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By MIKE MAGEE

“As machines become more intelligent and can performance more sophisticated functions, a new relationship between human and automation is dawning. This relationship is moving from master-servant to teammates…” NASA Langley Research Center/2019

“DeepSeek’s Breakthrough Sparks National Pride in China,” screamed the Wall Street Journal headline last week. In the age of Trump’s promise that crippling tariffs would “put China in its place,” the shot across the bow of Silicon Valley’s AI hubris sent Nividia and its allies (and even the reemerging Nuclear power industry whose investors were convinced that AI’s ceaseless thirst for electric power would shift the public’s risk/benefit of nuclear energy in their favor) into the red this past week.

For Nividia, it was a tough way to start the week. As Forbes reported last Monday, “Nvidia lost $589 billion in market capitalization Monday, which is by far the single greatest one-day value wipeout of any companyin history…” Of course, it rebounded 8.8% the following day, and by week’s end was near record highs.

As the industry struggles to define just how much of a threat China’s Open-Source cut-rate AI effort is, there is no disagreement on the coming impact of AI on nearly every sector of society, not the least of which is health care. As the NASA report from 2019 suggested, human “master” control of machines is increasingly tenuous, and to succeed we must embrace AI technologic applications as fully enfranchised “teammates.”

Medicine has historically embraced, and even championed their machines, as superhuman extensions of themselves, and featuring them as intricate to “doctoring.” Consider the ubiquitous image of doctor with stethoscope hanging from the neck. It arrived on the scene roughly two centuries ago, in France in 1816. Its creation is attributed to Rene’ Laennec, and was little more than a wooden tube he incorporated as a hearing device after experimented with rolled paper tubes. He likely got the idea after observing the effectiveness of “ear trumpets”, the hearing aid of its time. But it was modesty, according to some historians, that pushed the French doctor to action. He was apparently uncomfortable putting his ear on a woman’s heaving bosom to listen to her heart sounds. The device, an assist, offering better auscultation at the required distance.

Of course, we’ve come a long way since then. But if anything, health care professionals are more reliant than ever on machines. Consider AI-assisted Surgery. Technology, tools, machines and equipment have long been a presence in modern day operating suites. Computers, Metaverse imaging, headlamps, laparoscopes, and operative microscopes are commonplace. But today’s AI-assisted surgical technology has moved aggressively into “decision-support.”

Surgeon Christopher Tignanelli from the University of Minnesota says, “AI will analyze surgeries as they’re being done and potentially provide decision support to surgeons as they’re operating.”

The American College of Surgeons concurs: “By highlighting tools, monitoring operations, and sending alerts, AI-based surgical systems can map out an approach to each patient’s surgical needs and guide and streamline surgical procedures. AI is particularly effective in laparoscopic and robotic surgery, where a video screen can display information or guidance from AI during the operation.” Mass General’s Jennifer Eckoff goes a step further, “Based on its review of millions of surgical videos, AI has the ability to anticipate the next 15 to 30 seconds of an operation and provide additional oversight during the surgery.”

Surgical educators see enormous promise in AI-assisted education. One commented, “Most AI and robotic surgery experts seem to agree that the prospects of an AI-controlled surgical robot completely replacing human surgeons is improbable…but it will revolutionize nearly every area of the surgical profession.”

Johnson and Johnson, a major manufacturer of AI surgical tools, had this to say, “Surgeons are a lot like high-performance athletes. New and learning surgeons want to see how they performed and learn from their performances and how others performed… Now, surgeons can look at what happened during procedures practically in real time and share the video with residents and peers, offering valuable post-case analysis and learning opportunities.

Teaming up with AI in Medicine will likely inform well beyond the operating suite. Its population wide recommendations might guide us toward interventions that are more selective and effective, less biased overall, and less expensive. We might see fewer doctors, fewer drug ads, and fewer bills. But at the same time, that system might demand greater patience, greater personal responsibility and compliance with behavioral changes that ensure health.

Can we trust A.I.? That’s a question that AI master strategist Mark Minevich was recently asked regarding our new teammate status. His response was, “There are no shortcuts to developing systems that earn enduring trust…transparency, accountability, and justice (must) govern exploration…as we forge tools to serve all people.”

What are those AI tools? He highlighted four: Risk Assessment; Regulatory Safeguards; Pragmatic Governance; and Public/Private Partnerships.

 Like it or not, AI has arrived, and its impact on individual health and that of our health systems in the U.S. will be substantial, disruptive, painful for some, but hopeful for many others. Tools like the stethoscope have served us well, and it is not surprising that they have earned our affection and loyalty over these many years. But AI generated tools have grown up and demand inclusion and respect if we wish to avoid becoming their servants.

Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/11/man-and-machine-a-new-age-for-medicine/ [pubDate] => Tue, 11 Feb 2025 04:26:10 +0000 [category] => Health Tech [guid] => https://thehealthcareblog.com/?p=108941 [description] => By MIKE MAGEE “As machines become more intelligent and can performance more sophisticated functions, a new relationship between human and automation is dawning. This relationship is moving from master-servant to teammates…” NASAContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [2] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/02/10/vc-returns-well-its-stock-trading/ [title] => VC returns: Well, it’s stock trading… [timestamp] => 1739203320 [author] => matthew holt [content] =>

By MATTHEW HOLT

There’s been a lot of discussion lately about whether digital health is a legitimate place for venture capital. There have been lots of huge failures, very few notable successes (and certainly no “biggest companies in the world” yet), while some real giants (Walmart/Walgreens/Amazon) have come in and then got out of health care.

I don’t have to tell you again that most of the publicly traded digital health companies are trading at pennies on the dollar to their initial valuations. But I will. Look at that chart below.

Heck even Doximity– which prints money (45% net margins!)–is trading at well under its post IPO high. My quick overview is that there are not very many publicly traded companies at unicorn status. With really only Doximity, HIMS and Oscar being very successful. (We can have a separate argument as to whether Tempus and Waystar are “digital health”). And there are many, many that are well off the price they IPOed at. All that at a time when the regular stock market is hitting record highs.

Which makes it interesting to say the least that Define Ventures just came out with a report saying that in general digital health has done well as a venture investment and that it was likely to do even better, soon.

The report isn’t that long and is well worth a read but their basic argument compares digital health venture investments to those in fintech and consumer tech. Essentially it took digital health a lot longer to get to 10% of total venture investment than fintech or consumer tech, but it got there after 2020. Now more than 10% of all VC backed unicorns out there are health tech companies. Yes there was a retrenchment in 2022-3 but health tech investment fell less than other sectors in 2022-3 and is basically back in 2024.

The Define forecast forecast is interesting (it’s the chart below). Define posits that it took 4-5 years after the fintech and consumer tech sectors became 10% of VC dollars for them to start pumping out exits and IPOs. There are 30-50 each in those sectors now, but health tech was ahead of that with 18 exits already in the first 5 years after getting to 10% of VC dollars, and those exits were on average double the size of the fintech/consumer tech exits. (Although to be fair the health tech exits were when the market was higher after 2020)

In fact their analysis is that capital returned was about 10x investment. You might say, but hey Matthew didn’t you just show me a chart that most of those 18 companies were public market dogs? And you’d be right.

If we look at the 18 companies Define examines, they don’t actually match the list of 11 unicorns I have on my chart earlier but in general they haven’t done well in the long run.

Some have gone under (Science 37 & NueHealth sold for parts), some have been bought for real money, if way less than they once traded for (One Medical was at one point $50 a share but bought for $18, but that was $3.9 billion including debt, Accolade was just bought by Transcarent for about $600m), whereas most have slowly declined to well less than IPO price (Amwell, Talkspace, Health Catalyst, and all the bits currently inside Teladoc, including Livongo & InTouch).

But Define compared those public companies’ performance to some other unprofitable early stage public companies and saw that those companies they defined as “services” and “payers” did worse but “hybrid” and “SaaS” did better than other tech companies.

(By the way, it’s pretty amazing that someone put together an index of loss making public tech companies but apparently Morgan Stanley did! It’s called MSUPTX although my Googling can’t find it!)

Define is also suggesting that the next set of digital health companies to go public or exit via M&A will do so faster and at a higher value. In general that’s because “component parts tech” is more easily available to buy off the shelf, with AI being the obvious “component” example. Therefore these companies will get to scale quicker, and AI will accelerate that. Here’s their list, which includes one services company, Carebridge, that already had a good exit.

But I’m still highly concerned that these companies can’t get to a sensible valuation based on what they have raised. Let’s compare them to the darling of what Define calls “Wave 1” of health tech IPOs. Livongo raised $237m before its IPO. Ok that’s not chicken feed but it was valued below $1bn before the IPO and around $4bn soon after the IPO. 3 months later it was trading back down closer to $2bn and then began its pandemic-fueled rise to a $20bn market cap and the famous $19bn merger with Teladoc.

$237m may sound like a lot for total capital raised but Innovacer has raised $675m, Lyra & Hinge Health nearly $1bn each, Included Health’s component parts have raised “only” $500m, and Devoted Health has raised over $2.25bn. So those companies are going to have to get out at multi-billion dollar valuations to do anything like compared to Livonogo’s success, and then public market investors (or their acquiring companies in the case of M&A) are going to expect them to grow from there. Given the performance of the companies in the sector now, and that there are still many similar companies worth a whole lot less on the public market, either these private companies have some tremendous performance going on, or you’d imagine they are going to disappoint their investors.

So how can Define claim that the first wave of companies returned 10 times the capital invested?

I think that’s relatively simple.

Many of those companies IPOed or were acquired at a price well in excess of where they ended up. But if you were an early stage investor able to sell at the IPO or shortly after, you may well have made that ten bagger return.

Maybe if you invested early enough in the second wave, you might see that return too. But so many of those companies raised so much money at such a high valuation in the halcyon days of 2021 & early 2022 (not to mention late 2024 and early 2025) that it’s hard to see those levels of returns for most investors. And of course if you are a public market investor buying in the frothy period post-IPO, the chance that you’re a pig being led to slaughter is very high indeed.

But if you’re a VC and you can buy in cheap enough you can make great returns. So long as you do your stock trading carefully, and have some luck!

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/10/vc-returns-well-its-stock-trading/ [pubDate] => Mon, 10 Feb 2025 16:02:00 +0000 [category] => venture capital [guid] => https://thehealthcareblog.com/?p=108933 [description] => By MATTHEW HOLT There’s been a lot of discussion lately about whether digital health is a legitimate place for venture capital. There have been lots of huge failures, very few notable successesContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [3] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/02/06/thcbgang-revisited-ian-morrison/ [title] => THCBGang Revisited: Ian Morrison [timestamp] => 1738860900 [author] => matthew holt [content] =>

Ian Morrison died yesterday. 4 years ago in one of the early THCB Gang’s, we had a rash of late cancellations. So I talked to Ian solo about his journey, and his views about health care. I re-listened to it this morning and thought you might enjoy it

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/06/thcbgang-revisited-ian-morrison/ [pubDate] => Thu, 06 Feb 2025 16:55:00 +0000 [category] => Ian Morrison [guid] => https://thehealthcareblog.com/?p=108929 [description] => Ian Morrison died yesterday. 4 years ago in one of the early THCB Gang’s, we had a rash of late cancellations. So I talked to Ian solo about his journey, and hisContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [4] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/02/06/ian-morrison/ [title] => Ian Morrison [timestamp] => 1738856280 [author] => matthew holt [content] =>

I got the very sad news today that Ian Morrison died peacefully at home yesterday. He had been sick and in hospice for some time but a few months back he told me that he was going for Jimmy Carter’s record. Ian was my first boss in American health care when I worked for him at Institute for the Future and he was as kind and lovely as he was funny and knowledgeable. I was very glad that when I started THCBGang during the pandemic that he was a regular member.

Ian spent decades working with everyone across health care in American and internationally, but as he used to say essentially was paid to insult people. That he did it so humorously and usefully was the reason he kept being invited back. Any Ian Morrison keynote at a big health care conference was both a chance to learn something and laugh hysterically.

He also never ignored the chance to help those trying to make health care fairer and more equitable, serving on the boards of Martin Luther King Jr hospital, the California Healthcare Foundation and many others. He remained a jovial Glaswegian socialist at heart.

Ian liked to say that he went from Scotland where death was imminent, to Canada where death was inevitable, to California where death was optional. Sadly that last crack wasn’t quite true.

My heart goes out to his wife Nora and their children and grandchildren. There’ll be a more formal obituary and a celebration of his life in the days and weeks to come–Matthew Holt

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/06/ian-morrison/ [pubDate] => Thu, 06 Feb 2025 15:38:00 +0000 [category] => Ian Morrison [guid] => https://thehealthcareblog.com/?p=108925 [description] => I got the very sad news today that Ian Morrison died peacefully at home yesterday. He had been sick and in hospice for some time but a few months back he toldContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [5] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/02/05/jonathan-bush-zus-health/ [title] => Jonathan Bush, Zus Health [timestamp] => 1738762020 [author] => matthew holt [content] =>

It’s always fun to chat with Jonathan Bush. You kids today may not remember that he was the first CEO to take a cloud-based (Health 2.0!) company public back in 2007! Athenahealth didn’t end up challenging Epic because a cosmically evil hedge fund took it (and him) down as it was on its way to try to do that, but Jonathan has moved on and is now building a clinical data integration company called Zus Health. We talked Zus, digital health, whether there will ever be value-based care and more. 20 mins of digital health gold right here–Matthew Holt

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/05/jonathan-bush-zus-health/ [pubDate] => Wed, 05 Feb 2025 13:27:00 +0000 [category] => Zus [guid] => https://thehealthcareblog.com/?p=108922 [description] => It’s always fun to chat with Jonathan Bush. You kids today may not remember that he was the first CEO to take a cloud-based (Health 2.0!) company public back in 2007! AthenahealthContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [6] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/02/04/dei-is-now-a-four-letter-word/ [title] => DEI Is Now a Four Letter Word [timestamp] => 1738654380 [author] => matthew holt [content] =>

By KIM BELLARD

I’d love to be writing about something fun. Something that makes us think about things in a new way, or something exciting that will take us into the future. There are lots of such things happening, but there’s too many Orwellian actions happening that I can’t be silent about.

Diversity, we’re told, is actually a pretext for racism – against white people. Equity is foolhardy at best and pernicious at worst. Inclusion only matters if you are the “right” kind of person. “Meritocracy” is the new buzzword; we want only the “best and brightest,” with none of the lowering of standards that we’re being told comes with trying to ensure that everyone has a fair chance to prove their merits.

The Trump Administration has declared war on DEI. It has fired scores of workers whose jobs involve DEI, has asked other workers to inform on people they think may be involved in DEI, and is searching out even workers who attended diversity training (mandated or not). All that would be horrifying enough but it isn’t ending there.

Federal websites are being cleansed of any references to anything that might be construed as DEI. Pages are being edited, or taken down entirely. The NIH has ground to a halt until the appropriate authorities can ensure that no grants are being even to anything that might possibly be related to DEI. The CDC has been forced to pull papers from its researchers that are up for publication for similar review.

The Atlantic reports: “the government was, as of yesterday evening, intending to target and replace, at a minimum, several “suggested keywords”—including “pregnant people, transgender, binary, non-binary, gender, assigned at birth, binary [sic], non-binary [sic], cisgender, queer, gender identity, gender minority, anything with pronouns”—in CDC content.”

Thousands of pages of data from the CDC and Census Bureau have “disappeared,” and the same from other agencies. Health data is prominent among the missing. Angela Rasmussen, a virologist at the University of Saskatchewan, told Science: ““I knew it was going to be bad, but I didn’t know it was going to be this bad. It’s like a data apocalypse.”

Elon Musk, who has no official power yet seems to have control over government IT and the data it contains, is shutting down U.S.A.I.D., who provides almost $40b annually in health services, disaster relief, anti-poverty, and other social mission programs. Previously the Administration had shutdown, then reinstated, PEPFAR, a vital international HIV program that has been credited with saving millions of lives.

The President and his team even tried to blame last week’s Washington D.C. plane-helicopter collision on DEI.  That’s just “common sense, ok,” according to President Trump.

As if all that wasn’t enough, The Washington Post reported:

Late Friday, newly confirmed Defense Secretary Pete Hegseth ordered the agency to stop commemorating cultural celebrations such as Black History Month. The message to staff was headlined: “Identity Months Dead at DoD.”

On Thursday, the FBI directed janitorial staff at Quantico to paint over a multicolored mural that once featured the words “FAIRNESS,” “LEADERSHIP,” “INTEGRITY,” “COMPASSION” and “DIVERSITY.”

I can’t even…

The breadth and depth of the changes caught many off guard, but people are starting to respond. Stat reports that CDC’s advisory board has demanded to be told why information has gone missing from CDC websites, and when it will be restored. “Silence is not an option right now,” said one advisory board member, Daniel Dawes. “I try to use the term unprecedented sparingly, but I believe this is an unprecedented moment. There will be dire consequences if they do not restore this information and it may not come back if we do not speak out.”

The Guardian reports that a union representing 5,000 NIH researchers filed a legally binding demand to bargain over the sweeping changes. Marjorie Levinstein, a postdoctoral fellow at the National Institute on Drug Abuse and a union bargaining committee member, told The Guardian: “We cannot do our research effectively, and this is putting into question delaying research on cancer and diabetes, on drug addiction, on heart disease. And this is going to delay medical breakthroughs that the American people deserve.”

Alexander Jordan Lara, a postbaccalaureate fellow at the National Institute of Dental and Craniofacial Research and also a member of the union’s bargaining committee, added: “We were anticipating changes, and that it would be a new relationship we would have to manage but I don’t think anyone expected this firehose.”

We should have expected it.

Let’s be clear what all this is. “His attacks on diversity, equity and inclusion aren’t about a particular program or some acronym — they’re just a sanitized substitute for the racist comments that can no longer be spoken openly,” Margaret Huang, the Southern Poverty Law Center’s president and chief executive said.

When I heard “meritocracy,” I think of an exchange in the TV adaption of Celeste Ng’s Little Fires Everywhere. When the rich employer criticizes her minority employee about her life choices, the latter responds: “You didn’t make good choices. You had good choices. Options that being rich, and white, and entitled gave you.”

Somehow the meritocracy never see that.

And let’s be clear where this is all going. As George Orwell’s 1984 said:

Now I will tell you the answer to my question. It is this. The Party seeks power entirely for its own sake. We are not interested in the good of others; we are interested solely in power, pure power. What pure power means you will understand presently. We are different from the oligarchies of the past in that we know what we are doing. All the others, even those who resembled ourselves, were cowards and hypocrites. The German Nazis and the Russian Communists came very close to us in their methods, but they never had the courage to recognize their own motives. They pretended, perhaps they even believed, that they had seized power unwillingly and for a limited time, and that just around the corner there lay a paradise where human beings would be free and equal. We are not like that. We know that no one ever seizes power with the intention of relinquishing it. Power is not a means; it is an end. One does not establish a dictatorship in order to safeguard a revolution; one makes the revolution in order to establish the dictatorship. The object of persecution is persecution. The object of torture is torture. The object of power is power. Now you begin to understand me.

Sadly, we’re only beginning to understand.

As Professor Dawes said, silence is not an option now. Make yourself heard.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamentedTincture.io, and now regular THCB contributor

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/04/dei-is-now-a-four-letter-word/ [pubDate] => Tue, 04 Feb 2025 07:33:00 +0000 [category] => Trump [guid] => https://thehealthcareblog.com/?p=108920 [description] => By KIM BELLARD I’d love to be writing about something fun. Something that makes us think about things in a new way, or something exciting that will take us into the future.Continue reading... [dc] => Array ( [creator] => matthew holt ) ) [7] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/02/03/who-will-oppose-american-apartheid/ [title] => Who Will Oppose American Apartheid? [timestamp] => 1738562580 [author] => matthew holt [content] =>

By MIKE MAGEE

This past month Bishop Mariann E. Budde drew the Episcopal Church into the national spotlight through a single act of courage. She is not the first, nor likely the last from this denomination to do so. There is a history. More on that in a moment.

TheEpiscopal churchis an offshoot of the Anglican Church of England which dates back to 1534 when King Henry VIII broke with the Catholic Pope who opposed his marriage to Anne Boleyn. Two-hundred and fifty four years later,in 1789,Anglican Church leaders who had helped settle colonies in North America, gathered to form a united Episcopal Church, revising their Book of Common Prayer to exclude its blessing to the English monarch.

Though declining in modern times, missionary minded Anglicans spread throughout the British empire and remain connected to the mother Church as members of theAnglican Communion. For example, British Anglican military chaplains were part of the force that occupied Cape Colony in South Africa in 1795. By 1821, they had established a formal religious foothold. Today, they claim3.5 millionmembers. In 2012, they elected their first female bishop,Ellinah Wamukoya of Swaziland. And yet, arguably the most influential female Anglican from South Africa is an immigrant to America, an emotional ally of Bishop Budde, and a retired Chief Justice of the Massachusetts Supreme Court.

Her name is Margaret Marshall, and her place in American history dates back to June 6, 1966. That was the date this then 20 year old student, who was vice-president of theNational Union of South African Students, was asked to stand in for the organization’s president, Ian Robertson (who was under house arrest for speaking out about Apartheid). She met and transported Bobby Kennedy to speak to over 1000 university students packed into the college auditorium at their“Day of Affirmation.”

Much like Mariann Budde last week in Washington,Bobby Kennedycaught his hushed audience by surprise that evening with these opening remarks:

“I come here this evening because of my deep interest and affection for a land settled by the Dutch in the mid-seventeenth century, then taken over by the British, and at last independent; a land in which the native inhabitants were at first subdued, but relations with whom remain a problem to this day; a land which defined itself on a hostile frontier; a land which has tamed rich natural resources through the energetic application of modern technology; a land which was once the importer of slaves, and now must struggle to wipe out the last traces of that former bondage. I refer, of course, to the United States of America.”

Margaret Marshall, some six decades later, recalled that moment in a conversation withDoris Kearns Goodwin. She said, “There was great tension in the room. People were on edge…As soon as the audience realized what he said, there was laughter and a sense of total relief. It was simply fabulous.”

After becoming president of the student organization the next year, the Anglican woman raised in a religious home in Newcastle, South Africa, emigrated to the U.S., and earned a masters in education at Harvard, and a law degree from Yale in 1976. Two years later, she was awarded U.S. citizenship.

She carried with her to her new country a prior interest in the law, and specifically American Law. In an interview in 2020, around the time of her prestigiousSandra Day O’Connor Awardfor “extraordinary service and commitment to justice,” she recalledher favorite American law caseas a South African student:

“The Massachusetts case, decided in 1783, was a case decided under the new, then very new, Massachusetts constitution, which predates the federal constitution. The Massachusetts constitution opens, or started at the time, with the words, ‘All men are created equal…’ The case was brought by a slave in Massachusetts who challenged his servitude under that provision. . . In 1783, the Supreme Judicial Court of Massachusetts ruled that slavery was inconsistent with the words of the new Massachusetts Constitution. That was the second case of which I knew while I was in South Africa. A court had outlawed slavery. For that reason, the Supreme Judicial Court had always been a revered institution for me.”

It is fitting, therefore, that 20 years after becoming a lawyer, Massachusetts Gov. William Weld appointed her an Associate Justice of that very same Massachusetts Supreme Court. Over the next fourteen years, she wrote more than 300 opinions, most notablyGoodridge v. Department of Public Health.The decision affirmed that the Massachusetts Constitution prohibits the state from denying same-sex marriage. In an unspoken link to her childhood beginnings,she wrote,“Massachusetts Constitution affirms the dignity and equality of all individuals.It forbids the creation of second-class citizens.”

Three years after the decision, Chief Justice Marshall had an opportunity to reflect on the broader law and order implications of her ruling as Trump prepared to overthrow the 2020 election.

She stated on theJudgement Calls Podcast,“Judges are part of our the government. If the United States Supreme Court issues a decision, you can criticize it. Everybody can criticize it. The Massachusetts Governor criticizedGoodridge. But the Governor never suggested that he would not obey the order…Think about Bush against Gore, which was one of the closest, most bitterly fought cases. The day after the court decided, was the court’s decision criticized? Of course, it was criticized. But…there were no troops out on the street. That is a privilege that we have in the United States. It is because I come from another country that I feel so passionately about what we have to protect here, what is so important here. But for me, an immigrant, for waves of immigrants, we know.We know.”

It is fair to say that this Anglican daughter of South Africa, who ushered Bobby Kennedy that evening in 1966 to a tense auditorium, exactlytwo years to the datebefore he would be assassinated in Los Angeles, has paved the way for another member of the Anglican Communion, Episcopalian Bishop Mariann E. Budde to exhibit her act of moral courage.

With intelligence and conviction, seven feet above and 40 feet across from a figure reminiscent ofSouth Africa’s P.W. Botha, she locked eyes with President Trump. She stood tall and erect, buoyed by the Washington National Cathedral’s limestone Canterbury Pulpit,whose central carvings portray the signing of the eight century old Magna Carta, andaddressed the manwho would later charge that “She was nasty in tone, and not compelling or smart.”

But her words in our nation’s Capitol were as powerful that evening as Robert Kennedy’s in Capetown. With Margaret Marshall at his side, RFK said,“Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring those ripples build a current which can sweep down the mightiest walls of oppression and resistance.”

Six decades later, these words of Bishop Budde created a flood of debate across America:

“Let me make one final plea, Mr. President: Millions have put their trust in you. And as you told the nation yesterday, you have felt the providential hand of a loving God.”

“In the name of our God, I ask you to have mercy upon the people in our country who are scared now. There are gay, lesbian and transgender children in Democratic, Republican and independent families, some who fear for their lives.”

“And the people, the people who pick our crops and clean our office buildings, who labor in poultry farms and meatpacking plants, who wash the dishes after we eat in restaurants and work the night shifts in hospitals, they — they may not be citizens or have the proper documentation, but the vast majority of immigrants are not criminals.”

“I ask you to have mercy, Mr. President, on those in our communities whose children fear that their parents will be taken away, and that you help those who are fleeing war zones and persecution in their own lands to find compassion and welcome here, Mr. President.”

Moral courage chooses its own time and place. But when it presents itself, it is recognizable by all – including those in agreement and those who stubbornly descent.

The final words from RFK enjoin each of us and all of us, across the ages:

“With a good conscience our only sure reward, with history the final judge of our deeds, let us go forth and lead the land we love, asking His blessing and His help, but knowing that here on earth God’s work must truly be our own.”


Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside America’s Medical Industrial Complex. (Grove/2020)

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/02/03/who-will-oppose-american-apartheid/ [pubDate] => Mon, 03 Feb 2025 06:03:00 +0000 [category] => Trump [guid] => https://thehealthcareblog.com/?p=108907 [description] => By MIKE MAGEE This past month Bishop Mariann E. Budde drew the Episcopal Church into the national spotlight through a single act of courage. She is not the first, nor likely theContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [8] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/01/31/how-did-we-end-up-with-a-broken-health-insurance-system/ [title] => How Did We End Up with a Broken Health Insurance System?  [timestamp] => 1738308360 [author] => matthew holt [content] =>

By LEONARD D’ AVOLIO

The murder of UnitedHealthcare CEO Brian Thompson has drawn attention to Americans’ frustration with the for profit healthcare insurance industry. Change is possible but less likely if people don’t understand how we got here, the real issues, and how they might be fixed.

Health insurance wasn’t always run by big for profit corporations

According to Elizabeth Rosenthal’s book, An American Sickness (a must read), it all started in the 1920s when the Vice President of Baylor University Medical Center discovered that they were carrying a large number of unpaid bills. The goal wasn’t to make money. It was to keep sick people from going bankrupt while helping keep the lights on at not-for-profit hospitals.

Baylor launched “Blue Cross” as a not-for-profit and it offered one-size-fits-all coverage, one-size-fits-all pricing, and all were welcome. By 1939, Blue Cross grew to 3 million subscribers and health insurance might have stayed this way if it wasn’t for two important innovations that would change healthcare and insurance as we know it.

Before the late 1930s, there wasn’t a heck of a lot we could do for sick people. That all changed with two innovations: 1) the ventilator and 2) the first intravenous anesthetic. The ability to put people to sleep and keep them breathing opened the door to a whole array of new surgical and intensive care interventions. More interventions meant more lives saved. It also meant longer hospital stays, more expensive equipment and care. Insurance would have to evolve to keep up with medical innovation.

We probably could have solved that problem with direct-to-consumer private insurance (like car or life insurance). But World War 2 introduced a creative workaround to a labor shortage that gave employers an outsized role in determining our health.

Health insurance tied to employment

During World War 2, the National War Labor Board froze salaries and companies faced labor shortages. Employers figured out they could attract employees by offering health insurance. The government encourages this by giving a tax break to employers on health insurance spending.

The number of Americans with health insurance skyrockets. Between 1940 and 1955, this number increased from 10% to over 60%, with the not-for-profit Blue Cross dominating. It’s hard to believe nowadays, but at the time, an insurance company was one of the most beloved brands in America.

The extreme growth of the health insurance market attracted existing for-profit life insurance companies like Cigna and Aetna. They were already good at pricing and selling insurance. Importantly, they weren’t strapped with the nonprofit mission of “providing high quality, affordable care for all.” They entered the market by selling plans to employers with younger, healthier workers at lower prices.

The lower prices were welcomed by employers. Unfortunately, it was now up to the employer, not the person in need of healthcare, to decide what insurance employees will / will not be receiving and the benefits offered.

The fall of the not-for-profits

By the 1990s the Blues were getting killed by their for-profit competitors. As long as their mission committed them to providing care to all and the premiums of healthy people were going to the for-profits, they couldn’t compete.

In 1994 the Blues’ board voted to allow Blues franchises to become for profit. At first they said it was to gain access to the stock market to raise some cash to dig out of the hole they were in. But when a public service mission goes head-to-head with a responsibility to raise shareholder value, profit tends to win.

The newly for-profit Blues started gobbling one another up to consolidate market power. Blue Cross of California was renamed Wellpoint. Many Blues merged or were acquired and rolled up into Anthem. In New York, the former Blue Cross operates under Empire. Today, along with United, Cigna, and Aetna, they’re among the largest and most powerful for-profit companies in the U.S. — and they operate accordingly.

The profits > people playbook

Not-for-profit organizations exist to provide a benefit to the public. For-profit organizations exist to earn a profit and have a fiduciary responsibility to use that profit to reward their owners and shareholders. These legally binding obligations lead to two very different playbooks. The original Blue Cross was obligated to provide “high quality, affordable care for all.” What does the playbook look like when the obligation is to increase shareholder value?

Before the Blues went for-profit, 95 cents of every dollar of premiums went to medical care. In 2010 in Texas, the birthplace of nonprofit health insurance, the for-profit Texas Blues spent 65 cents of each dollar on medical care. How do these corporations use their profits to make more profits and reward their shareholders?

They follow a 4 step plan:

  1. Tie executive pay to profits
  2. Buy the favor of elected officials
  3. Vertical integration
  4. Stock buybacks

First, they create executive compensation packages tied directly to how much money the corporation makes. Today, those packages are in the 10s of millions of dollars per year. What’s the most obvious way for executives to generate profits when revenues come from premiums and the expenses are paying for care? Raise premiums and cut benefits.

In 2010, Wellpoint planned to hike their premiums by 39%–before the CA attorney general stepped in. It turns out, once a health plan dominates a local market, only government regulation can prevent them from setting their own prices or denying medical coverage.

Which necessitates the next area of investment in the for-profit health insurance playbook – buying the favor of elected officials. Insurance companies spend more than $150M each year lobbying the folks that are supposed to regulate them. Elected officials need this money to be elected and stay in office. The lobbyists of multi-billion dollar corporations make the price of their support (and the cost of opposing them) crystal clear.

The blessing of elected officials becomes even more important for the next strategic investment of for profit health insurance corporations – “vertical integration.” That’s when insurance companies buy the companies that they used to pay or negotiate prices with. Vertical integration locks out competitors and gives greater price control over not just premiums but doctors, drugs, services, etc. In the last two decades health insurance corporations have bought pharmacy benefits managers, billing and service companies, clinics, consultants, and so on. United Healthcare now employs 90,000 doctors – that’s 10% of all MDs in the US. That’s a lot of leverage over what will and will not be covered and the price of each service.

If this plan of incentivising executives, raising premiums, cutting coverage, denying claims, buying political protection, and vertical integration works as it should, you’ll have enough money to give the ultimate reward to your shareholders – the stock buyback.

The stock buyback is a transfer of wealth from the company directly to the company’s shareholders. The way it works is the corporation buys its own shares from the public market, in effect reducing the total number of shares available for sale. This makes the existing shares worth more, rewarding existing investors.

Since 2010, health insurance corporations have been on a stock buyback tear, spending $120B of their profits – not to lower premiums or improve care – but to increase the wealth of their shareholders. Why? Because that is the obligation of directors and officers of for-profit companies.

How do we move forward?

Don’t reduce this problem to the greed of a few executives. It may be morally repugnant, but it’s predictable if not inevitable that executives of for-profits will do everything allowable by law to generate profits and use them to reward their shareholders.

Things are getting worse quickly, making it harder to fix. As for-profit health insurance corporations grow, they gain more power–more pricing power, greater market dominance, greater sway over elected officials. They are getting more extreme in their denial of claims, acquisitions, reduction of customer service, and in their monopolistic behavior, because they have done the math and they have determined that they can.

Change from our elected officials is the only way forward. We give our elected officials the power to regulate for-profit corporations so that enriching shareholders doesn’t come at the expense of poisoning our drinking water or allowing our cars to burst into flames. In this case, they’ve neglected their duty to oversee a market that deals in human health.

They too have done the math. They will not prioritize change unless their calculus concludes that the best way to keep their positions is to regulate the for-profit healthcare insurance industry. Thus far, that has not been the case.

Leonard D’Avolio, PhD is an Asst. Professor at Harvard Medical School. He can be reached at ldavolio@gmail.com

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/01/31/how-did-we-end-up-with-a-broken-health-insurance-system/ [pubDate] => Fri, 31 Jan 2025 07:26:00 +0000 [category] => Wellpoint [guid] => https://thehealthcareblog.com/?p=108827 [description] => By LEONARD D’ AVOLIO The murder of UnitedHealthcare CEO Brian Thompson has drawn attention to Americans’ frustration with the for profit healthcare insurance industry. Change is possible but less likely if peopleContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [9] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/01/30/its-money-that-changes-everything-or-doesnt-for-surgeons/ [title] => It’s Money That Changes Everything (Or Doesn’t) For Surgeons [timestamp] => 1738223280 [author] => matthew holt [content] =>
This image has an empty alt attribute; its file name is Michael-Millenson-Headshot-Profile-Photo-2024-larger.jpeg

By MICHAEL MILLENSON

Money changes everything,” Cyndi Lauper famously sang about love to a pulsating rock ‘n’ roll beat. So, too, when it comes to financial incentives for surgeons, two new studies suggest, although “How much money?” and “What do I have to do?” are the keys to unlocking monetary motivation.

The first study, a JAMA research letter, examined the impact of a new Medicare billing code for abdominal hernia repair that paid surgeons more if the hernia measured at least 3 centimeters in size. Previously, “size was not linked to hernia reimbursement,” noted University of Michigan researchers.

Surprise! The percentage of patients said to have smaller, lower-payment hernias dropped from 60% to 49% in just one year. Were “small hernia” patients being denied care? Nope. Were surgeons perhaps more precise in measuring hernia size? Maybe. Or possibly, wrote the researchers in careful academic language, “the coding change may have induced surgeons to overestimate hernia size.” Ambiguous tasks, they added, “can be conducive to perceptive [cq] bias and potentially even dishonest behavior, perhaps more so with financial incentives at play.”

This being an academic publication, two footnotes informed us that dangling money in front of our eyes can cause people to “see what you want to see” and come up with an “elastic justification” for truth.

If a simple coding change can apparently boost the number of large-hernia patients by 18% in just one year, what about a payment incentive meant to induce more urologists to follow the medical evidence on low-risk prostate cancer and adopt “active surveillance” (formerly known as “watchful waiting”), rather putting patients through a painful and expensive regimen of biopsies and surgery?

A second study, also in Michigan, involved commercial and Medicare-age members of the state’s Blue Cross and Blue Shield plan. However, after three years and more than 15,000 patients, “the payment incentive was not associated with increased surveillance use among patients with low-risk disease,” researchers concluded in a JAMA Network Open article.

A financial incentive fails

This inertia belied the enormous potential for improvement. A previous study found active surveillance for low-risk prostate cancer patients among Michigan urology groups – a rate adjusted for the patient’s clinical condition – ranged from 30% to 73%. In one urology practice, the rate among individual clinicians – a half-century after the first studies of practice variation practice variation among similar doctors with similar patients – ranged from zero to 96%!

Yet even in those physician groups with the lowest rate of active surveillance use and the highest proportion of patients from Blue Cross – the groups expected to be most “sensitive” to a financial incentive – there was no statistically significant change. Why?

Once again, the researchers carefully noted that surgical treatment decisions “may be partly driven by nonclinical factors, including financial incentives.” For instance, “physicians may make thousands of dollars more in the first year through primary treatment as opposed to active surveillance.” Moreover, for any individual surgeon to actually receive the health plan’s financial incentive, the entire urology group had to meet a target requiring almost three-quarters of men eligible for active surveillance to either be offered it as an option or accept it.

For all the loud proclamations by payers, providers and policymakers that the U.S. healthcare care system is well on its way to “value-based payment,” the pronouncements about an emphasis on patient preferences and the “cost-quality equation” remain just that empty words when compared to the concrete value signified by an immediate paycheck boost. When a new billing code pays more to individual surgeons, significant change swiftly follows, even if only in documentation. Roll out a convoluted payment scheme that requires an entire surgical group to alter its doctors actually practice, however, and very little happens.

The “effective” way “to align prostate cancer care quality with payment,” the researchers concluded, may require “reimbursement parity between [low-risk prostate cancer] management strategies.”

In other words, if you want financial incentives for surgeons to really work, it pays to remember a declaration a Tom Cruise film made famous: “Show me the money.”

Michael L. Millenson is president of Health Quality Advisors & a regular THCB Contributor. This originally appeared on Forbes.

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/01/30/its-money-that-changes-everything-or-doesnt-for-surgeons/ [pubDate] => Thu, 30 Jan 2025 07:48:00 +0000 [category] => Prostate Cancer [guid] => https://thehealthcareblog.com/?p=108899 [description] => By MICHAEL MILLENSON “Money changes everything,” Cyndi Lauper famously sang about love to a pulsating rock ‘n’ roll beat. So, too, when it comes to financial incentives for surgeons, two new studiesContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [10] => Array ( [uri] => https://thehealthcareblog.com/blog/2025/01/29/doctors-must-fight-the-rfk-nomination/ [title] => Doctors Must Fight the RFK Nomination [timestamp] => 1738139760 [author] => matthew holt [content] =>

By DANIEL STONE

As a doctor, I consider Secretary Xavier Becerra and his Department of Health and Human Services (HHS) to be allies of practitioners like me. The behemoth federal agency administers Medicare and Medicaid, the Food and Drug Administration, and an army of public health workers. The Surgeon General, symbolic leader of the nation’s healthcare providers, reports to HHS. For decades, the Department has supported medical science in safeguarding the public’s health. Now that sacred trust faces the threat of Donald Trump’s nomination of Robert F. Kennedy Jr. to run HHS.

RFK’s first problem is a stunning lack of qualifications. After a laudable triumph over drug addiction, he used his legal background to work on environmental protection. Kennedy never held a federal government position nor administered any public agency. He now appears poised for on-the-job training at an agency with 80,000 employees and a $1.7 Trillion budget. In contrast, Becerra served for years in Congress and on its Health Sub-Committee. He also served as State Attorney General, managing 4,800 employees. The qualification issue is not political. During Trump’s first term, his last HHS secretary, Alex Azar, had served as HHS general counsel and president of pharmaceutical giant Eli Lilly. RFK has nothing remotely resembling his would-be predecessors’ qualifications.

Unfortunately, RFK’s shortcomings go well beyond mere lack of qualification. His distortions and public denials of established medical science infuriate practitioners like me. He casts baseless doubt on the well-established benefits of vaccines and on the polio vaccine in particular. Despite the seven decades since polio vaccine’s introduction, doctors still see patients who were infected before it was available. My patient Donna, born in 1955, counts herself among this group. She wears leg braces and often struggles with daily activities. For me, she symbolizes those who by accident of birth or happenstance missed the profound benefits of vaccines that RFK now disparages.

RFK also opposes fluoridation of water. Another patient, Judith, age 80, scoffs at such skepticism. She grew up in Niagara Falls, NY, before fluoridation and its dental protection. She remembers her childhood dentist finding 13 cavities and the trauma and pain of prolonged dental work at an early age.

Primary care doctors like me spend our professional lives working to prevent life limiting and life-threatening conditions like those affecting Donna and Judith. We struggle with the challenges of insurance denials, clunky electronic records, healthcare bureaucracy and ballooning patient loads. We don’t need an HHS administrator opposing our efforts to provide standard preventive care. And if RFK’s judgment on vaccines is so poor, who can trust him on other critical healthcare issues like pandemic management or drug authorizations?

How should physicians respond? I recently exchanged messages with a politically diverse group of local medical leaders. They all opposed RFK but disagreed on tactics. Some said that the American Medical Association leadership believes RFK to be headed for confirmation. They fear that failed opposition might jeopardize RFK’s support on Medicaid and Medicare reimbursements.

The local doctors’ reasoning reflects the same transactional “what’s in it for me” approach that led to RFK’s nomination. RFK mortgaged a share of the Kennedy legacy to help Trump win the Presidency. Now Trump is returning the favor with a cabinet position despite RFK’s lack of qualifications and practitioners’ opposition. Should organized medicine really adopt the same “what’s in it for us” approach?

I told my colleagues that I can accept being on the losing side. Despite my efforts, my patients sometimes get sick and even die. But I don’t quit on them or ask, “what’s in it for me?” So I will not shrug my shoulders as those representing America’s doctors swallow RFK’s nomination like a dose of castor oil. The senators voting on RFK have their own doctors and medical societies in their home states. Those doctors must explain to their senators why RFK is unacceptable to those on healthcare’s front lines.

I will not shrug my shoulders as those representing America’s doctors swallow RFK’s nomination like a dose of castor oil. I have belonged to the California Medical Association for more than 20 years and to the American College of Physicians, the nation’s largest medical trade association, for over 30. Although proud of those associations, I will resign from both if they fail to issue strong, evidence-based statements explaining why the RFK nomination is unacceptable. I hope my colleagues do likewise.

As physicians, we take an oath to do no harm. Sometimes doing nothing causes harm. It is time for organized medicine to do the right thing and fight the RFK nomination.

Daniel Stone is a practicing internist and geriatrician with Cedars Sinai Medical Group. This piece was originally published in the Jewish Journal

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [link] => https://thehealthcareblog.com/blog/2025/01/29/doctors-must-fight-the-rfk-nomination/ [pubDate] => Wed, 29 Jan 2025 08:36:00 +0000 [category] => Trump [guid] => https://thehealthcareblog.com/?p=108885 [description] => By DANIEL STONE As a doctor, I consider Secretary Xavier Becerra and his Department of Health and Human Services (HHS) to be allies of practitioners like me. The behemoth federal agency administersContinue reading... [dc] => Array ( [creator] => matthew holt ) ) [11] => Array ( [uri] => https://www.healthcare.gov/blog/explore-your-health-care-options-after-open-enrollment [title] => Discover your health care options after Open Enrollment [timestamp] => 1736985600 [author] => Healthcare.gov [content] =>

Missed the January 15 deadline for 2025 Marketplace Open Enrollment? Don’t worry—you may still have options for health coverage for the rest of the year.

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Enroll with a Special Enrollment Period

You could be eligible for a Special Enrollment Period to get or change your health coverage if:

If you qualify, you can enroll in Marketplace coverage anytime this year, even outside the regularOpen Enrollment Period.

Find out if you qualify

Enrollthrough Medicaid or CHIP

You can apply for health coverage through Medicaid or the Children’s Health Insurance Program (CHIP) at any time if you’re eligible.

  • These free or low-cost programs provide coverage for hospital stays, doctor services, prescription drugs, and more for children and qualifying adults.
  • Learn more about these programs.

With Open Enrollment now over,explore your coverage options for the rest of the year.

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Missed the January 15 deadline for 2025 Marketplace Open Enrollment? Don’t worry—you may still have options for health coverage for the rest of the year.

Image

Enroll with a Special Enrollment Period

You could be eligible for a Special Enrollment Period to get or change your health coverage if:

If you qualify, you can enroll in Marketplace coverage anytime this year, even outside the regularOpen Enrollment Period.

Find out if you qualify

Enrollthrough Medicaid or CHIP

You can apply for health coverage through Medicaid or the Children’s Health Insurance Program (CHIP) at any time if you’re eligible.

  • These free or low-cost programs provide coverage for hospital stays, doctor services, prescription drugs, and more for children and qualifying adults.
  • Learn more about these programs.

With Open Enrollment now over,explore your coverage options for the rest of the year.

[link] => https://www.healthcare.gov/blog/explore-your-health-care-options-after-open-enrollment [guid] => https://www.healthcare.gov/blog/explore-your-health-care-options-after-open-enrollment [pubDate] => Thu, 16 Jan 2025 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [12] => Array ( [uri] => https://www.healthcare.gov/blog/going-once-going-twice-open-enrollment-ends-soon [title] => Going once, going twice...Open Enrollment ends soon! [timestamp] => 1736294400 [author] => Healthcare.gov [content] =>

Time’s almost up to get health coverage for 2025. Act before January 15 to enroll in health coverage that starts February 1.

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Enroll in health coverage now that meets your budget & needs

Depending on your expected household income for the year, you or members of your household may qualify for lower costs or coverage through Medicaid or the Children’s Health Insurance Program. Got questions about applying? Get help now.

Ready to enroll?

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Time’s almost up to get health coverage for 2025. Act before January 15 to enroll in health coverage that starts February 1.

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Enroll in health coverage now that meets your budget & needs

Depending on your expected household income for the year, you or members of your household may qualify for lower costs or coverage through Medicaid or the Children’s Health Insurance Program. Got questions about applying? Get help now.

Ready to enroll?

[link] => https://www.healthcare.gov/blog/going-once-going-twice-open-enrollment-ends-soon [guid] => https://www.healthcare.gov/blog/going-once-going-twice-open-enrollment-ends-soon [pubDate] => Wed, 08 Jan 2025 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [13] => Array ( [uri] => https://www.healthcare.gov/blog/beat-the-deadline-open-enrollment-ends-in-1-month [title] => The clock is ticking! Open Enrollment ends in 1 month [timestamp] => 1734220800 [author] => Healthcare.gov [content] =>

Do you hear that? It’s the clock ticking towards the January 15 deadline. You still have time to apply for, renew, or change 2025 health insurance.

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Note these important dates:

Don't miss out! After January 15, you can only enroll in or change your health plan for 2025 if you qualify for a Special Enrollment Period. If not, you may have to wait until next year to get coverage.

Ready to apply & enroll today?

Have questions? Get help now.

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Do you hear that? It’s the clock ticking towards the January 15 deadline. You still have time to apply for, renew, or change 2025 health insurance.

Image

Note these important dates:

Don't miss out! After January 15, you can only enroll in or change your health plan for 2025 if you qualify for a Special Enrollment Period. If not, you may have to wait until next year to get coverage.

Ready to apply & enroll today?

Have questions? Get help now.

[link] => https://www.healthcare.gov/blog/beat-the-deadline-open-enrollment-ends-in-1-month [guid] => https://www.healthcare.gov/blog/beat-the-deadline-open-enrollment-ends-in-1-month [pubDate] => Sun, 15 Dec 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [14] => Array ( [uri] => https://www.healthcare.gov/blog/to-begin-your-coverage-make-sure-you-pay-your-monthly-premium [title] => To start your coverage, make sure you pay your monthly premium [timestamp] => 1733961600 [author] => Healthcare.gov [content] =>

To start your new 2025 Marketplace coverage, pay the first premium. This is the amount you pay every month to the health insurance company to keep your coverage.

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Pay your monthly premiums

How to pay your monthly premium to start your coverage

Follow your insurance company’s instructions on how to pay.

Get details on how to pay your premium to complete your enrollment.

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

To start your new 2025 Marketplace coverage, pay the first premium. This is the amount you pay every month to the health insurance company to keep your coverage.

Image
Pay your monthly premiums

How to pay your monthly premium to start your coverage

Follow your insurance company’s instructions on how to pay.

Get details on how to pay your premium to complete your enrollment.

[link] => https://www.healthcare.gov/blog/to-begin-your-coverage-make-sure-you-pay-your-monthly-premium [guid] => https://www.healthcare.gov/blog/to-begin-your-coverage-make-sure-you-pay-your-monthly-premium [pubDate] => Thu, 12 Dec 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [15] => Array ( [uri] => https://www.healthcare.gov/blog/dont-delay-sign-up-by-dec-15-for-coverage-that-starts-jan-1 [title] => Act now: Enroll by December 15 for coverage that starts January 1! [timestamp] => 1733356800 [author] => Healthcare.gov [content] =>

Don't wait—time is running out! The December 15 deadline to apply, renew, or make changes for Marketplace coverage starting January 1 is fast approaching. Take action now to ensure you don't experience any gaps in your coverage.

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Prioritize your health in 2025: Apply today

Kick off 2025 by getting health coverage for you and your family that starts January 1. Act now to ensure you’re ready for the year ahead.

Even if you want to keep your current plan, it’s important to review and update your application to account for any income or household changes, see all available options, and make sure you don’t miss the chance for coverage starting January 1.

Get Marketplace overview

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Don't wait—time is running out! The December 15 deadline to apply, renew, or make changes for Marketplace coverage starting January 1 is fast approaching. Take action now to ensure you don't experience any gaps in your coverage.

Image

Prioritize your health in 2025: Apply today

Kick off 2025 by getting health coverage for you and your family that starts January 1. Act now to ensure you’re ready for the year ahead.

Even if you want to keep your current plan, it’s important to review and update your application to account for any income or household changes, see all available options, and make sure you don’t miss the chance for coverage starting January 1.

Get Marketplace overview

[link] => https://www.healthcare.gov/blog/dont-delay-sign-up-by-dec-15-for-coverage-that-starts-jan-1 [guid] => https://www.healthcare.gov/blog/dont-delay-sign-up-by-dec-15-for-coverage-that-starts-jan-1 [pubDate] => Thu, 05 Dec 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [16] => Array ( [uri] => https://www.healthcare.gov/blog/want-coverage-that-starts-january-1 [title] => Only 2 weeks left for January 1 coverage [timestamp] => 1733011200 [author] => Healthcare.gov [content] =>

Apply for, renew, or change your Marketplace plan by December 15 to make sure your coverage starts January 1.

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Already have Marketplace coverage?

Whether you want to keep your current coverage or you’re ready for a change, you should log into your account to update any income or household changes for next year. This makes sure you get the right amount of savings and can help you find other plans that may better fit your needs.

Applying for the first time?

Start next year off right. Make sure you’re covered starting January 1.

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Apply for, renew, or change your Marketplace plan by December 15 to make sure your coverage starts January 1.

Image

Already have Marketplace coverage?

Whether you want to keep your current coverage or you’re ready for a change, you should log into your account to update any income or household changes for next year. This makes sure you get the right amount of savings and can help you find other plans that may better fit your needs.

Applying for the first time?

Start next year off right. Make sure you’re covered starting January 1.

[link] => https://www.healthcare.gov/blog/want-coverage-that-starts-january-1 [guid] => https://www.healthcare.gov/blog/want-coverage-that-starts-january-1 [pubDate] => Sun, 01 Dec 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [17] => Array ( [uri] => https://www.healthcare.gov/blog/act-now-for-health-coverage [title] => Act now for health coverage in 2025 [timestamp] => 1732147200 [author] => Healthcare.gov [content] =>

Open Enrollment is now. Start 2025 off right by enrolling in coverage for the new year.

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For coverage to start:

Make time today for a few easy steps. Coverage may be more affordable and easier than you think.

Apply & enroll today:

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Open Enrollment is now. Start 2025 off right by enrolling in coverage for the new year.

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For coverage to start:

Make time today for a few easy steps. Coverage may be more affordable and easier than you think.

Apply & enroll today:

[link] => https://www.healthcare.gov/blog/act-now-for-health-coverage [guid] => https://www.healthcare.gov/blog/act-now-for-health-coverage [pubDate] => Thu, 21 Nov 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [18] => Array ( [uri] => https://www.healthcare.gov/blog/check-out-marketplace-coverage-options [title] => Check out 2025 Marketplace coverage options – find, compare, & save! [timestamp] => 1730937600 [author] => Healthcare.gov [content] =>
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Before you apply, check out 2025 coverage options in the Marketplace and get an idea if you qualify for savings. Answer a few quick questions to preview plans and prices before enrolling or renewing coverage for 2025 — you don’t even have to log in!

Enroll by December 15 for coverage that starts January 1.

Check to see if you'll save on 2025 Marketplace coverage:

Apply now

Need help applying or have questions? Get help now.

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>
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Before you apply, check out 2025 coverage options in the Marketplace and get an idea if you qualify for savings. Answer a few quick questions to preview plans and prices before enrolling or renewing coverage for 2025 — you don’t even have to log in!

Enroll by December 15 for coverage that starts January 1.

Check to see if you'll save on 2025 Marketplace coverage:

Apply now

Need help applying or have questions? Get help now.

[link] => https://www.healthcare.gov/blog/check-out-marketplace-coverage-options [guid] => https://www.healthcare.gov/blog/check-out-marketplace-coverage-options [pubDate] => Thu, 07 Nov 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [19] => Array ( [uri] => https://www.healthcare.gov/blog/apply-for-marketplace-insurance-today [title] => Enroll in 2025 Marketplace health insurance: Apply today! [timestamp] => 1730419200 [author] => Healthcare.gov [content] =>

Don’t delay — enroll today! Open Enrollment for 2025 health insurance is here. Enroll in a new plan or change your coverage for the year ahead.

Enroll by December 15, so your coverage can start January 1. Open Enrollment ends on January 15, 2025.

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Apply and enroll at HealthCare.gov

There are several ways to sign up for health coverage, but the quickest and easiest is to apply online. Here’s how to get started:

Follow these 4 simple steps to complete your enrollment.

Got questions? Help is available

Don't wait to enroll for 2025 — most people qualify for savings, and plans cover preventive care, essential health benefits, and more!

Learn more about Marketplace plans

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Don’t delay — enroll today! Open Enrollment for 2025 health insurance is here. Enroll in a new plan or change your coverage for the year ahead.

Enroll by December 15, so your coverage can start January 1. Open Enrollment ends on January 15, 2025.

Image

Apply and enroll at HealthCare.gov

There are several ways to sign up for health coverage, but the quickest and easiest is to apply online. Here’s how to get started:

Follow these 4 simple steps to complete your enrollment.

Got questions? Help is available

Don't wait to enroll for 2025 — most people qualify for savings, and plans cover preventive care, essential health benefits, and more!

Learn more about Marketplace plans

[link] => https://www.healthcare.gov/blog/apply-for-marketplace-insurance-today [guid] => https://www.healthcare.gov/blog/apply-for-marketplace-insurance-today [pubDate] => Fri, 01 Nov 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) [20] => Array ( [uri] => https://www.healthcare.gov/blog/available-now-plans-prices [title] => Preview 2025 plans & prices now! [timestamp] => 1729728000 [author] => Healthcare.gov [content] =>

Jump start Open Enrollment for 2025 coverage by previewing plans with personalized price estimatesbased on your estimated income and household size.

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Preview personalized 2025 plans & prices

Preview 2025 plans & prices

Come back during Open Enrollment from November 1 - January 15 to get exact prices, compare plans, and enroll!

Need help estimating your income?

[enclosures] => Array ( ) [categories] => Array ( ) [uid] => [description] =>

Jump start Open Enrollment for 2025 coverage by previewing plans with personalized price estimatesbased on your estimated income and household size.

Image

Preview personalized 2025 plans & prices

Preview 2025 plans & prices

Come back during Open Enrollment from November 1 - January 15 to get exact prices, compare plans, and enroll!

Need help estimating your income?

[link] => https://www.healthcare.gov/blog/available-now-plans-prices [guid] => https://www.healthcare.gov/blog/available-now-plans-prices [pubDate] => Thu, 24 Oct 2024 00:00:00 GMT [dc] => Array ( [creator] => Healthcare.gov ) ) ) )