To the editor:
Imagine that your loved one, let’s call him David, is in dire need of life-changing medication. David’s condition causes double vision, pain, swelling, permanent disfigurement, and vision loss. Prompt treatment can prevent further deterioration, which can lead to permanent damage if left untreated. David even underwent tests to confirm that damage to his optic nerve had already occurred. But there’s a problem. His insurance company doesn’t make the decision.
Instead, they request information about unrelated laboratory tests that have nothing to do with his eye condition, making it difficult for David’s health care providers to obtain information. David finds himself in a desperate situation, navigating a labyrinthine bureaucracy of phone calls, transfers, music on hold, and dropped calls. All the while, he continues to suffer, his condition worsening day by day.
David’s story is not unique. As an ophthalmologist in a large rural population, I have witnessed countless patients fall victim to a broken health care system that prioritizes profits over people. This is a story of how insurance companies use tactics like step edits and pre-authorizations to save money at the expense of patient health and well-being.
Tactics deployed by insurance companies not only waste valuable time, but also generate significant costs for healthcare providers. These man-hours could be better spent on patient care, but instead are wasted on administrative battles with insurance companies.
To make matters worse, insurance companies are well aware that their strategies are highly damaging to both providers and patients. They use intermediaries, such as pharmacy benefit managers, to further complicate the process and impose additional obstacles for patients to receive the care they need.
During this medical crisis, it is important to recognize that there are patients who desperately need timely treatment to alleviate their suffering. On the other hand, there are insurance companies driven by the pursuit of higher profits, higher stock prices, and higher executive salaries and bonuses. Medical institutions in the midst of this tug-of-war are struggling with declining medical fees and increasing patient numbers while insisting on appropriate patient care.
The question we need to ask is: What are our priorities as a society? Shouldn’t the well-being of patients like David take precedence over corporate profits and executive perks?
It’s time for a change. We need a health care system that puts patients before profits and streamlines access to life-changing medicines and treatments. This is a system where administrative complexity does not get in the way of timely care. This is a system where David and countless others like him do not have to suffer unnecessarily.
David’s story is a call to action. This is a reminder that we must demand a health care system that works for our patients, not against us. The time has come to hold insurance companies accountable for their actions and advocate for a health care system that truly meets people’s needs.
Let’s come together and say “enough is enough.” It’s time for a change. The time has come to build a healthcare system that puts patients first.
Clifford Brooks, MD, Seymour
