Letter to the editor: Patients suffer while insurance companies play games with health care


To the editor:

Imagine your loved one, let’s call him David, is in dire need of a life-changing medication. David’s condition causes double vision, pain, swelling, permanent disfigurement and vision loss. Quick treatment can prevent further worsening, which could lead to permanent damage if left untreated. David has even undergone testing confirming damage to his optic nerves is already occurring. But there’s a problem — his insurance company won’t make a decision.

Instead, they demand information on unrelated lab tests having no relevance to his ocular condition, making it difficult for David’s health care provider to procure. David’s desperate situation hangs in the balance as he navigates a labyrinthine bureaucracy with phone calls, transfers, hold music and dropped calls. All the while, he continues to suffer, his condition worsening each day.

David’s story is not unique. As an ophthalmologist serving a large rural population, I’ve witnessed countless patients who are victims of a broken health care system that prioritizes profits over people. It’s a story of insurance companies using tactics like step edits and prior authorizations to save money at the expense of patients’ health and well-being.

The tactics deployed by insurers not only waste valuable time but also incur substantial expenses for health care providers. These man hours could be better spent on patient care, but instead, they are squandered on administrative battles with insurance companies.

What’s worse, insurance companies are well aware of the toll their tactics take on health care providers and patients alike. They use intermediaries like pharmacy benefit managers to further complicate the process and put more obstacles in the way of patients receiving the care they need.

It’s important to recognize on one side of this health care crisis, there are patients who desperately need timely treatment to alleviate their suffering. On the other side, we have insurance companies driven by the pursuit of higher profits, larger share prices and inflated executive salaries and bonuses. In the middle of this tug-of-war are medical offices struggling with declining reimbursements and increasing patient volumes while advocating for appropriate patient care.

The question we should be asking is where are our priorities as a society? Shouldn’t the well-being of patients like David come before corporate profits and executive perks?

The time has come for change. We need a health care system that prioritizes patients over profits, that streamlines access to life-changing medications and treatments. It’s a system where administrative hassles don’t stand in the way of timely care. It’s a system where David and countless others like him don’t have to suffer needlessly.

David’s story is a call to action. It’s a reminder we must demand a health care system that works for us, the patients, and not against us. It’s time to hold insurance companies accountable for their actions and advocate for a health care system that truly serves the needs of the people.

Let’s stand together and say, “Enough is enough.” It’s time for change. It’s time for a health care system that puts patients first.

Clifford Brooks, MD, Seymour

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