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A psychiatrist accused of negligence in Maradona's death does not regret the treatment provided

A psychiatrist accused of negligence in Maradona's death does not regret the treatment provided

Washington Post09-05-2025
BUENOS AIRES, Argentina — Psychiatrist Agustina Cosachov, one of the seven healthcare professionals on trial accused of negligence in the death of soccer great Diego Maradona testified on Thursday that she does not regret the treatment she provided to the former national team captain and blamed the private medical company for the deficiencies in his home care.
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A $101,000 knee replacement? Why some hospitals charge far more than others.
A $101,000 knee replacement? Why some hospitals charge far more than others.

Yahoo

time2 hours ago

  • Yahoo

A $101,000 knee replacement? Why some hospitals charge far more than others.

People are usually savvy enough to check whether their hospital or doctor takes their insurance. But it's often a mystery how much a medical procedure or operation will cost, even with coverage. A new report from Trilliant Health, a health care analytics company, shows how much prices for the same medical service can vary at different hospitals and surgery centers. Want a total knee replacement? It can cost as little as $12,870 or as much $101,527. An ankle replacement? An Austin, Texas, hospital charges $22,011 while a New Jersey hospital billed more than $197,000 for the same operation. These wide price swings can leave insured consumers with big bills, loans and medical debt. Using claims data from two major health insurers, Trilliant Health analyzed inpatient and outpatient rates charged by nearly 2,700 hospitals and 3,500 surgery centers. The report found prices can vary as much as nine-fold for the same operation or procedure. And hospital prices within the same state varied more than three-fold, the report said. Trilliant also analyzed 10 hospitals listed on multiple best hospital lists and found no link between higher prices and improved health quality. Allison Oakes, chief research officer for Trilliant Health, said the report aims to inform consumers and employers on health care prices so they can better gauge the value of services they are purchasing. Oakes said health care prices − and the discounted rates negotiated by insurance companies − historically have been a "very well protected industry secret." "The fact that we now have information related to price, we can hopefully begin to rein in our spending," said Oakes. Hospital prices drive health spending higher Research shows such price variation is a key contributor to why health care costs so much more in the United States than any other nation. The U.S. spent $4.9 trillion in health care in 2023 − or $14,570 for every person. Despite spending more than any other nation, U.S. life expectancy is the lowest among large, wealthy nations, according to the Peterson-KFF Health System Tracker. Employers who pay for health insurance for working-age adults historically didn't have prices when deciding which hospitals and surgery centers to include in their workplace insurance plans' networks. Consumers with high-deductible health plans often pay thousands of dollars out of pocket before coverage kicks in. Or they often are charged coinsurance, which requires they pay a percentage of a medical bill. Over the past 25 years, the cost of employer health insurance premiums has nearly tripled the rate of workers pay raises, according to a 2024 study in peer reviewed Health Affairs. A major contributing factor: hospital prices. Under federal price transparency rules adopted earlier this decade, health insurance companies must disclose prices negotiated with hospitals and other health providers. Trilliant's analysis included prices negotiated by two national health insurers: UnitedHealth Group and Aetna. Will price transparency spur competition, lower prices? Researchers not involved in the Trilliant report have analyzed price transparency data and reached similar conclusions about widespread price differences. One study by Johns Hopkins University found prices of X-rays and CT scans varied more than 10-fold nationwide. The study found prices for the same scan in the same hospital nearly tripled based on different plans from the same insurance company, said Ge Bai, a Johns Hopkins University professor of accounting and health policy and management. Bai said the study underscores the lack of competition in health services. "We have a long way to go before we can reach a competitive market for health care prices," Bai said. Rice University's Baker Institute compared prices of three Houston hospitals and found large price differences negotiated by three health insurers: Blue Cross Blue Shield of Texas, United Health and Humana. The biggest price gap: an overnight stay covered by a Humana PPO plan ranged from an average of $17,628 to $57,898 at different Houston-area hospitals. Vivian Ho, a Rice University economist who has studied hospital pricing, said employers can use pricing information to tailor their health insurance offerings to workers. "There is a great deal of opportunity for employers to take this information and start restructuring their benefits," Ho said. A large New York labor union attempted to steer employees away from New York-Presbyterian to other hospitals as part of a cost-savings move. The union, Local 32BJ of the Service Employees International Union, requested the Justice Department investigate New York Presbyterian over claims that anti-competitive behavior kept hospital prices high. The Justice Department has launched an investigation into the high-profile hospital chain and its insurer contracting practices, according to a subpoena reviewed by the New York Times. A New York-Presbyterian spokesperson declined to comment. Another study of Massachusetts health plans that examined the use of tiered pricing that charged consumers higher copays if they chose more expensive hospitals. Consumers could choose copays of $250, $500 or $750, with the higher copays linked to more expensive hospitals. After three years, overall spending dropped by more than 8%, an indication consumers were willing to choose lower-cost copays and hospitals. Ho said the tiered copay approach is easier for consumers to understand health prices − and what steps they can take to lower their costs. "The average consumer doesn't understand the problem," Ho said. Consumers are quick to blame their insurer when health prices rise, Ho said. And while insurers have been scrutinized for practices such as prior authorization and service denials, the main driver of health insurance premiums are hospital charges for both inpatient and outpatient services, Ho said. "The hospitals and the consolidated health care systems are charging very high prices," Ho said. "And there's nothing in your health insurance benefit to stop you from going to the highest-priced providers." Email consumer health reporter Ken Alltucker at alltuck@ This article originally appeared on USA TODAY: A $101,000 knee replacement? Why hospital charges vary so much. Solve the daily Crossword

Over-the-counter birth control pills have been available in the US for over a year. Here's who's using them
Over-the-counter birth control pills have been available in the US for over a year. Here's who's using them

CNN

time7 hours ago

  • CNN

Over-the-counter birth control pills have been available in the US for over a year. Here's who's using them

About two years after the US Food and Drug Administration approved the first over-the-counter birth control pill in the United States, a new study suggests that many people who may not have had access to contraception before are now using the over-the-counter option. More than a quarter – 26.2% – of people now using over-the-counter oral contraceptives were using no modern method of birth control before, according to the study published Monday in the medical journal JAMA Network Open. People relying on the over-the-counter birth control pill, which requires no prescription, are more likely to be uninsured, adolescents and living in rural areas, the study found. Not having health insurance and residing in rural areas are two of the main barriers for people trying to access any health care, said the study's lead author, Dr. Maria Rodriguez, professor of obstetrics and gynecology at Oregon Health & Science University in Portland and director of the OHSU Center for Women's Health. In July 2023, the FDA approved the birth control pill Opill to be available over-the-counter, making it the first nonprescription birth control pill available in the United States. In March 2024, the first shipments of Opill were sent to distributors, major drug stores and pharmacies. The pills became available in many retail pharmacy chains such as CVS, Walgreens and Walmart, costing $19.99 for a one-month supply, $49.99 for a three-month supply and $89.99 for a six-month pack. 'This pill is basically reaching the exact populations that need it the most, people with structural barriers to health care, and people that are at the greatest risk for the harms that come along with unintended pregnancy, in a country where we have a maternal health crisis and access to safe abortion is limited,' Rodriguez said. Rodriguez and her OHSU colleagues surveyed 986 people, ages 15 to 45, using an online questionnaire, asking specifically about their contraceptive use. The study participants were from 49 states, Rodriguez said, and they had obtained some form of oral contraceptive pills at pharmacy stores or online between April 2024 and February 2025. The researchers found that 32.5% of the study participants had used over-the-counter birth control pills. The survey data showed that having access to over-the-counter birth control pills was associated with an increase of 31.8 percentage points in switching to using the over-the-counter pill after using no contraception. 'Giving that choice to people who can become pregnant, to control their own access to contraception, I think is really powerful,' Rodriguez said. 'It's also something that is done around the globe. The US is really delayed in making a form of oral contraception available over the counter. Over 30 countries around the world have had this available for use for many years, and we know that it's safe and effective.' The survey data also revealed that one of the most common reasons why the study participants said they were using the over-the-counter birth control pill was because it did not require a doctor's appointment to get a prescription. 'Not having insurance makes it a lot harder to be able to afford to get into a clinic to get any kind of care that's preventative,' Rodriguez said, adding that people living in rural areas often have limited options for reproductive health care. 'We're seeing that with labor and delivery units closing due to costs, a shrinking of the contraceptive workforce, and then there's the suggestion that we also are seeing some providers leaving states post-Dobbs too, all of which is impacting contraceptive access for people.' The researchers wrote that their study provides a 'first look' at who is using over-the-counter oral contraceptive pills, 'as the method has been available in the US for only approximately a year.' And while the study estimates what the early uptake of over-the-counter birth control pills has been in the past year, more research is needed to assess how that uptake may change over time and what impact it may have on unintended pregnancy rates. Opill was approved by the FDA without age restrictions and is 'suitable for most people of reproductive age to use to prevent pregnancy,' according to its website. Opill works as a 'mini-pill,' using only the hormone progestin to prevent pregnancy. It's a different formulation than what is in combination hormonal birth control pills, which contain both progestin and estrogen. Combined birth control pills may carry risks for people with uncontrolled hypertension or blood clot risks for smokers older than 35. Contraindications for progestin-only pills include conditions such as breast cancer or liver disease, or the use of certain medications. When taken as directed at the same time every day, Opill has been found to be 98% effective at preventing pregnancy, according to Perrigo, the company behind the product. Most birth control pills are up to 99% effective at preventing pregnancy if taken as instructed every day. Last year, when Opill first became available, public health experts anticipated that it would benefit women living in remote rural areas, Dr. Anne-Marie Amies Oelschlager, professor of obstetrics and gynecology at the University of Washington School of Medicine, who specializes in adolescent care, said at the time. 'The biggest population that will benefit from this are those who have limited access to contraception in the first place,' Oelschlager said last year. 'There are a lot of people in our country that live in what we would call contraceptive deserts, and these are areas where they have limited to no access to a reproductive health care provider, meaning they'd have to drive really far away to be able to access a provider.' The more avenues through which people can access contraception – whether it's over the counter in a store or online – the more control they can have over their reproductive health and choices, Megan Kavanaugh, a principal research scientist at the Guttmacher Institute, a nonprofit that has been tracking the rollout of Opill, said last year. 'It's a huge milestone that Opill is available over the counter,' she said last year. 'And I think we should really celebrate the milestone, and we should situate this milestone on this trajectory of always wanting to move towards increased access for all people.'

Over-the-counter birth control pills have been available in the US for over a year. Here's who's using them
Over-the-counter birth control pills have been available in the US for over a year. Here's who's using them

CNN

time8 hours ago

  • CNN

Over-the-counter birth control pills have been available in the US for over a year. Here's who's using them

About two years after the US Food and Drug Administration approved the first over-the-counter birth control pill in the United States, a new study suggests that many people who may not have had access to contraception before are now using the over-the-counter option. More than a quarter – 26.2% – of people now using over-the-counter oral contraceptives were using no modern method of birth control before, according to the study published Monday in the medical journal JAMA Network Open. People relying on the over-the-counter birth control pill, which requires no prescription, are more likely to be uninsured, adolescents and living in rural areas, the study found. Not having health insurance and residing in rural areas are two of the main barriers for people trying to access any health care, said the study's lead author, Dr. Maria Rodriguez, professor of obstetrics and gynecology at Oregon Health & Science University in Portland and director of the OHSU Center for Women's Health. In July 2023, the FDA approved the birth control pill Opill to be available over-the-counter, making it the first nonprescription birth control pill available in the United States. In March 2024, the first shipments of Opill were sent to distributors, major drug stores and pharmacies. The pills became available in many retail pharmacy chains such as CVS, Walgreens and Walmart, costing $19.99 for a one-month supply, $49.99 for a three-month supply and $89.99 for a six-month pack. 'This pill is basically reaching the exact populations that need it the most, people with structural barriers to health care, and people that are at the greatest risk for the harms that come along with unintended pregnancy, in a country where we have a maternal health crisis and access to safe abortion is limited,' Rodriguez said. Rodriguez and her OHSU colleagues surveyed 986 people, ages 15 to 45, using an online questionnaire, asking specifically about their contraceptive use. The study participants were from 49 states, Rodriguez said, and they had obtained some form of oral contraceptive pills at pharmacy stores or online between April 2024 and February 2025. The researchers found that 32.5% of the study participants had used over-the-counter birth control pills. The survey data showed that having access to over-the-counter birth control pills was associated with an increase of 31.8 percentage points in switching to using the over-the-counter pill after using no contraception. 'Giving that choice to people who can become pregnant, to control their own access to contraception, I think is really powerful,' Rodriguez said. 'It's also something that is done around the globe. The US is really delayed in making a form of oral contraception available over the counter. Over 30 countries around the world have had this available for use for many years, and we know that it's safe and effective.' The survey data also revealed that one of the most common reasons why the study participants said they were using the over-the-counter birth control pill was because it did not require a doctor's appointment to get a prescription. 'Not having insurance makes it a lot harder to be able to afford to get into a clinic to get any kind of care that's preventative,' Rodriguez said, adding that people living in rural areas often have limited options for reproductive health care. 'We're seeing that with labor and delivery units closing due to costs, a shrinking of the contraceptive workforce, and then there's the suggestion that we also are seeing some providers leaving states post-Dobbs too, all of which is impacting contraceptive access for people.' The researchers wrote that their study provides a 'first look' at who is using over-the-counter oral contraceptive pills, 'as the method has been available in the US for only approximately a year.' And while the study estimates what the early uptake of over-the-counter birth control pills has been in the past year, more research is needed to assess how that uptake may change over time and what impact it may have on unintended pregnancy rates. Opill was approved by the FDA without age restrictions and is 'suitable for most people of reproductive age to use to prevent pregnancy,' according to its website. Opill works as a 'mini-pill,' using only the hormone progestin to prevent pregnancy. It's a different formulation than what is in combination hormonal birth control pills, which contain both progestin and estrogen. Combined birth control pills may carry risks for people with uncontrolled hypertension or blood clot risks for smokers older than 35. Contraindications for progestin-only pills include conditions such as breast cancer or liver disease, or the use of certain medications. When taken as directed at the same time every day, Opill has been found to be 98% effective at preventing pregnancy, according to Perrigo, the company behind the product. Most birth control pills are up to 99% effective at preventing pregnancy if taken as instructed every day. Last year, when Opill first became available, public health experts anticipated that it would benefit women living in remote rural areas, Dr. Anne-Marie Amies Oelschlager, professor of obstetrics and gynecology at the University of Washington School of Medicine, who specializes in adolescent care, said at the time. 'The biggest population that will benefit from this are those who have limited access to contraception in the first place,' Oelschlager said last year. 'There are a lot of people in our country that live in what we would call contraceptive deserts, and these are areas where they have limited to no access to a reproductive health care provider, meaning they'd have to drive really far away to be able to access a provider.' The more avenues through which people can access contraception – whether it's over the counter in a store or online – the more control they can have over their reproductive health and choices, Megan Kavanaugh, a principal research scientist at the Guttmacher Institute, a nonprofit that has been tracking the rollout of Opill, said last year. 'It's a huge milestone that Opill is available over the counter,' she said last year. 'And I think we should really celebrate the milestone, and we should situate this milestone on this trajectory of always wanting to move towards increased access for all people.'

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