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Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
@mass_marion
May 13, 2022 • 8 tweets • 9 min read • Read on X
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🧵Re baby formula #shortages:
@PressSec us pediatricians cannot conjure up baby formula.
We will do whatever we can to help our patients but you and @POTUS need to own the colossal supply chain mess that now threatens babies.
@PressSec @POTUS @RogerMarshallMD @RepKimSchrier @MartyMakary @Rosemary100 @ab_peds @MedscapePeds 🧵While hospitals have been better at purchasing and distributing less formula, in an effort to encourage #breastfeeding , they still distribute a LOT of formula . Love to know how much @ahahospitals
🧵As for how baby formula and other supplies get into nursing homes, learn about #GPO, medtwitter !
GPO control supplies of the hospitals in 🇺🇸 including masks, drugs, medical devices, solutions, and.....
@CourierTimes @SenBlumenthal @ChuckGrassley
theintell.com/story/opinion/…
🧵HealthTrust is a GPO owned by HCA... a big hospital conglomerate.
They buy in bulk through GPO.
We should be asking these hospitals how much supply they have @PressSec and @POTUS
From: healthtrustpg.com/thesource/clin…
🧵Perhaps if #GPO middlemen were not allowed to legally collect #kickbacks then maybe we would not have almost all formula coming from 3 companies . But these companies can pay to make most of the hospital formula, then dominate the market.
🧵big baby formula maker Abbott is The pediatric supplier of the year for #kickback collecting #GPO @VizientInc
Things that make you go hmmmm...
newsroom.vizientinc.com/vizient-inc.-r…
🧵I am glad Kansas pediatricians are sounding the alarm bell of the danger of making homemade formula, or watering down formula.
I recall in residency, babies presenting with seizures from low sodium from watered down formula kansascity.com/news/nation-wo… @RogerMarshallMD @RepMann
🧵Re the mess of the supply chain and #babyformula :
Physicians feel a LOT like the characters in MASH... our profession is far from home, dealing with shortages, patients keep coming.
You figure out YOUR part @PressSec @POTUS
Supply chain is ON YOU and the corporate suits

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More from @mass_marion

Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Nov 30
For sure!
Non profit hospitals bought the whole town? How about 1/5 of the country? Kaiser, largest MCO in the US, acquired Geisinger in Pa. Now 9 states plus DC.

Look 👀at that real estate in DC, just blocks from the Senate buildings. No wonder I get nailed with parking tickets for the most minor of transgressions.

But wait.... there's more. More COI, more questions...

🧵1/?Image
🧵2/9 I have read that though Kaiser Permanente is non-profit, each Permanente Medical Group functions as a separate for-profit partnership or professional corporation within its specific territory.
Fascinating. How much transparency exists for this?
Does the IRS have an arm that scrutinizes this stuff with an honest accountant?
🧵3/9 Don't forget that Kaiser's top dog on the top 10 compensated CEO:
Read 8 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Nov 12
Why Healthcare is broken.
7 of the current top 11 lobby groups are HC related
A thread. 🧵1/6 Image
@WallStreetApes @OccupyWallSt @WillCainShow @AAPSonline @newtgingrich @CharlieK_news @NanHayworth @ehlJAMA Here is the historical list of top lobbyists. Chamber (insurance related) Hospitals, Pharma, AMA (insurance related) BCBC and AARP ( insurance related) have been there for years
2/6 🧵 Image
@WallStreetApes @OccupyWallSt @WillCainShow @AAPSonline @newtgingrich @CharlieK_news @NanHayworth @ehlJAMA 3/6🧵Here is a piece I wrote a few years back that points out how the very people who lobby the most are the ones who profitted the most from Obamacare.
Funny how that worked. goerie.com/story/opinion/…Image
Read 6 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Oct 26
I do love that you are doing the math and comparing what happens if we lower Medicare age to 50.
Some questions/points:
-"no longer needing to pay premiums"? most people pay a premium for Medicare Part B and some for Part A. Part D has its own premium.
-The government subsidizes these medicare premiums (813 billion in 2023) and It's ⬆️ . See pic which is from CBO report here cbo.gov/publication/59…
-Most people don't have standard medicare, over 50% have bought into an advantage program to get more 'coverage' which is often now not covering and is being manipulated by big insurers to defraud the government of billions per year through a trick called 'up-coding'.
-The biggest up-coder has a CMS contract to help prevent fraud waste and abuse, yet both @SenWarren and @DrOz defined this up-coding as 'fraud' in Dr Oz's confirmation hearings
-In the 1960's, when Medicare was created, the estimates were that it would cost USA $11 billion by 1980. Instead it cost $111 billion
-Americans were promised that if they paid into this program, it would all be 'free' in our twilight years. Makes one think that we cannot trust the government with our tax dollars.
-In the 1960's the president of the AMA gave a speech of why he did not want Medicare to pass. It was eerily predictive, I'll link it in the thread below.
-side point is that the TOTAL subsidies the government pays into health 'insurance' Is an amount equal to 7-8% of our GDP. Wow. How can we afford that? 🧵1/6 (Hey, it's Sunday, grab some coffee and join me. If you know something to read about more important than figuring out how to spend less so our children have a shot at the American 🇺🇸 dream, let me know! )Image
In this @WSJ bit of ⭐️ reporting it was exposed that insures sent nurses to patient homes after bribing them with gift cards and made fraudulent (sometimes anatomically impossible) diagnoses in order to collect in excess of $50 billion. hey call this 'up-coding'. I call it fraud, but hey, if you give it a cutsie name, maybe America🇺🇸 won't notice. wsj.com/articles/medic… 2/6 🧵
"Patricia Greene had spent a month recovering from a devastating stroke when her Medicare Advantage insurer, a unit of UnitedHealth Group, decided to stop paying for her nursing home." This was not an isolated case, it's a pattern.
So after coverage was subsidized by our tax $$ to go to the insurers, the patient was forced to flee to standard Medicare when she needed coverage the most.
It seems that United HC thinks the old axiom 'you get what you pay' for doesn't apply to them
What kind of sickies are we allowing to sit on top of the food chain of American HC? 3/6🧵

wsj.com/articles/medic…
Read 7 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Jan 15
USA needs to 👀 at the 340B program.
Here's a ⭐️ piece in @nytimes
-Cancer patient gets a drug from a non-profit 340B hospital. List price for drug is $2700
-Hospital bills insurance $22K for drug, insurance pays $10K
-Hospital bills cancer patient $2500, and sends her to collections when she won't pay
-Pt moves to free-standing Oncology who billed much less, pt charged nothing.
-Reporter discovers a little-known middleman named Apexus has been cashing in working behind the scenes to supercharge the #340B program

Let's learn more about Apexus.
You can learn the most about 340B from @DrDiGiorgio
He's an uber expert. 1/ 5🧵
nytimes.com/2025/01/15/us/…
@nytimes @Free2care wrote about 340B in our last paper
👀 here, start on p 19, it's brief
2/5 🧵 free2care.org/files/report.p…Image
From the times article on 340B,
-the feds have given apexus an exclusive contract for the 340B program for 20 years
- Apexus has profit margins above 80 percent
-HRSA an agency within H.H.S. that oversees the program, declined to answer detailed questions from @nytimes
-A decade ago, sales of 340B drugs were $12 billion. In 2023, they reached a high of $66 billion.
-Apexus is allowed to collect a fee for almost every drug sold under the program, giving the company an incentive to help hospitals and clinics capture as many prescriptions as possible 3/5🧵
Read 5 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Dec 21, 2024
I am happy that the out of pocket costs for this person ( @Crimsontider ) are low.
But what is Medicare paying for these prescriptions?
If Medicare is paying far too much ( they are) the system is unsustainable for our kids and grandkids.
So to ONLY worry about your copay is to ignore the plight you are leaving behind for kids and grandkids.
A thread 1/? 🧵Image
Let’s use a real life example. This coverage statement was shared by the caretaker of a special-needs person with seizures who  is on a Medicare plan. Let’s call the patient ‘Elle’. Caretaker was shocked at how much money Medicare ‘covered’ for Elle’s Fintelpa. She’s a smart cookie this caretaker and knows that Fintelpa is half of the old diet drug FenFen so it’s years and years old. Should be cheap
Even though Elle paid nothing in co-pay, her caretaker was shocked to see that for a months worth of a decades old drug, Medicare paid $12,000. 2/5 🧵Image
From our example, our special needs patient Elle tried and failed on seizure med Fintepla, which should be inexpensive, but Medicare paid $12,000 in one month for. They were required to use a specialty pharmacy.

From Elle’s caretaker: 
“We don’t have trouble accessing meds and we don’t pay much in copays. I am just appalled at the cost to taxpayers. I think everyone making money see our Elle as a cash cow.”

How sad that industry is profiting off the sick at the expense of taxpayers. 3/5🧵
Read 5 tweets
Marion E Mass, M.D. #patientsfirst #scrubsnotsuits Profile picture
Dec 19, 2024
Guess who makes a pile of money 💰 marketing United’s Medicare advantage plans?
AARP
1/4🧵 Image
The millions in conflict of interest the AARP has with United healthcare makes it very problematic that AARP has time and again supported PBM kickbacks.
Here is whole article in @GoErie 2/4🧵 goerie.com/story/opinion/…Image
@GoErie These non profits like AARP, often have many people profiting handsomely. 3/4 🧵 Image
Read 4 tweets

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