Health insurers are increasingly interfering in care, an NBC News investigation found. Doctors say the stakes are highest in cancer care, when delays can be the difference between life and death.

cross-posted from: https://lemmy.world/post/23596638

Summary

Health insurance companies are increasingly denying cancer treatments and screenings recommended by physicians, leading to delays and potential harm for patients.

These denials, often based on internal rules lacking transparency, can result in serious adverse events, disease progression, and even death.

While prior authorization is intended to save money, physicians argue that the current system is inefficient and detrimental to patient care.

  • jetAEnglish
    15·
    1 day ago

    Deny coverage, delay and argue. Even if you eventually do have to pay for coverage some of the patients will die before then, saving money statistically.

    The oncologists described the serious adverse event as “delay of treatment” 96% of the time, “denial of treatment” 87% of the time, “disease progression” 80% of the time, and “loss of life” 36% of the time.

    Just a financial perverse incentive. Once someone demonstrates a expensive chronic condition you save money by exiting them from coverage as fast as possible. Either through rejections, denials, or waiting out their deaths… Not to mention sick people are usually not in a good position to fight a Kafkaesque nightmare of bureaucracy

    • sunzu2@thebrainbin.org
      7·
      1 day ago

      a Kafkaesque nightmare of bureaucracy

      A key piece within the extraction machine. Corporate bureaucracy expects you to act in good faith, while they are acting in bad faith.