Putting the Care Back in Healthcare: Why Doctors Should Prescribe Freely

The American healthcare system faces numerous challenges, but one of the most pressing concerns is the growing influence of insurance companies in medical decision-making. This interference often manifests in the form of prior authorization, a process where doctors must seek approval from insurance companies before prescribing certain medications or treatments. This system is deeply flawed and has detrimental consequences for patients and doctors.

A physician was stopped from prescribing opioids to a patient who was in hospice because the product was a “controlled substance”. Another patient who has persistent back pain caused by an MV accident has to see at least three doctors before she can get an Rx to help her cope with her pain. The idea that doctors can prescribe what they want is not accurate. Too often, prescribing is put into the hands of the insurer or state because they don’t trust educated medical staff to do what’s best for the patient.

Here’s why doctors should be allowed to prescribe what they want without insurance interference:

  1. Doctors are the experts: They are trained in medicine, have years of experience diagnosing and treating patients, and are best equipped to determine the most appropriate course of action for each individual. On the other hand, insurance company employees typically lack medical expertise and often base their decisions on cost-cutting rather than patient needs.

2. Delaying care can be harmful: Prior authorization processes can be lengthy and bureaucratic, causing delays in patients starting necessary treatment. This can have serious consequences, especially for patients with chronic or life-threatening conditions.

3. Insurance company interference undermines trust: When patients feel like their doctor’s recommendations are second-guessed by an insurance company with no medical expertise, it erodes trust in the healthcare system.

4. It stifles innovation: Insurance company restrictions can prevent doctors from using newer, more effective treatments that insurers haven’t yet approved. This can limit patients’ access to the best possible care.

5. It increases costs: The administrative burden of prior authorization processes adds unnecessary costs to the healthcare system. These costs are ultimately passed on to patients through higher premiums and deductibles.

The solution:

The current system needs to be reformed to give doctors the autonomy they deserve. This can be achieved through:

  • Limiting prior authorization: Prior authorization should be restricted to situations where there is truly a question about the medical necessity of a treatment.

  • Improving transparency: Insurance companies should be required to disclose their criteria for approving and denying treatments, and patients should have the right to appeal decisions.

  • Investing in alternative payment models: Moving away from fee-for-service models and towards models that reward value and quality over quantity can incentivize doctors to provide the best possible care without being constrained by insurance company restrictions.

Giving doctors the freedom to prescribe what they want is not only the right thing to do for patients but also essential for ensuring a strong and sustainable healthcare system. By putting care back into healthcare, we can ensure all Americans have access to the high-quality, patient-centered care they deserve.