Eleven Percent

Last summer the stage was set. Insurers would cut prior authorization. Eighty percent of plans. Eighty percent of the conditions. By January. Public dashboards so you could watch them do it.

July came. The insurer trade group counted the result. About eleven percent fewer services still need that permission slip. The dashboards never showed up. Some of the same plans already say they will not keep every promise on the pledge sheet.

I am not shocked. A voluntary deal with the people who invented the delay is still a delay. The American Medical Association asked a thousand doctors whether they believed the pledges would matter. One in three said yes. The other two thirds already knew the room.

We do not ask for prior auth. You call. We see you. The fee is on the wall. Eleven percent is what a handshake buys when nobody has to show the scoreboard.