One in Four Doctors’ Orders Get Denied

The Texas Medical Association found that one in four people say their health insurance company has refused to cover what their physician ordered for them or their families. My answer to that is, “No sh$t, Sherlock”. It is time we break the addiction to these criminals.

I started my career in Medicine thirty years ago. We were in the early stages of HMO trend. When I used to order tests there was no diagnostic code needed. There was no prior authorization needed. The test was just done. This may sound crazy to some of you reading this but all these “justifications” for getting some referral or labs or study are just dogma you are accepting. There is no evidence that the insurers have cut down on meaningless or inappropriate orders by doctors to help people. They just have cut them down to save money, which they keep. Care was NOT worse in the old days when we didn’t need to beg these douchebags to do what was right for our patients. In fact, if you look at the 25% of orders refused by the insurers today I bet you will find that 99% were blocked for no valid reason at all.

Let’s go back to the major medical insurance era. I am all in for catastrophic plans with no frills. If your doctor orders a test for you then you may want to push back on why he/she wants it and then try to find the cheapest place to get it. If your doctor won’t help you do that then find another doctor (DPC docs all help with this kind of stuff). The bottom line is we need to get rid of these behemoth insurance companies who are only trying to make themselves more and more money and don’t give a crap about you as a patient.

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