Alejandro Badia, MD

Today, I went to the House floor to shed light on the egregious, profit-driven practices that health insurance companies are using to wreak havoc on American patients. Patients must come first.

@RepGregMurphy The public, Including us clinician, are very grateful I too am puzzled as to why there was not more engagement and a bigger audience Does congress not care about 20% or the US economy ? Book #HealthcareFromTheTrenches

Des and Nurses are underpaid. Independent doctors are getting ripped off to the point of barely getting paid after fees The biggest insurance companies are awful for beneficiaries and for employers. One example ? What good is insurance if patients can't afford their deductible?

@txsportsdoc Joining now. Reposted with great pleasure ! Thanks for doing this. Author #HealthcareFromTheTrenches

If you are an independent physician, we would like to invite you to list your practice on our new website. It’s completely FREE. We want to build a network of independent physicians across the US, where patients can connect with you. The only way we will change healthcare, is if independent physicians start leading. We believe this is the first step. Please share this link and invite your colleagues. 😃 theprivatedocs.com

PLEASE join this group if you are an independent private practice physician. Those who are salaried or directed by private equity should reach out if you decide to join us. #takemedicineback #healthcarerevolution #HealthcareFromTheTrenches

If I tried to make medical decisions about someone I had never evaluated, never spoken with, and barely reviewed records on, I could risk losing my medical license. — article written by Daniel Paull M.D. doctorsonsocialmedia.com/prior-authoriz… via @somedocs

From the article: If insurance companies are confident enough to overrule physicians, then perhaps it is time for them to do what the rest of us in medicine must do. Put their money where their mouth is. — Daniel Paull doctorsonsocialmedia.com/prior-authoriz… via @somedocs Pretty clear concept- why do you think the public can’t even physicians continue to tolerate this?

@DutchRojas Agree, but the challenge remains physician collaboration, which is lacking for many reasons as I discussing chapter 4 of my book #HealthcareFromTheTrenches

There is no law preventing physicians from forming a purchasing cooperative, negotiating vendor contracts collectively, and redistributing the margin back to members. There is only the widespread belief among physicians that someone else will do it, which is a different kind of problem entirely.

Your doctor went to medical school for 12 years. The person denying your claim went through a two-week training module.

@noahkaufmanmd @KaufCare @OrthoNOW Good thinking. You can easily reach me via Dr Badía dot com

@drbadia @KaufCare @OrthoNOW Thanks Alejandro! That’s lame. Partly why I put part of my name on it (and TM). But still… yes your experience and insights could be invaluable.

After 20 years working in emergency departments, I decided to try something different. We're opening a new kind of clinic in Denver called @KaufCare. Advanced urgent care run by board-certified ER physicians. Transparent pricing. No insurance games. Opening in about a month.

@patriotprov2 @Inevitablewest @SMHonk1983 “Mentirita” as many call that beloved cocktail. Soon it will be aptly named….. #freecuba

@Inevitablewest @SMHonk1983 what a time to be alive !

🚨BREAKING: The dictator of Cuba, Miguel Díaz Canel, announces to the nation that they have given in to the pressure and are officially in negotiations with the United States The Cuban regime is about to fall!

They want to save face. Understandable given their unwavering commitment to this farce of a system. For the good of the people, let’s just work with them to find an actual solution. Imagine having lived a lie your entire life. I had family like that and difficult to admit to yourself.

Private equity firms bought 500 hospitals. Death rates in their emergency rooms went up 13%. They fired 12% of the staff. Then they paid themselves billions in dividends. A Harvard study just confirmed what doctors already knew: people are dying so investors can hit quarterly targets. Exactly what happens. A PE firm buys a hospital using debt. The debt gets placed on the hospital's balance sheet, not the firm's. Now the hospital owes hundreds of millions it never borrowed. To service that debt, the hospital cuts costs. Costs mean nurses. The numbers from the Harvard/University of Chicago study are horrifying. After PE acquisition, emergency department salary spending dropped 18.2%. ICU salary spending dropped 15.9%. Hospital-wide employees were cut 11.6%. Emergency department deaths rose 13%, seven additional deaths per 10,000 visits. A separate study found patients undergoing surgery at PE-acquired hospitals had 17% higher odds of dying within 90 days. Steward Health Care, owned by Cerberus Capital, filed bankruptcy with $9 billion in debt after closing hospitals across Massachusetts. The CEO lived on a $40 million yacht while emergency rooms went dark. Eight hospitals serving 2 million people nearly disappeared because a PE fund extracted more cash than the system could survive. The private equity industry has poured over $1 trillion into healthcare. They operate a quarter of ERs nationwide. This isn't going away. The investing angle nobody talks about. Non-PE hospital operators like HCA Healthcare (HCA) and Tenet (THC) are the direct beneficiaries. Every time a PE hospital closes or deteriorates, patients flow to the nearest competitor. HCA has returned 1,200% since 2011. Patient volume from PE closures is a structural tailwind nobody's pricing in. Medical staffing firms (AMN Healthcare, Cross Country) charge premium rates specifically because PE hospitals cut staff. The staffing shortage IS the business model for these companies. The disruption play: outpatient surgical centers (SCA Health, now part of UnitedHealth) are pulling profitable procedures out of hospitals entirely. PE-owned hospitals lose their highest-margin surgeries to outpatient, and the death spiral accelerates. Pull up tradevision and monitor healthcare M&A alerts, hospital closure filings, and patient volume migration data. When a PE-owned hospital announces "restructuring," the patient volume shift to competitors like HCA starts within 30 days. That 30-day window is when the competitor's earnings revisions haven't updated yet. Free to try. (a private equity firm bought your local hospital. borrowed $500 million in the hospital's name. fired 12% of the nurses. emergency room deaths rose 13%. then they paid themselves dividends. nobody went to prison. they're currently buying another hospital.)

@SurgeryCenterOK Waiting to speak to you guys. Nearly the entire ASC community greatly admires what you have done in Oklahoma.

Medicare is a middleman and should be abolished. CMS has no money it did not steal from the working poor and middle class. GKS

@DrLizaMD Society is very fortunate. It’s amazing that so many pray upon our altruism.

Medicine is the only profession where people willingly give up their youth to study for twelve years beyond high school while accumulating interest on $300K worth of student debt, only to be told they’re: 1) Pharma Shills 2) Doing it all wrong 3) Unsafe without supervision from folks with a fraction of the training As thanks, Doctors work nights, weekends & holidays, pay thousands out of pocket for ever increasing “merit badges” like “maintenance of certification”… And still have to ask for permission to prescribe drugs or perform a procedure….from people who aren’t at the bedside. Those bureaucrats also give them 10-15 minutes to spend with each patient, while documenting minutiae that is completely irrelevant to care. They top off the week with uncompensated documentation time so hospitals can make more money off of their work. God forbid they prescribe an opioid… That’s career ending.

@mass_marion We should be calling THEM “providers”. We are only physicians… the irony.

Why do we call these companies ‘insurance companies’? The model of insurance is that you pay a premium and the company covers unanticipated events. Like the cancer your patient still has in her body. Why do we continue to pay these companies large companies that take the premiums and deny necessary care?

@kevinmd Prior Authorizations. A subsection in my book is entitled “authorization is a four letter word.” Thoughts? Book #HealthcareFromTheTrenches

Medicine has changed. Patient care is now buried under prior auths, "pajama time," and unvetted AI. 🤯 We cannot fix physician burnout by blaming the "lazy" younger generation for wanting boundaries, or by funding wellness programs with a $0 budget. It is a system failure. Which of the 5 burdens in this image needs to stop first? Search "The Podcast by KevinMD" on Apple or Spotify. #MedTwitter #KevinMD #PhysicianBurnout #HealthcareReform #StopRushingAI

@DutchRojas Wow, that is an incredible way of looking at it. I would see a psychiatrist for reactive depression if I could only “get an appointment.”

You pay for healthcare seven times. Once through your premium. Once through your deductible. Once through Medicare payroll taxes. Once through Medicaid via state income taxes. Once through local hospital district levies. Once through charity care baked into every negotiated rate. And once through your employer’s “contribution,” which is your compensation, redirected before you see it. After all seven payments, 30 cents of every dollar still goes to administration. Other developed nations average 12%. The money isn’t missing. It’s just going somewhere else.