Real Doc Speaks
@realdocspeaks
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A Patient-focused physician, speaks out on health issues to clarify complexities, expose middlemen, and explore the future of medicine. NOT medical advice
Joined November 2023
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Last Seen Profiles
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This article reports that on 2/21/2024, the day Change Healthcare suffered a cyberattack, five of United Health top executives sold $17.7 Million of company stock. The five included the CEO Andrew Witty as well as the General Counsel.
The following
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@halletecco
Always ask for the cash price. I check every medicine on Cost Plus Drugs, and on one, I save 70% by not using insurance. The ACA mandated prescription drug coverage, and for most people, it is a waste of money.
If something is good, it doesn't need to be mandated!
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My last job as an OB Hospitalist paid $125 per hour with some vague bonus language. I went into a Lexus dealership today and the labor rate is $199.99 per hour. Thank God that 12 years of education after high school is paying off!
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Mark Cuban's Costs Plus Drugs will start manufacturing two medications in Dallas. This is great news as currently most generic meds are produced in India or China. Both of these countries facilities are plagued by problems with safety and purity and the FDA makes no surprise
Mark Cuban Cost Plus Drug Co. plans to begin manufacturing epinephrine and norepinephrine this week at its 22,000-square-foot drug facility in Dallas, Mr. Cuban confirmed to Becker's on March 5.
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The brain drain will come, and it won't be reversed when it does. The old ways of medical practice are already long gone. Patients no longer have "their" Doctor, the one who they could call 24/7 with an emergency. He or she has retired because he or she couldn't stand to be
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@cllaucll2y
Very sorry to hear the news. I practiced in NE Wisconsin for 25 years, moved to Florida and practiced for a short while and shocked by the marked difference in practice styles.
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@MZHemingway
This is a terrible precedent that the left will regret when it is used against them.
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Steward Health Care files for Chapter 11. They claim that it is due to low Government health reimbursements, high labor costs and challenges from a post Covid world. The real reason is that they took a series of safety net hospitals that were already
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@shuntedmdphd
You will be a God send for all of the patients. Best of luck and don’t give up, we need you in medicine!
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This is a joke. Physicians have had twenty years of pay cuts and are the only entities not indexed to inflation. I would encourage physicians to opt out of Medicare and charge what their services are worth. UNH and PBMs have increasing real earnings, A 1.7 percent increase
It is STILL a paycut... Any other profession getting regular paycuts in this inflationary environment?
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Credentialing for insurance companies and hospitals is a time-wasting scam. I served on a hospital credentialing committee, and after the 90-120-day waiting period, everyone was credentialled. This could have been done in a few days. It does limit physician mobility and acess.
The Healthcare Big Short - “Credentialing”. A word made up by Health Insurance. It’s why Doctors can’t open their own practice and bill insurance and worsens the Doctor Shortage. Health Insurance won’t pay for 3 months because of the “Credentialing” process. Medicare 6 months.
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This is a very disturbing article that raises many concerns. It describes Dr. Debby Day, a long time Medical Director at Cigna and her experience and her reasons for retiring from Cigna. Some of the concerns raised include:
1. The article describes
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As an OB who does Ultrasounds in the office, I have interpreted more studies than any radiologist in a community hospital. However, when in the ER, not only do I review the images and talk with the tech, but I also look at the radiologist's report. Many times, they will add
These people are so full of hubris!!! I am an emergency physician who has treated thousands of patients… yes, I review the initial radiology study and put in my initial read in order to expedite patient care HOWEVER I’m not a radiologist and I am not competent to do the final
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Walmart is closing all of its 51 Health centers across 5 states as well as it's virtual care clinics.
Walmart opened the health centers in 2019. The reasons given were rising costs, poor reimbursement, and lack of profit.
It is very difficult to
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You are confusing capitalism with crony capitalism. I have no problems with companies seeking to increase earnings through legal means and through ways that are available to all parties.
Here are the issues I have with UNH:
1. They vertically integrated to avoid the Medical
"Greed" is just economic self interest.
Everyone is self interested. Hospitals, doctors, nurses, pharma, patients... This isn't unique to insurance companies.
If we get "corporations" out of healthcare, then who runs it? The only other option is a government run system.
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Terrible but unsurprising news! Optum gets to purchase the Corvallis clininc in Oregon on an emergency basis. The emergency-they weren't getting paid by Optum after the Change Healthcare cyber attack. But don't worry Optum has plenty of money to
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@etasjim
Unfortunately, physicians spend too much time focusing on electronic health records, what diagnosis codes to use, and how to please the insurance company. These activities are a tremendous waste of time and distract from patient care.
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The White House will hold a listening session to find out how to reform PBMs. The issue isn't that we don't know what needs to be done; the issue is that the politicians are addicted to money from PBM lobbyists and will not take the correct action. The
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The WAR on physicians continues! Congress has refused to pass site-neutral payment for physicians. Physicians are paid more for administering medications in a hospital than in an office. The article claims this is a "controversial" policy and was informed by 5 lobbyists that
Congress has decided not to pass a site-neutral hospital pay policy along with an upcoming government funding package.
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You are correct that hospitals were originally entirely different from what they are today. They were built by the town's leading members, often in conjunction with a church. The hospital president worked closely with and was respected by the medical and nursing staff.
The
Looking back when
#USHealthCare
was a federal function to provide
#ServiceToThePeople
rather than
#ProfitsToTheRich
.
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The Physicians always get blamed for the insane costs of healthcare. We do not set the prices, we get a small sliver of the total price and we are your only ally.
Remember folks… physicians count for 6.8% of total healthcare costs… where does the other 93.2% go??? Here:
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Allison is correct! There have been too many people getting rich off of the labor of physicians. We should be paid for any extra time that the EHR takes. The data selling needs to stop!
@realdocspeaks
It takes 50% longer to finish a chart with an EMR. They should pay for that. Also, the EMR has turned me into a data entry monkey so that people can use my data for stupid quality metrics that are not meaningful or reliable or to sell my data to make money.
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I just published Dana — Farber Cancer Institute Leadership Lacks Accountability as Scandal Continues
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Physicians are all overpaid and are responsible for the rise in healthcare spending. This is one of the biggest lies in healthcare.
This article discusses the outrageous salalaries and perks of non-profit hospital CEO's.
They discuss the salary of Todd
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A new Virginia law requires the presence of a physician in the ER and not merely on call. It takes effect 7/25. This law should be in effect yesterday and why is ever allowed to have an ER without a physician? I am shocked that JCAHO is ok with no doc in
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UNH never had any credibility with me or my group. They are nothing but bullies because they have an anti-trust exemption and Physicians don’t. They audited me for 30 surgeries dating back four years and wanted 30K. My billers spent hours going through all the records and when
Whatever shred of credibility
@UHC
had w/ clinicians & hospitals--a very poor reputation earned long before this cyberattack & via many interactions--is gone.
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An interesting article that discusses the growing concern of hospitals with Medicare Advantage reimbursement. The reimbursement is about 85% of Medicare and includes numerous delays and denials. Hospitals continue to drop plans and the extras the seniors
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I have to respectfully disagree with Blake. PE is NOT allowed to own law firms but they are free to do whatever they want in healthcare. This makes no sense as health systems, hospitals and physician groups should always be patient focused and not profit focused. Physicians
Private equity belongs in healthcare.
PE isn't the villain; it's the lack of transparency in healthcare overall, which isn't limited to PE.
That's why
@mcuban
's
@costplusdrugs
prioritizes radical transparency in healthcare as a core differentiating factor👇
While radical
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. This report claims that a $22 million dollar ransom was paid by UNH to Blackcat for the Change Healthcare cyberattack. If this is true it will be one of the largest ransoms paid and will encourage future cyberattacks on healthcare entities. This is a
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@jjfitzgeraldMD
Why not train the generalist better in residency and have them treat the more straight forward cases. For example, a patient with isolated SUI is usually easily treated. The patients who are older, with mixed UI or those who have had previous surgery would be appropriate for a
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United Health is a large part of the health insurance, PBM, claims processing, and health IT services. They also crush competitors and increase costs to the end consumer. This is the textbook definition of anti-trust, and there is NO reason they should not be broken into
“we’re a comparatively small part of the $5 trillion healthcare system”
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@StephenFisherMD
We were sold out by both parties at different times and in different ways. But the outcome is the same, we have no friends in D.C.
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Traditional Medicare is a fee-for-service program. We have all been told that fee-for-service is evil and rewards greedy physicians.
Medicare Advantage was invented to allow insurance companies to manage the costs of Medicare, and through their genius, Billions would be saved
Make no mistake that the
#healthplans
have their futures tethered to
#MedicareAdvantage
. Recall that
@Humana
exited the commercial insurance biz in the past 2 yrs. That
@UHC
is the largest
#MA
plan showcases the importance but also the vulnerability. Let’s be frank: many of the
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No physician should ever let anyone call them a provider. I did not attend provider school.
"Primary care staff" in the UK is equivalent to "Providers" in the U.S. Conflation of professions is the
#1
bulls**t strategy in the corporatization of healthcare.
Same game, different name.
@iDrSunny
@Xeon4f145d96s1
@TakeMedBack
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We need real PBM reform and it is not complicated.
1. Large payers can't own a PBM, Pharmacy or Health Clinics
2. No Formularies
3. No Spread pricing
4. No kickbacks, rebates or other terms
5. PBMs have to pay Pharmacy costs + for all meds
6. PBM fees can not be related to
As long as health ins cos/PBMs are publicly traded for-profit cos, OF COURSE they are going choose the most profitable drug (highest price) Until profit is taken out of health ins, none of this is surprising. We can't make them choose to make less money.
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This is a very detailed report about Optum, the upcoding of patients, the violation of HIPPA, and employees' interest in unionization. Patient records are shipped to India for coding, nonsecure email is used for results, and much more. Bottom line: Corporate entities should NOT
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Patients now understand that they have lost "their" physician. Now, they may or may not see a physician, and if they do, it is a rotating crew. This is destroying health care and the middlemen are thriving.
In 2010, 80% of physicians were in private practice.
In 2024, 80% of physicians are employed.
Is this good for medicine?
Is this good for patients?
Is physician autonomy essential for good medical care?
What are the primary factors that led to the transition?
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Great question Sarah! Medicare Advantage was supposed to save money compared to traditional Medicare but actually cost billions more. It underpays physicians, hospitals and restricts access for patients. It is a cash cow for large insurance companies and is terrible for
@realdocspeaks
I am confused. So that 50% of seniors and disabled can't see a doctor? There must be a better way, no? Increase reimbursement and get rid of Medicare Advantage
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This is absolutely correct. The EHR was never studied, we were told by those with no knowledge of medicine that the EHR will save medicine. It will make us more efficient, save lives, and increase quality and safety.
No mention or concern was given to cybersecurity and
@realdocspeaks
@etasjim
Absolutely. I am just old enough to remember the tail end of the “before times” prior to EHR. It was sold to us that EHR was going to benefit us, be more efficient, take less time and allow more time with actual patient care. The opp has been true, by a large multiple.
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The real money in the healthcare system is spent on middlemen that you never see, and that is how they like it. The CEO of Change Healthcare is paid $9.5 Million a year and has never saved a patient's life. The CEO's of Large insurance companies make 20+ Million a year and I
@realdocspeaks
I think at some point though you have to admit physicians play a huge part in the overall expenses to the system. Why are billions billed in unnecessary procedures? It's so easy to waste patient's money & the gov'ts. Physicians need some skin in the game. It is what it is.
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@AshleyGWinter
Great question! I want women to come in before attempting pregnancy for a consultation and exam. Check for normal BP, normal glucose if they have DM, review teratogenic meds. review and complete carrier screening, check rubella immunity, get a pap smear, start folic acid and
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This article describes the upcoming merger of Mass General and Brigham and how the Physicians are feeling devalued.
There is no clarity in how the combined system would consolidate departments, who would lead the departments and if there will be layoffs.
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@JNicholsonnn
I am sorry this happened to you. I had a similar experience with Optum, and they should not be allowed to try to claw back money they have already paid. They will disallow a claim that is not filed in a timely manner but reserve the right to claw back money.
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Pediatrics is the lowest-paying specialty, and 30% of the residency spots went unfilled in the last match.
Medical Students are graduating with increasing student debt and choose higher-paying specialties as a result.
Two solutions would be to pay pediatricians more money and
30% of pediatric residency programs did not fill their residency positions this year.
We need more pediatricians and to pay them better.
Rx & prevention of diseases in childhood is the highest yield and most cost-containing of all medical specialties.
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The death toll for independent docs came when the AMA supported the ACA. The ACA was anti-independent doc with no tort reform, prohibition on physician ownership of hospitals and on growth of current hospitals, encouragement of risk in ACOs, no patient responsibility in the ACOs
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This is the testimony of the United Health CEO regarding the Change Healthcare cyberattack. The testimony will be provided in person on May 1, 2024. I would differ from his account in the following:
1. He reports that Optum is a distinct and
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Bob, why do we need electronic health records? Here are a few issues with EHRs:
1. Very expensive to purchase, operate, and train staff on.
2. The lack of cybersecurity is a ticking time bomb; it's not a matter of if, but when, all the medical records on EHRs will be hacked.
Healthcare delivery continues changing.
The latest change is a focus by
@JusticeATR
on antitrust issues in healthcare. Any antitrust adds cost and friction to personal and professional interactions.
Any significant changes in healthcare will require better electronic health
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The safe harbor that PBMs have for kickbacks and their anti-trust exemption allows them to make massive profits for shuffling virtual paperwork. West Virginia dropped the PBMs for their state Medicaid program and save 54 million dollars the first year. This is criminal that
“this kickback scheme that ultimately enables and rewards intermediaries and middlemen at the expense of the end-paying consumer," -
@A_Ciaccia
Why should wealthy
#PBM
have the government enable them by allowing them to collect kickbacks?
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Zero people worked late/early in my office. I was first in and last out. The nurses pulled the charts for the next day on the day before. There was no need for any extensive preparation. We always did what was best for the patient. The problem is that you never performed
@realdocspeaks
@crappiedoc
How many people work late/early, in advance, to prep things for you and your patients? Your day might be done, but someone is transcribing, putting results into charts, etc. It's a team. The team is supposed to do what is best for the patient, not the doctor.
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This translates to they pay us more money than you. Having said that I do agree that Physicians need to be more politically active. Our national organizations seldom lobby on issues that affect practicing physicians. We need to form groups of Physicians, set an agenda and meet
@EdGainesIII
a Senator’s staffer point blank said to us “they (insurers, hospitals) just lobby better than you (doctors)”
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The PBMs are out of control, and Congress has to step in and fix this. Take away the anti-trust exemption, do not allow payers to own PBMs, and do not allow PBMs to own pharmacies.
Whats funny is that the PBM outrage is palpable, real, and can be found down the street in any local town. But the fixation is on drug pricing, one component of a massively broken system.
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It is crazy that this young man died because he couldn't get an Advair prescription! NO more formularies, NO more charging the US 5 times what you do in other countries, NO more PBMs, NO more convoluted supply chain for meds that allow profiteering, and NO more vertically
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The 2 big lies in health care are that physicians control everything, and health care in the US is the most expensive in the world because Physicians are massively overpaid. Remember that physicians make little money until the early to mid-thirties. They miss out on years of
Next time you’re inclined to blame physician compensation for your healthcare costs, take a pause.
This study is relevant to Medicare-related procedures.
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You can experience single-payer health in the US right now, that is, the VA and Military health systems. I have worked in both, and they are NOT what Americans envision for a healthcare system. We are better off reforming our current system by eliminating useless middlemen and
For those who are all in on advocating for a single payer system in the US… this is what’s happening happening in the UK. What will we do differently to prevent this?
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This is a disaster for physicians as well as patients. Patients will realize that the employed doc is not the same as the independent. The independent doc can advocate for you and can offer great service at a good price. The employed doc has no ability to go out of their way
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The dangers of Private Equity ownership of hospitals is on full display with Steward Health. They have taken a series of safety net hospitals in Boston and stripped them of any assets they could, and avoided paying bills. This led to a maternity death
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This is a sobering article about physician employement. The promise of physician employement were:
1. Increased Access
2. Lower costs
3. Investment in the practice.
Sadly, none of these have occured and the conclusion is that we sold our souls and
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This is exactly why PBMs are not saving money. They are a useless middleman and need to disappear.
@PatToomey
@MarkCuban
Here’s a little snippet of some of those cost differences. For them to keep covering the brand and not generic- the PBM must be getting one Hell of a Rebate!!
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Insurance company denials of care should be rare and thorough. The entire record should be reviewed by a physician in the same specialty. The goal of denial of care should not be to save money but to ensure the patient is receiving the correct care.
The peer-to-peer should
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Optum should not be allowed to profit from the cyberattack they failed to prevent! If this is allowed to proceed then there is no question Optum owns the government.
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The HITECH Act was terrible and corrupt legislation written for the benefit of Epic and other large players.
There should have been interoperability from day 1 and there should have been Beta testing on a small sample of patients to see if the EHR was going to work.
Anytime we
Interoperability
Holding back safe, secure, easy, & ubiquitous sharing of individuals electronic health records?
Some combination of:
* Ignorance
* Incompetence
* Misfeasance, and
* Malfeasance
For 20 years the current project approach hasn't worked -- and isn't working now.
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This article reviews that Community Health Systems is the first system to purchase inpatient meds that are manufactured by Mark Cuban Cost Plus Drugs. The system is purchasing epinephrine and norepinephrine for use in its hospitals. This is an important
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We need Congress to perform 3 tasks
1. Pass REAL PBM reform
2. Rescind the anti-trust exemption for payers and PBMs
3. Mandate that Medicare and Medicaid negotiate the price of ALL meds to that of the average paid by Comparable other Countries
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The average person has NO idea about the change healthcare hack! If only T Swift could write a song about it!
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The DOJ is suing Apple Computer for anti-trust violations through their actions in the iPhone arena. I think the DOJ's resources would be better spent on addressing the harm that mega-insurance companies cause. The major payers are all vertically
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Because the margins for primary care are terrible. The expenses are high, labor cost and supply cost have skyrocketed. That 100 dollar payment isn’t received that day of service. It may come in 30-60-90 or sometimes not at all. If your costs go up you can’t raise your prices.
There are 300M Americans with health insurance. The average PCP visit gets reimbursed for about $100.
If you can just build a practice that sees 1% of all US patients each month, you can create a $3.6B company pretty quickly.
Why isn't anyone doing this?
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Optum admits to a $14 Billion backlog of payments from the 2/21/2024 cyber attack on Change Healthcare. Since Optume knows of the backlog they should pay NOW! The Maryland Medical Society reports they are offering only a bad 10-day loan program. The Sec of HHS needs to demand
Maryland has issued more than 500 loans due to Change Healthcare cyber attack
“All Optum has done, who owns Change Healthcare, is offer a really bad 10-day loan payment program as their solution"
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The FTC needs to break up the three largest PBMs and decouple them from the payers and their specialty and mail order pharmacies.
“CVS Caremark is committed to working with our retail network pharmacy partners to help mitigate the unintended consequences with CMS Medicare Part D changes in 2024”…
If you cared THAT much, then why don’t you just eliminate your DIR fees that you purposely STEAL from us?
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This one-page order of denial of the DOJ case allowed United Health to purchase Change Healthcare. We now have a crippling cyberattack that has affected more than 900,000 Physicians, 33,000 Pharmacies and 5,500 hospitals. Unlike Physicians, Federal
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Mark Cuban did a fantastic job of clearly making the case against the large integrated PBMs. We all know that Mark is 100% correct and we all know what reforms are needed. Now it is up to Congress to ban the lobbyist and do their job! Put Americans before greed for once and
❗️Many comments from supporters on my TikTok are seriously asking
@mcuban
to run for president after today's listening session.
America is exhausted with congress & many presidents failing to take action on PBMs. It's time.
@WhiteHouse
@TheJusticeDept
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Anytime the PBM is getting between the physician and the patient ,there should be an individual identified who is making the decision. If the decision leads to patient harm the individual should be held liable. If you want to play Doctor, you should have all the liability that
Why do PBMs who don’t know the patient get to essentially practice medicine without a license?
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Medicare Advantage plans costs more, provide less care for patients and less reimbursement for Physicians and Hospitals. Some things are clear, outlaw Medicare Advantage! Do you thing the salesmen for MA inform the senior that they only have one opportunity to purchase a
The bottomless
@CMSGov
budget has an unlimited amount of money to pay
@BMAlliance
with no evidence of improved patient outcomes.
In fact, the only legitimately "measurable" quality is time on hold, quite a "measure" of quality.
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I agree that we have no representation at the National level. During the ACA negotiations, the AMA agreed to the ACA without any benefits for physicians and many negatives for us. Physicians of that era were very busy practicing and taking great care of patients and were very
@realdocspeaks
So you think physicians haven’t played a role in relinquishing our autonomy?
Do you not agree we should have had an organized response sufficient to say no to the afore mentioned onerous regulations?
You are arguing that we are indeed powerless. Seems to be true.
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@doclauravater
Also, for a man in medicine. We all need a very patient, caring spouse to pick us up when we stumble and who reins us in when we are a little too confident!
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Senator Ron Wyden wants answers to how the Change Healthcare cyberattack occurred. He wants the CEOs of UNH and, presumably, the subsidiaries to be held responsible. I join the Senator in this quest but would also ask why UNH and Change Healthcare were
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This is the new normal in healthcare. Cyberattacks occur, and the system shuts down. Medical records, including past labs, pathology, and imaging, are unavailable. This paralyzes the entire healthcare system. Prior to EHRs, this never would have happened, and the patient's
Ascension uses
#EPIC
EMR. Notice the article doesn’t even make mention of this. WI has been affected w this
#hack
. Yesterday’s appt w my son at his Dr’s was interesting. No ability to see prior notes, appts, meds, NOTHING. All down.
@ACRheumDC
@AmerMedicalAssn
@CSROAdvocacy
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It is not a minor deal when the PBM pays the independent rural pharmacy less than its wholesale cost and drives them out of business. Of course, the patients can always use the PBM mail order or specialty pharmacy. PBMs add NO value. West Virginia got rid of them for the
Hey Pete, if PCMA is tweeting your quotes then you are doing something very wrong. Downplaying PBMs impact on drug pricing shows a lack of awareness usually reserved for health economists. I would expect better from
@Public_Citizen
@Maybarduk
@truthrx
#TwitteRx
#Pharmacy
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It is interesting that the PBM story is so ignored by the mainstream media. This is a story of greed, monopoly, raising drug prices beyond people’s ability to pay, dropping crucial medications from formularies (Flovent), anti-trust and kick backs, overseas entities and
“CVS rage” is not limited to their retail store experience. Just wait until
@bostonglobe
@BethTeitell
learn behind the scenes CVS Health’s PBM controls the prescription benefits for 1 in 3 Americans (no matter where you pick up your medication) & they are even more frustrating.
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The doctor-patient relationship is the key to all of healthcare. However, the exam room has gotten very crowded with payers, PBMs, policy wonks, attorneys, politicians, pharmaceutical companies, consultants, EMR consultants, regulators and a host of others lurking in the shadow.
In the US through the 1970s, it was considered so anathema that anyone would interfere in the doctor-patient relationship that corporate medicine was illegal in most states.
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I was thinking about Cole in Appleton, WI. He was the young man who died because a generic advair was NOT on the formulary. A PBM reform bill never came up for a vote in the Wisconsin Assembly. Politicians do not want to have to vote against PBM reform because they know it is
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@DrDiGiorgio
Involving the government in any service will guarantee that the costs of that service will rise faster than inflation. The cost curve of healthcare and higher education are remarkably similar because of government involvement.
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Lina Khan, this is all you need to know. Stop your PBM investigation and take action. You are fiddling while Rome burns!
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Physician practices should only be owned by physicians. Nothing good comes of corporate ownership. The patients become an after thought and it is all about maximizing the revenue.
Another challenge to United Healthcare's growing monopoly of doctor's practices...
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The DOJ sued to prevent UNH from purchasing Change Healthcare, and their concerns have been proven by the large impact of this cyber attack. A Federal Judge threw The suit out, and the DOJ didn't appeal. At the very least, large health insurance companies and PBMs need to lose
Hospitals and pharmacies are getting stuck in an insurance processing logjam after UnitedHealth Group cyberattack. And it's caught the attention of federal law enforcement agencies.
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Non competes make no sense. Most of the employed Physicians work with a large employer who can afford to onboard a new physician without any difficulty. For example the largest employer of physicians is United Health through their Optum division. Noncompetes restrict the
Cardiologist signs 3-year contract. His non-compete is 4-years.
So if he leaves in 3 years, he must relocate to work.
If the government cares so much about healthcare access and the critical physician shortage, ban NON-COMPETE CONTRACTS
#MedX
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The preferred solution to increasing Medicare cost is to eliminate useless greedy middleman. We do NOT need Pharmacy Benefit Managers, consultants, GPOs, and a host of other hidden cost centers. Then we should NOT pay more for medications than comparable other countries, we
@realdocspeaks
@fuzzymittens
Interesting and compelling arguments/opinions... What is the preferred solution and how can it ever be implemented?? Insurance is too high for many and yet Europe seems to be more effectively grappling with these same issues....or are they??
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Sen Wyden is right on target. But now we need action; The FTC must bust up the UNH cartel. We also need real PBM reform and cybersecurity.
Today on Capitol Hill,
@UnitedHealthGrp
's CEO Andrew Witty is rightfully being grilled by
@SenateFinance
&
@HouseCommerce
re:
#Change
#cyber
attack.
➡️ We could not agree more with
@RonWyden
! We need more of this!
@WydenPress
#BreakUpUnited
#medtwitter
#healthcare
@myUHC
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This is a great review of the Hospital Out Patient Department scam. In this scam the patient is charged a facility fee that raises the costs of the procedures 2-3 times what it would be at a physician owned facility. A former physicians office or
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@jjfitzgeraldMD
There are few surgeries as complicated and frought with hazzard as a Cesearean Hysterectomy! I have done a few and they all went well, but they are nerve racking to perform as a generalist in a community hospital.
We used to put Woman and Children in the lifeboats first and
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The PBMs add no value to the system and they increase costs and decrease access. They choose expensive drugs over generics as they receive a large "rebate" or kickback from the expensive drug. This increases the price to the patient and often makes the drugs unaffordable.
PBMs
Here’s an important piece from a conservative economist explaining why interfering in the drug market by targeting PBMs will only raise costs.
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The administration's response to the Change Healthcare cyber attack has been inept. Physicians, Pharmacies, and Hospitals are not getting paid despite premiums still flowing into the coffers at UNH. It doesn't help that the Secretary of HHS is an attorney, not a physician or
The president's budget includes $1.3 billion to support hospitals’ cybersecurity efforts, and proposes to penalize hospitals that do not meet minimum requirements.
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I think this is just incredible luck on their part, and no malfeasance is involved. I also believe that Nancy Pelosi and other members of Congress and the Senate are also incredibly lucky. I know that if you or I were ever that lucky, we would be in an Orange jumpsuit.
UnitedHealth Chair, Executives Sold $102 Million in Stock Before US Probe Became Public
There’s no indication that the trades were executed according to scheduled trading plans in filings related to the transactions. UnitedHealth said officers and directors must get clearance
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Taking out non-competes is vital for physicians and patients. Most of the State laws will add provisions to the laws that will excluded physicians. For example they will allow non-competes if the employee makes more than $250K. It is laughable that an employee of a large
Oregon HB 4130 not only limits corporate ownership in medical practices, it outlaws non-compete and non-disparagement clauses from employment contracts, a favorite tactic among private equity firms
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Washington could care less that 39 State Attorneys General send a letter asking for PBM reform. This is the ultimate screw-you move by Congress to the States and to all of us. The state attorney Generals should come together and file a class action suit
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This is incredible and very sad. The PBMs are destroying the delivery of prescription medications and add no value.
@LinaKahn
No more need to investigate PBMs!
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Physicians were told EHRs will make us more productive, increase quality and safety, and benefit patients. However, this was the opinion of elites and those who produced the systems, and the EHRs were never tested before being mandated. They are a constant source of frustration
We are having the wrong conversation.
Limiting working hours isn't the way to improving physician well-being.
Instead, replace EHR with something user-friendly.
Simplify the documentation requirements, allow voice-driven notes & order entry, and eliminate burdensome busywork.
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@cscla
I agree that the costs of higher education are unreasonably high. The main driver of that is student loans. The government increases the amounts that can be borrowed, and the schools build a new student center and increase tuition. The rise of tuition has greatly outpaced
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@AlliBeanMDPhD
You are Dr. Bean in all professional settings. You worked hard and earned that designation. When I was a student I would never have addressed you by your first name, even if you allowed it!
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