Day: January 20, 2025

Is United Healthcare Evil?

Since the CEO of United Healthcare was popped on the streets of NYC there has been scrutiny over what drove the assassin to commit murder.

There have been several stories of people that were screwed over by the big insurance giant…..this is the one that stuck with me….

A month after the killing of UnitedHealthcare CEO Brian Thompson prompted many Americans to share personal horror stories of the company’s coverage denials and other practices, a doctor in Austin, Texas on Wednesday shared her own experience that she said exemplified how the for-profit health system “just keeps getting worse.”

In a video posted to TikTok, Dr. Elisabeth Potter said she recently received an unprecedented phone call from UnitedHealthcare about a patient—one who was already under anesthesia and having surgery.

Potter, a plastic surgeon who specializes in reconstructive surgery for breast cancer patients who have had mastectomies, said she was performing a bilateral deep inferior epigastric perforator [DIEP} surgery when UnitedHealthcare called her in the operating room.

The call was urgent, she was told, and needed to be returned right away.

“So I scrubbed out of my case and I called UnitedHealthcare, and the gentleman said he needed some information about her,” said Potter. “Wanted to know her diagnosis and whether her inpatient stay should be justified.”

Potter found that the person calling wasn’t aware that the patient whose care he was questioning had breast cancer and was in the operating room—that information was known by “a different department” at UnitedHealthcare.

Potter’s account, said Nidhi Hegde, managing director at the American Economic Liberties Project, was “another horror story from a doctor dealing with United Healthcare’s terrible authorization process.”

https://www.commondreams.org/news/united-healthcare-surgery-coverage

This is horrific but it is not an outlier…

Then there is news about their and others drug pricing…..

The Big 3 companies acting as intermediaries between drugmakers and insurance providers made billions by needlessly jacking up the prices of lifesaving drugs, according to the Federal Trade Commission. In its second interim staff report on pharmacy benefit managers (PBMs), released Tuesday, the FTC said CVS Health’s Caremark Rx, Cigna’s Express Scripts, and UnitedHealth Group’s OptumRx “marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent,” generating $7.3 billion in revenue in excess of the acquisition costs of the drugs over five years beginning in 2017.

In theory, PBMs act as middlemen, negotiating fees with drugmakers on behalf of employers and reimbursing pharmacies for prescriptions, per Reuters. But the FTC’s earlier report on PBMs, released in July, found they are “vertically integrated” with healthcare conglomerates, which “exercise vast control over huge swaths of the healthcare sector.” That report analyzed two specialty generic drugs, flagging markups over 1,000%. This report expands the analysis to 51 specialty generic drugs. For these, the Big 3’s price-markup revenue climbed from $522 million in 2017 to $2.1 billion in 2021. “Cancer drugs alone made up nearly half of the $7.3 billion” in revenue over five years “with multiple sclerosis medications accounting for another 25%,” per NBC News.

The companies—found to have “reimbursed their affiliated pharmacies at a higher rate than they paid unaffiliated pharmacies on nearly every specialty generic drug examined”—also generated an additional $1.4 billion over five years through the practice of billing plan sponsors more than they reimbursed pharmacies for the drugs, the report notes. A rep for Express Scripts says the report is misleading, with the analyzed drugs accounting for less than 2% of what health plans spend on medications in a year, per Reuters. An OptumRx rep said the company lowers drug costs and saved patients $1.3 billion last year. But the report found patients’ out of pocket costs for the 51 drugs totaled $279 million in 2021, “an annual compound increase of 14%-21% since 2017,” per Reuters.

To my way of thinking this is evil and all the industry needs to be held to a higher standard than it is today….but sadly if that happens it will be after this next 4 years.

These companies are just sick as well as greedy and evil…..period.

I Read, I Write, You Know

“lego ergo scribo”

Will It Last?

Since today is the big day this question could be about the upcoming 4 years but it is not rather it is about the ceasefire deal in the Middle East which began yesterday.

The AP reports Majid al-Ansari said in a post on X that the ceasefire will start at 8:30am local time Sunday. He advised people to exercise caution when the agreement goes into effect and to wait for directions from officials.

Under the first phase of the ceasefire, 33 hostages are set to be released over the next six weeks, in exchange for hundreds of Palestinians imprisoned by Israel. The exchange will begin Sunday at 4pm. During each exchange, prisoners will be released by Israel after the hostages have arrived safely. The remainder, including male soldiers, are to be released in a second phase that will be negotiated during the first. Hamas has said it will not release the remaining captives without a lasting ceasefire and a full Israeli withdrawal.

The plan says that during phase one, some 1,900 Palestinian prisoners will be released, in exchange for 33 Israeli hostages, both alive and dead. Among the prisoners, 1,167 are residents in Gaza who were held by Israel but were not involved in Oct. 7. All women and children under 19 from Gaza held by Israel will be freed during this phase. All Palestinian prisoners who were convicted of deadly attacks will be exiled, either to Gaza or abroad, and barred from returning to Israel or the West Bank. Some will be exiled for three years and others permanently, according to the plan.

Despite the ceasefire news, sirens sounded across central Israel on Saturday, with the army saying it intercepted projectiles launched from Yemen. The Iran-backed Houthis have stepped up their missile attacks in recent weeks. The group says the attacks are part of their campaign aimed at pressuring Israel and the West over the war in Gaza. There were also continued Israeli strikes into Gaza. The Palestinian Health Ministry said at least 23 people were killed in the previous day.

So will this ceasefire last?

Likely not…..

The ceasefire agreement regarding the Gaza Strip can be welcomed as a modest reprieve from the immense suffering that the residents of that territory have endured for the past 15 months.

The Israeli military assault on the Strip has inflicted deaths that according to the official count has passed more than 46,600. This tally likely undercounts actual deaths by more than 40 percent, with the majority of fatalities being women, children, and the elderly.

This is in addition to all the other suffering from continuing military operations. There have been more than 111,265 reported injuries, including life-changing disabilities in an environment in which Israel has largely destroyed the healthcare system.

The agreement also commits Israel to allowing an increased number of trucks bearing badly needed humanitarian aid into the Gaza Strip. Other benefits include the release of a number of Israeli hostages that Hamas took in its attack in October 2023. Also to be released are several hundred Palestinians whom Israel has imprisoned. The Palestinians can be considered hostages, too. Although some of those to be released have been given sentences of imprisonment, many of the Palestinians Israel incarcerates are held indefinitely without charge, incommunicado, and without legal representation.

https://responsiblestatecraft.org/gaza-ceasefire-2670860243/

I have not decided if the swearing in is worth my attentio9n.

I Read, I Write, You Know

“lego ergo scribo”