Factually! with Adam Conover Proof that Health Insurers Screw You Deliberately with T. Christian Miller and Patrick Rucker
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Feb 5, 2025 Investigative reporters T. Christian Miller and Patrick Rucker expose the profit-driven motives of health insurance companies that often result in denied medical claims, even for life-saving procedures. They discuss how these denial practices are rooted in complex dynamics with prior authorization processes and reveal chilling individual cases that highlight the dangers of prioritizing profits over patient care. The reporters call for accountability and reform in a system that allows such unethical practices to flourish.
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Little John Cupp's Case
- Little John Cupp, from Ohio, experienced shortness of breath and tiredness, leading his doctor to recommend a heart catheterization.
- Evacor, Cigna's subcontractor, denied the procedure, delaying treatment and resulting in Cupp's death after a less effective stress test.
Prior Authorization Creep
- Insurance companies initially increased prior authorizations to scrutinize excessive care, starting with costly treatments like inpatient rehab.
- Over time, this scrutiny expanded to even minor expenses like lidocaine patches, increasing administrative burdens and patient exhaustion.
Short-Term Focus of Insurers
- Health insurers, driven by profit, prioritize short-term cost reduction over long-term patient health.
- Unlike national healthcare systems focused on citizens' lifelong well-being, insurers prioritize immediate profits, given patients' short average tenure.