‘Make money by denying care’: new US rules aim to curb use of approval by private health insurances
‘Make money by denying care’: new US rules aim to curb use of approval by private health insurances
Patients, advocates and researchers welcome regulations but argue rules don’t go nearly far enough to tackle scale of problem
Patients, advocates and researchers welcome regulations but argue rules don’t go nearly far enough to tackle scale of problem
A new set of rules from the Biden administration seeks to rein in private health insurance companies’ use of prior authorization – a byzantine practice that requires people to seek insurance company permission before obtaining medication or having a procedure.
The cost-containment strategy often delays care and forces patients, or their doctors, to navigate opaque and labyrinthine appeals.
The administration’s newly finalized rules will require insurance companies who work in federal programs to speed up the approval process and make decisions within 72 hours for urgent requests. The regulations will also require companies to give a specific reason as to why a request was denied and publicly report denial metrics. The regulations will primarily go into effect in 2026.
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But I thought if we had universal healthcare there would be death panels deciding whether gradma got her medicine! Now you're telling me its the private insurers that do that?
Now you're telling me its the private insurers that do that?
Always has been.
I was being ironic
Hence the meme response.
Medicare for All would have evil government death panels. Health insurance is evil corporate death panels, which are better because reasons.
They were outraged that the death panels wouldn’t be able to use profit motive any more.
Well it's obviously better because if consumers get mad about the decisions from the death panel at company A, they can just go to company B. Like if you don't like McDonald's, you can just go to Burger King instead.
Except there might not be a Burger King restaurant (let's say in Burger King's "network") anywhere near where you live. And your employer already decided that everyone on the payroll has to eat at McDonald's, and trying to deviate from that is a gigantic expensive hassle for some reason. And you're basically locked into a single burger chain for the year, except for a tiny window of time when you can elect to switch. And you're on the verge of starvation.
I want my death panels incentivized by .. keeping me alive to keep paying taxes, instead of incentivized to reduce costs and increase short-term profits.
Everyone does that. Unless you are filthy rich you cannot afford whatever medical costs you might have. Private insurance means you get to choose which death panel decides your case - except that the way insurance is setup in the US you don't get that choice.
Okay, stupid question, as an European I don't know if that's the case with our insurance. Sure there may be waiting times for organ donors or whatnot, but healthcare is not going to put me into debt. I've had one in a million illnesses in my family where one has to stay at a hospital for months before and after a complex surgery, but it never has been a money issue.
Most beople have health insurance here and don't go into debt. it is a minority that run into problems.
you may not be allowed some expensive care, but your doctor won't tell you it is an option elsewhere as you can't get it. If you have such a condition you could go to a different country for care, but odds are you don't as such things are rare.