Category Archives: Healthcare Reform

HHS Working to End Insurance Pre-Authorization

I’ll believe it when I see it.

Health insurance pre-authorization, for example, is when your eye specialist recommends removal of your cataracts so you can see again, but your insurance company wants some clerk or administrator to review everything and either agree or disagree with your physician. If disagree, no eye surgery for you. Unless you’re willing to pay entirely out-of-pocket. Mind you, the clerk does not have a medical degree and has never examined you or spoken to you. Isn’t this one of the reasons Luigi Mangione executed that healthcare executive?

From American Greatness:

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. joined other federal health officials on Monday to promote an initiative to end the practice of healthcare insurance pre-authorization.

Kennedy was joined by Centers for Medicare & Medicaid Services Administrator Mehmet Oz as part of a roundtable discussion with insurers to discuss pledges made by the health insurance industry to streamline and reform the prior authorization process for Medicare Advantage, Medicaid Managed Care and Affordable Care Act Health Insurance Marketplace plans which account for most insured Americans.

The HHS Secretary commented on how when he joined the presidential transition team, he was told that the single most important thing he could do to improve the experience of patients across the nation was to “end the scourge of pre-authorization.”

Of course, the unsurers will argue that pre-authorization is necessary because those greedy doctors are recommending that surgery, MRI scan, specialty consultation, or physical therapy merely out of greed.

Steve Parker, M.D.

Isn’t That Special: Eliquis Costs $700 in Germany But $8,000 in the U.S.

From Karl Denninger, an article titled Enough of this Nonsense:

I’m talking about the basic economic question: Supply, demand and what happens when you allow someone to force another person to pay your bill.

I keep hammering on this and will until people stop running tropes whether out of sincere (but false) belief or some other reason.

Let’s take Eliquis.  Its a common medication and its expensive.  Roughly 3.5 million Americans take this drug and it is one of the most-commonly prescribed for people who have atrial fibrillation.  It appears to be reasonably effective in reducing the risk of strokes and heart attacks in people with that condition.

It is also about $8,000 a year in the United States without insurance and “insurance” forces those who do not have that condition to pay for those who do — including Medicare and Medicaid.

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The common claim is that “if you cut that off those people will die” because they can’t possibly afford the price.

The claim is false.

In Germany the drug costs about $700 a year, so it is ten times as expensive in the United States.


Parker here. I know why Eliquis (apixaban) so much more expensive in the U.S. I wrote all about it in my latest book. Read Denninger for his opinion. (He’s smarter than me but was wrong about his predicted 2024 severe economic contraction. Making predictions is hard, especially when it’s about the future.)

Steve Parker, M.D.

When It Makes Sense to Go Without Health Insurance in the U.S.

The bike repair shop owner in this video is probably looking at one of the Obamacare insurance plans. They want him to pay $4,000 a year, the government is paying the insurer $7,000 yearly, and yet his deductible is $20,000. That means that if he develops a major medical problem or injury, he still has to pay $20,000 out of pocket before insurance pays a penny. Note that he is in his 30s and relatively healthy. He’s seriously thinking about going without insurance. When and if that major medical problem arises, he’ll just go on Medicaid.

He should think about putting money into a Health Savings Account.

One of the reasons I’m still working at age 71 is that my younger wife needs health insurance and we can get it through my employer.

Steve Parker, M.D.

PS: The books I write generate very little $. I’m just trying to help you guys get healthier and avoid the medical-industrial complex.

This Should Be Good

Bowl fragrant popcorn munch on“/ CC0 1.0

Crenshaw accepted the opportunity for a sit-down interview with Shawn Ryan, tentatively scheduled for Jan 2, 2026.

Shawn Ryan should have mentioned that he is not suicidal and that his vehicles are in good working order.

Someone in the comment section quoted Harry Truman: “Show me a man that gets rich by being a politician, and I’ll show you a crook.” That’s a legit idea even if Truman never said it.

Sadly, any major reform of the U.S. healthcare system will depend on federal and state legislators like Dan Crenshaw.

Steve Parker, M.D.

How Can You Tell When a Politician is Lying?

Remember this when you think about politicians reforming U.S. healthcare.

The Unabomber Brought “Manifesto” to the Fore

The Unabomber’s manifesto was 35,000 thousand words long. Mine’s got him beat by 2,000 words, every one of which was carefully curated!

The Unabomber was Ted Kaczynski. He titled his manifesto “Industrial Society and Its Future.” It wasn’t about healthcare. He was found dead in his jail cell at age 81; reportedly killed himself.

Most of my writing on health, nutrition, and fitness is designed to keep you out of the clutches of the medical-industrial complex. Don’t get involved with that system if you can safely avoid it!

Steve Parker, M.D.

A “Fun” Guide to the U.S. Healthcare System

Photo by Dominika Greguu0161ovu00e1 on Pexels.com

Opthalmologist Dr. Will Flannery has put together a whimsical guide to the U. S. healthcare system. It’s well worth a look if you’re relatively new to the system and need help understanding deductibles, co-pays, out-of-pocket maximums (hint: they’re not really maximums), in-network, out-of-network, vertical integration, “surprise” medical bills, etc. I was particularly impressed with the section on fighting claim denials; I hope I remember to re-read it when the time comes.

Dr. Glaucomflecken’s Incredibly Uplifting and Really Fun Guide to American Healthcare.

Remember how Obamacare was supposed to make healthcare more affordable? From the guide, “The 2025 out-of-pocket maximum for an Affordable Care Act plan can’t be more than $9,200 for an individual and $18,400 for a family.” When half of Americans can’t afford an emergency $500 bill, how do they pay up to $9,200.

Dr. Glaucomflecken also offers some system improvements that I also advocate in my latest book, Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform.

Steve Parker, M.D.

“Resuscitating U.S. Healthcare” Book Now on Sale

I’d be much appreciative of some Amazon reviews of my 2024 book, Resuscitating U.S. Healthcare: An Insider’s Manifesto for Reform.

To make the book available to more readers, I just dramatically reduced the price at the U.S. Amazon store. $2.99 for the e-book (Kindle) or $9.95 for the paperback. If you’re curious, Amazon pays me $2.06 for each e-book sold, and $2.74 for the paperback.

I don’t care if you leave a favorable or bad review at Amazon. Just be honest. I’ll incorporate helpful and insightful criticism into the 2nd edition.

BTW, Luigi Mangioni’s manifesto was under 300 words. Mine’s about 35,000. But it’s a quick read.

Steve Parker, M.D.

Should We Convert U.S. Health Insurance Into True Insurance?

William M. Briggs thinks that would be a great idea. He starts with this explanation:

Health Insurance should be, but isn’t, a bet you make that you hope you lose.

It has become instead an inefficient form of socialized medicine, increasing costs. Here’s how.

Here’s what insurance should be. You bet with an Insurer that you get cancer, say. If you get it, the Insurer pays costs of care X. If you lose and remain cancer free, you pay Y. You re-bet every month (or whatever). You pay Y every time you lose. The X and Y are negotiated between you and the Insurer, and the risk of cancer is decided by you and separately by the Insurer. That is the bare bones of true Insurance. Or, indeed, of any bet.

You can also group diseases, say cancer and CHF. Then you pay Y_1 + Y_2 (say) and the costs are X_1 + X_2. The result is a contract bet just the same. But with higher stakes for both.

Suppose you already have cancer and bet the Insurer you won’t get it. You immediately win the bet! The Insurer must pay X.

How much should the Insurer charge you for this sure-thing bet? X. After all, your “pre-existing condition” is a sure-thing bet the Insurer is bound to lose. There is no sense in you making the bet.

Unless a Ruler steps in and says “Insurer, you must take this bet!” Which, of course, happens. Then the Insurer must spread the costs of X to others.

If the Insurer doesn’t spread the costs, he has sure loss (assuming calibrate bets, about which more later). Which means if you bet you have cancer when you do, when your neighbor makes a bet for cancer when he doesn’t have it, he must pay Y+S, where S represents the spread. The more people in the system, the smaller S is.

Voilà! With coverage mandates Insurance automatically becomes socialized medicine. Very inefficient, too, because not only are we paying a private entity to manage this, and take his profits, we pay bureaucrats to monitor it all. Costs must increase. Health care won’t get better, but costs must rise. 

It’s worse than all this, too!

RTWT. I discuss the pros and cons of this approach in my new book below.

Steve Parker, M.D.

United Healthcare’s CEO Murdered In Cold Blood

Bob Lefsetz is a music industry journalist blogger that I follow regularly although not reading every post. He lives in the Los Angeles area. He wrote recently about the apparent execution of United Healthcare’s 50-year-old CEO in NYC:

And we thought the revolution would arrive as a result of the red/blue divide. When in truth, it’s all about income inequality.

Please don’t criticize me for having sympathy for those screwed by the insurance companies. If I were in charge, there’d be no guns at all, or a law akin to that in Australia. But one would posit that the shooter is pissed because the insurance company didn’t pay.

But that’s what insurance companies do, not pay. That’s their business model. Even assuming you can see the doctor of your choice, which is rare. As a matter of fact, essentially all my doctors in L.A. don’t take insurance at all. You pay the freight, which ain’t inexpensive. And why did these MDs stop taking insurance? Because the insurance companies were running them ragged.

And then there are the hospitals… If you can even find an independent doctor… Everybody is now part of a giant organization, which squeezes the physicians. My dermatologist couldn’t sleep. She was on the edge of giving up practice, because at Cedars they required her to see an inordinate number of patients per hour. And this is the only doctor who could diagnosis my pemphigus, even the supposed biggest guy in L.A. couldn’t. She didn’t insist that I follow her into private practice, but for me it’s a no-brainer.

And my internist… He left the UCLA system and it was like he had a personality transplant. Instead of being harried and short, he’s folksy, talks music, and is unbelievably thorough. He diagnosed my leukemia. Do you really think I’m going to go back to the factory?

Although we don’t yet know much about the shooter’s motive, Bob ties the murder to the U.S. healthcare system.

Steve Parker, M.D.