The Daily Rise: Monday, August 1

We’re Getting Robbed by UnitedHealth

UnitedHealth’s earnings jumped 11 percent last quarter. And some patients are learning exactly how the insurance giant is hauling in record profits.

“We’re getting robbed,” one patient tells Fox 8 Live’s investigative unit, which revealed that UnitedHealth patients are being gouged for their prescription drugs. One patient repeatedly paid a fraction of the total cost by NOT using his insurance.

“Rick sent us receipts from last Wednesday. He went to the pharmacy to buy prescription eye drops. Through his United insurance, the pharmacist tried to charge him $52. He decided to pay without insurance. It cost him a lot less – $12 less,” Fox 8 reports.

Rick isn’t alone. Throughout the country, patients are paying inflated prices for treatments as a result of insurance company and pharmacy benefits managers’ mark-up. As Fox 8 notes, “Rick thought pharmacy benefits card would help reduce his healthcare costs. Now he and many other people are learning the company providing their insurance sometimes charges a premium for their prescription medication.”

The entire scheme is best summed up by Tulane law professor Joel Friedman: “This is a form of fraud. You are expecting, as they have represented it, that you’re going to get a price that’s less, than the actual price, the retail price of the prescription drug. That’s why people buy insurance, because group buying power.”

Check out the entire story and video at Fox 8 Live.

This is Innovation

The Guardian reports on a new finding from the United Kingdom that cancer patients in the United Kingdom are twice as likely to live at least 10 years after being diagnosed with cancer compared to the 1970s. Macmillan Cancer Support’s new report “Cancer: Then and Now” has found that more than 170,000 British cancer patients first diagnosed in the 1970s and 1980s are still alive.

What’s the cause of patients living longer? Innovation.

“Developments of cancer treatment are just getting better and better,” says Thames Ditton, a 37-year-old cancer survivor, “so I hope that more people don’t have to go through what I’ve been through as a child. I’m just trying to enjoy every day as it comes and just grateful to be here.”

Value frameworks ignore these findings, which confirm the value of innovation. Treatments will continue to improve — giving new options to patients that have nothing available at the present moment.

California’s Electoral Regret

Could patients in California have prevented looming health insurance rate hikes?

Next year, Anthem Blue Cross anticipates a 17 percent health insurance premium hike, with Blue Shield seeking a 20 percent increase. The Ventura County Star reminds patients that voters had the opportunity to block these “unconscionable rate hikes” with a state ballot measure in 2014. Proposition 45 would have restricted insurance rate hikes and granted more power to the state insurance commissioner to veto unreasonable rate hikes.

“That proposition would have given the state insurance commissioner the power to reject excessive health care insurance rate increases,” the Star editorializes. “It also would have required insurance companies to publicly disclose their rates and their justifications for proposed premium increases.”

In 2014, insurance companies spent $57 million to block the measure — a point not lost on the Star. “It should not be surprising that we voted down Prop. 45. We were told to vote no over and over and over again, through a barrage of campaign messages on TV and in our mailboxes.”

Trans-Atlantic Partnership to Fight Superbugs

A global partnership is preparing for the global fight against superbugs.

The U.S. Department of Health and Human Services announced last week that it was investing $250 million into a research initiative to develop new drugs that will target antibiotic-resistant bacteria. Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, or CARB-X, joins U.S. health officials with Britain’s Wellcome Trust, a London-based global biomedical research charity.

“There are a lot of companies that have potential new antibiotics or other therapies, but it’s a very tough environment to raise funds in,” Allan Coukell, one of Pew’s top antibiotic experts, told the Washington Post. “The market for these products are generally small. Creating an economic incentive where they can tap into capital to get these products developed and also access some expertise has the potential to have a real impact.”

Antibiotic resistance is a major problem that can only be avoided by investing today in new research and development of better antibiotics. Unfortunately, as the Washington Post reveals in the graphic below, we’re behind in our development of new drugs.

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