Profiteering on your health and education

By Rhiannon Meyers Collette, Communications Manager
 

Even before COVID-19 and the economic crisis, Americans were worried about how to pay for their health care. Millions skip needed care every year because they can't afford it. Compounding that financial threat is a predatory practice known as surprise medical billing.

What’s happening: Surprise medical billing happens when patients get unexpected — and often very expensive — medical bills from hospitals and physicians who aren't in their insurance networks. Worse, these bills often come from providers patients couldn't choose — like emergency room doctors or anesthesiologists. Sometimes, these doctors are working inside hospitals and clinics that are actually in-network, but the providers themselves are out-of-network, a business strategy that has been used especially by private equity-backed providers to maximize profits.

Bottom line: Surprise medical billing was bad before 2020, but this year’s crises have only amplified the threat. In a new video, Arnold Ventures explores the problems posed by surprise medical billing and explains what needs to happen next to protect patients, employers and taxpayers from the impacts of this practice.

TL;DR: Congress has a bipartisan solution that it could pass now to end surprise medical billing once and for all.

Related: Debunking the myths in the surprise medical billing debate.
 

Related: New polling finds that half of all Americans are concerned that a major health event could lead to bankruptcy. 

Podcast: In a new episode, Tradeoffs tackles the scope of the surprise billing problem and who's to blame.

By Adrienne Faraci, Communications Manager

Josue Perez dreamed of starting his own spa business. After leaving high school he enrolled in Everest Institute, then a subsidiary of the since-shuttered for-profit higher education company Corinthian Colleges. The school promised ease of access with rolling admissions, and Perez powered through 11 months of classes for eight hours a day, five days a week — and even received honors. But when the time came for him to get his diploma, it never materialized. Scrambling for work and now with mounting debt, Perez’s dream is far away.

What’s happening: Latino students like Perez account for a fifth of today’s U.S. undergraduates, and their enrollment is increasing at a faster rate than their Black and white peers. But research shows many are struggling to finish their degrees — and their overrepresentation at predatory for-profit schools is a key reason. Latino students, according to a new study by UnidosUS, face a number of systemic challenges that make them uniquely vulnerable to the predatory recruitment tactics employed by for-profit colleges, where just one in five first-time, full-time undergrads get their degrees within six years. 

What can be done: UnidosUS is working to remove barriers to postsecondary access, completion, and success. Many of their initiatives center on strengthening accountability when it comes to for-profit institutions through updates to the Higher Education Act, which hasn’t been reauthorized in more than a decade. The group is also advocating for the Obama-era gainful employment rule to be reinstated and restoration of the 85/15 rule, which would limit the share of revenue that for-profit colleges receive from federal aid.

By Rhiannon Collette Meyers, Communications Manager

Here’s a startling fact: Drug prices in Australia are substantially less than what those same medications cost in the U.S. — so much that flying there for your medication would be cheaper in some cases, according to a new analysis from 46Brooklyn. Discounts down under are so deep that U.S. taxpayers would save billions of dollars every year if drugs were priced at Australia’s negotiated rates. The report comes amid renewed interest in a “most-favored nation" policy that calls for linking U.S. drug prices to international rates.

Why it matters: President Trump has said he signed an executive order tying Medicare Part B drug prices to the lower rates paid abroad, but the order has not been published or made public, and the details are thin. 46Brooklyn conducted a side-by-side comparison of the top 10 drugs in Medicare Part B that drive nearly half of the spending in that program and discovered that, if they were priced at Australian rates, U.S. taxpayers would save 68 percent, or about $10 billion per year. The savings are even more substantial for Medicare Part D, and the two combined are enough to give every public school teacher in America an $11,000 pay raise. (And they deserve it — especially now.) 

What’s next: The most-favored nation proposal has been maligned by the pharmaceutical industry. Will the administration stand up to pharma and publish its rule? How would it be implemented? What impact would it have on drug prices? These are questions that remain to be answered.

Related: Bloomberg reports that the pharma lobby is disputing President Trump’s claims that drug companies are negotiating on his “favored nations” executive order.

Related: “It should be offensive to all that President Trump and the drug industry are competing to offer the most disingenuous plan for making prescription meds more affordable,” writes columnist David Lazarus in the Los Angeles Times.

Related: Fact Check: The Trump Era has been a gold mine for drug companies.

“The most beautiful, gutting prose I’ve read in a long time,” said one friend. “Best read of the day,” said another. So I clicked. Facebook is good for something. 

“My beloved died in January. He was a foot taller than me and had large, beautiful dark eyes and dexterous, kind hands. He fixed me breakfast and pots of loose-leaf tea every morning. He cried at both of our children’s births, silently, tears glazing his face. Before I drove our children to school in the pale dawn light, he would put both hands on the top of his head and dance in the driveway to make the kids laugh. He was funny, quick-witted, and could inspire the kind of laughter that cramped my whole torso. Last fall, he decided it would be best for him and our family if he went back to school. His primary job in our household was to shore us up, to take care of the children, to be a househusband. He traveled with me often on business trips, carried our children in the back of lecture halls, watchful and quietly proud as I spoke to audiences, as I met readers and shook hands and signed books. He indulged my penchant for Christmas movies, for meandering trips through museums, even though he would have much preferred to be in a stadium somewhere, watching football. One of my favorite places in the world was beside him, under his warm arm, the color of deep, dark river water.

In early January, we became ill with what we thought was flu... Read “On Witness and Respair: A Personal Tragedy Followed by Pandemic” by Jesmyn Ward.

“After Truth: Disinformation and the Cost of Fake News,” a 2020 HBO documentary that somehow feels both dated (a blow-by-blow of Jade Helm and Pizzagate, which seem like eons ago) and very relevant amid this week’s news of Russian disinformation campaigns on social media (and what I’ve seen on Facebook with my own eyes). While I thought I knew the extent of the deceptions retold in this film, it was still a mind-boggling journey into how quickly disinformation can be planted and spread in the new age of information warfare. One part that especially hit home for me was Alex Jones and his Infowars attempt to paint the Sandy Hook school massacre as a hoax — with agonizing impacts on the victims’ parents. I visited Newtown in 2012 as a journalist to help a sister paper cover the story, and the idea that someone would use that tragedy to further their wild political agenda is abhorrent. As with all of the events covered here, peddling fake news does real damage to real lives. I’m awaiting the inevitable sequel.

By Stuart Buck, Vice President of Research

This week, I'll just recommend a column by David Spiegelhalter, the respected statistician at Cambridge University. It’s a rallying cry for better statistics about the COVID-19 crisis, including from expert regulators who should know better than to proffer dishonest claims. (He says of a recent press conference by FDA Commissioner Hahn: "This is possibly the most statistically dim-witted utterance I have witnessed from any authority during this crisis, and he’s up against some pretty stiff competition.") Worth reading.