05/14/2026
Insurance companies say they’re “managing costs.”
What many patients experience instead is delay, denial, and exhaustion.
As a neurologist, I’ve learned something uncomfortable:
The system often doesn’t reward the best treatment.
It rewards the best documentation, persistence, and escalation strategy.
The patients who get approved fastest are rarely the sickest.
They’re usually the ones who know how to fight the system.
That should bother all of us.
Prior authorizations now consume hours of physician time every week while patients wait, worsen, miss work, land in the ER, or simply give up. Meanwhile, many first denials are generated before a specialist ever reviews the case.
Healthcare has quietly become a war of attrition.
So here’s the question:
Should medically necessary care depend on how aggressively a patient and physician can navigate insurance bureaucracy?
What’s the most absurd denial you’ve ever seen?