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.

  • @FlowVoid
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    621 day ago

    Blue Cross and Blue Shield of Illinois, Pike’s health insurer through his employer, had declined to cover the roughly $40,000 treatment.

    Blue Cross and Blue Shield of Illinois is a nonprofit, so it turns out nonprofits deny care too.

    • Flying Squid
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      651 day ago

      There’s no such thing as “nonprofit” insurance in a for-profit healthcare system. If they aren’t making money for themselves, they’ve been created to make money for everyone else.

      • Nougat
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        191 day ago

        The difference between a for profit and a non profit is just in the way they do accounting for where the money goes.

        • @FlowVoid
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          111 day ago

          The bigger difference is that NPOs don’t have shareholders who demand profits.

      • @FlowVoid
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        1 day ago

        The hospital in this story, MD Anderson, is also a nonprofit. In fact it’s part of the University of Texas, a state-run school. So nobody profited from what happened here.

        And in general, insurance companies have an antagonistic relationship with health care providers. Because when insurance companies deny care, health care providers lose money.

    • HubertManne
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      171 day ago

      oh yeah. been on blue cross most of my life. Its like you see with so many things now. Denial is standard to see if they can shake out anyone who won’t go through the appeals process. The more expensive the more they fight the appeals and repeat the denials. If you fight and live long enough you might get the needed care.