Exposed: The Commercial Health Insurance Industry Denial of Care Business Model is Called Out, Again
Dr. Shikha Jain boldy blows the whistle on the Commercial Health Insurance industry for methodical, systemic Denial of Care and for imposing Moral Injury on ethical medical professionals
The New York Times has published an OpEd video featuring my colleague Dr. Shikha Jain, who is the founder of Women in Medicine.
Watch the featured short here.
As piecemeal legislation in various states—including Illinois—aims to address the barbarism of Prior Authorization, we need to point out (very loudly) that Prior Authorization is but one Denial of Care tool architected by the Commercial Health Insurance industry…of thousands. Other tools for methodical Denial of Care include PxDx AI predictor tools, nH AI predictor tools, preexisting condition issues, restricted networks, pharmacy formularies, bogus physician and clinic guides, limiting the number of physical therapy sessions allowed, restricting access to specialists of choice, onerous copays, falsely-inflated deductibles, irrationally priced premiums, ever-increasing out-of-pocket costs, burdensome out-of-network costs, surprise billing for private ambulance use, extraordinarily high private Life Flight costs, systemic over-billing, mergers and acquisitions that escalate vertical integration with pharmacies…and directly employing unthical physicians.
Prioritizing ROI for shareholders over patient safety and patient care—that’s the business model. Denial of Care is the business model. After 40 years of Managed Care, that’s what we know.
We need to return decision-making autonomy to physicians and patients rather than allow the Commercial Health Insurance industry quants to continue dictating the health outcomes of American citizens and residents.
The arsenal of Harm-for-Profit tools is deadly.
Many, many thanks to Dr. Jain for boldly blowing the whistle confidently without fear of reprisal. I, along with Dr. Linda Peeno, will be talking a lot this year about the need to enact S.1655, so we can end this methodical cruelty. We’ll also be talking about how Whistle Blowers can prevent harm in the healthcare industry and learn to boldly step up to prevent harm.
Let’s turn the corner.
Managed Care has failed. The preventable harm and death it has imposed for 40 years must be stopped.
Learn more about the Women in Medicine Summit and register for the conference here.
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