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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The Murdoch Children’s Research Institute (MCRI) in Australia will receive a $5 million federal grant to launch a pioneering research team for children’s health.
The grant was announced at MCRI’s 40th anniversary gala in Melbourne on Saturday night.
“For 40 years, MCRI has been a global leader in children’s health research,” Prime Minister Anthony Albanese told guests at the gala, which was attended by 300 of Australia’s most esteemed medical experts, political leaders, philanthropists and sports luminaries.
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“My government is proud to partner with MCRI, so our world-leading researchers have the best opportunities to support healthier childhoods for Australians now and into the future.”
The $5 million will directly support medical research aimed at preventing numerous childhood conditions, including obesity, heart disease, mental health issues and disabilities.
Australian Prime Minister Anthony Albanese speaks at the MCRI gala. (Penny Stephens/Murdoch Children’s Research Institute)
Also announced at the gala, a lead donation from Sarah and Lachlan Murdoch will launch the Horizon Fund — a permanent endowment for MCRI aimed at funding long-term children’s health research and future medical breakthroughs.
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The goal is for the fund to raise between $50 million and $100 million in its first year and to reach $200 million within five years.
The fund is designed to back researchers’ immediate priorities while safeguarding long-term capital for future medical breakthroughs in children’s health.
Pictured above, Sarah Murdoch (MCRI co-chair); Jodie Haydon (wife of Prime Minister Albanese); Australian Prime Minister Anthony Albanese; Kathryn North (MCRI director); and Patrick Houlihan (MCRI chair). (Christopher Hopkins/Murdoch Children’s Research Institute)
In 2020, the Murdochs donated $5 million to establish a perpetual fellowship supporting leading researchers in fields including stem cell technology and genomic precision medicine.
Co-founded in 1986 by philanthropist and child health advocate Dame Elisabeth Murdoch and pediatrician and genetics pioneer Professor David Danks, MCRI comprises 1,800 scientists, researchers and clinicians.
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“Dame Elisabeth’s leadership, along with her values, shaped both the direction and the ethos of the Institute we were to become – for all children to live a healthy and fulfilled life,” said Sarah Murdoch, who is Dame Elisabeth Murdoch’s granddaughter-in-law and MCRI’s global ambassador and board co-chair.
Sarah Murdoch (MCRI co-chair) is pictured with Kathryn North (MCRI director) at the Murdoch Children’s Research Institute 40th Anniversary Gala at the State Library Melbourne. (Penny Stephens/Murdoch Children’s Research Institute)
“With the generosity of a remarkable group of founding donors alongside the Murdoch family – Sir Jack Brockhoff, the Miller family, and The Scobie and Claire Mackinnon Trust – the foundations were laid for an Institute designed to bring our brightest minds, to serve all children, not only in that moment, but for generations to come,” Ms. Murdoch added.
“I see what is possible when foresight, science, commitment, collaboration and heartfelt generosity come together,” she emphasized.
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“Because behind every breakthrough is a child — a family desperate for answers. A future changed because of the commitment by so many.”
MCRI Director Kathryn North expressed appreciation at the gala to the prime minister for the $5 million grant.
“From the beginning, MCRI has been guided by a simple but powerful purpose: to give all children the opportunity to live a healthy and fulfilled life,” said the MCRI director. (MCRI)
“From the beginning, MCRI has been guided by a simple but powerful purpose: to give all children the opportunity to live a healthy and fulfilled life,” North said.
“It reflects a belief that good health is the foundation for a full life, and that opportunity should never be limited by circumstance.”
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Professor North mentioned the Institute’s focus on developing therapies for previously incurable diseases.
“We are harnessing the power of human stem cell technologies to grow heart patches, functional mini kidneys, blood and immune cells … to better understand disease, and to develop regenerative therapies using a patient’s own stem cells to replace organ transplants and the risk of rejection,” she said.
The Institute’s next challenge is to address chronic conditions like asthma, obesity, allergies and mental health conditions that can persist for decades. (iStock)
The Institute’s next challenge, North said, is to address chronic conditions like asthma, obesity, allergies and mental health conditions that can persist for decades.
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“These are big problems that will require significant and ongoing support,” she said. “Through our work globally, we are helping communities raise their expectations to both deliver and receive the sort of healthcare we take for granted.”
“Our ambition now is to translate these partnerships into population-scale solutions that improve the lives of millions of children worldwide,” North added. “This is not simply the next chapter for MCRI – it is the work of building the future of children’s health.”
FDA fast-tracks pancreatic cancer drug daraxonrasib
Family and emergency medicine physician Dr. Janette Nesheiwat discusses how artificial intelligence could help detect pancreatic cancer earlier and the FDA fast-tracking the drug daraxonrasib on ‘Fox Report.’
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A new drug for pancreatic cancer is showing promise in early testing.
Daraxonrasib is a daily pill designed to block cancer signals linked to the RAS gene. It has now finished an early-stage clinical trial — the first time it was tested in people — to evaluate both its safety and effectiveness.
The clinical trial, led by the Dana-Farber Cancer Institute and published in The New England Journal of Medicine, tested the drug in 168 patients with advanced pancreatic cancer whose tumors had mutations in the RAS gene. All study participants had previously received at least one chemotherapy treatment.
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The drug is designed to block multiple active cancer signals that help tumor cells grow. This is especially important because more than 90% of pancreatic cancers carry these harmful mutations, researchers said.
Existing and older drugs that target RAS mutations only work on certain types that are uncommon in pancreatic cancer, such as KRAS mutations.
Daraxonrasib is a daily pill designed to block cancer signals linked to the RAS gene. It has now finished an early-stage clinical trial to evaluate its safety and effectiveness. (iStock)
At the 300-milligram dose — the amount that will be used in larger phase 3 trials — about 30% of patients saw a positive response, researchers noted. Overall, about 90% of patients had their cancer either shrink or stop getting worse.
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There were some side effects reported — most commonly rash, mouth inflammation, nausea and diarrhea.
Lead investigator Dr. Brian Wolpin, director of the Hale Family Center for Pancreatic Cancer Research at Dana-Farber, commented in a press release statement that this development could change the future of cancer care.
About 90% of patients treated with the drug experienced disease control, meaning their cancer was reduced or stabilized. (iStock)
“If supported by data from future clinical trials, daraxonrasib would be a targeted therapy relevant to nearly all patients with advanced pancreatic cancer,” he said.
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“This trial provides the first published data showing the safety and broad activity of a RAS(ON) multi-selective inhibitor in pancreatic cancer,” Wolpin went on. “If it proves effective in larger clinical trials, it would signify a substantial shift in how this disease is treated.”
In an interview with Fox News Digital, the researcher claimed that daraxonrasib represents “one of the most promising therapy advances we’ve seen in pancreatic cancer.”
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This is especially significant since pancreatic cancer has had “very few effective therapies” in the past, Wolpin noted.
“The study also showed disease control in approximately 90% of patients with metastatic pancreatic cancer, which is extremely exciting,” he added.
The study does not prove daraxonrasib is superior to standard treatment of chemotherapy, researchers noted. (iStock)
Wolpin noted that while side effects were common, most patients were able to tolerate treatment with “supportive care measures, and very few patients needed to stop therapy due to side effects.”
As this was a phase 1/2 study, it does not “definitively prove” the superiority of daraxonrasib compared to chemotherapy, Wolpin added.
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“The study did not include a randomized control arm that directly compared daraxonrasib with chemotherapy,” he said. “That being said, the results for daraxonrasib looked substantially better than what we have seen in prior clinical trials of chemotherapy in patients with previously treated metastatic pancreatic cancer.”
It also remains unclear how the drug may perform earlier in the disease, as the trial included patients who had already received prior treatments.
“Additional research is needed to determine how best to sequence or combine therapies to provide the most durable responses and cures,” the lead investigaror sid. (iStock)
For patients and families affected by pancreatic cancer, Wolpin noted that daraxonrasib signals “real momentum” toward effective treatments, but it is still investigational and is not a cure.
“Pancreatic cancer remains a challenging disease, and additional research is needed to determine how best to sequence or combine therapies to provide the most durable responses and cures,” he said.
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Brian Slomovitz, director of gynecologic oncology and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, applauded this development in a separate interview with Fox News Digital.
“We are anxiously awaiting the upcoming plenary presentation of RASolute 302 at the ASCO meeting later this month,” said the expert, who was not involved in the study. “Greater than 90% of pancreatic cancers have activation of kRAS, which is a major factor in the development and progression of these cancers.”
“Doubling the survival time in pretreated patients is unprecedented.”
“If the full dataset results that will be reported later this month confirm what was earlier released, I believe this will be one of the most important breakthroughs in all solid tumors,” Slomovitz went on. “Doubling the survival time in pretreated patients is unprecedented.”
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The doctor added that the “magnitude of benefit” could “reshape the treatment landscape” and “establish a new standard of care.”
“We will need to evaluate the full dataset for efficacy and safety,” Slomovitz added. “I am more than cautiously optimistic, and I am truly excited for our patients and their families that suffer from this dreadful disease.”
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People who regularly visit museums or participate in creative activities may be aging more slowly on a biological level, according to a new study from the United Kingdom.
Researchers from University College London analyzed data from more than 3,500 adults and found that people who frequently engaged in arts and cultural activities showed signs of slower biological aging in several DNA-based measurements.
The findings were published in the journal Innovation in Aging.
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The study examined activities including painting, photography, dancing, singing, visiting museums and attending cultural events or historic sites.
People who frequently visit museums or engage in artistic activities may experience slower biological aging. (iStock)
Researchers compared participation in those activities with “epigenetic clocks,” scientific tools that examine chemical changes in DNA over time.
Adults who participated more often, and in a wider variety of activities, tended to show slower aging scores compared to people who rarely engaged in arts or cultural experiences.
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The association appeared even stronger among adults over age 40.
Researchers also noted that the effect sizes were comparable to those linked to physical activity, one of the most widely studied behaviors associated with healthy aging.
The study found that adults who engaged more often in arts and cultural activities showed slower biological aging. (iStock)
Jessica Mack, a health and wellness expert and founder of The Functional Consulting Group who was not involved in the study, said the findings reflect a growing understanding that health is influenced by more than exercise and nutrition alone.
“Arts and cultural engagement may be associated with slower epigenetic aging, with effects comparable in some measures to physical activity,” Mack told Fox News Digital.
She said activities such as visiting museums and engaging with music or art may help reduce stress, improve emotional regulation and increase social connection.
Experts say these activities may reduce stress, improve emotional regulation, and strengthen social connections. (iStock)
“These are not ‘extra’ lifestyle activities,” Mack said. “They may be deeply connected to how the body manages inflammation, stress hormones, mood and overall resilience.”
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Mack added that people experiencing stress, social isolation, retirement or caregiving responsibilities may especially benefit from meaningful cultural engagement.
Experts cautioned, however, that the study does not prove arts engagement directly slows aging.
“This is an observational study, not an experiment,” Professor Steve Horvath of UCLA, a longevity researcher and pioneer in epigenetic aging research who was not involved in the study, told Fox News Digital.
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“So when researchers find that the people who go to museums have younger epigenetic age, we cannot tell whether the museum visits slowed their aging, or whether their slower aging is what allowed them to keep visiting museums,” he said.
While the findings suggest a link, experts caution that the study cannot prove arts and cultural activities directly slow aging. (iStock)
Horvath said both explanations may be true to some degree, though he described the research as “methodologically careful” and worthy of further study.
The findings remained consistent even after accounting for factors such as smoking, income, body weight and other lifestyle habits.
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He added that regardless of whether arts engagement is directly slowing biological aging, staying socially and mentally active is still associated with healthier aging overall.
“The prescription is the same,” he said. “Keep going.”
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