CVS says it can’t make enough money covering a million Americans — just as it celebrates nearly $2 billion in quarterly profits and doubles down on high-dollar weight-loss drugs.
MKBroker you speak like a broker. Cold and calculating. The medical economy is not just about profit and loss.
Your “flawed premise” is that health care should generate profit the way other corporate sectors generate profit. The flawed premise is that free market capitalism can fix the problem of health care access in this country.
If 1.8 billion quarterly is not satisfactory profit for private enterprise, then we need to nationalize.
When things fall apart after they gut Medicaid we will have to pick up the pieces as a Nation.
Mark my words: all the INSCOs will get out of health care when it is no longer profitable to the degree the shareholders deem adequate.
I suppose you could consider me cold. I am certainly pragmatic. I do have 1k+ clients in this market depending on me to help guide them to the best coverage available now. I'm not going to be particularly helpful if I spend all day focused on structural problems with US health insurance. That doesn't mean that I don't agree with you though. We should move to a system not dependent on profit (be it Medicare for all; single payer, etc), but until we're there, there are real people who need help today and can't wait for big systemic change. We're all stuck in the same system for now and that system is capitalistic centered around profit and loss. You're making a broader argument that the system needs to change, but that's not the primary message in this article.
The article insinuates that Aetna leaving the individual market is a negative thing. My comment below describes why I don't believe that's the case with our current system. I'm glad Aetna is being driven from the individual market; carriers that offer subpar products should fail. Until we transition to a new system, I am sure you and I agree that we both want what's best for consumers. In this case, Aetna leaving the market is a good thing for consumers.
I want the INSCOs like Aetna/BCBS/Cigna/Humana and United to be held accountable to their subscribers, and to the US government.
Aetna leaving the market makes the market tighter, and will make getting insurance more expensive and more difficult to find. Some markets, in fact, may not have any ACA plans offered at all.
They may be consumers to you, but they are patients to me.
They are clients and friends to me. I care for them deeply and I also want what's best for them. If you are insinuating otherwise, you are mistaken.
"Some markets, in fact, may not have any ACA plans offered at all." Can you name a single rating area across the USA where Aetna is the only carrier? I expect not. Carriers coming and going from the market is a normal occurrence. We lost Ascension under Biden in Indiana, for example. We have lost IU health plans, Humana, PHP, UHC (left and returned), Anthem (functionally departed and returned) and MDwise since the start of the ACA as well. Some carriers can't make it work while others, like CareSource and Ambetter have found some success and stayed with the individual market over the years. You can see yourself here: https://www.in.gov/idoi/compliance-rates-and-forms/indiana-aca-filings/
In this case, I want carriers that offer subpar products to fail in order to incentivize others to offer better options. Aetna offered a poor product at an uncompetitive price and they rightfully failed. None of the options under the current system are ideal, but clearly some companies and plans are better than others. I want the better ones to succeed until we can see larger system change.
I am grounded in the current reality. Your patients deserve the best treatment you can provide now under the current system. We can all hope for a better future, but we have to work with what we have now for people with current needs.
Kenneth Arrow covered all of this in 1963. Over half of the US has socialized care, but by a different name (Medicare, Medicaid, Tricare, the VA system, CHIP, “bad debt,” insurance for public servants, and charity care). The system presents itself publicly as a free capitalist market, but it’s not. This erodes trust, and it is a very crap way of building a healthcare sector, so we are living in a perceived state of policy paralysis. Honestly though, once we accept that people in the US aren’t ever going accept socialized healthcare unless you give them that chewable vitamin and call it candy, we are and have been on a very good track towards achieving the triple AIM. My little one in 10, and her generation is already more indoctrinated into prevention than any generation that came before her, and I have no doubt that it won’t take but one more generation for that shift to be complete.
Right leaning or left leaning, nearly everybody I talk to on Medicare loves Medicare. It seemed to me like lowering the age from 65 to 55 would both help significantly reduce rates on the individual and group market while making a lot of folks in that age range very happy. It could also be a means to move towards medicare for all or for a universal single payer system. You're right though that I would want it done in a way that wouldn't harm the current Medicare enrollees either.
This news is abominable. Once again we need Medicare for All, and dump all of these private insurance companies. Health care is a obligation of the United States Government to take care of its citizenry, and the first rule is that the Government sets the costs, and these profiteering companies have to deal with it or get out like Aetna is doing, leaving a million or more people scrambling to get health care in this allegedly richest country in the world that let's its People go bankrupt because skyrocketing costs (short-term profits) are the only goal of these companies; it is certainly not the health and care of patients. It is high time the US Congress and especially the Senate pull the plug on Medicare Advantage privatized policies and start to live up to the goals that are the contract with the American People. We are an embarrassment to the rest of the World as far as a so-called Super Power that cannot even manage to bring down medical and pharmacy costs will sucking on the teats of the Health Insurance and Big Pharmaceutical lobbies. We have become a 4th World country and that is unconscionable. It's clear that this Administration by its selection of a lousy Health Secretary who has profited from his anti-vaccine stance that health care in practice is not considered part of the overall National Security of this country, but subsidizing our bloated defense budget is the only hold on power that we have left, since Trump seeks to over turn democracy. What a shame of a Nation we have become.
Agreed. Only happy to see residents of all states getting screwed, the way Floridians have for decades. Just allowing a broken immigration system to destroy , overwhelm and cheapen health care system to a 3rd world level or worse. SRSLY . I am a victim of this and even I WANT HEALTHCARE FOR ALL. These ppl deserve decent care too !
It’s odd to me that people stand by idle while big healthcare continues to buy local provider groups and strip care to the core. Example - United and Optum. But, do doctors really need to make millions per year in private practice? Let’s be honest, the greed isn’t just with the big corporations.
1 also shared that when he needed xray for one elbow, had to wait 2 1/2 hrs, in Urgent care .....and HE IS A SURGEON at that hospital. So , he gets it too but powerless to take on the Behemoth System of Evil , profits over patients always.
Prime example of how the American system of health insurance is fundamentally broken. We need Medicare for All and to put these behemoths out of business. People’s health and survival should not depend on factors like market share or how much these insurance companies can bilk out of the consumer.
Regardless of the possibility that the business practices are valid, it appears that this article points out an alarming trend in what's happening in healthcare overall.
The premise of this article is flawed: Aetna should have no expectation to maintain unprofitable lines of business nor should we want them to.
In Indianapolis, for example, Aetna rolled out a poor uncompetitive product in 2024 that utilized a Franciscan health centered network, which is a fringe medical group with only one major hospital far from the center of the city. Their premiums were at or above more competitive carriers who offered more broad provider networks. Consequently and unsurprisingly, they never gained significant market share here and now they are on their way out.
This is a good thing. We want carriers offering poor products with narrow provider networks to fail. It sends a message to other carriers to expand their provider networks and improve their product offerings or they may face a similar fate as Aetna and the narrow networked Ascension plan that departed the Indiana market in 2024.
The relatively few insureds with Aetna now will have the opportunity to change to an alternative carrier in 2026. They're not losing coverage or being thrown into chaos like the article insinuates. I appreciate the content, but I wish the authors could step back and return to more fact based, measured, earnest, less sensationalized coverage. The truth is scary enough.
Getting rid of Aetna, and United Healthcare's profiteering motives is desirable since we should properly fund and manage both the ACA and Medicare strictly in accordance with the Government's obligations to the American People. Enough coddling with Big Capitalist Businesses that merely exploit Americans as commodities, not as loyal and valuable customers.
Years ago (2002)I tried using CVS. I Heard to tell you a leopard doesn’t change its spots. They were awful back then and just showed me who they really are! The scum of the earth.
Since apparently every other developed country in the world has universal healthcare, and 23 emerging nations too, we don’t have to reinvent the wheel.
Missing from this cause-and-effect analysis is the likely cause.
Aetna is lead defendant, ahead of UNH and Humana, in an ex rel action taken over by DOJ on May 1st, after sitting idle 4 years. Alleged: That Aetna, Humana and UNH paid hundreds of millions in kickbacks to brokers who promised not to market a Medicare Advantage plan built for disabled seniors. Net result: Aetna is in a desperate struggle to 1) survive and 2) get the lawsuit dropped. Which, conceivably, they might accomplish by exiting the ACA markets and hoping someone in Congress can find a way to make that kickbacks-for-discrimination sound less ugly than it is. I see it as a blindfolded full-court throw that will probably drop in the bleachers instead of scoring 3 points
Why should a corporation whose obligation is to its shareholders be expected to stay in unprofitable business lines and not optimize its profits through vertical integration? This is capitalism. But employers and consumers have the power to create change. I was CFO of a 100 employee company, self-insured with CVS. As I dug into our plan costs, it became clear that all parts of the CVS machine are profit centers for CVS. CVS’s profits from its PBM, TPA, pharmacies = cost to the company and our employees above and beyond the cost of care. When I realized what was happening, I fired CVS and moved to an independent PBM, TPA and network. What happened? Our costs went down! The best illustration of this - when we were on CVS’s plans, a month of insulin cost $600 through CVS mail order pharmacy. With the independent PBM we moved to, a month of insulin cost $11 picking up from a CVS pharmacy. More than $500 of additional profit to CVS, $500 of additional cost to our company and employee. Wake up employers! Stop spending your company’s and employees’ money on big insurance carrier profits! There are other options - independent PBMs and TPAs outside of the BUCAHs (capitalism, once again, is the fix as new players have stepped in to compete with the large carriers). If our 100-employee company can do it, so can you!
Reality check. For everyone that's still calling for "medicare for all" in the US. For the developed counties in Europe (that are democracy's) the average tax rate that the citizens of these countries pay is 50% of their income in order to finance their Universal Healthcare systems. You think that Americans across the board are willing to pay 50 cents on the dollar of every dollar that they earn to pay for the irretrievably broken healthcare system in the US ? I don't think so.
The healthcare system in the US is so badly broken, everyone that has experienced the healthcare system in the US that is intelligent and honest and that tells the truth knows that. And it's rotten and falling apart from the inside out. 20% of the US GDP goes towards healthcare. That's absurd for something that's so broken and that does not serve it's citizens to the level that it should.
When will we learn - healthcare shouldn’t be done for profit. Corporations are heartless and care about profit and appeasing shareholders. Healthcare is human and should focus on the human under the guidance of doctors. Not algorithms
MKBroker you speak like a broker. Cold and calculating. The medical economy is not just about profit and loss.
Your “flawed premise” is that health care should generate profit the way other corporate sectors generate profit. The flawed premise is that free market capitalism can fix the problem of health care access in this country.
If 1.8 billion quarterly is not satisfactory profit for private enterprise, then we need to nationalize.
When things fall apart after they gut Medicaid we will have to pick up the pieces as a Nation.
Mark my words: all the INSCOs will get out of health care when it is no longer profitable to the degree the shareholders deem adequate.
We the people will be left holding the bag.
I suppose you could consider me cold. I am certainly pragmatic. I do have 1k+ clients in this market depending on me to help guide them to the best coverage available now. I'm not going to be particularly helpful if I spend all day focused on structural problems with US health insurance. That doesn't mean that I don't agree with you though. We should move to a system not dependent on profit (be it Medicare for all; single payer, etc), but until we're there, there are real people who need help today and can't wait for big systemic change. We're all stuck in the same system for now and that system is capitalistic centered around profit and loss. You're making a broader argument that the system needs to change, but that's not the primary message in this article.
The article insinuates that Aetna leaving the individual market is a negative thing. My comment below describes why I don't believe that's the case with our current system. I'm glad Aetna is being driven from the individual market; carriers that offer subpar products should fail. Until we transition to a new system, I am sure you and I agree that we both want what's best for consumers. In this case, Aetna leaving the market is a good thing for consumers.
I want what’s best for my patients.
I want the INSCOs like Aetna/BCBS/Cigna/Humana and United to be held accountable to their subscribers, and to the US government.
Aetna leaving the market makes the market tighter, and will make getting insurance more expensive and more difficult to find. Some markets, in fact, may not have any ACA plans offered at all.
They may be consumers to you, but they are patients to me.
They are clients and friends to me. I care for them deeply and I also want what's best for them. If you are insinuating otherwise, you are mistaken.
"Some markets, in fact, may not have any ACA plans offered at all." Can you name a single rating area across the USA where Aetna is the only carrier? I expect not. Carriers coming and going from the market is a normal occurrence. We lost Ascension under Biden in Indiana, for example. We have lost IU health plans, Humana, PHP, UHC (left and returned), Anthem (functionally departed and returned) and MDwise since the start of the ACA as well. Some carriers can't make it work while others, like CareSource and Ambetter have found some success and stayed with the individual market over the years. You can see yourself here: https://www.in.gov/idoi/compliance-rates-and-forms/indiana-aca-filings/
In this case, I want carriers that offer subpar products to fail in order to incentivize others to offer better options. Aetna offered a poor product at an uncompetitive price and they rightfully failed. None of the options under the current system are ideal, but clearly some companies and plans are better than others. I want the better ones to succeed until we can see larger system change.
I am grounded in the current reality. Your patients deserve the best treatment you can provide now under the current system. We can all hope for a better future, but we have to work with what we have now for people with current needs.
There are many other ways to make a buck than preying on poor, sick and suffering living things.
Agreed. Medicare for all or some sort of single payer/universal healthcare reform is urgently needed.
Kenneth Arrow covered all of this in 1963. Over half of the US has socialized care, but by a different name (Medicare, Medicaid, Tricare, the VA system, CHIP, “bad debt,” insurance for public servants, and charity care). The system presents itself publicly as a free capitalist market, but it’s not. This erodes trust, and it is a very crap way of building a healthcare sector, so we are living in a perceived state of policy paralysis. Honestly though, once we accept that people in the US aren’t ever going accept socialized healthcare unless you give them that chewable vitamin and call it candy, we are and have been on a very good track towards achieving the triple AIM. My little one in 10, and her generation is already more indoctrinated into prevention than any generation that came before her, and I have no doubt that it won’t take but one more generation for that shift to be complete.
If Medicare for all doesn’t crush Medicare for those using it now . It’s not exactly cheap to have but it’s good coverage .
I’ve been on Medicare for more then 20 years and counting all I pay for healthcare It’s about $900 per month!
They need to cover dental .
Keep in mind the amount I pay covers everything .
Right leaning or left leaning, nearly everybody I talk to on Medicare loves Medicare. It seemed to me like lowering the age from 65 to 55 would both help significantly reduce rates on the individual and group market while making a lot of folks in that age range very happy. It could also be a means to move towards medicare for all or for a universal single payer system. You're right though that I would want it done in a way that wouldn't harm the current Medicare enrollees either.
More like your article shows how broken the system is.
Aetna was never a premium healthcare provider. You are telling it like it is.
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This news is abominable. Once again we need Medicare for All, and dump all of these private insurance companies. Health care is a obligation of the United States Government to take care of its citizenry, and the first rule is that the Government sets the costs, and these profiteering companies have to deal with it or get out like Aetna is doing, leaving a million or more people scrambling to get health care in this allegedly richest country in the world that let's its People go bankrupt because skyrocketing costs (short-term profits) are the only goal of these companies; it is certainly not the health and care of patients. It is high time the US Congress and especially the Senate pull the plug on Medicare Advantage privatized policies and start to live up to the goals that are the contract with the American People. We are an embarrassment to the rest of the World as far as a so-called Super Power that cannot even manage to bring down medical and pharmacy costs will sucking on the teats of the Health Insurance and Big Pharmaceutical lobbies. We have become a 4th World country and that is unconscionable. It's clear that this Administration by its selection of a lousy Health Secretary who has profited from his anti-vaccine stance that health care in practice is not considered part of the overall National Security of this country, but subsidizing our bloated defense budget is the only hold on power that we have left, since Trump seeks to over turn democracy. What a shame of a Nation we have become.
Absolutely not.
Definitely need to break up big Healthcare and Big Pharma, though.
PBMs are the hidden scumbags . Serve NO INTENDED PURPOSE , and oppositely drive prices ever upward. They profit off percentages. SO WRONG .
Can’t argue with that one. Another one reason to break these guys up.
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Agreed. Only happy to see residents of all states getting screwed, the way Floridians have for decades. Just allowing a broken immigration system to destroy , overwhelm and cheapen health care system to a 3rd world level or worse. SRSLY . I am a victim of this and even I WANT HEALTHCARE FOR ALL. These ppl deserve decent care too !
It’s odd to me that people stand by idle while big healthcare continues to buy local provider groups and strip care to the core. Example - United and Optum. But, do doctors really need to make millions per year in private practice? Let’s be honest, the greed isn’t just with the big corporations.
I have listened to several Interv.Radiologists , complain they get less and less have huge malpractice premiums , ….., and hope to retire by 40 .
Retire by 40? Wow 🤯
1 also shared that when he needed xray for one elbow, had to wait 2 1/2 hrs, in Urgent care .....and HE IS A SURGEON at that hospital. So , he gets it too but powerless to take on the Behemoth System of Evil , profits over patients always.
Sure, create lack of supply and drive up the price. Reason 3 to break them up.
Prime example of how the American system of health insurance is fundamentally broken. We need Medicare for All and to put these behemoths out of business. People’s health and survival should not depend on factors like market share or how much these insurance companies can bilk out of the consumer.
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Regardless of the possibility that the business practices are valid, it appears that this article points out an alarming trend in what's happening in healthcare overall.
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What part of “for-profit” do we not understand?
Maybe it’s time to _mandate_ a return to non-profit insurance just as long ago insurance began.
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The premise of this article is flawed: Aetna should have no expectation to maintain unprofitable lines of business nor should we want them to.
In Indianapolis, for example, Aetna rolled out a poor uncompetitive product in 2024 that utilized a Franciscan health centered network, which is a fringe medical group with only one major hospital far from the center of the city. Their premiums were at or above more competitive carriers who offered more broad provider networks. Consequently and unsurprisingly, they never gained significant market share here and now they are on their way out.
This is a good thing. We want carriers offering poor products with narrow provider networks to fail. It sends a message to other carriers to expand their provider networks and improve their product offerings or they may face a similar fate as Aetna and the narrow networked Ascension plan that departed the Indiana market in 2024.
The relatively few insureds with Aetna now will have the opportunity to change to an alternative carrier in 2026. They're not losing coverage or being thrown into chaos like the article insinuates. I appreciate the content, but I wish the authors could step back and return to more fact based, measured, earnest, less sensationalized coverage. The truth is scary enough.
Getting rid of Aetna, and United Healthcare's profiteering motives is desirable since we should properly fund and manage both the ACA and Medicare strictly in accordance with the Government's obligations to the American People. Enough coddling with Big Capitalist Businesses that merely exploit Americans as commodities, not as loyal and valuable customers.
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Then, BOYCOTT
Years ago (2002)I tried using CVS. I Heard to tell you a leopard doesn’t change its spots. They were awful back then and just showed me who they really are! The scum of the earth.
Since apparently every other developed country in the world has universal healthcare, and 23 emerging nations too, we don’t have to reinvent the wheel.
Just copy the decent countries.
Wow. Greed is gonna greed.
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the MAGAs are here!
Everything isn’t MAGA. Grow up.
No, some is MCGA! C for corporations😆
Same concept, think deeper.
New CEO Joyner, plenty of personal private equity experience.
CVS Donations to far right agenda: https://www.golocalprov.com/news/CVS-Under-Fire-For-Right-Wing-Political-Donations
Private equity firm Glenview gets board seat on CVS.
You can see this train wreck coming.
Missing from this cause-and-effect analysis is the likely cause.
Aetna is lead defendant, ahead of UNH and Humana, in an ex rel action taken over by DOJ on May 1st, after sitting idle 4 years. Alleged: That Aetna, Humana and UNH paid hundreds of millions in kickbacks to brokers who promised not to market a Medicare Advantage plan built for disabled seniors. Net result: Aetna is in a desperate struggle to 1) survive and 2) get the lawsuit dropped. Which, conceivably, they might accomplish by exiting the ACA markets and hoping someone in Congress can find a way to make that kickbacks-for-discrimination sound less ugly than it is. I see it as a blindfolded full-court throw that will probably drop in the bleachers instead of scoring 3 points
Why should a corporation whose obligation is to its shareholders be expected to stay in unprofitable business lines and not optimize its profits through vertical integration? This is capitalism. But employers and consumers have the power to create change. I was CFO of a 100 employee company, self-insured with CVS. As I dug into our plan costs, it became clear that all parts of the CVS machine are profit centers for CVS. CVS’s profits from its PBM, TPA, pharmacies = cost to the company and our employees above and beyond the cost of care. When I realized what was happening, I fired CVS and moved to an independent PBM, TPA and network. What happened? Our costs went down! The best illustration of this - when we were on CVS’s plans, a month of insulin cost $600 through CVS mail order pharmacy. With the independent PBM we moved to, a month of insulin cost $11 picking up from a CVS pharmacy. More than $500 of additional profit to CVS, $500 of additional cost to our company and employee. Wake up employers! Stop spending your company’s and employees’ money on big insurance carrier profits! There are other options - independent PBMs and TPAs outside of the BUCAHs (capitalism, once again, is the fix as new players have stepped in to compete with the large carriers). If our 100-employee company can do it, so can you!
Reality check. For everyone that's still calling for "medicare for all" in the US. For the developed counties in Europe (that are democracy's) the average tax rate that the citizens of these countries pay is 50% of their income in order to finance their Universal Healthcare systems. You think that Americans across the board are willing to pay 50 cents on the dollar of every dollar that they earn to pay for the irretrievably broken healthcare system in the US ? I don't think so.
The healthcare system in the US is so badly broken, everyone that has experienced the healthcare system in the US that is intelligent and honest and that tells the truth knows that. And it's rotten and falling apart from the inside out. 20% of the US GDP goes towards healthcare. That's absurd for something that's so broken and that does not serve it's citizens to the level that it should.
When will we learn - healthcare shouldn’t be done for profit. Corporations are heartless and care about profit and appeasing shareholders. Healthcare is human and should focus on the human under the guidance of doctors. Not algorithms