Relevant and even prescient commentary on news, politics and the economy.

CMS proposes prior authorization rule changes for healthcare plans

More on the practices of Medicare Advantage plains and also ACA, Medicaid and Medicare. The practice being delayed prior authorizations, the amount of time it takes, and the resulting tragedies. CMS proposes prior authorization rule changes for health plans, BenefitsPRO, Lauren Sausser Starting in 2026, a proposed CMS rule would require plans to respond to […]

Medicare Advantage uses Algorithms to block care for Seniors

Kip Sullivan has been writing about the issues with Medicare Advantage. I have joined with Kip in bringing the issues of Medicare Advantage to the forefront. Angry Bear has featured Kip and I have added to the dialogue. This next commentary details how Healthcare Insurance, mostly Medicare Advantage has been using artificial intelligence in the […]

A New Year in 2022 and New Pharmaceutical pricing, a short Explanation

An early attempt as to explaining the drug market. It is a start and I have to program myself to understand what is said. Brief and down to earth with pictures too! Much of this is a C&P with some editing. Much credit to the authors for giving us this opportunity to understand. Welcoming a […]

Medicare Plan Commissions May Steer Beneficiaries to Wrong Coverage

This article is easy reading exploring some the differences and why people may choose one plan over the other plan. Attached is also a Commonwealth Fund article with more detail. Medicare Plan Commissions May Steer Beneficiaries to Wrong Coverage, MedPage Today, Cheryl Clark. Agents and brokers selling Medicare plan coverage often steer their clients to […]

Accountability for Medicare Advantage Plans is long Overdue

A different viewpoint by the Physicians for a National Health Program. Mainly speaking as advocates for a universal national health program which would be as cost-effective as possible. They are proposing the plan could be constructed as an improved form of Traditional Medicare. They do too find similar issues as what Gilfillan and Berwick extensively […]

Interesting Stuff from My In-Box,

Quick two weeks went by and have been pretty busy. Starting to warm-up in Arizona. Been spending more time outside while I can and before it gets hot. Environment, Consumerism, Technology Micro-Apartment Makeover Includes Mini-Loft and Space-Saving Furniture,, Kimberley Mok. The comfort and livability of a 300-square-foot apartment are beautifully improved in this smart […]

Kids and work

The NYT addresses the increasing use of child labor in the US (the link allows access to the article whether you have a subscription or not): Arriving in record numbers, they’re ending up in dangerous jobs that violate child labor laws — including in factories that make products for well-known brands like Cheetos and Fruit […]

Part 2: Building on the ACO Model

Part Two explores where Medicare should be going forward as determined by doctors Richard Gilfillan and Donald M. Berwick. It is an endorsement of the ACO model with changes to it creating greater efficiency. I am not so sure Kip Sullivan would endorse this approach as opposed to Single Payer. Ultimately Single Payer is less […]

February jobs report shows decelerating trend continuing

February jobs report: the decelerating trend resumes   – by New Deal democrat As I’ve written several times this week, my focus on this report was on whether manufacturing and residential construction jobs turned negative or not, whether temporary jobs continued on their downward trajectory, and whether the deceleration apparent in job growth would reappear after […]

Direct Contracting and The Medicare ‘Money Machine’

This is Part One covering Medicare Advantage, Direct Contracting, and the MA Money Machine of which the Risk Scores drive the payout. If the Risk Scoring methodology was eliminated, ~$355 billion over the next eight years if just the risk-score related overpayments were eliminated. This is a pretty good read if you have the patience […]