Author Jim Kahn Frequently asked questions. 81 items Posts pagination Newer 1 … 4 5 6 7 8 9 Older Medicare Advantage Overpayment >$100 Billion October 9, 2023 Summary: Physicians for a National Health Program released a valuable summary of Medicare Advantage overpayments. The scope and scale is breathtaking: $100 billion annual payoff for attracting inexpensive enrollees, upcoding disease severity, and biased price-setting procedures. OUR PAYMENTS THEIR PROFITS: Quantifying Overpayments in the Medicare Advantage ProgramPhysicians for a National Health ProgramOctober 2023 By our […] Lancet Panel on Investor-Owned Health Care October 3, 2023 Summary: The recent Lancet webinar on private for-profit ownership of US health care assembled leading experts on this crucial issue. We must – and can – reverse this commoditization of health care. Public policy and health in the USA: should investors own healthcare?https://www.thelancet.com/webinars (scroll down to “On-demand webinars”)The Lancet WebinarsSep, 2023 Claudia Fegan: The question of “Should […] Denied Medical Claims Most Likely with Private Insurance & Rarely Resolved October 1, 2023 Summary: This national survey finds that 21% of privately insured individuals had claims denied in the last year, on top of a similar frequency of denied or delayed prior authorizations. Those with other insurance problems (like high drug copays) had more denials, suggesting flawed insurance. Just 29% of denials were resolved. Consumer Survey Highlights Problems […] Health Reform Essentials in Entertaining 2-Minute Videos September 25, 2023 Summary: Dr. Glaucomflecken and John Stewart offer a master class on how to concisely convey what’s wrong with US health insurance and why. A dozen 2-minute videos. Dr. Glaucomflecken30 Days of US HealthcareSeptember 2023videos (2 min each) Job Benefits DeductiblesCo-insuranceSurprise BillingPharmacy Benefit ManagersInsurance Kickbacks [to PBMs]DIR Fees [PBM fees on pharmacies]Out of Pocket Maximum Hospital […] Understanding & Fighting Investor Ownership of Health Care September 20, 2023 Summary: Private for-profit ownership of health care is undermining the health care mission, diverting care resources to shareholder bank accounts. Single payer financing is not enough … we need to resist the corporate takeover. Two important webinars are coming up NEXT WEEK. Listen in, and get involved. Medicare for All Is Not EnoughThe NationMarch 31, […] US Health Care Is Pretty Good … If You Own an Insurance Company September 14, 2023 Summary: John Stewart nails it in a vivid one-minute video: Our government-funded health care benefits private for-profit corporations, especially insurers, at our expense. America’s F*cked Up Tax SystemThe Problem With John StewartAugust 29, 2023Video (1 min) Here’s how the system works. You pay taxes to the government, the government pools that money and uses it […] Let’s Not Further Privatize Medicare September 8, 2023 Summary: A new book by mainstream health economists and policymakers argues that we should expand and tinker with Medicare Advantage to save Medicare. But why double down on the part of Medicare that is extracting massive profits and limiting access to care? A New Prescription For What Ails MedicareHealth Affairs ForefrontAugust 25, 2023By Alain C. […] How Tom Scully Scuppered Health Coverage September 2, 2023 Summary: The man who as a federal policy official drove the privatization of Medicare then jumped to the private sector and profited massively from the changes. Others follow the same pattern. Clever investors make billions of dollars. The rest of us suffer the consequences in higher costs and lower access to care. Patient ZeroTom Scully […] The Avaricious Ascent of UnitedHealth Group August 28, 2023 Summary: This summer The American Prospect ran 8 terrific health policy articles, which HJM covers starting today. First up: a blow-by-blow account of the rise of the enormous, enormously diversified, and enormously profitable UnitedHealth Group (and on the origins of corporate managed care). Health Care’s Intertwined ColossusHow decades of policy failures led to the ever-powerful […] Missing Teeth – The Odd Isolation of Dental Insurance August 22, 2023 Summary: Our favorite absurdity-revealing ophthalmologist comedian again sinks his teeth into our health insurance morass. Glaucomflecken Explains: What’s So Special About Teeth?Dr. Glaucomfleckenvideo, 2 minutes The American Dental Association (ADA) successfully resisted participating in Medicare in the 1960s. Today, medical insurance has an out-of-pocket maximum for policyholders, whereas with dental insurance the maximum is for […] Posts pagination Newer 1 … 4 5 6 7 8 9 Older