Insurers say prior authorization helps control costs by preventing medically unnecessary care, but patients say the process can delay or deny access to needed treatments.
We need nationalized healthcare. Now. There are 32 developed nations on earth. 31 of them have nationalized healthcare options. We are the only country that does not.
Why are conservatives (and neo-liberals) so opposed to modern healthcare?
There are, unfortunately, many people who only get enjoyment out of other people’s jealousy. They are proud that they have “good” insurance that covers everything, in the same way they are proud of their expensive house/car/boat/etc. If everyone has that thing, they aren’t special and it isn’t a cool toy because anyone could
“I know my job makes the world a worse place and my boss treats me like trash, I wish I could just quit and pursue my own dreams, but I need health insurance!”
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“Prior authorization” is bullshit. You know what kind of prior authorization you need for a procedure or prescription? The doctor fucking ordering it.
I love needing to get ‘prior’ authorization once a year to continue taking the same medication I have taken for the last decade.
No, I don’t want to try the ones that don’t work again just because they look similar on your spreadsheet.
What I like is having to get “prior authorization” for an antidepressant that I’ve been taking for years, and then I run out because it’s the weekend and nobody can get hold of anybody for anything.
Haha. Succinct.
I’m sure there’s plenty of examples but I’m going to share one from my work experience.
We had a patient who survived a really bad car accident but their jaw was broken in 4 (four) places. One of those cases when the doctor will wire your mouth shut leaving a small hole for the straw so you can drink your soup for the next x weeks.
The patient had a facial reconstructive surgery coming and their surgeon ordered an MRI of their jaw to see where the pieces were before cutting them open. The patient, unfortunately, had one of those cheapo insurance plans that were provided by their employer. Said insurance denied the MRI authorization 3 (three!) times due to “lack of medical necessity”. It took us literal hours of arguing with that arsehole adjustor and their supervisors on the phone until they finally approved it.
The federal government has proposed ways to reform prior authorization that would require insurance companies to provide more transparency about denials and to speed up their response times.
So insurance companies can keep doing the same bullshit, they just need to send you more meaningless fine print about it more quickly. Gee, thanks Biden administration.
If finalized, those federal changes [wouldn’t ] be implemented [until] 2026.
Ok, I already said my sarcastic “thanks,” you can stop making it worse now.
But even then, the rules would apply only to some categories of health insurance, including Medicare, Medicare Advantage, and Medicaid plans, but not employer-sponsored health plans. That means roughly half of all Americans wouldn’t benefit from the changes.
Ffs
