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    Young Americans Can’t Keep Funding Boomers and Beyond

    You know the expression “OK, Boomer”? Better said as “Boomer OK.” That’s because the social safety net in the United States is increasingly favoring the old over the young. And this affects our political views and the security of future generations.Younger Americans have valid reason for disgruntlement: Big shifts in income and wealth are dramatically favoring their elders. Under almost every president since 1980, 80 percent of the real growth in domestic spending has gone to Social Security and health care, with Medicare the most expensive health program, according to calculations based on federal data. As a share of GDP, all other domestic outlays combined have declined.Our current tax system also largely does not help Americans, most of whom are younger, pay for their higher education. That wasn’t as big a deal in the 1960s or 1970s, when the average college graduate most likely had little or no student debt. Today, the average taken out each year is about seven times that in 1971, in part because state governments have stripped colleges and universities of funding. This is happening at a time when owning a house is increasingly out of reach. The median price has risen from about 3.5 times median annual income in 1984 to 5.8 times in 2022.So it shouldn’t come as a surprise that today, younger generations are more likely to fall into lower-income classes than their parents or grandparents. Nearly a half century ago, it was the reverse. And in 1989, the median net worth of Americans aged 35 to 44 was nearly 75 percent of those aged 65 to 74. By 2022, that ratio had fallen to one-third.The why is simple. Unlike most other spending, Congress effectively designed Medicare in 1965 and Social Security in the 1970s in such a way that outlays would increase forever faster than our national income. That’s partly because Medicare costs keep rising along with medical prices and new treatments and because Social Security benefits are designed to increase for each new generation along with inflation and wages. And we’re living longer, which means more years of benefits.Today, tax revenues are so committed to mandatory spending, largely for older Americans, and to interest on the national debt (which has quadrupled as a share of G.D.P. since 1980) that few revenues are left for everything else. So, unless we borrow to pay for it, there’s little for education, infrastructure, environment, affordable housing, reducing poverty, or the military.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Trump propuso que la fertilización in vitro fuera gratuita. ¿Es posible?

    Conseguir que se cubran los costosos tratamientos de fertilidad sería algo que no puede hacer un presidente solo, dijeron los expertos en políticas de salud.[Estamos en WhatsApp. Empieza a seguirnos ahora]El expresidente Donald Trump dijo el jueves en campaña que quiere que el tratamiento de fertilización in vitro (FIV) sea gratuito para todos los estadounidenses.“Bajo un gobierno de Trump, tu gobierno pagará o tu compañía de seguros estará obligada a pagar todos los costos asociados con el tratamiento de fertilización in vitro”, dijo Trump el jueves en un mitin en Potterville, Míchigan.La fecundación in vitro suele costar decenas de miles de dólares. Las políticas para cubrir esos costos serían difíciles de implementar, dijeron los expertos.Exigir a las aseguradoras que paguen estos procedimientos probablemente significaría aprobar leyes en el Congreso o persuadir a un panel de expertos para que añadan la FIV a una lista de servicios preventivos gratuitos de salud femenina establecidos por la Ley de Asistencia Asequible, la ley de cobertura de salud que Trump trató de derogar.Si el gobierno pagara directamente la FIV, se crearía un sistema de pagador único para una sola condición. El enfoque requeriría que el Congreso financie una nueva división del gobierno federal para supervisar el programa.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Congress Presses Health Insurance Regulators on ‘Troubling’ Billing Tactics

    Lawmakers are zeroing in on MultiPlan, a firm that has helped insurers cut payments while sometimes leaving patients with large bills.Lawmakers on Tuesday called on health insurance regulators to detail their efforts against “troubling practices” that have raised costs for patients and employers.In a letter to a top Labor Department official, two congressmen cited a New York Times investigation of MultiPlan, a data firm that works with insurance companies to recommend payments for medical care.The firm and the insurers can collect higher fees when payments to medical providers are lower, but patients can be stuck with large bills, the investigation found. At the same time, employers can be charged high fees — in some cases paying insurers and MultiPlan more for processing a claim than the doctor gets for treating the patient.The lawmakers, Representatives Bobby Scott of Virginia and Mark DeSaulnier of California, both Democrats in leadership positions on a House committee overseeing employer-based insurance, highlighted MultiPlan as an example of “opaque fee structures and alleged self-dealing” that drive up health care costs. In their letter, they pressed the department for details on its efforts to enforce rules meant to promote transparency and expose conflicts of interest.MultiPlan’s business model focuses on the most common way Americans get health coverage: through an employer that “self-funds,” meaning it pays medical claims with its own money and uses an insurance company to process claims. Insurers such as Aetna, Cigna and UnitedHealthcare have pitched MultiPlan’s services as a way to save money when an employee sees a provider out of network.In many cases, MultiPlan uses an algorithm-based tool to generate a recommended payment. Employers typically pay insurers and MultiPlan a percentage of what they call the “savings” — the difference between the recommendation and the original bill.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    2026 Prices for Drugs That Are Subject to Negotiations

    The prices were made possible by the Inflation Reduction Act, which granted the health secretary the authority to negotiate on behalf of Medicare.The Biden administration on Thursday announced the results of negotiations between Medicare and pharmaceutical companies over the prices of 10 costly or common medications. The new prices, which will take effect in 2026, are the maximum Medicare Part D plans and patients will pay for a one-month supply.1. Eliquis, for preventing strokes and blood clots, from Bristol Myers Squibb and Pfizer, $2312. Jardiance, for diabetes and heart failure, from Boehringer Ingelheim and Eli Lilly, $1973. Xarelto, for preventing strokes and blood clots, from Johnson & Johnson, $1974. Januvia, for diabetes, from Merck, $1135. Farxiga, for diabetes, heart failure and chronic kidney disease, from AstraZeneca $1786. Entresto, for heart failure, from Novartis, $2957. Enbrel, for autoimmune conditions, from Amgen, $2,3558. Imbruvica, for blood cancers, from AbbVie and Johnson & Johnson, $9,3199. Stelara, for autoimmune conditions, from Johnson & Johnson, $4,69510. Fiasp and NovoLog insulin products, for diabetes, from Novo Nordisk, $119 More

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    Antisemitism on Campuses, Ivy and Beyond

    More from our inbox:A Middleman’s Role in Drug PrescriptionsObjection, Your HonorTrump vs. the Environment Alex Welsh for The New York TimesTo the Editor:Re “Should American Jews Abandon Elite Universities?,” by Bret Stephens (column, June 26):Mr. Stephens has issued a sobering and well-documented indictment of antisemitism on elite campuses. The question asked by the headline is timely and troubling for many Jewish high school students and their families.As noted by Mr. Stephens, confused administrators and revisionist curriculums contributed to this crisis. But the insensitivity and hypocrisy of supposedly idealistic and enlightened college students may be the most striking and unkind cut of all.“Safe spaces” and rules against “microaggressions” have become commonplace on campuses. Yet when Jewish students made it known that calling for deadly attacks on Jews (“Globalize the intifada!”) is offensive and intimidating, they were ignored.Chants in favor of colonization or racism would never — and should never — be met with such indifference. It hurts.Perhaps the headline of Mr. Stephens’s column should be rephrased: “Have Elite Universities Abandoned American Jews?”Alan M. SchwartzTeaneck, N.J.To the Editor:While the Ivies have claimed the antisemitism spotlight this year, Jew-hatred is flourishing on many other campuses, including mine, the University of California, Davis.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Your Hologram Doctor Will See You Now

    A Texas hospital is experimenting with hologram technology for doctors to see patients. Some health care experts wonder if it’s beneficial.A patient walks into a hospital room, sits down and starts talking to a doctor. Only in this case, the doctor is a hologram.It might sound like science fiction, but it is the reality for some patients at Crescent Regional Hospital in Lancaster, Texas.In May, the hospital group began offering patients the ability to see their doctor remotely as a hologram through a partnership with Holoconnects, a digital technology firm based in the Netherlands.Each Holobox — the company’s name for its 440-pound, 7-foot-tall device that displays on a screen a highly realistic, 3-D live video of a person — costs $42,000, with an additional annual service fee of $1,900.The high-quality image gives the patient the feeling that a doctor is sitting inside the box, when in reality the doctor is miles away looking into cameras and displays showing the patient.The system allows the patient and doctor to have a telehealth visit in real time that feels more like an in-person conversation. For now, the service is used mostly for pre- and postoperative visits.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Women Are Paying for Birth Control When They Shouldn’t Have To

    Senator Bernie Sanders of Vermont has called on a government watchdog to investigate. Here’s what you need to know.Last week, Senator Bernie Sanders of Vermont, chair of the Senate health committee, called on a government watchdog to investigate why insurance companies are still charging women for birth control — a move that thrust access to contraceptives back into the spotlight.In a letter to the Government Accountability Office, the senator noted that insurance companies were charging Americans for contraceptives that, under federal law, should be free — and that they were also denying appeals from consumers who were seeking to have their contraceptives covered. Some experts estimate that those practices could affect access to birth control for millions of women.Since 2012, the Affordable Care Act has mandated that private insurance plans cover the “full range” of contraceptives for women approved by the Food and Drug Administration, including female sterilizations, emergency contraceptives and any new products cleared by the F.D.A. The mandate also covers services associated with contraceptives, like counseling, insertions or removals and follow-up care.That means that consumers shouldn’t have any associated co-payments with in-network providers, even if they haven’t met their deductibles. Some plans might cover only generic versions of certain contraceptives, but patients are still entitled to coverage of a specific product that their providers deem medically necessary. Medicaid plans have a similar provision; the only exception to the mandate are plans sponsored by employers or colleges that have religious or moral objections.Yet many insurers are still charging for contraceptives — some in the form of co-payments, others by denying coverage altogether.A Quarter of Women Are Paying Unnecessarily for Contraceptives In his letter, Senator Sanders cited a recent survey by KFF, a nonprofit health policy research organization, that found that roughly 25 percent of women with private insurance plans said they had paid at least some part of the cost of their birth control; 16 percent reported that their insurance plans had offered partial coverage, and 6 percent noted that their plans did not cover contraceptives at all. Additionally, a 2022 congressional investigation, which analyzed 68 health plans, found that the process to apply for exceptions and have contraceptives covered was “burdensome” for consumers and that insurance companies denied, on average, at least 40 percent of exception requests.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Some States Say They Can’t Afford Ozempic and Other Weight Loss Drugs

    Public employees in West Virginia who took the drugs lost weight and were healthier, and some are despondent that the state is canceling a program to help pay for them.Joanna Bailey, a family physician and obesity specialist, doesn’t want to tell her patients that they can’t take Wegovy, but she has gotten used to it.Around a quarter of the people she sees in her small clinic in Wyoming County would benefit from the weight-loss medications known as GLP-1s, which also include Ozempic, Zepbound and Mounjaro, she says. The drugs have helped some of them lose 15 to 20 percent of their weight. But most people in the area she serves don’t have insurance that covers the cost, and virtually no one can afford sticker prices of $1,000 to $1,400 a month.“Even my richest patients can’t afford it,” Dr. Bailey said. She then mentioned something that many doctors in West Virginia — among the poorest states in the country, with the highest prevalence of obesity, at 41 percent — say: “We’ve separated between the haves and the have-nots.”Such disparities sharpened in March when West Virginia’s Public Employees Insurance Agency, which pays most of the cost of prescription drugs for more than 75,000 teachers, municipal workers and other public employees and their families, canceled a pilot program to cover weight-loss drugs.Some private insurers help pay for medications to treat obesity, but most Medicaid programs do so only to manage diabetes, and Medicare covers Wegovy and Zepbound only when they are prescribed for heart problems.Over the past year, states have been trying, amid rising demand, to determine how far to extend coverage for public employees. Connecticut is on track to spend more than $35 million this year through a limited weight-loss coverage initiative. In January, North Carolina announced that it would stop paying for weight-loss medications after forking out $100 million for them in 2023 — 10 percent of its spending on prescription drugs.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More