A Note From Kyle Reyes, Owner of Law Enforcement Today: This editorial was submitted through a friend of LET who has asked to remain anonymous out of fear for their job. It appears that what has been discovered here is nothing short of MASSIVE fraud that was effectively legalized through a loophole, courtesy of the Obama administration. It's a prime example of why health costs are so astronomical and all of us are getting screwed... while big pharma is lining their pockets.
The article is technical... but it's absolutely worth drilling into and exposing.
--
The Affordable Care Act (ACA) introduced the “80/20 rule,” or Medical Loss Ratio (MLR), mandating that insurance companies spend at least 80% of premium revenue on medical care and quality improvement, capping administrative profits at 20%. While intended to curb corporate greed, this regulation inadvertently incentivized the vertical integration of insurers and care providers.
This paper explores the hypothesis that UnitedHealth Group (UHG) utilizes its subsidiary, Optum, to circumvent MLR caps through transfer pricing, charging its own insurance arm (UnitedHealthcare) above-market rates for services. This mechanism artificially inflates “medical costs,” creating a loop where the parent company profits from the very high costs it is supposed to manage, ultimately burdening the American consumer.
The U.S. healthcare system is often debated in terms of policy and...
MADISON, Wis. (Gray) - The U.S. Department of Homeland Security and the Dodge County Sheriff’s Office are denying claims made by a 28-year-old U.S. citizen who says she was detained at Chicago O’H...