Christopher Weaver
👤 PersonAppearances Over Time
Podcast Appearances
Yeah, that's right. So we decided to dip into this area, which is just a huge portion of the federal budget, so we could see how these giant insurers were operating, what kind of care they were providing, and how much they were getting paid.
So we paired that with extensive interviews of doctors, medical providers, patients, and other people who interact with the system.
So we paired that with extensive interviews of doctors, medical providers, patients, and other people who interact with the system.
So we paired that with extensive interviews of doctors, medical providers, patients, and other people who interact with the system.
The federal government pays insurers essentially monthly lump sums to cover all of their care. And those lump sums go up when people are sicker. So like an example would be somebody who's obese might generate like a 30% higher payment for the insurer than the same person who's not. Or somebody who has diabetes might generate for the insurer like a 10% higher payment than somebody who doesn't.
The federal government pays insurers essentially monthly lump sums to cover all of their care. And those lump sums go up when people are sicker. So like an example would be somebody who's obese might generate like a 30% higher payment for the insurer than the same person who's not. Or somebody who has diabetes might generate for the insurer like a 10% higher payment than somebody who doesn't.
The federal government pays insurers essentially monthly lump sums to cover all of their care. And those lump sums go up when people are sicker. So like an example would be somebody who's obese might generate like a 30% higher payment for the insurer than the same person who's not. Or somebody who has diabetes might generate for the insurer like a 10% higher payment than somebody who doesn't.
And in Medicare Advantage, the incentives are basically to make patients look sicker on paper because insurance get paid more when they do that.
And in Medicare Advantage, the incentives are basically to make patients look sicker on paper because insurance get paid more when they do that.
And in Medicare Advantage, the incentives are basically to make patients look sicker on paper because insurance get paid more when they do that.
Insurers have defended their practices. They've argued that some of their practices lead to diagnosing patients with serious conditions sooner so they can get the treatment that they need. They argue that their practices lead to better outcomes for patients and end up costing beneficiaries less than traditional Medicare.
Insurers have defended their practices. They've argued that some of their practices lead to diagnosing patients with serious conditions sooner so they can get the treatment that they need. They argue that their practices lead to better outcomes for patients and end up costing beneficiaries less than traditional Medicare.
Insurers have defended their practices. They've argued that some of their practices lead to diagnosing patients with serious conditions sooner so they can get the treatment that they need. They argue that their practices lead to better outcomes for patients and end up costing beneficiaries less than traditional Medicare.
These are conditions that no doctor or hospital treated, and that insurers basically went behind the scenes to add or dispatch nurses to patients' houses to sort of work them over, do a bunch of tests, that kind of thing, but for which they were getting no care. And it was astounding, and UnitedHealth, more than any other insurer, engaged in those practices.
These are conditions that no doctor or hospital treated, and that insurers basically went behind the scenes to add or dispatch nurses to patients' houses to sort of work them over, do a bunch of tests, that kind of thing, but for which they were getting no care. And it was astounding, and UnitedHealth, more than any other insurer, engaged in those practices.
These are conditions that no doctor or hospital treated, and that insurers basically went behind the scenes to add or dispatch nurses to patients' houses to sort of work them over, do a bunch of tests, that kind of thing, but for which they were getting no care. And it was astounding, and UnitedHealth, more than any other insurer, engaged in those practices.
They had already had the lenses of both eyes surgically removed and replaced during routine cataract surgeries. And it's literally impossible to get cataracts again after you've had cataract surgery in both eyes.
They had already had the lenses of both eyes surgically removed and replaced during routine cataract surgeries. And it's literally impossible to get cataracts again after you've had cataract surgery in both eyes.
They had already had the lenses of both eyes surgically removed and replaced during routine cataract surgeries. And it's literally impossible to get cataracts again after you've had cataract surgery in both eyes.
the quanta flow, it wasn't very specific. Basically, it had a relatively high rate of false positives. And under certain circumstances, nurses who used it would say cold in the room or something that might produce an inaccurate result.