Vermont for Single Payer

11/22/2024

“The lawsuit we filed Oct. 24 (PDF) against MultiPlan Inc. is just one example of this proactive approach. Along with the Illinois State Medical Society (ISMS), we filed this action in federal court in Chicago, seeking injunctive relief against a multilateral price-fixing conspiracy with the nation’s largest insurance companies. We believe this unlawful scheme, in place for almost a decade, harms physicians by denying fair payment for out-of-network health care services, and harms patients by greatly limiting free-market competition that may lead to lower costs and improved care. ”

To protect patients and physicians, the AMA seeks injunctive relief against a multilateral price-fixing conspiracy led by MultiPlan Inc.

11/22/2024

11/21/2024

McCarty Carino: I suppose, sadly, in this country, few people would be surprised that health insurers are taking steps to cut their costs in this way. But what surprised you the most while you were doing this investigation?
Miller: What surprised me the most was that this is just business as usual. Nothing that EviCore did was out of the ordinary.

T. Christian Miller, a reporter at ProPublica, explains how EviCore's tool is manipulated to increase denials and cut costs.

11/21/2024

“The Bronx-based Centers Health Care nursing home network will pay the state $45 million to settle charges of extensive fraudulent activity and patient neglect at facilities it owns across New York. The company and its executives have been the subject of intense scrutiny from state regulators for allegations of Medicaid embezzlement that have resulted in harmful conditions for elderly residents.”

State Attorney General Letitia James had previously charged the company's executives with extensive Medicaid fraud and patient neglect.

11/20/2024

“Hospital groups say high executive pay and perks are necessary to attract top talent. But nurses say exorbitant compensation is hurting patient care.”

Hospital groups say high executive pay and perks are necessary to attract top talent. But nurses say exorbitant compensation is hurting patient care.

11/19/2024

https://www.statista.com/statistics/310446/annual-median-rate-of-long-term-care-services-in-the-us/
Annual median cost of long-term health care services in the United States as of 2023, by type (in U.S. dollars)

11/18/2024

“If Republicans gain control of Congress, they are widely expected to allow the enhanced ACA subsidies to expire at the end of 2025, depriving many people who buy coverage through the ACA and who currently receive these subsidies of that financial assistance, according to health care policy experts.
“So-called enhanced Affordable Care Act (ACA) subsidies, which lower the cost of health plans for millions of Americans and were passed under the Biden administration, will expire unless lawmakers renew them. During his first term in office, President-elect Donald Trump backed efforts by Republican lawmakers to repeal the ACA, but hasn't yet revealed his plans for the program, commonly known as Obamacare, for his second term in office.
“Americans with incomes over 400% of poverty — those who make just above four times the poverty level, or $103,280 for a family of four — are eligible for the enhanced ACA insurance subsidies. They also increase financial help for those who were already eligible for assistance under the ACA.
“KFF, an independent health policy nonprofit, estimates the subsidies have cut premiums for eligible enrollees by 44%, or $705 annually. The organization says that if the tax credit expires, average premiums for subsidized enrollees in 12 states would at least double.”

Allowing enhanced subsidies for health insurance bought through ACA marketplaces to expire would cause premiums to soar, experts warn.

11/17/2024

Same Story Everywhere.....
“Premiums are set to rise across the board for employer-based insurance, Obamacare plans and Medicare.
“Health care costs for employer-based plans are expected to rise 5.8% on average per employee next year, even after accounting for cost-reduction measures, according to a survey by the consulting firm Mercer.
…
“New Jersey's largest hospital systems continue to grow by buying up practices and negotiating higher reimbursement rates from insurers. They are also spending hundreds of millions to expand the physical footprint of their medical centers and offices.”

Premiums are set to rise for employer-based insurance, Obamacare plans, and Medicare. Employer-based plans are expected to rise 5.8% on average

11/16/2024

"Medical Tourism"--Traveling to Another country to Beat America's High Cost of Healthcare
“Medical tourism has experienced exponential growth in recent years due to the rising cost of healthcare in many countries, coupled with advancements in technology and travel. More individuals are opting to travel abroad to receive high-quality healthcare services at a fraction of the price, all while also enjoying a new vacation experience.”

Things in the US are so bad that the state of Utah Utah pays for public employees to travel to Mexico to fill prescriptions for certain expensive drugs (and gives them a cash bonus as incentive)---https://www.sltrib.com/news/2018/10/28/fight-high-drug-prices/

Medical tourism and proactive wellness travel are becoming popular, offering high-quality, cost-effective healthcare combined with vacation experiences.

11/15/2024

Even Now They Try to Address the Symptom as the Basic Problem Grows and Grows and Grows
“As employee health insurance rates spike in Vermont, some municipalities are reevaluating their options.
“The Moretown Select Board voted at its Monday, November 4, 2024 meeting to change insurance providers for the town’s six employees, saving $8,000 in next year’s budget. The town switched from a plan under Blue Cross Blue Shield (BCBS) Vermont – the state’s largest insurer – to a plan under MVP Health Care, the only other commercial insurer that sells qualified health plans on Vermont’s insurance marketplace.
“With the MVP plan, Moretown will still see a 15% increase in employee health insurance costs from this year. With the prior BCBS plan, the town would have seen a 45% increase. Another option was to switch to a different BCBS plan, bringing a 25% increase.
“Earlier this year, BCBS and MVP both got permission from state regulators to increase rates for next year, after the state’s Department of Financial Regulation found insurers were dealing with an influx of health care claims and low reserves, nearing financial collapse.”

Vermont towns face growing health care costs that threaten budgets

11/15/2024

“Ramaswamy, who ran for the Republican presidential nomination before suspending his campaign in January, has since said that money spent on expired government programs should be stopped. In a post on X, formerly Twitter, Ramaswamy cited the $516 billion spent on expired acts for the 2024 fiscal year.
"’There are 1,200+ programs that are no longer authorized but still receive appropriations,’ which he described as ‘totally nuts’ and advocated for saving ‘hundreds of billions’ of dollars each year by ‘defunding government programs that Congress no longer authorizes.’
…
“Legislative authorities can expire and continue to receive appropriations—a law of Congress that provides an agency with budget authority—subject to congressional reauthorization. Among those expired appropriations is the Veteran's Health Care Eligibility Act, which amounted to $119 billion in government spending for 2024.
“The act provides health care benefits to those who have served in active military, naval, or air service and did not receive a dishonorable discharge. It covers outpatient services like health appointments, immunizations, nutrition education, and inpatient services such as surgeries, acute care, and some conditions or injuries that may require urgent care. The act expired in 1998 but has been continually funded.”

Vivek Ramaswamy has said the government should not "spend money on programs that have expired."