Breaking Up Big Medicine: The Prior Authorization Crisis

What happens when the companies that profit from denying care also decide what care you get? Nurse Rosa sits down with Hannah Garden-Monheit and Emma Freer, senior fellows at the American Economic Liberties Project and leaders of the Break Up Big Medicine Coalition, to talk about their report on prior authorization.

Hannah shares the personal story behind her work: her father's cancer, his amputation, and the prior auth denials that followed. Emma explains the moral injury clinicians feel when paperwork pulls them away from the bedside. Together they walk through the numbers, the policy fixes, and what nurses, clinicians, and patients can do right now about a system that too often works against the people it's supposed to serve.

Timestamps

0:00 Welcome and guest introductions

1:12 Hannah's personal story: her father's cancer, amputation, and United Healthcare's prior auth denials

2:26 The Kafkaesque bureaucracy: "This is unreasonable, but I don't know how to fix it"

3:17 The inherent conflict of interest: insurers save money by denying care

3:37 Nurse Rosa on preventable disability and the economic cost of denied care

3:48 Emma on moral injury among healthcare professionals pulled away from the bedside

5:16 Heartbreaking stories: a cancer patient missing chemo infusions, migraine medication abruptly denied

5:18 Collecting patient stories at earful.us/c/prior-auth

6:19 The $32 billion annual paperwork cost, and why insurance-funded studies ignore it