#aca

[liberalsarecool]

We need to end lobbyism as we know it. Corporate bribery is the worst way to provide a human right like health care.

Sad that $800 million/year in bribes costs us $650 billion/year in savings.

#health care #aca #lobbyists

[wizard0rbs]

when the academic article is so good it has you giggling and kicking your feet

#im sitting in my uni library trying really hard not to jump around with joy #this article is soo fascinating and has so many interesting points ugh #also itll be very helpful for a paper im writing so double yay #its 'the trick of the runes in the husband's message' by john d. niles btw and its available on jstor #in case anyone is interested #OE studies #aca #studyblr

[nipsyyy]

“For most of history anonymous was a woman.”

-Virginia Woolf

#prose #spilled poetry #poems on tumblr #academia #academia aesthetic #art #romantic academia #prose poetry #heartache #taylor swift #dark acamedia #dark academia quotes #chaotic academia #dark acadamia aesthetic #light academia #dark academia #classic academia #aca

[manincaffeine]

The biggest compliment I've received from girls is, "I feel safe with you ".

#desiblr #desi tumblr #txt post #desi academia #txt #dark romanticism #dark academia #intimacy #writers on tumblr #artists on tumblr #all tumblr girls #desi girl #spilled writing #spilled ink #writers #love quotes #aca

[blueprint-9376]

08.03.2024 [😄]

🍒: 긍정적으로 생각하자/A lot of difficult things are happening recently, but I'm trying to think positively

#diary #online diary #student #study aesthetic #study blog #study motivation #study tips #studyblr #online #journal #academia aesthetic #aca #classic academia #dark academia aesthetic #dark academia #academia style #dark acadamia #daily list #light #daily life #dailyquotes #daily blog #lifestyle blog #blog post #blogger #blog #study time #study hard #studying #studyspo

[winterbear-a]

'Not sure if I need a glass of wine or a gun or both.'

🍷🖋️🪞

—Charles Macaulay, The Secret History by Donna Tartt (1992).

#charles macaulay #the secret history #donna tartt #camilla macaulay #francis abernathy #henry winter #richard papen #bunny corcoran #dark academia #dark aesthetic #tsh donna tartt #classic academia #chaotic academia #aca

[sysy-studyblr]

monday 11/09/23

first day of actual class! honestly it was a bit different meeting people + there were only two brown people there [me and another girl] and that was weird too but all in all i liked it!

♫ sloppy stella - between friends ♫

#studyblr #studyspo #study aesthetic #stem #dark academia #chaotic academia #romantic academia #aca #studying #light acadamia aesthetic #light academia #light academia aesthetic #poc dark academia #germany #german language #german language studies #learning german #learning languages #A1 germany #german studies #learning language #study motivation #studystudystudy #art study

[mostlysignssomeportents]

Private equity finally delivered Sarah Palin's death panels

Tonight (Apr 26), I’ll be in Burbank, signing Red Team Blues at Dark Delicacies at 6PM.

Remember “death panels”? Sarah Palin promised us that universal healthcare was a prelude to a Stalinist nightmare in which unaccountable bureaucrats decided who lived or died based on a cost-benefit analysis of what it would cost to keep you alive versus how much your life was worth.

If you’d like an essay-formatted version of this post to read or share, here’s a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2023/04/26/death-panels/#what-the-heck-is-going-on-with-CMS

Palin was right that any kind of healthcare rationing runs the risk of this kind of calculus, where we weight spending $10,000 to extend a young, healthy person’s life by 40 years against $1,000 to extend an elderly, disabled person’s life by a mere two years.

It’s a ghastly, nightmarish prospect — as anyone who uses the private healthcare system knows very well. More than 27m Americans have no health insurance, and millions more have been tricked into buying scam “cost-sharing” systems run by evangelical grifters:

https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html

But for the millions of Americans with insurance, death panels are an everyday occurrence, or at least a lurking concern. Anyone who pays attention knows that insurers have entire departments designed to mass-reject legitimate claims and stall patients who demand that the insurer lives up to its claim:

https://kffhealthnews.org/news/article/khn-podcast-an-arm-and-a-leg-how-to-shop-for-health-insurance-november-24-2021/

The private healthcare sector is designed to deny care. Its first duty is to its shareholders, not its patients, and every dollar spent on care is a dollar not available for dividends. The ideal insurance customer pays their premiums without complaint, and then pays cash for all their care on top of it.

All that was true even before private equity started buying up and merging whole swathes of the US healthcare system (or “healthcare” “system”). The PE playbook — slash wages, sell off physical plant, slash wages, reduce quality and raise prices — works in part because of its scale. These aren’t the usual economies of scale. Rather the PE strategy is to buy and merge all the similar businesses in a region, so customers, suppliers and workers have nowhere else to turn.

That’s bad enough when it’s aimed at funeral homes, pet groomers or any of the other sectors that have been bigfooted by PE:

https://pluralistic.net/2022/12/16/schumpeterian-terrorism/#deliberately-broken

But it’s especially grave when applied to hospitals:

https://pluralistic.net/2020/05/21/profitable-butchers/#looted

Or emergency room physicians:

https://pluralistic.net/2022/03/14/unhealthy-finances/#steins-law

And if you think that’s a capitalist hellscape nightmare, just imagine how PE deals with dying, elderly people. Yes, PE has transformed the hospice industry, and it’s even worse than you imagine.

Yesterday, the Center for Economic and Policy Research published “Preying on the Dying: Private Equity Gets Rich in Hospice Care,” written by some of the nation’s most valiant PE slayers: Eileen Appelbaum, Rosemary Batt and Emma Curchin:

https://cepr.net/report/preying-on-the-dying-private-equity-gets-rich-in-hospice-care/

Medicare pays private hospices $203-$1,462 per day to take care of dying old people — seniors that a doctor has certified to have less than six months left. That comes to $22.4b/year in public transfers to private hospices. If hospices that $1,462 day-rate, they have lots of duties, like providing eight hours’ worth of home care. But if the hospice is content to take the $203/day rate, they are not required to do anything. Literally. It’s just free money for whatever the operator feels like doing for a dying elderly person, including doing nothing at all.

As Appelbaum told Maureen Tkacik for her excellent writeup in The American Prospect: “Why anybody commits fraud is a mystery to me, because you can make so much money playing within the guidelines the way the payment scheme operates.”

https://prospect.org/health/2023-04-26-born-to-die-hospice-care/

In California, it’s very, very easy to set up a hospice. Pay $3,000, fill in some paperwork (or don’t — no one checks it, ever), and you’re ready to start caring for beloved parents, grandparents, sisters, brothers, aunts and uncles as they depart this world. You do get a site inspection, but don’t worry — you aren’t required to bring your site up to code until after you’re licensed, and again, they never check — not even if there are multiple complaints. After all, no one at the Centers for Medicare & Medicaid Services (CMS) has the job of tracking complaints.

This is absolute catnip for private equity — free government money, no obligations, no enforcement, and the people you harm are literally dying and can’t complain. What’s not to like? No wonder PE companies have spent billions “rolling up” hospices across the country. There are 591 hospices in Van Nuys, CA alone — but at least 30 of them share a single medical director:

https://auditor.ca.gov/reports/2021-123/index.html#pg34A

Medicare caps per-patient dispersals at $32,000, which presents an interesting commercial question for remorseless, paperclip-maximizing, grandparent-devouring private equity ghouls: do you take in sick patients (who cost more, but die sooner) or healthy patients (cost less, potentially live longer)?

In Van Nuys, the strategy is to bring in healthy patients and do nothing. 51% of Van Nuys hospice patients are “live discharged” — that is, they don’t die. This figure — triple the national average — is “a reliable sign of fraud.”

There are so many hospice scams and most of them are so stupid that it takes a monumental failure of oversight not to catch and prevent them. Here’s a goodun: hospices bribe doctors to “admit” patients to a hospice without their knowledge. The hospice bills for the patient, but otherwise has no contact with them. This can go on for a long time, until the patient tries to visit the doctor and discovers that their Medicare has been canceled (you lose your Medicare once you go into hospice).

Another scam: offer patients the loosest narcotics policy in town, promising all the opioids they want. Then, once their benefits expire, let them die of an overdose (don’t worry, people who die in hospice don’t get autopsies):

https://www.newyorker.com/magazine/2022/12/05/how-hospice-became-a-for-profit-hustle

You can hire con artists to serve as your sales-force, and have them talk vulnerable, elderly people into enrolling in hospice care by convincing them they have nothing to live for and should just die already and not burden their loved ones any longer.

Hospitals and hospices also collude: hospitals can revive dying patients, ignoring their Do Not Resuscitate orders, so they can be transfered to a hospice and die there, saving the hospital from adding another dead patient to their stats.CMS’s solution is perverse: they’re working with Humana to expand Medicare Advantage (a scam that convinces patients to give up Medicare and enrol in a private insurance program, whose private-sector death panel rejects 13% of claims that Medicare would have paid for). The program will pay private companies $32,000 for every patient who agrees to cease care and die. As our friends on the right like to say, “incentives matter.”

Appelbaum and co have a better idea:

Do more enforcement: increase inspections and audits.

Block mergers and rollups of hospices that make them too big to fail and too big to jail.

Close existing loopholes.

They should know. Appelbaum and her co-authors write the best, most incisive analysis of private equity around. For more of their work, check out their proposal for ending pension-plan ripoffs by Wall Street firms:

https://pluralistic.net/2022/05/05/mego/#A09948

Catch me on tour with Red Team Blues in Burbank, Mountain View, Berkeley, San Francisco, Portland, Vancouver, Calgary, Toronto, DC, Gaithersburg, Oxford, Hay, Manchester, Nottingham, London, and Berlin!

[Image ID: An industrial meat grinder, fed by a conveyor belt. A dead, elderly man is traveling up the conveyor, headed for the grinder's intake. The grinder is labelled 'HOSPICE' in drippy Hallowe'en lettering. It sits in a spreading pool of blood.]

Image: Seydelmann (modified) https://commons.wikimedia.org/wiki/File:GW300_1.jpghttps://commons.wikimedia.org/wiki/File:GW300_1.jpg

CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0/deed.en

#pluralistic #cepr #medicare advantage #medicare #hospice #aca #aging #death panels #fraud #california #preying on the dying

[necarion]

Been watching Leverage, and came across an episode where a minor character has been denied life-saving coverage because she had a totally unrelated pre-existing condition. And I checked and this show is from 2008.

For all of its imperfections, the ACA stopped that particular bit of bullshit. Even at the time, that was one of those things (like civil asset forfeiture) that normal people think is made up, because of how batshit evil/criminal it sounds. And now, people have forgotten it existed because we actually fixed it.

#aca #obamacare #leverage #pre existing conditions

[mysharona1987]

#medicine #capitalism #democrats #republicans #politics #news #cartoins #aca #art

[samasnotebook]

10

I'm about to go back to college for my next exam. I just wanted to share notes that I made before my last exam as a spiritual goodbye.

Hope you're having a lovely weekend 🌞

#samasnotebook #studyblr #study #studying #exams #academic #aca #finance #notes #exam notes #test notes

[odinsblog]

If you’ve gotten a free flu shot, mammogram or diabetes screening lately, there’s a good chance you can thank the Affordable Care Act (ACA), aka Obamacare. Unfortunately, a recent court decision may take that coverage away from millions of Americans.

Some 20���40 percent of U.S. deaths from cancer, heart disease and other leading causes of mortality are preventable. Preventive health services can ward off disease entirely, or detect a condition early when interventions are most effective. Before the ACA passed in 2010, insurance companies didn’t always cover preventive services, and, if they did, they could make enrollees pay deductibles, co-payments or other out-of-pocket cost sharing. So Congress required most private health insurance plans to cover a set recommended by the U.S. Preventive Services Task Force (USPSTF) and several other expert bodies. Most Americans with private health insurance—estimated at over 150 million people—are enrolled in plans that have had to meet these coverage requirements. And as the ACA’s drafters had hoped, expanding no-cost coverage led millions more people to use many of these important services.

Unfortunately, two ongoing crusades—one to weaken the ACA and the other to impose certain religious views on other people’s health care—might roll back this health care success. In late March, federal judge Reed O’Connor, whose courtroom is a popular venue for anti-Obamacare plaintiffs, issued a ruling in Braidwood v. Becerra that blocked a portion of the act’s prevention services provision nationwide.

O’Connor’s order, if upheld, will have antiscientific and deeply discriminatory effects on Americans’ access to health care.

(continue reading)

#politics #religion #republicans #healthcare #religious reich #religious freedom #freedom from religion #christian nationalists #evangelical christians #insurance #aca #affordable care act #science #reed oconnor #reed o’connor #braidwood v becerra #preventative healthcare

[sukunu]

ACA

#hazbinhotel #aca #hazbin alastor #hazbin charlie #hazbin adam

[nipsyyy]

-Noor Unnahar

#poems on tumblr #prose #spilled poetry #academia #academia aesthetic #romantic academia #art #prose poetry #taylor swift #heartache #dark academia quotes #chaotic academia #dark acamedia #dark acadamia aesthetic #light academia #dark academia #classic academia #aca

[remusapprentice]

“By the time that wretched summer term ended, the only person Remus despised more than Sirius was himself, for continuing to love him just the same.” - All the Young Dudes

#remus lupin #remus lupin aesthetic #marauders #marauders aesthetic #aesthetic #marauders era #marauders moodboard #remus lupin moodboard #remus moodboard #hogwarts moodboard #hogwarts academia #aca #hogwarts aesthetic

[gwydionmisha]

The Republican War on Health Care continues.

#Texas #ACA #PrEP #Theocracy #News