibility, provide tax incentives, and solidify the legal framework for ICHRA . SOURCE

By Pinnochio

In a late midnight session Congress passed an amendment to the 1964 Civil Rights Act mandating a seismic change affecting the American insurance industry.

Most hospitals are required to have programs that discount or completely forgive bills for some patients. But they don’t make it easy. We’re a nonprofit organization and we help you apply. It’s quick, easy, and free.

A fiduciary is an individual who has a business, legal or ethical responsibility to maintain a relationship of trust, faith, confidence, loyalty and duty to another individual or business. Fiduciaries are typically well-versed in a particular field and in a position of superiority over their clients regarding the knowledge required to take care of their clients’ assets and well-being.

“Our unwavering goal is to achieve profitability and positive cash flow by the end of 2025” – Damien Lamendola

2025 Dallas Cowboy Cheerleaders Can’t Wait To Start New Diet Program

Why go on one of those crazy diets that never work when all you have to do is take a damn pill! Why pay for gym membership! Why put your body through rigorous physical exercise when you can chill out munching on popcorn while watching your favorite movies!

And I Walked Out to Build Something Better

Rachel Strauss ⭐️

Founder, CEO PBM Princess 👑 | Healthcare’s Connector-in-Chief | Cost-Containment Specialist Public Speaker | Host of InsFluencers | Sales + GTM Strategy + Sparkle| Advocate for Access, Affordability | Funding Finder

California Dreaming………………

Good news! The governor of California is proposing access to an affordable state funded health care plan for only $100 per month if you qualify. The bad news is not everyone will ……………

In their April 24, 2025 Commissioners Court meeting county commissioners awarded their group medical insurance program to Blue Cross to be effective October 1, 2025.

PBM Sales Rep. Reacts

PBM’s do a lousy job sourcing best pricing as it’s not in their best financial interests. More plan sponsors are realizing sourcing is the key to lower prescription drug costs and are ditching their PBM.

“Show me the incentive and I’ll show you the outcome”-Charlie Munger

Just like nationalized health insurance, it all boils down to economics, and what to do instead.

BY MONTE K. JENNINGS – APR 09, 2025

What is Direct Primary Care (DPC)?

Direct Primary Care (DPC) is a healthcare business model in which patients purchase a membership that allows them unlimited access to certain primary care services. The patient pays a monthly fee to the medical office, and can then access care as needed, without paying an additional fee at the time of service. In the United States, DPC is a type of primary care billing and payment arrangement made between patients and medical providers, without sending claims to insurance providers. Patients pay their physician or practice directly in the form of periodic payments for a defined set of primary care services.

Diabetes Reversal Group® (DRG) was founded to provide a natural diabetes treatment, non-drug approach to helping people with metabolic and nutritional imbalances. These imbalances can lead to many health problems traditionally treated with invasive prescription drug therapy, such as Type 2 Diabetes, Neuropathy and Heart Disease.

National Survey Reveals Only 18% Of Employers Cover GLP-1 Drugs

As consumers are clamoring for access to pricey GLP-1 drugs for weight loss, employers are feeling the need to modify or update their plans to accommodate new demands and costs. 

“Oh Oh, does this mean we won’t get free TPA administration anymore?” asks the school board. “Nope, it’s the unintended effect of Dr. Donny’s Miracle Drug Executive Order!” responded the district’s insurance consultant…..

Trump Seeks to Match US Drug Costs With Cheaper Ones Abroad

Revlimid. a derivative of thalidomide, is a 25-cent pill that sells for almost $1,000 in the United States. “Let’s go shopping Jimmy!” said the CFO to his health insurance broker.

With rising health care costs and onerous governmental diktats placing plan sponsors at risk of punishing government mandates and sanctions, more employers want out of the health insurance business. ICHRA may be their best solution.

Did you submit a Felony Conviction Notice?

Business is about solving other people’s problems. Solving the high cost of healthcare giving employers a competitive advantage is ours.

H.R.3162 – To amend the Federal Food, Drug, and Cosmetic Act to allow for the importation of affordable and safe drugs by wholesale distributors, pharmacies, and individuals.

Texas Local Government Code § 271.903, titled “Commitment of Current Revenue,” addresses how local governments in Texas can structure contracts for acquiring real or personal property without creating long-term debt obligations.

Sharing Is Caring……………….

“We need a little help in paying for these expensive GLP-1 drugs” explained the company owner. “We simply can’t afford to carry the full freight on these drugs anymore without raising everyone’s rates by 40% this year. We need your help!”

By Doug Aldeen

Don’t let your babies grow up to be Cowboys or Texas state legislators.

HB 2911 was recently introduced into the 89th Texas legislative session. HB 2911 permits Texas school districts that opted out of TRS-Active Care the ability to opt back in to the state’s largest pool of teachers and staff BUT also provides equitable funding for those school districts that either do not want to re-enroll in TRS-Active Care or desire to leave for whatever reason and set sail on their own and manage their own risk.

CrowdHealth provides you a portfolio of tools, seamlessly woven together, that creates a beautiful, low cost healthcare solution. We help you find awesome doctors, negotiate your bills, and fund those bills through a peer to peer funding platform…for less.

Welcome to an easier way to pay for healthcare.

Amazing story out of New York!

Uninsured student suffers painful knee injury while playing scrimmage football. Onsite clinic successfully treats the injury, no insurance necessary.

SOURCE: Fierce Healthcare

Aetna will exit the individual markets in 2026, less than five years after making a return to this space.

Self-taught venom expert Tim Friede has voluntarily injected himself with snake venom 856 times across 18 years. Now, in spite of the odds, Friede’s extremely dangerous hobby has led scientists to create the most widely effective snake antivenom on record

After hearing about how we at Mitigate Partners were significantly reducing health insurance costs for Florida based employers, Patient Rights Advocate asked if they could film our clients’ success stories

Helping employers reduce health plan costs… one community at a time………..

“You owe us $152,334!” said the hospital……..: “What’s the $334 for?” asks the Illegal Exotic……..“That’s for the toothbrush!” says the snarling straight faced clerk with the Pinocchio nose.

Your employer is covering 100% of your health plan — no premiums for you!