Why Health Insurance Is Getting Worse: It's Not Just About Greed

You might be blaming health insurance companies for rising costs and denials, but wait. Let's dive deeper. The root of the problem started when politicians made promises they couldn't keep. Back in 2013, before the Affordable Care Act (ACA) took effect, insurers were denying around 1. 5% of claims. But after the ACA, denials skyrocketed to almost 15%. Now, some insurers are even denying a third or more of claims. Why the change? It's not all about profit. The ACA set rules that limited how much insurers could profit. Instead, insurers had to cut costs elsewhere. One big way was through prior authorizations. Remember, before you get treatment or a new medication, your doctor has to call the insurer. And sometimes, it's not even a specialist who picks up the phone.

Think about Dr. Debra Patt, an oncologist. She had to wait weeks for approval on a drug combo for a patient with metastatic breast cancer. While waiting, she had to use standard chemo instead. Sadly, her patient passed away. This is happening all over, and it's not fair. Politicians promised to treat everyone equally with the ACA. But the math doesn't work. Just 5% of the population uses over 50% of health care spending each year. So, insurers have turned to harsh methods to stay afloat. And who benefits? Politicians, who look good for making big promises. But we're all losing out. Delays and denials are only getting worse. And the sickest among us are suffering the most. Some states are trying to fix this, but we need a bigger change. We should reassess how managed care works. There's little proof it improves health. In fact, since the ACA started, Americans are getting sicker and living shorter lives.

Actions