no wonder you post all this you're in the healthcare business a state employee of California - San Francisco right? is this what you do all day instead of provide services? does you employer know you spend all day posting and not working?
Wasn't the original plan to separate health insurance from the employer After the great recession of 2008 many people lost their job and then their insurance Also remember those greedy CEO golden health care plans. Those were to be taxed, except when the time came to tax them the unions found that they have the same golden plans....so all that went away
The original proposal was to implement a public plan in the U.S. similar to the healthcare plans in most leading western nations -- this would ensure that everyone is covered even if they did not have a job. However once the healthcare and insurance lobbies got involved and pushed their own plan we got Obamacare instead. The ACA is/was basically a giveaway to insurance, healthcare and pharma industries. The insurance companies got screwed when Congress later took away "risk corridors" which assured them profits no matter what.
No wonder Luigi is so popular... UnitedHealth, employer of slain exec Brian Thompson, found to have overcharged some cancer patients for drugs by over 1,000% https://fortune.com/2025/01/15/ftc-...cvs-caremark-cigna-pharmacy-benefit-managers/ OptumRx, the group’s pharmacy benefit manager, along with its two main peers, Express Scripts and CVS Caremark Rx, have pocketed an extra $7.3 billion over cost thanks to price gouging, according to the findings of a report by the Federal Trade Commission. CVS Caremark Rx blasted the findings for cherry picking certain drugs in an effort to push what it called an ‘anti-PBM’ narrative. UnitedHealth Group is charging patients a markup for key life-saving drugs that could easily exceed their cost by a factor of ten or more, according to findings from the Federal Trade Commission. The report, which levels the same allegations at CVS and Cigna, is the latest indictment of America’s broken healthcare system and comes on the heels of last month’s shocking murder of UnitedHealthcare CEO Brian Thompson. The U.S. is notorious for incurring the highest costs per capita of any wealthy nation, yet failing to achieve an even remotely equivalent improvement in patient outcomes versus Europe’s social market-based economies. Critics argue that is due largely to the highly opaque manner in which needless markups are hidden to conceal inefficiencies that serve various vested interests. These include, but are not limited to, the big three drug middlemen known as pharmacy benefit managers (PBMs). According to the FTC report, UnitedHealth’s OptumRx, along with Cigna’s Express Scripts and CVS Caremark Rx, were able to collectively pocket $7.3 billion in added revenue above cost during the five year period of the study through 2022. “The Big 3 PBMs marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent,” it concluded. A thousand percent increase in the price of a drug that costs $10 wholesale would result in a retail price of $110. This markup rate applied to 22% of the specialty therapies examined, including Imatinib, a generic used to treat leukemia, or non-oncological Tadalafil for pulmonary hypertension. Others such as Lamivudine needed by HIV-positive patients were nearly quadruple the price of their acquisition cost. Independent Vermont Sen. Bernie Sanders has been conducting Congressional hearings in an attempt to shed light on the problems posed by these drug middlemen as well as drugmakers themselves. UnitedHealth Group in headlines for all the wrong reasons The accused killer of Brian Thompson cited the industry’s failures as his motive for assassinating the UnitedHealth executive on the streets of New York. Luigi Mangione ended up receiving an outpouring of support on social media from Americans furious how the Minnesota-based company mistreated their loved ones. The business that was managed by Thompson, the group’s insurance arm United Healthcare, had denied twice as many claims as the industry average, according to figures from comparison site ValuePenguin. Just this month, surgeon Elisabeth Potter recounted how she was in the midst of operating on a breast cancer patient when an urgent call came in from United Healthcare demanding proof the procedure was in fact justified. “It’s out of control,” she said in a video uploaded to TikTok, “insurance is out of control.” The findings levelled at the three big PBMs stem from a report carried out under the leadership of outgoing FTC chair Lina Khan. She has been a frequent target of criticism due to her robust approach to investigating monopolies and waging battle with Big Tech, earning her the ire of major figures in Silicon Valley on both sides of the political divide. Importantly, all five FTC commissioners signed off on the release of the report. This includes Andrew Ferguson, Khan’s designated replacement under Trump, as well as his fellow Republican, Melissa Holyoak. Cherry picking data to push an ‘anti-PBM’ narrative UnitedHealth’s OptumRx told Fortune it is still reviewing the specifics of the report, but the PBM said it helped eligible patients save $1.3 billion in costs, estimating the median out-of-pocket payment to be $5. “Optum is lowering the cost of specialty medications, which comprises half of all drug expenditures, and providing clinical expertise, programs and support for patients with complex and rare conditions,” it said. CVS Caremark, by comparison, argued the FTC was guilty of “cherry picking” its analysis by focusing on generics, which represent a tiny fraction of client spending over branded specialty drugs in an attempt to mislead. It, too, said it was saving clients money: out-of-pocket costs have dropped seven straight years for a total reduction of 29% since 2016. “If we’re going to have an investigation like this, the American people deserve to see the complete story based on all the facts and not just those that support a predetermined narrative,” it countered in a statement to Fortune. “The ‘anti-PBM’ policies the FTC is currently pursuing would only increase U.S. drug costs for American patients, employers, unions, and taxpayers.” Branded drugs, however, bear substantial risk as they are unproven and highly risky endeavors that can take years of experimental trials before they can achieve a return on investment—assuming they ever do at all. By comparison, generic versions of off-patent drugs only cost the materials needed to produce them and enjoy an already built-in market with regulatory approval. Cigna, parent of Express Scripts, did not respond to a request for comment.
Once in a while these healthcare insurers pay a minor fine which they view as a small cost of doing business. They will scrounge around in the couch cushions to come up with some spare change. 3 UnitedHealthcare-affiliated insurers ordered to pay $165 million for misleading consumers It's believed to be the highest total of civil penalties ever brought by the office under the Massachusetts Consumer Protection Act. https://www.boston.com/news/health/...-to-pay-165-million-over-deceptive-practices/
It seems to be generally not appreciated among the public that the ACA as it exists today has been drastically altered from what the Obama Administration originally proposed and wanted the Congress to pass. The Obama Admin had originally proposed that a medicare like "public option" be included so that Americans could either choose to be covered by a medicare-like government insurance plan or select an alternative private plan administered by for profit insurance companies; a proposal that might have brought medical care costs down dramatically via competition in the best tradition of real capitalism. The public option was killed by the Republicans with the critically important vote of Democrat Senator Max Baucus. (The number one recipient of Insurance Company and Big Pharma political contributions in the U.S. Senate.) Once the ACA, sans public option, had been passed, the Republicans immediately began to take a wrecking ball to what remained. First the Republicans tried to get the entire Act thrown out on the grounds it was unconstitutional. When that didn't fly, they went after the ACA piecemeal. Specific targets were the public mandate and the required State's expansion of Medicaid. These were critically important features of the ACA as originally passed. Our Supreme court obliged the Republicans, at least on the matter of Medicaid expansion, and the subsequent Trump administration obliged on the matter of the Insurance Mandate: they didn't enforce it. The bastardized remains of the ACA , once referred to as "Obamacare", did retain some key features such as insurance companies being prohibited from refusing coverage on the basis of pre-existing medical conditions and the retention of young adults on parents policies. Nevertheless, after hits from the Republicans' wrecking ball, the ACA, as originally proposed or even as originally passed, is hardly recognizable in today's post-supreme-court version.
If we knew the end result was to sign up 25 million , of whom we subsidize 85% or more of the premium,. A simpler program could have been set up....One were many would be able to keep their doctor
What religion do you claim to be? It’s not Christianity right? “A good tree does not produce wicked fruit” “Don’t use foul or abusive language. Let everything you say be good and helpful, so that your words will be an encouragement” Ephesians 4:29 Prov 12: “6. The words of the wicked are murderous, but the words of the righteous rescue those who are threatened. 7 The wicked meet their downfall and leave no descendants, but the families of the righteous live on. 8 If you are intelligent, you will be praised; if you are stupid, people will look down on you. Matthew 7: 5.Then the Pharisees and scribes asked him, Why do your disciples not walk according to the precepts of the elders, but eat bread with unwashed hands? 6 He answered and said to them, Well did Isaiah prophesy of you hypocrites, as it is written: This people honours me with their lips, but their heart is far from me. 7 In vain they worship me, teaching doctrines which are nothing but the commandments of men. 8 For you lay the commandment of God aside, and observe the precepts of men, such as the washing of pitchers and of cups. And many other suchlike things you do. 9 And he said to them, All too well do you cast aside the commandment of God to maintain your own precepts. 1 18: And he said to them, Are you also without understanding? 20 And he said, What defiles a man is that which comes out of a man. 21 For from within, namely out of the heart of men, proceed evil thoughts: adultery, fornication, murder, 22 theft, covetousness, wickedness, deceit, uncleanness, a wicked eye, slander, pride, foolishness. 23 All these evil things come from within, and defile a person
Successful Capitalism requires that economic rents be driven toward zero via robust competition. (That's why the Sherman Anti-trust Act was passed in the 19th Century, and our politicians ignorance of capitalism's requirements is why we ignore the Sherman act today!) The U.S. has by far the most capitalist economy among all major nations. This has resulted in aspects of our economy, such as medical care, prisons, etc., being forced into a capitalist mold even though they won't fit because competition is inadequate. It is no wonder that these parts of our economy are failing us. Of course, it is difficult to arrange for robust competition in healthcare without our acceptance of more risk. Furthermore, there is a moral dimension to health care. Probably the majority of humans on the planet believe access to basic health care, so long as it exists at all, is a fundamental right as opposed to being strictly a privilege that one must earn. This difficulty of creating a highly competitive healthcare market without unacceptable risk is why all developed nations, other than the U.S. of course, have adopted some sort of universal, government subsidized and controlled healthcare. The lack of competition combined with the forcing of healthcare into a profit-driven capitalist mold where it won't fit has resulted in sky high rents which is antithetical to Capitalism.