Denying Your Health Care Is Big Business in America | NYT Opinion
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Published 2024-03-14
Doctors are often required to get insurance permission before providing medical care. This process is called prior authorization and it can be used by profit-seeking insurance companies to create intentional barriers between patients and the health care they need.
At best, it’s just a minor bureaucratic headache. At worst, people have died.
Prior authorization has been around for decades, but doctors say its use has increased in recent years and now rank it as one of the top issues in health care.
To produce the Opinion Video above, we spoke to more than 50 doctors and patients. They shared horror stories about a seemingly trivial process that inflicts enormous pain, on a daily basis. The video also explains how a process that is supposed to save money actually inflates U.S. health care costs while enriching insurance companies.
Prior authorization has come under intense scrutiny in Congress in the past few years, but bipartisan proposals have repeatedly stalled. Under public pressure, some insurance companies — like United Healthcare and Cigna — have said they would reduce the use of prior authorization. And in January, the Biden administration finalized a plan to put limited guardrails around this practice. But doctors say that these efforts only scratch the surface and should go further.
This issue is ultimately about the role of insurance companies in American health care: Should they have more power than your doctor to decide what’s medically best for you?
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All Comments (21)
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Hi! My name is Alex Stockton. I'm a video journalist with New York Times Opinion and I produced this video. For our reporting, we spoke with more than 50 doctors and patients. They told us horrific stories of being blockaded by insurance companies. Has this happened to you? Let me know about your experiences navigating this system. And I'd be happy to answer any questions. Thanks for watching
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If insurance companies are making medical care decisions and patients are being harmed they should be legally liable for malpractice.
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This is what happens in a country that measures its success on GDP, the stock market, and profit rather than happiness, life expectancy, and human flourishing.
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Putting half of my Salary into my portfolio at the start of each month has always been my approach. My second approach is to hold off on selling for at late, my portfolio has seen a significant fall with losses of around $65k, Please what can i do? half of my Salary into my portfolio at the start of each month has always been my approach. My second approach is to hold off on selling for at late, my portfolio has seen a significant fall with losses of around $65k, Please what can i do?
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Fighting the insurance companies was harder than fighting the cancer I had.
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Aren't insurance companies the primary reason healthcare is expensive to begin with?
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Healthcare should NOT be for-profit, period.
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My dad was diagnosis with stage 4 lung cancer, he lost his battle after 9 terrible weeks. I wish I tracked the amount of time I spent on the phone with his insurance fighting for treatment, medicine and medical equipment. Hours upon hours trying to get things approved, messaging his doctors for them to resubmit the same request allover agian. Having someone you love who is sick and dying is so hard, having to deal with these insurance companies is just cruel. Those hours I spent on the phone I could have spent with my dad, holding his hand, hearing his stories, telling him I loved him. Our system is beyond broken.
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2 months ago I went to my doctor for recurring pain in my neck, shoulder, and arm. I hadn't injured myself in any way that I could remember. My doctor said, ok, let's get you an xray, and mri, and a nerve test to check for damaged nerves, pinches, broken bones, etc. My insurance allowed xrays and nerve test.. They denied my mri, telling me I needed to do 6 weeks of 'conservative' treatment which was basically physical therapy. I did the 6 weeks of physical therapy, which has made the pain in my neck WORSE. My doctor says it's definitely a nerve issue, that the mri would have given us a clear indication of. But now I have pain that MIGHT be permanent because my insurance decided that their profits are more important than my health and happiness. This video is my story, and the story of hundreds of thousands of other Americans. We need to burn this whole system to the ground.
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As a physician, this is the bane of my existence everyday. I didn’t go all these years of medical school and training to do this BS paperwork
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absolutely ridiculous system of healthcare here in America
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I live in Canada. Several years ago I had black spots and flashes in my eyes and I went to the hospital emergency. Yes I had to wait three hours to see the doctor. After my initial exam, he said your retina is threatening to detach, you’re not going anywhere we are calling in a specialist to do laser surgery on your eyes.I waited another two hours the specialist arrived and did the surgery. I paid nothing out out of pocket except for the parking fees.
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People in the US need to rise up and throw off these insurance companies. They are standing between you and universal health care.
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At $22 billion profit by just one insurance company it’s pretty obvious that insurance owns the government.
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Why are the US nationals not revolting against this?
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I’m a RN case manager and I was fired from my position when I fought for my elderly patients denial of service
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Our healthcare system is the #1 reason why I want to leave this country someday.
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Faces you will never see, people you will never know, get to decide your quality of life, or death, in the name of making rich people even richer. We are fodder.
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Prior authorisation is a euphemism for death farming.
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The big argument about Universal Healthcare was nobody wanted a panel of bureaucrats deciding wether someone lives or dies or imposing long waits. We now have a private system that does exactly that.
