Monday, December 16, 2024

AARP labeled an accessory to UnitedHealthcare's 'scamming' of the elderly



I am a member of AARP, have been for over 25 years, and I was shocked with the recent article, "How AARP Shills for UnitedHealthcare." It comes from The American Prospect, whose founders include Robert Reich, Former United States Secretary of Labor, American professor, author, lawyer, and political commentator. With that credibility I can proceed to point out just how AARP, a non-profit organization, forces profit-centered UnitedHealthcare on its 58 million members, knowing full-well it is the industry’s worst insurer.

Robert Kuttner, author of the article, and co-founder and co-editor of The American Prospect, and professor at Brandeis University’s Heller School. who lives in Massachusetts says...
"where I live, a supplemental Medicare policy from UnitedHealth costs $251 a month. An identical policy from Blue Cross, which has the state’s best record in not denying care, costs $212."

Kuttner asks, "Why on earth would consumers buy such a flawed insurance product?" It's obvious, we are forced to do so by AARP, have no choice, and AARP doesn't seem to care that its members are the losers. Data confirms...

"In 2023, UnitedHealth’s denial rate of claims was 32 percent, compared to an industry average of 16 percent. Nonprofits had a far better record than for-profits."

I have trusted AARP for the 25 years I have been a member, as I am sure the 58 million members have. But I am seriously searching for new coverage, but time is limited. This is what HealthCare.gov says...

"You can change your plan during the yearly open enrollment period, which is 
November 1–January 15. You can also change your plan outside of open enrollment if you experience a life event that qualifies you for a Special Enrollment Period."

AARP has been a huckster for UnitedHealthcare for 27 years receiving a kick back of 4.95 percent of premium income from AARP subscribers. Here's the scenario...

"According to AARP’s audited financial report, AARP made $289.3 million from member dues, but $1.134 billion from kickbacks from insurers, of which the lion’s share, $905 million, was from health insurers. AARP delicately refers to these as royalties.

There's more...

"In its role as supposed advocate for the elderly, in 2003 AARP lobbied heavily in favor of George W. Bush’s misbranded and badly flawed “Medicare Part D”—the private insurance company drug insurance policies blessed by the federal government. Part D was mainly a way for UnitedHealth and others to make even more money and AARP to reap more kickbacks."
AARP is a non-profit but has been able to avoid taxes paying only about $3 million in federal income taxes on “royalties” of well over a billion. AARP has been sued by members but you won't believe the court decision...
"Credulous judges have thrown out the suits on the grounds that the premium rates had been duly approved by regulators, that premiums would not necessarily have been lower, and that the purchasers were consenting adults."
Kuttner says AARP won't talk to him but comments that in their "Online Community, the comments are thick with scathing accounts of UnitedHealth claims denials and bewilderment that AARP would sponsor such a product. Now, one can only hope that the bad publicity (but not condoning the murder of Brian Thompson) could cause AARP to change carriers; are they willing to lose the income? Donald Trump and Elon Musk must be stopped in their tracks to radically change Medicare.


Friday, December 13, 2024

UPDATE - 12/15/24: The arguable politics of Texas Attorney General Ken Paxton


LATEST: New York Attorney General Letitia James today released a statement after the Attorney General of Texas filed a lawsuit against a New York doctor for providing telehealth abortion care. See it here.

Ken Paxton


What is the goal of this sue-happy backwoods lawyer from Texas in his non-stop litigation? He has filed 100 lawsuits against Joe Biden, alone. He is so proud of this distorted interpretation of the law that he posts it on his own site. He is suing companies over forever chemicals, also filed a lawsuit to stop Texas counties from sending out voter registration. The list goes on and on with this scenario...
"In 2020, seven members of Paxton’s staff reported concerns to federal authorities that he was abusing the powers of the office of Attorney General. All of those aides were subsequently fired, resigned, or placed on leave. Four of those fired aides then filed a whistleblower lawsuit against Paxton. And while Paxton survived a trial in the Texas Senate over their allegations, the lawsuit remained."
This is Texas politics and Paxton, along with Texas Gov. Greg Abbott, are beginning to make Florida Gov. Ron DeSantis look good. These two tyrants have turned the state of Texas into an oligarchy, and the residents of the state seem either oblivious or uncaring. There is even an influx of people moving into the state. I dare say most of them are conservatives since most liberals would not deign to this kind of rule. Paxton was denied in appeal his motion to allow Texas fair-goers to carry guns in the fairgrounds.

Paxton joined Abbott in erecting barbed wire and floating marine barriers on the Mexican border for the purpose of denying immigrants entry. Two died from the razor wire and, since 1998, at least 8,000 undocumented migrants have died attempting to cross the border from Mexico to the US. Of course these people from Mexico and other countries should be forced to enter legally, and that is a huge shortcoming by both the right and the left, but the way
Greg Abbott
Texas is handling it is barbaric. 

And yet another massively inhumane law, The Texas Heartbeat Act, which has been in effect since September 2021, prohibits abortions once a 'fetal heartbeat' is detected, except in emergency situations. Any doctor who violates this strict law risks up to 99 years in prison. There have been three deaths of Texas women who weren't allowed the care to save their lives. This has prompted many women to travel out of the state for abortions. The law has also motivated several doctors to close practices and move out of Texas.

So, I say, why would anyone want to live where the state government is in perpetual litigation for, in some cases, questionable issues.. Your tax dollars are paying for the millions in attorneys fees from the law firms Paxton has hired. The time spent on all these escapades could certainly go toward more productive things for the people of Texas. The Washington Post wrote in 2022...
"Ken Paxton, the Republican attorney general of Texas, has been under felony indictment for securities fraud since 2015...He is under FBI investigation for assisting a real estate developer who allegedly hired his mistress and remodeled his home."
And Texas politics strikes once again. Prosecutors in March of 2024 agreed to drop the securities fraud charges facing Attorney General Ken Paxton if he performs 100 hours of community service and fulfills other conditions of a pretrial agreement. 

Yes, people are still dying from the killing machine at the border, and women die because of a cruel law that sacrifices their life for political gain. It is all beyond understanding.


Thursday, December 12, 2024

Two sides of death

Heaven and Hell

Thomas Paine was a deist, which is the belief in a God who created the universe but does not intervene in its functioning. He was an opponent of organized religion and Christianity, but he believed in a deity that was evident in nature. I am an agnostic, somewhat similar to Paine, and, in lieu of Christianity, I have a different opinion about the hereafter. Here is more Paine...

Paine believed that those who spent their lives trying to make others happy would be happy in the afterlife. He also believed that the wicked would be punished.

My opinion of the hereafter is a place where there is a huge chain-link fence to affinity, with one side bright, cheerful, upbeat and festive. The inhabitants reside in paradise, a blissful utopia that sees its residents in the prime of existence with no physical problems.

The other side dark, raining, sleeting, snowing with regular bouts of oppressive wind and engulfing surges of water. The occupants are all chained with a length that only allows them the room to get to the fence and wish they had led a better life.

There is a watchdog and it is his job to come up with methods to further torture those on the dark side. Like the denial of food and drink, forcing the bottom dwellers to disrobe in the cold, rain and snow. Making these poor souls walk on hot coals to get to the food and drink they are allowed.

Donald Trump will destroy democracy

These are two very specialized ideologies, but meant to be a simplification of the unyielding difference between right and wrong. We have lost our way in this determination today, particularly on the political scene. We have an incoming Oval Office lunatic that has threatened to jail Jan. 6 committee members and his enemies in general; He wants to deport 11 million immigrants and doesn't care if there are U.S. citizens caught up in the process; He has focused on unqualified and incompetent people to fill his administration.

There is more, much more, and the downside of it all is that Donald Trump wants to destroy our democracy and replace it with an autocracy. And, unfortunately, some of the American public, and it must be a relatively large portion, has turned into apathetics. They want someone to make their decisions, and for the life of me I will never understand how they want to trust Donald Trump with this task. The next four years could prove a reckoning and this includes Trump and all his minions.

Wednesday, December 11, 2024

Donald Trump's new administration of criminals

People who left Trump White
House first admin.
Donald Trump could not have done any better in assembling a gang of criminals for his administration than if he had conducted his recruitment in a prison. To begin with, Trump, himself, has been indicted in four cases, convicted in one and penalized in several civil lawsuits. Political scientists Austin Sarat and Tom Dumm, in a Salon article republished by RawStory, say...

"There is, of course, nothing wrong with giving people second chances after they have paid their debt to society," the pair wrote. "But everyone Trump has nominated or appointed thinks they owe no debt to society. Each of them contends or is portrayed by Trump’s transition team as a victim of a political prosecution or a left-wing smear campaign."
  • First, there is former trade adviser Peter Navarro who will return to the White House after serving a prison sentence for contempt of Congress.
  • And then there is his son-in-law, Jared Kushner's father, Charles Kushner, who will be ambassador to France, despite his own criminal convictions.
  • Although there is no litigation, former Fox News host Pete Hegseth was picked to be defense secretary, in spite of multiple charges of misconduct.
  • Again with no litigation, former Rep. Matt Gaetz had to withdraw as attorney general nominee due to accusations of his sexual trysts with minors.
The authors bring up the competence of the nominees and while Navarro and Gaetz are questionable, and Kushner is most certainly borderline, Pete Hegseth's nomination as
Pete Hegseth

Defense Secretary is beyond ludicrous. There are lots more who are somewhat dubious but don't necessarily carry the baggage of legal problems. Are you ready for this?
  • Marco Rubio does not have the strength to be Secretary of State.
  • Pam Bondi would trash the Attorney General's office with her spoken vendetta of Donald Trump's enemies.
  • There are screams all over the medical community from doctors and scientists that Robert F. Kennedy Jr. will destroy medicine as we know it today.
  • And Kristi Noem as the Secretary of homeland security is another one that keeps you rolling in the aisles with laughter.
  • Tulsi Gabbard, as Director of national intelligence, is highly questionable since she doesn't really know if she's on our side or the side of the Russians.
  • Dr. Mehmet Oz has a fascination with Medicare advantage, in lieu of its rival so his nomination as Centers for Medicare and Medicaid Services administrator could jeopardize regular Medicare.
  • Elon Musk and Vivek Ramaswamy heading Department of Government Efficiency is a total joke. Two morons for the job and Ronald Reagan couldn't make it work. Donald Trump sure as hell won't be able to.
  • Stephen Miller as Deputy chief of staff for policy and homeland security adviser worries me a lot. This man and his ideologies are just plain scary.
  • Kash Patel as FBI director is in the Pam Bondi mode; would rein the department with his rage against Trump enemies.
  • here is one who appears qualified for the job, Susie Wiles, as White House chief of staff. And if she can hold Donald Trump down, she will deserve our applause.
It will be interesting if all, or at least some of these nominees are approved by the Senate, just how long it will take for the axe to fall on the first one.

Tuesday, December 10, 2024

Who is to blame for Brian Thompson's murder?

Police closing in on Brian Thompson shooter


First up would be the shooter, whom authorities believe they have found. You might think that is sufficient to explain the taking of a person's life but you would be wrong. Remember, this person had positioned him or herself in wait for Brian Thompson, the CEO of UnitedHealthcare, for the purpose of killing him. It would appear that the shooter didn't know Thompson, thus, there was some other objective in what he did. The people have spoken in social media with an opinion that Thompson deserved what he got.

Vox says it all in its headline, "The deep roots of Americans’ hatred of their health care system." The article by Dylan Scott reports there is significant evidence of the fact that the way the country provides medical services is costly in both money and human life. Not only the lives of patients but now a life of the CEO of the largest health insurer in the U.S., UnitedHealthcare. The public is more than justified in its anger when a company who could save your life uses AI for a reason to let you die. Vox goes on...
"On the same day as the shooting, news that a different insurer would restrict coverage for anesthesia during surgeries went viral, serving as a kind of cosmic confirmation of this line of thinking."

This was withdrawn almost immediately with the murder of Brian Thompson. It was a stupid decision to arbitrarily restrict anesthesia time in surgeries, to save money, of course, with no consideration whatsoever for the needs of the anesthesiologist, who, in fact, has the responsibility for the patient. Here's another blunt comment from Vox...

"Put every aspect of this tragic episode together and you have the rotten core of American health care. The cruelties of the US medical system and the ongoing blame game between the private industries that profit from it have left patients angry and confused — and looking for someone, anyone, to blame, fairly or not."
Luigi Mangione, suspected
Brian Thompson murderer

Scott thinks the only way to solve the problem is to confront all the industry offenders who are responsible for this aggregate of failures. The author also harks back to the days when medicine was much simpler. The participants were allies, not fighting each other constantly for profits. He also explains, "prices have continued to spiral upward, accelerated by the aging of the baby boomers and by important but costly advancements in medical science." Conversely, guess we couldn't do without any of this.

Obamacare was a strike against the private insurance industry, but since its enactment, Republicans have tried non-stop to kill the program. With only a mention now, but worth considerable coverage in the future, big pharma was caught off-guard by Biden's recent Inflation Reduction Act. We'll see the full effect in 2025....
"a provision allowing for Medicare to negotiate prices with drugmakers, which would lower costs and allow the program to cap seniors’ out-of-pocket costs."

And I have never seen a blame game carried out with the intensity of that in the medical insurance industry. Here are the sordid facts...

  • Hospitals blame drug companies (for charging high prices that they must pass on to payers) and insurers (for restricting benefits and leaving patients exposed to uncovered bills)
  • Drug companies blame insurers (for charging patients high out-of-pocket costs for medications) and hospitals (for exploiting technical programs like 340B to artificially boost their profits); they also blame the pharmacy benefit managers (PBMs) who coordinate among drug manufacturers, plans, and pharmacies
  • Insurers blame hospitals and drug companies (for charging too much money for their services and products, which patients bear through higher premiums and out-of-pocket costs)
  • Patients blame everybody (for the high costs they face and the hassles of navigating this complicated system).
I can only hope that this murder will not take the same course as does those in gun violence...here today, gone tomorrow.


 




Monday, December 9, 2024

Will Brian Thompson's murder end a corrupt insurance industry practice?



Doctors without authority



Brian Thompson, CEO of UnitedHealthcare was murdered and drew headlines like this on WGTC...
"‘He was a serial killer’: Americans have no tears to shed for murdered CEO who denied patients life-saving care."
This may seem callous to some but it is a pent-up feeling for years of those deprived of their rightful medical care. WGTC continues...
"UnitedHealthcare is the kind of insurance company that scams people, but we hardly ever hold it accountable. Well, some people on the internet haven’t forgotten about the company’s past."
Social media is screaming how UnitedHealth has the most denied claims in the industry and they do it by using AI. The U.S. Senate Permanent Subcommittee on Investigations reported, "the nation’s insurers have been using AI-powered tools to deny some claims from Medicare Advantage plan subscribers," according to YahooNews.

There's more...
"The report found that UnitedHealthcare’s denial rate for post-acute care — health care needed to transition people out of hospitals and back into their homes — for people with Medicare Advantage plans rose to 22.7% in 2022, from 10.9% in 2020."

There is also a lawsuit accusing Brian Thompson and other executives of UnitedHealth of insider trading related to an ongoing Justice Department investigation, according to YahooNews. Here's the scenario...

"Thompson, 50, was one of three UnitedHealth Group executives named in a class action lawsuit filed in May that accused them of dumping millions of dollars worth of stock while the company was the subject of a federal antitrust investigation, which investors say wasn’t immediately disclosed to shareholders."
Taking advantage of this privileged access to inside information is considered a breach of the individual's fiduciary duty. And if you're willing to break one rule, why not another, which, of course, was Thompson's initiation of the use of AI for the purpose of denying claims. A move that ranks UnitedHealth the frontrunner in that process. 

Neiscope says the public's reaction is incredibly dark, with one person cracking the following remark, "Our apologies, but bullet wounds are only covered under our Platinum+ package." Police Commissioner Jessica Tisch commented...
"Let's be clear: any act of violence or loss of life is a tragedy. But the internet's indifference to Thompson's passing — and gallows humor about the notorious deficiencies of the private insurance industry — are simultaneously ghoulish and illustrative of America's profoundly dysfunctional medical system."
The cost of medical care has gone up while the quality of care has gone down. But the epitome of it all this is there is now a company "whose business model depends on turning down payments for care recommended by doctors for their patients," according to ProPublica.org. (They sell this software to insurance companies). The name of the company is EviCore by Evernorth and they are owned by the insurance giant Cigna. Here's the scenario...
"A ProPublica and Capitol Forum investigation found that EviCore uses an algorithm backed by artificial intelligence, which some insiders call “the dial,” that it can adjust to lead to higher denials. Some contracts ensure the [insurance] company makes more money the more it cuts health spending. And it issues medical guidelines that doctors have said delay and deny care for patients."
There is no wonder the American people are furious over being conned out of the healthcare that is rightfully theirs. But when will the masses revolt against this wrong and others perpetrated by Donald Trump?                                         

Friday, December 6, 2024

Why hasn't Joe Biden issued blanket precautionary pardons?


President Biden has a list but this time it is a good one. It includes those who have actively opposed Donald Trump, and he is considering giving them blanket precautionary pardons. Daily Beast describes them "Trump’s biggest political foes," with a mix of Republicans, Democrats and former administration staff...
The main three are former Wyoming Rep. Liz Cheney, Anthony Fauci, former head of the National Institute of Allergy and Infectious Diseases, and Adam Schiff, newly elected California Senator. There are more.
Here's a headline for you from Reuters: "Trump taps team geared toward retribution and remaking of government." A clearcut designation of loyalists who share Donald Trump's thirst for revenge. And, a promise to take away your democracy and turn it into a dictatorship. I don't believe the average person in this country wants to give up thinking for themselves and turn over their lives to an oligarchy. Only the double-digit Trump followers. 
And here's a kicker from Reuters: "Trump's team reflects preference for outsiders with disruptive mentality."
Kash Patel, Trum's current choice to head the FBI has bluntly "vowed to go after Trump's perceived enemies," according to Reuters. Listen to this from Politico..
"For years, Trump has peppered his speeches and social media posts with vengeful calls for his political opponents, his critics and members of the media to be prosecuted, locked up, deported and even executed. In the waning weeks of the 2024 campaign, he escalated those promises of retaliation to a fever pitch."

When conservatives turn against their own

 I have followed Wm. Kristol for years and it wasn’t very long ago that I considered him an ultra conservative that would never chastise the...