Patients, advocates and researchers welcome regulations but argue rules don’t go nearly far enough to tackle scale of problem

A new set of rules from the Biden administration seeks to rein in private health insurance companies’ use of prior authorization – a byzantine practice that requires people to seek insurance company permission before obtaining medication or having a procedure.

The cost-containment strategy often delays care and forces patients, or their doctors, to navigate opaque and labyrinthine appeals.

The administration’s newly finalized rules will require insurance companies who work in federal programs to speed up the approval process and make decisions within 72 hours for urgent requests. The regulations will also require companies to give a specific reason as to why a request was denied and publicly report denial metrics. The regulations will primarily go into effect in 2026.

  • Semi-Hemi-Demigod@kbin.social
    link
    fedilink
    arrow-up
    33
    ·
    10 months ago

    Medicare for All would have evil government death panels. Health insurance is evil corporate death panels, which are better because reasons.

    • deegeese
      link
      fedilink
      arrow-up
      20
      ·
      10 months ago

      They were outraged that the death panels wouldn’t be able to use profit motive any more.

    • lolola@lemmy.blahaj.zone
      link
      fedilink
      arrow-up
      17
      ·
      10 months ago

      Well it’s obviously better because if consumers get mad about the decisions from the death panel at company A, they can just go to company B. Like if you don’t like McDonald’s, you can just go to Burger King instead.

      Except there might not be a Burger King restaurant (let’s say in Burger King’s “network”) anywhere near where you live. And your employer already decided that everyone on the payroll has to eat at McDonald’s, and trying to deviate from that is a gigantic expensive hassle for some reason. And you’re basically locked into a single burger chain for the year, except for a tiny window of time when you can elect to switch. And you’re on the verge of starvation.

    • evatronic@lemm.ee
      link
      fedilink
      English
      arrow-up
      3
      ·
      10 months ago

      I want my death panels incentivized by … keeping me alive to keep paying taxes, instead of incentivized to reduce costs and increase short-term profits.