Delay, Deny, Defend

It might be easier to make sense of the recent fatal shooting of an insurance CEO, an act with ominous overtones about health care costs and insurance coverage, if any one aspect of health-care finance in America had gotten dramatically worse.

But what if there is no one thing?

Everything in American health care seems to cost more, across the board, year after year. Millions of insurance claims get denied. Medical debt routinely drives patients into bankruptcy. And patients see no relief in sight.

“Americans forgo necessary health care every single day, because they can’t afford it,” said Caroline Pearson, executive director of the nonprofit Peterson Center on Healthcare.

Americans spend more out of pocket on health care than people in most comparable countries, the health policy nonprofit KFF found. In the United Kingdom, for example, out-of-pocket health care costs totaled $764 per person in 2022.

“We don’t consume a lot more health care than other countries,” said Dr. Atul Grover, executive director of the nonprofit AAMC Research and Action Institute. “We just pay a lot more for each thing.”

United Healthcare reported net income of $22.3 billion last year, had net income of $20.6 billion in 2022 after making $17.3 billion in 2021 and $15.4 billion in 2020. Before the pandemic United Health made $13.8 billion in 2019.

Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It is a 2010 book by Rutgers Law professor Jay M. Feinman

Luigi Mangione Has Become A Social Media Folk Hero. The Glorification of Luigi Mangione Is Disturbing – But Not Surprising

Luigie Mangione is escorted into Manhattan Criminal court for his arraignment in the killing of UnitedHealthcare CEO Brian Thompson, Monday, Dec. 23, 2024, in New York.

Say Hello to Polio

The polio vaccine developed by Dr. Salk and colleagues is licensed in the U.S. Before the polio vaccine, the disease had been a major cause of disability in children. About 16,000 cases of polio (paralytic poliomyelitis) occurred each year in the U.S. in the 20th century compared with none in 2020.

An attorney connected to Robert F. Kennedy Jr., President-elect Donald Trump’s nominee to lead the Department of Health and Human Services, filed a petition on behalf of an activist group asking the Food and Drug Administration to suspend or withdraw approval of a polio vaccine for children.

Senator Elizabeth Warren sounds the alarm about Donald Trump’s idiotic decision to put conspiracy theorist RFK Jr. in charge of the Department of Health and Human Services.

She didn’t pull any punches…

“Say goodbye to your smile and say hello to polio — that’s what’s on the horizon if Robert F. Kennedy Jr. becomes the Secretary of Health and Human Services,” Warren wrote on X along with a video.

“You know I would laugh if it weren’t so scary,” she said in the clip. “Donald Trump just picked RFK Jr. to lead the Department of Health and Human Services. This is a man who wants to stop kids from getting their polio and measles shots.”

“He’s actually welcoming a return to polio a disease we nearly eradicated,” she continued. “But it doesn’t stop there. RFK Jr. also doesn’t believe fluoride should be in your water and that’s what keeps your teeth from rotting.”

“You can’t make this stuff up!” she added.

Affordable Health Care

Luigi Mangione, the 26-year-old Ivy League graduate accused of gunning down UnitedHealthcare CEO Brian Thompson in front of a New York City hotel last week is probably guilty.

Mangione’s hatred for the health insurance industry and health care in the United States has brought people cheering him as a folk hero. Singers have posted songs about him. On TikTok, folk singer Joe DeVito posted a song. Merchandise, including sweatshirts, wine tumblers and hats emblazoned with the words, began making their way around online storefronts, though some have since been removed, the Washington Post reported.

For as many jokes internet users cracked casting the suspected shooter as a “folk hero,” others pointed to the systemic wealth inequality governing a society in which UnitedHealthcare reported over $16 billion in operating profits in 2023.

On a personal side my daughter’s healthcare (California Care – part of ACA) has denied coverage repeatedly. The cost of her Dexilant is $500 a month but by accident we learned that she can buy the medication from a Canadian pharmacy for $92 a month. It’s not a generic.

At the very least Luigi Mangione has brought the health care industry to a forefront. Will anything change? Probably not. Making money is more important than affordable health care.

New Year’s Resolutions

I do not know if this is just an American pass time but every New Year many of us make a list of resolutions of things we promise ourselves to do but are quickly forgotten.

One of the most popular is losing weight. Weight Watchers, Nutrisystems and Jenny Craig all enroll thousands of new participants. The gyms all sign up hundreds and perhaps thousands of new members. Clearly this is a commercial bonus.

There are however many other kinds of resolutions. One person I know writes out a set of goals for the new year. He revises them annually. In his case that set of goals gives him directions to his life.

Forbes Magazine posts on line Seven Strategies for Highly Effective New Year’s Resolutions. Summarized as follows:

Know Your Why. For a resolution to stick, it has to be aligned with your core values. In other words, you have to “Know your why” and feel truly passionate about the goals you set for yourself.
Be Specific. Resolutions to ‘eat better, get fitter, be happier, relax more or have better life balance’ are doomed for failure because they lack specificity.
Don’t Just Think It, Ink it! A Stanford University study found that when people wrote down their goal, it increased the probability of them achieving it by over 70%.
Design Your Environment. Design your environment so that it’s hard NOT to do what you resolved. Create a progress chart, recruit a cheer squad among your family and friends, find someone to hold you accountable, hire a trainer, join a group, create a blog.
Narrow Your Efforts. Set yourself up for success and start with JUST ONE MAJOR UNDERTAKING come starting January 1^st.
Focus On The Process. PERSISTENCE ALWAYS PAYS OFF.
Forgive Your Failures. Your setbacks and failures will not define your success in the year ahead or any year. HOW YOU RESPOND WILL.

What are my resolutions? I have none today. I have never believed this process is a worthwhile endeavor. I have made resolutions but they were not tied to New Year’s day.

Good Luck!

Lifestyle

Congratulations to Weight Watchers for convincing millions of overweight people that their solution is a change of Lifestyle. Weight Loss Boss by David Kirchhoff, the CEO of Weight Watchers International, is all about Lifestyle. My lovely wife, who needs to lose at least another 18 pounds, contends that her revised eating habits are all about Lifestyle. Losing weight and keeping it off is not my idea of a Lifestyle.

I like the Wikipedia definition. Lifestyle (sociology), the way a person lives to one’s own ability. Individual identity. A lifestyle typically reflects an individual’s attitudes, values or world view. Therefore, a lifestyle is a means of forging a sense of self and to create cultural symbols that resonate with personal identity.

The Free Dictionary offers a concise easy to understand definition. A way of life or style of living that reflects the attitudes and values of a person or group.

Microsoft Word provides a definition by reading its Thesaurus. Way of life, Existence, Standard of living, Routine, Life, Daily life, Everyday life, Means.

What is the Lifestyle of the rich and famous? Robin Leach spotlighted the eccentricities and excesses of a different member of the “rich and famous” each week from 1984 to 1995.

My Lifestyle is doing the things I like to do without having a boss. It’s writing in this blog and walking or riding around taking pictures of unusual things.

I AM TRULY VERY FORTUNATE.

What’s your Lifestyle?

Health Care Mandates are not a New Idea

As a nation Americans are debating the power of the Federal government to pass laws that mandate our behavior in the area of health care. However, the Patient Protection and Affordable Care Act is not the first mandate pertaining to health care.

Three other mandates already exist. This information was posted in my local newspaper (Los Angeles Daily News).

Other health care mandates
The 1986 Emergency Medical Treatment and Active as Labor Act. It requires nearly all hospitals to treat and ‘or stabilize anyone needing emergency care, regardless .of ability to pay or legal U.S. residency. Critics call it an unfunded mandate. It was part of a budget law signed by President Ronald Reagan.
The 1996 Mental Health Parity Act. It prohibits group health plans from setting lower annual or lifetime dollar limits for mental health benefits as compared with medical a surgical benefits.
The 1996 Newborns’ and Mothers’ Health Protection Act. It requires plans offering maternity coverage to pay for at a least a 48-hour hospital stay following most normal deliveries, and 96 hours following a cesarean section. The mental health parity and maternal health laws were signed by President Bill Clinton.