Forty-Seven Percent of Insured Adults Had Care Denied or Delayed
Nearly half.
Forty-seven percent of insured adults say their health insurance company denied or delayed a service, treatment, or medication in the past two years. Among people with a chronic condition, it is fifty-seven percent. That is not a rounding error. That is the business model showing through.
KFF asked what hurts beyond cost. Prior authorization won. Sixty-nine percent of insured adults call it a burden. Thirty-four percent say it is the single biggest burden after price. Two-thirds of adults call delays and denials a major problem. The permission slip is the product.
Insurers will tell you prior auth is how they fight hospital prices they cannot control. Fair point on the monopoly side. Private hospital prices sit about double Medicare and climbed thirty percent while Medicare rose twenty-one. Their main lever on volume is still a faxable no. Patients feel the no. Doctors feel the no. The bill still arrives.
I am not shocked. The system was built to gatekeep. A visit gets a prior auth. A prior auth gets an appeal. An appeal gets a portal. Nobody asks whether primary care should have needed a claim in the first place.
I am not anti-insurance. Keep a policy for the wreck. Primary care is not a wreck. We take care of patients for a flat monthly fee. No claim. No network. No permission slip before you see your doctor. The number on the door is the number you pay.
Forty-seven percent is not a bad luck story. It is what happens when everyday care rides the same rails as the hospital. Direct care deletes the gate for the oil change. Keep coverage for the crash.