r/healthcare 3h ago

Other (not a medical question) Paid Premium, Denied Care

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36 Upvotes

You guys alright with this?


r/healthcare 1d ago

Discussion The future of medicine is looking wild.

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191 Upvotes

‘Murica


r/healthcare 2h ago

Question - Insurance Insurance broker scam?

2 Upvotes

Good evening everyone, at this point I don’t know what else to do but ask for help. I recently got a job doing 10-99 work and had to get insurance through a broker. I did my due diligence before and made sure I went with a company and agent that had all the correct documents so I wasn’t getting scammed but here I am. Going through the process he gave me 20 different plans to choice from. We narrowed it down to a plan that works for me and my pregnant wife and 2 other kids. We got the Summary of benefits and coverage and absolutely loved the plan so we paid for it. The insurance started today and the card we got is completely different than what we signed up for. I went back through to see if I missed anything and I didn’t. Is there anything I can do? My wife is due in December and the plan we chose had $0 OOP, deductible and specialist visit, hospital cost but higher premiums $2,500. Now it is $100 per specialty visit, $500 copay for hospital visit with the same premiums. My wife is going every week to her obgyn for the rest of the year. I messaged the broker and his response was “yes, unfortunately, last minute they did decide to add co pays to the doctors but everything else is still the same “. I was never notified of any of these changes and not what I signed. If anyone has any advice at all on what i can do i would appreciate it. Thank you all in advance if you read this and have any advice🙂


r/healthcare 25m ago

News EXCLUSIVE: How PBM reform and TrumpRx delivered a historic affordability win for Republicans

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Upvotes

r/healthcare 13h ago

News Massachusetts hospitals are teaching Trump how easily trans care can be erased

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advocate.com
6 Upvotes

r/healthcare 10h ago

News Tina wanted another baby. She also needed an abortion. Texas made both harder.

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19thnews.org
2 Upvotes

r/healthcare 1d ago

Discussion Yale says single-payer could save $1 trillion a year. Maryland's decade-old hospital model already proves part of it works.

28 Upvotes

In August, Yale researchers led by Alison Galvani published an analysis (https://www.medrxiv.org/content/10.64898/2026.07.22.26358689v1) estimating that a Medicare-for-All-style system would cut national health spending by $1.04 trillion a year — about 20% — while covering everyone. It's a preprint, not peer-reviewed, and the savings lean on three big assumptions stacked together (drug pricing, provider rates, one billing system). Stress-test those down to something more conservative and the number shrinks a lot. It doesn't disappear, though — some real savings survive almost any reasonable version of the model, which ended up mattering more to me than the headline figure.

That's basically what the Congressional Budget Office found (https://www.cbo.gov/publication/57637) too, back in 2022, modeling five illustrative single-payer designs: results ranged from a $700B decrease to a $300B increase in national spending, depending almost entirely on how providers get paid. The financing label doesn't determine the outcome. The rules inside it do.

So which rules actually work? Maryland's been testing one answer since 2014 — every hospital paid under the same regulated rates, on a global budget instead of fee-for-service. Hospital expenditure growth has run 8.74 points below the national average, saving Medicare an estimated [$1.6B](https://www.mathematica.org/publications/evaluation-of-the-maryland-total-cost-of-care-model-progress-report), and a 2025 Health Affairs study, (https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2025.01324) found utilization dropped 11 points more than in comparable states. Nobody had to abolish private insurance. CMS liked it enough to build its new AHEAD model (https://www.cms.gov/priorities/innovation/innovation-models/ahead) directly on Maryland's template.

Put those together and I don't think the honest answer is "pass 'Medicare for All' in one vote and hope." I believe it's a sequence: fix provider prices and hospital incentives first (the biggest, best-tested levers), negotiate drug prices without betting the whole plan on it, standardize the paperwork, then build a public option that covers the people the current system already fails — and only let it expand as far as the results justify. Nobody's employer coverage gets ripped up overnight, and nobody has to win an argument about the size of government first.

I laid the whole thing out step by step, with sources: [A Step-by-Step Path to Medicare for All (https://brokenpromiseshealthcare.org/step-by-step-path-to-medicare-for-all)

A phased in approach seems better to me than betting everything on Day One. I am sure a lot of you disagree with me. I would like to hear your ideas.


r/healthcare 1d ago

Discussion 27 Million Uninsured Americans

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155 Upvotes

r/healthcare 9h ago

Question - Insurance Doc's office can't even submit PA to Caremark: "Problem finding your patient" error. Could my dual coverage be causing this?

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1 Upvotes

r/healthcare 15h ago

Discussion I built a Monte Carlo model of US universal healthcare adoption. Six scenarios, 8,000 runs, every assumption exposed as a slider.

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2 Upvotes

r/healthcare 17h ago

Question - Other (not a medical question) Career shift from MD

2 Upvotes

I am a final-year MD student currently studying in the Philippines. Somewhere along the way, I completely lost interest in clinical medicine. I am looking for guidance on how to transition into a new career path with or without a masters and relocate to a country with better professional opportunities once I earn my degree. I am interested in administrative or health-tech roles related to healthcare, provided they do not require incurring significant student debt and offer a strong job market.


r/healthcare 17h ago

News ‘Work One Extra Year’: Healthcare Matters Only If You Add To GDP

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0 Upvotes

r/healthcare 1d ago

News Trump Strikes Medicaid Drug Price Deals With Nine Pharma Firms

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bloomberg.com
10 Upvotes

r/healthcare 1d ago

Discussion PBM reform puts greater focus on total pharmacy costs

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chaindrugreview.com
2 Upvotes

Federal efforts to increase PBM transparency are putting greater attention on whether changes to rebates and compensation ultimately lower pharmacy costs.


r/healthcare 21h ago

Question - Other (not a medical question) Any HIPAA complaint at home fax services?

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0 Upvotes

r/healthcare 1d ago

Other (not a medical question) I'm not a fan of Pokemon, but this I like XD

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4 Upvotes

r/healthcare 1d ago

Discussion Administrative fellowships: Has anyone heard back?

2 Upvotes

I applied a the major hospitals in Houston. (Methodist, MDA, Texas Children’s) Has anyone heard back about interviews? The MD Anderson website says interviews start tomorrow but I haven’t heard a thing. Feeling bummed because I got a first round interview last year. At least a rejection would end my suffering lol


r/healthcare 1d ago

Discussion How come doctors, and medical workers, thinks they are in a sector who makes people working superior, untill now 2026, but wourldwide currently there is still even malaria?

0 Upvotes

I saw Homer Simpson episod asking to astronaut things like this.


r/healthcare 2d ago

Discussion James Uthmeier files lawsuit against 2 Pharmacy Benefit Managers amid allegations of price fixing

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3 Upvotes

The Florida suit keeps getting posted like “see PBM logos are cosplay.”

It’s Prime and Express Scripts. Pharmacies are mad reimbursement went down after a 2019 contracting deal. Fine. That’s a pharmacy payday story.

It is not “patients got robbed” and it is not “nobody competes.” Plans still shop PBMs. Prime still does its own claims. Sharing manufacturer leverage is how you don’t pay list price like an idiot.

If every bit of scale gets called co-opetition, the only PBM people will accept is one too weak to negotiate. Cool slogan. Terrible benefit.


r/healthcare 2d ago

News New Menopause-Related Workplace Protections Coming to Illinois: How Your Business Can Prepare | JD Supra

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1 Upvotes

r/healthcare 2d ago

Question - Insurance Anthem vs Kaiser

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1 Upvotes

r/healthcare 2d ago

Discussion Going to the Doctor Still All-Day Mission!!

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1 Upvotes

r/healthcare 2d ago

Other (not a medical question) 10k steps in a day goal how i increase my steps

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1 Upvotes

r/healthcare 3d ago

News ‘Robbed of dignity’: Former nurses recount poor conditions inside PruittHealth-Palmyra nursing home

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12 Upvotes

r/healthcare 3d ago

Discussion Not understanding healthcare admin jobs

10 Upvotes

The jobs that I was told were for Healthcare Administrators, are all now saying RN required. Im confused as to how an RN would have the background knowledge to do finance for a clinic? This has been almost every job I've seen. I can't do a fellowship as it would be a dramatic drop in pay. Im just not understanding the jobs that fit this degree.