Washington Post medical reporter takes up the cause of a physician with a broken ankle from a car accident who was billed $64,000. Apparently a loophole in the “No Surprise Billing” law allowed sharp eyed private equity operators to generate the “medically unncessary” out-of-network bill.
That’s what I love about traditional Medicare – there is no for-profit insurer in the loop trying to swindel you.
free link:
https://wapo.st/48RSUYD
intercst
Ironically, Medicare Advantage is apparently bad for the insurance companies as well as patients.
By David Wainer, The Wall Street Journal, Oct. 29, 2025
…
Some of the steps insurers such as UnitedHealth and CVS are taking include eliminating certain plans, trimming benefits, raising out-of-pocket costs and pulling back from offerings such as PPO plans that give members more choice. The same discipline extends to care delivery: Much like CVS is pairing back growth ambitions for its senior clinics, UnitedHealth’s Optum Health unit is also retrenching, exiting low-margin contracts and narrowing provider networks….
Insurers are piling into Special Needs Plans, which serve chronically ill, frail or dual-eligible patients who qualify for both Medicare and Medicaid benefits. These plans can be more profitable despite serving more vulnerable groups. That is because CMS pays higher rates for sicker patients, and insurers that coordinate their care more efficiently get to keep more of that money….
General enrollment plans—open to all Medicare beneficiaries—are set to drop nearly 10%…
Medicare Advantage is no longer the profitable business it once was, but insurers are adapting. [end quote]
Wendy
It’s only “bad” in the sense that they’re not getting as much excessive Executive Compensation as they’d like. There’s still far more “skim” in MA versus traditional Medicare.
intercst
I haven’t watched this segment yet. But it’s good timing for this thread. I’ve never really heard anything good (from a patient’s perspective) about Medicare Advantage plans. Evidently, John Oliver didn’t either. He probably tore them a new one, if I know him.
