Pt2: A Treatise on the American Medical System in Three Parts

Part Two: Numbers and Names

Unitedhealth, Wellpoint, Kaiser, Aetna, Humana, Blue Shield, Cigna

Pfizer, Novartis, Sanofi-Aventis, Merck, GlaxoSmithKline, Roche,

AstraZeneca, Johnson&Johnson, Abbott Laboratories, Lilly

Hospital Corporation of America, Richard Bracken

Community Health Systems, Wayne Smith

LifePoint Hospitals, William F. Carpenter

Tenet Healthcare Corp., Trevor Fettor

Vanguard Health System, Charles Martin

Flowers Hospital, Dothan Alabama 53% operating margin

Del Sol Medical Center, El Paso Texas, 45% operating margin

Rochester Methodist, Rochester Minnesota, 37% operating margin

Saint Luke’s Hospital, Cedar Rapids Iowa, 36% operating margin

Names heard or not, hear the list of criminals and tyrant-cops

Drug pushers, medical device manufacturers, insurers, medial systems and hospital administrations

Billions whoop-whoop, why is granny’s hip a hundred grand-larceny?

A week in the hospital more than her house; American flag waving veteran’s widow down and out

Is there any doubt? Read the headlines of the internet that matter to the gang-land with my notes in italics.

 Pfizer reports Full-Year Revenues of $59.0 Billion in 2012.  2013,Pfizer, whose shares fell 3.6 percent in afternoon trading, earned $2.75 billion, or 38 cents per share in the quarter. "It was just a lousy quarter, relative to the company's potential and earnings power," said Michael Liss, portfolio manager with American Century Investments.  Well Shit. Revenue for the largest U.S. drugmaker fell 9 percent to $13.5 billion, below Wall Street expectations of $13.99 billion.

Lily Operating income decreased 21 percent to $5.015 billion due to the loss of patent exclusivity for Zyprexa.  Ahh fuck. The effective tax rate for 2012 was 22.8 percent. Net income decreased 23 percent, to $3.784.  I guess Christmas will be rough.

Cigna's net income rose to $505 million, or $1.76 per share, from $380 million, or $1.31 per share, a year earlier. Revenue rose to $7.98 billion from $7.42 billion, while analysts looked for $7.4 billion. Almost there if only we got that extra $20,000,000

 

UnitedHealth reported net income of $1.44 billion, or $1.40 per share, compared with $1.34 billion, or $1.27 per share, a year earlier.  Analysts on average had expected earnings of $1.25 per share, according to Thomson Reuters I/B/E/S.  Revenue rose to $30.4 billion. Analysts had expected $30.5 billion.  If only we had a $100,000,000 more cunts, we’d have made our nut!

The health reform law, known as Obamacare, sets targets for this ratio. It has also required many insurance plans to include more free preventative services.  Even so, insurers have benefited from Americans' reduced use of medical services over the past several years, a trend Skolnick said appeared to have continued this quarter. The suckers are too poor to even make the deductible so they don’t even go to the doctor when they’re sick anymore!  Look I just shit a roll of twenties!

Aetna agreed to buy Coventry for $5.6 billion last year, to expand its Medicare and Medicaid offerings. Profit for 2013 may be $5.50 to $5.60 a share, Aetna said today in a statement.

Humana reported net income of $420 million, or $2.63 per share, up from $356 million, or $2.16 per share, a year earlier.  Revenue rose to $10.3 billion from $9.7 billion, in line with analysts' expectations of $10.3 billion.  Phew just made that $10,300,000,000!

Blue Cross Blue Shield, Tennessee's biggest health insurer helped ensure its own fiscal health last year by boosting net income by more than 26 percent and swelling its reserves to more than 50 percent above what is legally required.

BlueCross BlueShield of Tennessee, the state's biggest nonprofit corporation with $5.6 billion in annual revenues, said Monday it earned record profits of $221.5 million during 2012.  Even with its income gain last year, BlueCross officials said the 4 percent profit margin was still the lowest among the major health insurers operating in Tennessee.

Novartis Earnings increased to $3.25 billion, the Basel, Switzerland-based company said in a statement today. Analysts predicted profit of $3.12 billion.

Novartis, Europe’s biggest drugmaker, benefited from Ranbaxy Laboratories Ltd.’s (RBXY) failure to market a copycat version of the Diovan hypertension drug. Sales growth from new treatments such as the Gilenya multiple sclerosis pill are slated to help replace revenue from the cancer medicine Gleevec and Diovan. The two products are the company’s biggest sellers, with revenue of $9.1 billion last year. They may reap just $5.2 billion in 2015 after losing patent protection, according to estimates compiled by Bloomberg.  One drug $9,200,000; one competitor still $5,200,000, the sky is fucking falling!

The company's board of directors announced that its outgoing board chairman, Daniel Vasella, would receive $5.2 million in cash and unrestricted shares plus a guaranteed minimum fee of $250,000 a year from 2014 through 2016, just to be available for consulting and coaching. He'll be paid a consulting rate of $25,000 a day.

Vasella's departure touched off widespread anger in Switzerland — and led to a national debate over executives' pay — for the huge $77 million severance package he was offered. He later declined to accept it because of the Swiss public's outcry.  Public outcry, oh wait, it’s the Swiss not the Americans, we’re still good.  I’ve got yacht payments coming up.

Novartis said in its financial results that quarterly net income fell to $2.548 billion, down from $2.675 billion in the comparable period a year ago.

Merck  Like other big pharma companies, Merck is facing increased competition from generic medicines. (Slay the generic plague, banner brand names, can’t wait for Merck Meth!) Merck has lost patent exclusivity for Singulair. The asthma medicine came under pressure starting in August from cheaper versions. “Our first quarter performance reflects the challenges of major patent expiries coupled with the impact of currency and other headwinds,” says CEO Ken Frazier says. Merck’s first-quarter net income was $1.59 billion, 52 cents a share, down from $1.74 billion, 56 cents a share, a year ago.  Sales were $10.67 billion, below the $11.09 billion that Wall Street predicted.

GlaxoSmithKline  LONDON--GlaxoSmithKline PLC GSK +0.12% Wednesday reported a 16% fall in second quarter net profit to 1.05 billion pounds ($1.61 billion), falling short of analyst expectations of GBP1.27 billion

.

Glaxo, the U.K.'s largest drug maker by sales, is being investigated for alleged bribery in China amid a broader probe of the pharmaceutical industry by the government. GSK said this week some of its senior executives appeared to have violated Chinese law.  (Silly that’s what happens when you don’t bribe enough, the slighted investigate you!  Do it sophisticatedly like in the U.S. Congress; campaign finance reform what the fuck is that?)

Roche Holding AG’s (ROG) first-half profit climbed 10 percent as new breast-tumor drugs Kadcyla and Perjeta showed signs of being able to fuel growth as the Swiss drugmaker prepares for lower-priced copies of its main cancer medicines.

Earnings excluding some items, which the company calls core net income, climbed to 6.65 billion Swiss francs ($7.1 billion), Basel-based Roche said in a statement today. Earnings per share on that basis were 7.58 francs, beating the 7.45-franc average of 12 analysts’ estimates compiled by Bloomberg.

Roche, the world’s biggest maker of cancer drugs, is racing to add new products before cheaper biosimilar copies of its Rituxan leukemia medicine and the Herceptin breast-tumor treatment reach the market. Today’s announcement shows the magnitude of its success in breast cancer, with second-quarter sales for Kadcyla, which got U.S. approval in February, reaching 65 million francs, said Fabian Wenner, a Zurich-based analyst for Kepler Cheuvreux. (Profit off those tis, fuck yeah, pelvic thrust, motorboat the air with a smile!)

“It was a blowout result” for Kadcyla, Wenner said.   First-half revenue climbed 4 percent to 23.3 billion francs, matching the average estimate. Roche doesn’t report full quarterly earnings.

A weaker U.S. economy has forced people to cut back on medical services in the past few years, reducing insurers' payments on claims. Companies like UnitedHealth Group Inc, WellPoint Inc, and Aetna Inc have beaten expectations for the quarter because of this trend.

AstraZeneca Plc (AZN) said second-quarter profit fell 12 percent as generic competition to some of its best-selling medicines eroded sales by $500 million. 

Profit declined to $2.06 billion, or $1.20 a share, from $2.33 billion, or $1.57, a year earlier. The U.K.’s second-biggest drugmaker faces a steady decline in sales as it loses patent protection on medicines including the Crestor cholesterol-lowering pill and the antipsychotic treatment Seroquel over the next three years.

Here are the five-day stock prices and percentage changes for the week of June 24 through 28.

Community Health Systems (Franklin, Tenn.): $46.88 per share (up 3.31 percent)

Health Management Associates (Naples, Fla.): $15.72 per share (up 1.68 percent)

Hospital Corporation of America (Nashville, Tenn.): $36.06 per share (down 3.69 percent)

LifePoint Hospitals (Brentwood, Tenn.): $48.84 per share (up 0.33 percent)

Tenet Healthcare (Dallas): $46.10 per share (up 10.16 percent)

Universal Health Services (King of Prussia, Pa.): $66.96 per share (up 1.73 percent)

Vanguard Health Systems (Nashville, Tenn.): $20.74 per share (up 67.66 percent)

Revenues for the six months ended June 30, 2013 totaled $16.890 billion compared to $16.517 billion in the same period of 2012. Net income attributable to HCA Holdings, Inc. was $767 million, or $1.66 per diluted share, compared to $931 million, or $2.03 per diluted share, for the first six months of 2012.

Revenues for the year ended December 31, 2012 totaled $33.013 billion compared to $29.682 billion in 2011. Net income attributable to HCA Holdings, Inc. in 2012 was $1.605 billion, or $3.49 per diluted share, compared to $2.465 billion, or $4.97 per diluted share, in 2011. 

Or maybe peruse this

http://www.time.com/time/magazine/article/0,9171,2136864,00.html

Numbers, numbers that matter: families, children, healed, less expensively, more efficiently equals a diametrically opposed motivation because profit mark-up is tied to every capsule, implant, specialist ordered, additional scan, test, and $30 box of band aids.

(Oh what’s that administrative cost to compute the net income how much is even medical cost?)

PHILADELPHIA--(BUSINESS WIRE)-- Administrative expenses of Blue Cross Blue Shield (Blue) Plans were 8.9% of premium in 2012. Administrative expenses grew by 5.1% per member.

CIGNA Corporation (NYSE:CI) is a health insurance company - sort of. For one, three-quarters of Cigna's health insurance business isn't really insurance - Cigna manages health plans for companies who self-insure, agreeing to pay employee's health care costs. Employees get Cigna cards and access to Cigna's negotiated rates with doctors, and Cigna handles billing, but the employer bears the risk of paying for care when employees get sick. 

United Health The expansion of Medicaid together with the health insurance mandate and premium subsidies are projected expand insurance to 32 million Americans without coverage. United stands to benefit from this, as the one of the largest insurers as well as the largest government contractor for administering Medicaid (UNH’s AmeriChoice program brings in $6 billion annually). 

The law ends will end the practices of refusing to cover patients with pre-existing conditions. This will likely lead to an increase in premium costs; however, given that the rule applies across the board, it may not hurt insurers’ competitive positioning. 

 

Cuts to Medicare Advantage program reimbursements may hurt UNH, with its roughly 2.0 million MA enrollees, in the short term. In the long term, UNH may lose out still more: as MA beneficiary premiums increase to reflect lower government reimbursements, Medicare patients may migrate to less profitable Prescription Drug Plans and opt to receive their medical benefits from the traditional government-run Medicare program. 

The health care law will also effectively begin to cap insurance company profits in 2011. Insurers will be required to spend 85% of large-group and 80% of small-group plan premiums on medical costs, or else improve health-care quality or return the difference to customers in the form of a rebate. Under the new law, such a performance will not be possible again in 2011. Moreover, the strong performance has analysts worried that UNH will draw unwanted political attention amid continuing negative political sentiment directed at insurers.  

However, insurer Wellpoint reportedly reclassified certain administrative expenses--$500 million dollars worth--in a way that increased its medical loss ratio. In January, WellPoint began costs such as as nurse hotlines, "medical management," and "clinical health policy," under medical benefits. Thus, the impact remains to be seen. 

(So crafty with the accounting, to lower reported profit and hide it to rationalize the revenues to the public to call an administrative cost as a medical cost, basically aid as non-aid, help as non-help, hell as non-hell. You can’t return a profit you hide in a mutated-cost.  )