Health Care Pricing Estimates Are Bullshit

SOURCE: Mitigate Partners, LLC | Employee Benefits Consulting

Somehow, hospitals and insurers continue to get away with only providing estimates and not actual prices for their services and procedures. This allows our healthcare system to remain rigged for their profit and to the detriment and demise of patients, families, communities, tax payers, unions, employers, and municipalities across the country.

Continue reading Health Care Pricing Estimates Are Bullshit

How to Fix Rural Healthcare: LEAVE US ALONE.

“I left our CAH almost 8 years ago and started a Direct Primary Care clinic. It operates purely in the free-market economy and is thriving. Small regional hospitals are now coming around to my way of thinking and are now beginning to bundle things like radiology studies, and surgery, etc. to compete with each other for cash business, and it’s making them money and saving patients money.  These hospitals have to find loopholes in the bureaucracy to do this (the government and the trillion-dollar insurance companies who control the elected officials in the shadows love the status quo and want prices to stay high).

Continue reading How to Fix Rural Healthcare: LEAVE US ALONE.

Dallas Based Charitable Pharmacy Expands To San Antonio

St. Vincent de Paul (SVdP) is a Dallas-based charitable pharmacy that fills prescriptions and provides free medication for those who otherwise could not afford it. Now, the organization is expanding across Texas and providing medication to those who are homeless or in transitional housing recovering from homelessness through Haven for Hope.

Continue reading Dallas Based Charitable Pharmacy Expands To San Antonio

Government Pays $100,000,000 In Obamacare Commissions During Open Enrollment

CMS highlighted how four in five Healthcare.gov customers were able to find coverage for $10 or less per month for the 2024 plan year after subsidies. The agency also credited the Biden Administration for giving out nearly $100 million in Navigator awards, which lets organizations hire staff to help consumers, according to the press release.

Continue reading Government Pays $100,000,000 In Obamacare Commissions During Open Enrollment

CrowdHealth Isn’t Health Insurance… and Why That’s a Good Thing!

“Did you know that the United States government limits the amount of profit health insurance plans can receive from your premiums? That sounds great in theory, but think about it this way: if a health plan can only make profits on up to 15% of your premium, and you have a $1000 premium per month, their profits are limited to $150 per month on that price. So then, what’s a major way health plans can grow their profits? By increasing your monthly premiums! If they boost your premium by 10% to $1100, they can now profit $165 per month. This means health plans are now incentivized to make your prices go up, not go down.”Did you know that the United States government limits the amount of profit health insurance plans can receive from your premiums? That sounds great in theory, but think about it this way: if a health plan can only make profits on up to 15% of your premium, and you have a $1000 premium per month, their profits are limited to $150 per month on that price. So then, what’s a major way health plans can grow their profits? By increasing your monthly premiums! If they boost your premium by 10% to $1100, they can now profit $165 per month. This means health plans are now incentivized to make your prices go up, not go down.”

Continue reading CrowdHealth Isn’t Health Insurance… and Why That’s a Good Thing!

The Best Work Comes Out of Great Relationships

By Bill Rusteberg

As a self employed insurance agent I’ve worked with hundreds of clients over the past 50 years, the result of calling on thousands more in prospecting efforts to gain more business. I’ve met all types of personalities, developing a skill few have. Understanding motivation, goals and interests is secondary to understanding moral and ethical values of those you strive to do business with.

Continue reading The Best Work Comes Out of Great Relationships

Will Government Grant Pardons To Death Row Inmates?

Government has been known to mandate certain life saving vaccines quickly, without years and years of clinical trials hobbled by a burdensome administrative state about as efficient as the U.S. postal service. Cancer patients dealt a death sentence wonder why a vaccine that’s been around for over a decade with a promising cure rate can’t be made widely available right now, before death do they part cancer’s death row.

Continue reading Will Government Grant Pardons To Death Row Inmates?

Bernie Sanders Proposes Subpoenas of CEOs of J&J, Merck On Drug Prices

U.S. Sen. Bernie Sander stares to the front and leans into his microphone at a hearing — politics coverage from STAT

“Considering that drugs like Eliquis have net prices that are a fraction of the list prices – with so many of those rebates going to government programs – if the committee wants answers for why the prices are so high, maybe instead of pharma execs, they should subpoena a mirror” Antonio Ciaccia

Continue reading Bernie Sanders Proposes Subpoenas of CEOs of J&J, Merck On Drug Prices

Insurance Coverage Makes Common Generic Drugs More Expensive

“Congress and state legislatures should consider allowing insurance plans not to cover common generic drugs. This move would fundamentally resolve the spread pricing problem created by pharmacy benefit managers, eliminate wasteful spending on these drugs and lower insurance premiums for all.”

Continue reading Insurance Coverage Makes Common Generic Drugs More Expensive

Assessing Early Experience With Arbitration Under The No Surprises Act

What is the No Surprises Act? “It’s a law that transfers balance billing liability from plan members to plan sponsors under certain circumstances gifting the balance biller a much better opportunity to recoup from a deep pocketed plan sponsor than from a Joe Sixpak.” Bill Rusteberg

Continue reading Assessing Early Experience With Arbitration Under The No Surprises Act

The Most Powerful Natural Pain Killer In The World?

You saw the media frenzy on Fox. After 11 years of private testing, Conolidine “Nature’s Morphine” is now legal worldwide.

After a 100,000 person clinical analysis Conolidine is now certified as the most powerful natural pain reliever in the world…. Boasting pharmaceutical level relief with no negative effects.

Continue reading The Most Powerful Natural Pain Killer In The World?

Top Dog Or Underdog? Bargaining Power In Healthcare

By Ge Bai – Contributor|HEALTHCARE

In healthcare and elsewhere, the price of services and products is determined by the relative bargaining power between the buyer and the seller. A top dog can afford to walk away without entering the transaction, whereas an underdog cannot. Being the top dog or the underdog makes all the difference for prices in healthcare.

Continue reading Top Dog Or Underdog? Bargaining Power In Healthcare

Marpai Hires The Best of The Best

Marpai Hires John Powers as President

MyHealthGuide Source: Marpai (Nasdaq: MRAI), 1/12/2024

NEW YORK — Marpai, Inc., an independent national Third-Party Administration company transforming the $22 billion TPA market supporting self-funded employer health plans, announced the appointment of John Powers as the Company’s President. Powers is an accomplished healthcare benefits executive with over 30 years’ experience. Powers was previously CEO of Homestead Smart Health Plans.

Continue reading Marpai Hires The Best of The Best

Helping People Feel (and look) Better In Deep South Texas

 “The Lower Rio Grande Valley, like many other communities in the United States, is facing a diabetes epidemic. The growing health crisis of widespread diabetes threatens individuals, families, the health system, and the prosperity of the Rio Grande Valley community.” SOURCE: Preventing Diabetes in the Rio Grande Valley – FSG

Continue reading Helping People Feel (and look) Better In Deep South Texas

Whiny College Professor Hates Aetna

A WHINY COLLEGE PROFESSOR POSTED THE FOLLOWING ON LINKEDIN:

Stanford University moved its health insurance from California Blue Shield to Aetna.  It is now January 9, and I have yet to receive a card showing my member number, which is the evidence of coverage virtually every pharmacy and medical provider demands in order to get service.”

Continue reading Whiny College Professor Hates Aetna

Differences In The 30 Day Cost of Two Prescription Drugs

“As the call for clearer prescription drug pricing has grown, there could be significant shifts in the prescription drug landscape in the coming years … Concerns have arisen around manufacturers potentially raising costs for non-Medicare plans to recoup lost revenue from IRA price negotiations. … There are several situations that could result in increased or decreased costs for plan sponsors in addition to potential price shifting.” 

Continue reading Differences In The 30 Day Cost of Two Prescription Drugs

Conservative Momentum Builds to Lower Health Care Costs

The following content is sponsored by Conservatives for Lower Health Care Costs.

Recently, Big Pharma and Big Government have teamed up in a full-blown attack against free market solutions in the prescription drug market by focusing on Pharmacy Benefit Managers (PBMs) – which currently serve as the only real check on big pharmaceutical companies’ ability to set sky-high prices for prescription drugs.

Continue reading Conservative Momentum Builds to Lower Health Care Costs

Skimming Money

PBM Representative Skims Off Drug Profits

Nearly half of every dollar spent by Medicare drug plans goes to private health insurers’ pharmacy benefit managers and wholesalers

By Wendell Potter

As members of Congress get back to business after the holidays, they seem to be poised to pass legislation that would address some of the abuses of pharmacy benefit managers (PBMs), the middlemen who extract so much money from the pharmaceutical supply chain.

Continue reading Skimming Money