Comparison shopping for a health plan

By Wendell Potter

California makes it easy to do your homework.

Excerpts from this story referencing "San Diego":

"… were followed by Blue Shield of California, Sharp Health Plan (in greater San Diego), and Western Health Advantage (in the Sacramento area). All of those plan …"

A call for more scrutiny of private Medicare Advantage plans

By Fred Schulte

Researchers say aggressive billing by private plans may require more scrutiny

Excerpts from this story referencing "Center for Public Integrity":

"… k score] adjustment,” Kronick said in response to questions posed by the Center for Public Integrity. (Kronick required that questions be submitted in writing and responded to …"

"… s and that results in massive profits across a population over time.” A Center for Public Integrity investigation published in June found that Medicare made ne …"

"… ther positively or negatively, on health care quality,” Kronick told the Center for Public Integrity. Kronick said that the Centers for Medicare and Medicaid Services, the ar …"

"… or may not be coming down the road,” said spokesman Raymond Thorn. (The Center for Public Integrity in May sued CMS under the Freedom of Information Act to compel the agency …"

Obamacare helps millions, but falls short in many ways

By Wendell Potter

The Affordable Care Act has reduced the ranks of the uninsured, but cost of care must be addressed.

Excerpts from this story referencing "Health":

"… in: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for M …"

New types of health care delivery are improving the 'patient experience'

By Wendell Potter

Commentary: eliminating role of insurers could improve health care delivery.

Excerpts from this story referencing "Health":

"… s in It for Me? What Everyone Needs to Know About the Affordable Care Act. …"

"… fact, in some ways they have been part of the problem. Providence-Swedish Health Alliance, a not-for-profit, hospital-based accountable care organization ( …"

"… he Health insurance market are hiring companies like Chicago-based Valence Health, a fast-growing firm that offers services ranging from claims adjudication …"

"… in: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for M …"

Health insurers turning into who knows what?

By Wendell Potter

Commentary: health insurers are transforming themselves — but into what?

Excerpts from this story referencing "Health":

"… at insurers with well-known brands like Aetna, Blue Cross, Cigna and UnitedHealthcare have been around forever and likely will always be with us as they are …"

"… profitable than other business lines that once defined them. As for UnitedHealthcare and WellPoint, few people had even heard of them 25 years ago. But tha …"

"… 30 countries in which we operate around the world.” According to UnitedHealth Group’s website, it is “the most diversified Health care company in th …"

"… in: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for M …"

Black lung disease surges to highs not seen since the '70s, research shows

By Chris Hamby

The likely culprit: a failure by coal mining companies to use readily available tools to control the dust that lodges in miners' lungs.

Excerpts from this story referencing "Virginia":

"… has hit especially hard in a triangular region encompassing southern West Virginia, eastern Kentucky, and southwestern Virginia. In these areas, thick deposi …"

"… on encompassing southern West Virginia, eastern Kentucky, and southwestern Virginia. In these areas, thick deposits of coal largely have been mined out, and c …"

Taking insurance companies out of health care

By Wendell Potter

If Boeing experiment flies, health care system could be transformed.

Excerpts from this story referencing "Health":

"… lth system,” Dr. Elliott Fisher, director of the Dartmouth Institute for Health Policy and Clinical Practice, was quoted as telling The Seattle Times. “ …"

"… Health insurers are quickly diversifying. Just two weeks ago, Modern Healthcare noted that because Health insurers are now required to spend at l …"

"… expect to realize higher returns. The magazine cited as an example UnitedHealth Group’s Optum division, which works in technology and population Health …"

"… th in operating earnings. Meanwhile, in its core insurance business, UnitedHealth saw its 2013 operating margin decline to 6.4 percent, down from 7.6 percen …"

Docs, drug companies, insurers drive up Medicare costs

By Wendell Potter

Commentary: reform drove down hospital costs, creating Medicare savings, but insurers, doctors and drug companies escaped cuts.

Excerpts from this story referencing "Medicare":

"… ated 78 million baby boomers in this country, I was delighted to hear that Medicare’s Hospital Trust Fund won’t run out of money until 2030 — 13 ye …"

"… attributed to the health care law, some of the provisions aimed at slowing Medicare spending, such as requiring Medicare to reduce payments to hospitals with …"

"… me of the provisions aimed at slowing Medicare spending, such as requiring Medicare to reduce payments to hospitals with high readmission rates, are likely he …"

"… elping. But the Hospital Trust Fund accounts for only about half of total Medicare spending. Most of the rest goes to cover physician fees, prescription drug …"

Dire predictions of endless waits for a doctor have proven unfounded

By Wendell Potter

Commentary: Obamacare has not resulted in long waits for a doctor.

Excerpts from this story referencing "Health":

"… out. To find out if the critics’ were prescient or way off base, Kaiser Health News reporter Phil Galewitz went looking for problems. He didn’t find ma …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "Health":

"… years. Analyzing government data never before made public, Department of Health and Human Services researchers found that many plans exaggerate how sick t …"

"… are and Medicaid Services, part of HHS. Kronick directs the HHS Agency for Healthcare Research and Quality, whose mission is to improve Health care delivery …"

"… said Dr. David Wennberg, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice who has studied Medicare billing trends. Hea …"

"… lth Policy and Clinical Practice who has studied Medicare billing trends. Health care fraud expert Malcolm Sparrow, a professor at Harvard’s Kennedy Scho …"

Critic of artificial sweeteners pilloried by industry-backed scientists

By Chris Young

Any criticism of the artificial sweetener industry is met with a barrage of criticism, often from questionable sources.

Excerpts from this story referencing "U.S. Department of Agriculture":

"… into Google, and the top search result is a webpage run by the U.S. Department of Agriculture. The page about sweeteners includes two links to Council-run webpages, inc …"

Black lung claims by 1,100 coal miners may have been wrongly denied

By Chris Hamby

Black lung opinions by Dr. Paul Wheeler of Johns Hopkins should be assumed to lack credibility, senators are told at a hearing.

Excerpts from this story referencing "California":

"… irginia, along with Sen. Tom Harkin of Iowa and U.S. Rep. George Miller of California. A bill might be ready before the August recess, a Casey staffer said. &n …"

Families sick from fracking turn to scientists

By Lisa Song

A Pennsylvania nonprofit provides free health consultations to people who live near gas drilling sites and complain of health effects.

Excerpts from this story referencing "Pennsylvania":

"… ions transformed by the shale energy boom, residents of Washington County, Pennsylvania, have complained of headaches, nosebleeds and skin rashes. But because the …"

"… on facilities that have sprung up around them. A group of scientists from Pennsylvania and neighboring states has stepped in to fill this gap by forming a nonpro …"

"… iting years or even decades for long-term studies to emerge, the Southwest Pennsylvania Environmental Health Project (SWPA-EHP) is using the best available scienc …"

"… h to study, analyze and mitigate the risks people face from drilling. The Pennsylvania Department of Environmental Protection — which oversees the oil and gas …"

Even low doses of arsenic trigger cancer in mice, study finds

By David Heath

Study by the National Institutes of Health found levels of arsenic similar to what some people consume caused cancer in mice.

Excerpts from this story referencing "Environment":

"… rs in history. Extrapolating from those studies, scientists with the U.S. Environmental Protection Agency have tentatively concluded that arsenic is a serious p …"

"… pears to be safe,” Linda Birnbaum, director of the National Institute of Environmental Health Sciences and the National Toxicology Program, said in a statement …"

What to do if your drinking water contains arsenic

By David Heath

Millions of Americans unwittingly consume arsenic, a potent carcinogen also linked to IQ deficits in children, in their drinking water.

Excerpts from this story referencing "Food":

"… enic and occasionally substituting other grains, such as quinoa. The U.S. Food and Drug Administration has said there is no immediate health risk from ea …"

Praise for UK-style health system vindicates spurned nominee

By Wendell Potter

Former Medicare chief's support for UK's health care system may win votes in race for governor of Massachusetts.

Excerpts from this story referencing "president":

"… y.” Obama didn’t give up entirely on Berwick. The Constitution allows presidents to make short-term appointments without Senate approval when Congress is …"

Home is where the money is for Medicare Advantage plans

By Fred Schulte

Medicare Advantage home visits may not improve health, but boost risk scores and cost taxpayers billions.

Excerpts from this story referencing "George W. Bush":

"… declined to be interviewed. Thomas A. Scully, who led CMS under President George W. Bush, serves on Matrix’s board and is a general partner in the investment fir …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "Health":

"… s having serious heart disease.  It took years for the Department of Health and Human Services (HHS) inspector general to publish those findings, and …"

"… ing errors tied to a complex payment formula known as a “risk score.” Health plans collect medical data that is used to compute the Health risks for ea …"

"… and secretive that it remains unfathomable to many Health professionals. Health plans that cheat can face civil or criminal penalties, but federal officia …"

"… Advantage contracts, records show.  CMS is but one part of the giant Health and Human Services Department. The HHS Office of Inspector General is supp …"

Labor Department issues warning about Hopkins doctor's findings on black lung claims

The U.S. Department of Labor warned its officials to view with skepticism any X-ray readings by Dr. Paul Wheeler of Johns Hopkins.

Excerpts from this story referencing "disease":

"… pkins University doctor who virtually never diagnoses black lung, a deadly disease that afflicts coal miners. The news organizations reported last fall that …"

"… claims for federal benefits, had never found the most severe form of the disease among more than 1,500 claims. Johns Hopkins suspended its black lung X-ray …"

Why Medicare Advantage costs taxpayers billions more than it should

By Fred Schulte, David Donald and Erin Durkin

Critics warned of billing abuse in Medicare Advantage health plans, but oversight is lagging.

Excerpts from this story referencing "Bush administration":

"… is cooperating with the investigation. In a separate civil case, a former Bush administration health official alleges in a whistleblower lawsuit unsealed earlier this y …"

Medicare Advantage made simple: a glossary

By Fred Schulte

Definitions for lesser-known terms relating to Medicare.

Excerpts from this story referencing "insurance plans":

"… vide. Medicare Advantage: Nearly 16 million seniors have joined about 700 insurance plans that accept a set fee from Medicare for covering each patient in exchange …"

Center sues in an effort to make Medicare Advantage files public

By Fred Schulte

Center sues to make records public.

Excerpts from this story referencing "Medicare":

"… nd Human Services, seeking a wide range of records concerning oversight of Medicare Advantage health insurance plans for senior citizens. The suit, filed tod …"

"… equires a response within 20 working days.  “The information about Medicare Advantage that we are asking for should be readily available to the taxpay …"

"… g our request,” said Bill Buzenberg, the Center’s Executive Director. Medicare Advantage, a privately-run alternative to standard Medicare, has enrolled …"

"… ive Director. Medicare Advantage, a privately-run alternative to standard Medicare, has enrolled nearly 16 million elderly and disabled persons at an annual …"

Forcing health insurers to do what's right

By Wendell Potter

Commentary: Policyholders benefit from Obamacare provision.

A different way of thinking about health care

By Wendell Potter

Commentary: Canadians take pride in their health care system.

Excerpts from this story referencing "insurance plans":

"… ericans, her cousin included, regularly postpone needed care because their insurance plans require paying several thousand dollars out of their own pockets before th …"

Keeping an eye on insurance companies that refuse to pay claims

By Wendell Potter

Commentary: Arizona case resolved after victim became a 'squeaky wheel'

Excerpts from this story referencing "Aetna":

"… hird-degree burns. Two days after he was discharged, he got a letter from Aetna telling him that the company didn’t believe his injuries were “suffici …"

"… be there for him if he ever had an emergency. Faraci filed an appeal, but Aetna executives wouldn’t budge. They said in their denial letter that Faraci …"

"… etter that Faraci’s coverage extended only to services and supplies that Aetna — not his doctors or hospital staff — deems medically necessary. Fara …"

"… king Channel 12 to intervene paid off. The independent examiner ruled that Aetna should pay half of Faraci’s hospitalization. Soon after that, Aetna told …"

The Canadian health care system I disparaged

By Wendell Potter

Commentary: health care system up north is more efficient.

Excerpts from this story referencing "New York Times":

"… with pride. Back in the states, among the distressing pieces I read was a New York Times story last Monday based on interviews with Americans who said they had dec …"

Be the 'squeaky wheel' if health claim denied

By Wendell Potter

Commentary: Obamacare may squeeze insurance industry profits, subscribers should know their rights when it comes to claim denials.

Excerpts from this story referencing "reform law":

"… to avoid paying claims whenever possible. That has been my fear since the reform law was passed and the consumer protections went into effect. So it’s especi …"

American-style health care system pushed in Canada

By Wendell Potter

Canada's conservative Prime Minister Stephen Harper wants to remake nation's health care system.

Excerpts from this story referencing "Insurance":

"… e campaign behind the scenes was the trade association, America’s Health Insurance Plans. With help from a right-wing Canadian outfit called the Fraser Insti …"

GOP opposition to Obamacare baffles Dr. Sullivan

By Wendell Potter

Commentary: former HHS Secretary Sullivan says Obamacare resembles plan crafted by Republicans.

Excerpts from this story referencing "New York Times":

"… ded workforce, Sullivan says, is oral health. In an op-ed in The New York Times in April 2012, Sullivan called on more states to follow Ala …"

The health care industry's campaign of fear, uncertainty and doubt

By Wendell Potter

Commentary: health insurers use a host of tactics to erode support for Obamacare.

Excerpts from this story referencing "Insurance":

"… re representatives of the industry’s big trade group, America’s Health Insurance Plans, and one of its PR firms, APCO Worldwide. The AHIP and APCO staffers …"

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