Health
Health care costs up to 300% higher for privately insured patients than those with Medicare, report reveals
Most Americans — more than 65% — have private health insurance, but a new report has revealed a potentially very expensive drawback.
Patients who have private (commercial) coverage may end up paying significantly more for their medical care compared to those who have public health insurance, such as Medicare, according to recent data from RAND Corp. in Washington, D.C.
As of 2022, employers and private insurance companies paid an average of 254% more for medical services than what Medicare programs would have paid.
HEALTH CARE COSTS UP TO 300% HIGHER FOR PRIVATELY INSURED PATIENTS THAN THOSE WITH MEDICARE
Several states — California, Florida, Georgia, New York, South Carolina, West Virginia, and Wisconsin — had medical costs that were more than 300% higher than Medicare prices, the report stated.
The researchers analyzed medical claims data from a “large population” of privately insured patients who were treated at over 4,000 hospitals across the country between 2020 and 2022.
Patients who have private coverage may end up paying significantly more for their medical care compared to those who have public health insurance, such as Medicare. (iStock)
The report also included the names and prices of each hospital.
“Calculating 4,000-plus U.S. hospitals’ overall relative prices has never been done before this study, because it’s so difficult to collect the requisite data and to get permissions to publish the hospital and health system names associated with each relative price,” said Brian Briscombe, a health care analyst at RAND and one of the study authors, to Fox News Digital.
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“This is real price transparency — naming the hospitals and presenting their overall relative prices in a way that anyone could understand.”
The report gives employers a tool they can use to become “better-informed purchasers” of health care services, Peter Hussey, director of RAND Health Care in Santa Monica, California, noted in a news release.
“Hospitals account for the largest share of health care spending in the U.S., so this report also provides valuable information that may aid policymakers interested in curbing health care costs,” Hussey also said in the release.
The researchers analyzed medical claims data from a “large population” of privately insured patients who were treated at more than 4,000 hospitals across the country between 2020 and 2022. (iStock)
The wide variance of prices across hospitals is the most important takeaway, according to Briscombe.
“Within a single city, you can find a hospital that (on average across all its services) charges privately insured patients about twice as much as Medicare charges for those same services — but down the street, another hospital charges three times what Medicare charges,” he told Fox News Digital.
The difference in prices cannot be explained by differences in quality, he added.
“This is real price transparency — naming the hospitals and presenting their overall relative prices in a way that anyone could understand.”
Dr. Brett Osborn, a Florida neurologist and longevity expert, was not involved in the RAND study but said the findings are “concerning.”
“Hospitals bill private insurers multiples of the Medicare allowable,” he told Fox News Digital.
“The elevated costs are passed onto patients, resulting in higher premiums and out-of-pocket expenses.”
As of 2022, employers and private insurance companies paid an average of 254% more for medical services than what Medicare programs would have paid, according to a new study. (iStock)
And these costs are on the rise, Osborn warned.
“People accept job offers because the employer offers health insurance — otherwise, for many, the premiums would be unaffordable,” he added.
Osborn emphasized the significant price variations among states.
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“Hospitals in some states charge less than 200% of Medicare rates, while others exceed 300%,” he said.
“Due to its size, Medicare can negotiate lower payments — but private insurers lack this leverage.”
“This discrepancy is due to some hospitals’ market power, making it hard for employers to avoid them. Due to its size, Medicare can negotiate lower payments — but private insurers lack this leverage.”
The doctor also called for greater price transparency from hospitals.
The new report published the names and pricing models of more than 4,000 U.S. hospitals. (iStock)
“Despite a federal rule for price transparency, only 24.5% of hospitals comply — highlighting the need for informed health care purchasing and policy changes to manage costs,” he said.
“The system is fundamentally flawed, designed to profit from illness rather than promote health,” Osborn continued.
“It clearly favors hospital systems, not the patients, reinforcing the harsh reality: There is money in the sick.”
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Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said the issue of price variations is complex.
“Sometimes these are hidden costs, and sometimes hospitals and other health organizations know they can get away with charging private insurers more while obscuring prices from both the insurer and the patient to help compensate for the shrinking reimbursements from public insurances,” Siegel told Fox News Digital.
“At the same time, more out-of-pocket costs are transferred to the consumer in terms of copays and deductibles, as middlemen take the profits.”
“The system is fundamentally flawed, designed to profit from illness rather than promote health.”
With the lack of price transparency, there is no way to introduce competition, Siegel said, as the true costs and prices are hidden.
The study did have some limitations, the researchers acknowledged.
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“We didn’t have sufficient claims data to publish all U.S. hospitals’ relative prices,” Briscombe told Fox News Digital.
“Some states in the U.S. don’t have All Payor Claims Databases (APCDs), so we have to collect claims from one data contributor at a time – usually from employers that operate in that location and whose employees and dependents use those hospitals.”
“Despite a federal rule for price transparency, only 24.5% of hospitals comply, highlighting the need for informed health care purchasing and policy changes to manage costs,” according to a doctor who spoke with Fox News Digital. (iStock)
Overall, he said, the researchers had a “sufficiently large sample of data” to estimate the overall relative price of each hospital and health system included in the report, Briscombe said, “but it would be nice to have even more claims data in order to publish the relative prices for all U.S. hospitals.”
Fox News Digital reached out to the Centers for Medicare & Medicaid Services and the American Hospital Association requesting comment.
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Americans are popping more supplements – and fewer multivitamins – than ever before, a new study found.
Research published in JAMA Network Open, led by researchers at Memorial Sloan Kettering Cancer Center in New York and the Harvard T.H. Chan School of Public Health in Boston, looked at 25 years of U.S. dietary supplement use data from 1999 to 2023.
This included more than 63,000 adults over the age of 20 who reported their supplement usage.
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When tracking patterns over time, the analysis revealed that overall supplement use increased from 51% of U.S. adults to 60%. The largest rise – from 62% to 78% – was identified in adults 65 and older.
Supplement use was found to be more common in women, people with a higher income or education, and those with insurance.
Supplement use was found to be more common in women, people with a higher income or education, and those with insurance. (iStock)
During the same period, multivitamin use decreased from 35% to 31%, while intake of vitamins and minerals outside of multivitamins increased.
Some of the largest increases in intake were seen in vitamin D, zinc, magnesium, vitamin B12 and turmeric. Other emerging supplements include ashwagandha, elderberry, collagen, hyaluronic acid, probiotics and prebiotics, according to the research.
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The later post-pandemic period saw an influx of immune support-based products, like zinc and vitamin D (outside of multivitamins).
The rise in supplement use aligns with the longevity movement, as more people seek products tailored to specific health goals, such as immune support, inflammation, gut health, skin health and joint health.
The study only shows that people are taking more supplements, but does not prove that they’re effective for these uses, the researchers noted.
Those on a GLP-1 medication should factor in a multivitamin to counteract the risk of nutrient gaps or deficiencies, an expert recommended. (iStock)
In an interview with Fox News Digital, Los Angeles-based registered dietitian nutritionist Ilana Muhlstein gave her take on the emerging supplement movement.
“I love that people are getting more educated and more intentional – I just wish they were being advised by more doctors and dietitians and less by ‘wellness influencers’ who are likely not doing the due diligence on the quality and efficacy of the supplements they’re promoting,” she said.
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Muhlstein expressed concern that all-in-one-multivitamin use has “slipped,” despite the rise in GLP-1 weight-loss medications.
“A multivitamin is where I think people should start as the foundation to help bridge nutrient gaps, especially for people on a GLP-1 who are eating about 15% to 30% less, and therefore likely consuming 15% to 30% less vitamins and minerals,” she said. “I recommend that everyone on a GLP-1 medication [should] take a multivitamin daily.”
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A daily probiotic, magnesium and vitamin D3 are also “smart for many of us,” the nutritionist added. She also recommends elderberry as an effective supplement for boosting the immune system when fighting a cold.
A nutrition expert cautioned against taking supplements that have not gone through third-party testing for safety and quality. (iStock)
Collagen has also been shown to benefit the skin and joints, which Muhlstein said is “worth considering as we get older.”
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“My real concern is the unregulated market,” she cautioned. “I can’t tell you how many calls I’ve received over the years of people pitching me new supplements … because the margins are high and the market is huge.”
“That’s why I’m extremely picky about what I take and what I recommend to my family and clients.”
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Muhlstein warned against taking a supplement that hasn’t gone through third-party testing for safety and quality.
“The best ones go further and test for pesticides, arsenic and heavy metals, especially for protein powders,” she said. “If a product has many ingredients, I like to see that they do testing on each individual ingredient.”
Bipartisan push to invest in US national parks
Bret Baier moderates a discussion with Representatives Bruce Westerman (R-AR) and Jared Huffman (D-CA) about the ‘America the Beautiful’ initiative. This bipartisan effort seeks to modernize national parks ahead of America’s 250th anniversary, investing $1.9 billion annually. They emphasize national parks as common ground, beloved by all Americans, and crucial for our shared heritage.
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As the United States celebrates its 250th anniversary, many Americans are taking extra notice of all the things the country has to offer.
One such case is our access to vast wilderness. Today, the nation’s national parks are bustling tourist attractions, but they may also serve as vital resources for public health, experts say.
The most immediate health boost comes from physical movement.
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Guidelines from the Centers for Disease Control and Prevention show that regular physical activity is crucial for reducing obesity, improving sleep quality and lowering the risk of chronic illnesses.
The nation’s public lands include parks, trails and open spaces that encourage outdoor recreation and physical activity.
Beyond physical fitness, national parks contribute to documented mental health benefits. (iStock)
A review by the Community Preventive Services Task Force (CPSTF) found that implementing park, trail and greenway infrastructure directly increases physical activity across communities.
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When people walk, hike or bike through national parks, they are actively lowering their blood pressure, boosting immune function and reducing overall mortality, data shows.
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Beyond physical fitness, national parks may contribute to documented mental health benefits.
Previous research has demonstrated that direct exposure to nature significantly reduces physiological stress, lowers heart rates and decreases levels of stress hormones, like cortisol.
Engaging in educational activities and lifelong learning preserves brain function, improves memory and helps stave off age-related cognitive decline, research shows. (iStock)
This research also shows that natural environments boost attention span, combat mental fatigue and improve cognitive performance.
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Parks also act as natural venues for mindfulness and social connection.
Research shows that practicing mindfulness in quiet outdoor spaces lowers stress and mitigates feelings of loneliness and social isolation.
Research highlights that practicing mindfulness in quiet outdoor spaces lowers stress and mitigates feelings of loneliness and social isolation. (iStock)
Additionally, because parks protect cultural and historical resources, they can inspire lifelong learning.
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According to the data, engaging in educational activities and lifelong learning preserves brain function, improves memory and helps stave off age-related cognitive decline.
The National Park Service was established in 1916 to conserve the nation’s natural and historic resources for future generations, according to the organization.
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Today, that mission has expanded, as parks are recognized not only for their scenic and cultural value, but also the opportunities they provide for recreation and physical activity.
Screwworm outbreak threat to US livestock, prompts USDA action
Agriculture Secretary Brooke Rollins discusses USDA’s response to the New World Screwworm outbreak in Texas and New Mexico, assuring safe food supply on ‘The Bottom Line.’ VI LONG DEK: Agriculture Secretary Brooke Rollins addresses the alarming resurgence of New World Screwworm in Texas and New Mexico, emphasizing USDA’s aggressive containment efforts. She confirms the food supply remains safe while highlighting the administration’s focus on domestic fertilizer production, investing billions in new plants and infrastructure projects. Rollins celebrates 250 years of American agriculture and its vital role in national security.
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Doctors thought a 60-year-old man had metastatic brain cancer after scans revealed multiple tumors – but further testing revealed a shocking diagnosis.
The Spanish man, who was not named, was found to have a parasitic tapeworm larvae lodged in his brain — a case of neurocysticercosis, a parasitic infection of the central nervous system caused by the pork tapeworm (Taenia solium).
The patient, a lifelong resident of Castellón, Spain, had not traveled to any regions where the disease is endemic, according to the case report published in the CDC journal Emerging Infectious Diseases.
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The man had initially come to the hospital after suffering two weeks of progressive headaches and mild behavioral changes.
Radiologic findings from a study of autochthonous neurocysticercosis brain lesions mimicking metastatic disease. (Emerging Infectious Diseases)
CT scans showed multiple abnormal spots that looked like tumors that had spread from cancer elsewhere in the body, leading doctors to suspect advanced brain cancer.
However, whole-body scans, a colonoscopy and specialized imaging failed to identify cancer anywhere in the patient’s body, the case report stated.
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When doctors performed a more detailed MRI, they discovered several fluid-filled cysts in the brain, some of which contained the head of a tapeworm. A blood test confirmed the diagnosis of neurocysticercosis.
The man was treated with a combination of albendazole and praziquantel (two antiparasitic medications), as well as corticosteroids to reduce inflammation. He successfully recovered with no complications, according to the case report.
CT scans (not pictured) showed multiple abnormal spots that looked like tumors that had spread from cancer elsewhere in the body, leading doctors to suspect advanced brain cancer. (iStock)
The authors suggested that the patient may have gotten the infection after accidentally ingesting microscopic tapeworm eggs years earlier.
The exposure may have occurred while working a construction job with migrant coworkers from regions where neurocysticercosis is endemic.
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People can catch the pork tapeworm in two different ways. Eating undercooked infected pork usually leads to an intestinal tapeworm, but accidentally swallowing the parasite’s eggs — typically through food or water contaminated with feces — can send the larvae into the bloodstream, where they may form cysts in the brain and other organs. This can cause the disease the patient in the case report acquired.
A photomicrograph shows histopathologic features in a brain tissue specimen from a case of neurocysticercosis caused by the pork tapeworm Taenia solium. The image documents pathological changes associated with this parasitic infection. (Smith Collection/Gado/Getty Images)
As this was just a single case, the source of transmission could not be proven, the researchers acknowledged, and the findings cannot be generalized to a wider population. The report shows that there is a possibility of local transmission in non-endemic settings, but cannot establish how often this occurs.
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In the United States, less than 2% of neurocysticercosis cases are considered domestically acquired, according to the case report.
A prior systematic review identified only 18 confirmed locally acquired cases in Western Europe between 1990 and 2011.
The authors suggested that the patient may have gotten the infection after accidentally ingesting microscopic tapeworm eggs years earlier. (Associated Press)
In some cases, NCC can cause serious symptoms, including seizures, stroke, neurological deficits and cognitive decline.
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“Our case emphasizes that the absence of travel history should not preclude NCC from the differential diagnosis of multiple ring-enhancing brain lesions, even in regions where metastatic cancer is statistically much more likely,” the researchers concluded in the case study.
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Detecting the worms earlier could have prevented “unnecessary invasive oncologic procedures and led to prompt, targeted antiparasitic therapy,” they added.
Fox News Digital reached out to the researchers for comment.
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