In an earlier article and in replies to comments on it, I said that having health insurance was no guarantee of good healthcare because of all the ways in which financial investments have taken over and control all aspects of medical practice. In this investigative report, ProPublica and The Capitol Forum reporters show how the practice of “prior authorization” for medical procedures created a new breed of companies whose purpose is to deny treatment for the insurers, how these companies sell themselves to the insurance companies, how they and the insurance companies justify the practice for good reason, and the resulting tragedy these companies cause individuals whose treatments are denied in spite of their doctor’s recommendations.
To understand the complicated issue of our healthcare system, we have to know the details of how it works. Only then can we think about what needs to be done and why. Political rhetoric will not do.
To read this article, click on “Not Medically Necessary”: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care