My idea for fixxing Healthcare

[AllentownJake]

Insurance companies are taken out of the business of deciding prior authorizations, denials, and appeals.

An independent group is set up by the government that is a partnership between government, healthcare advocates, and the insurance industry to oversee those funtions. The group does the prior authorization, denial, and appeal function for all insurnace and medicaid and medicare programs.

When a person needs a prior authorization, doctors who work for this body recieve the information without knowing anything about the insurance other than than the relevant medical data. They do not know whether it is a government or private insurer's claim or procedure needing approval. If the procedure is not covered by the plan, it is taken to a seperate body for appeals that is also independent however, insurance specific information will be needed for that as well. This only goes for procedures and drugs that are covered.

This takes the financial incentive to deny and delay by the doctors making approvals (they get bonuses with cost savings). It allows for doctors to only consider the best interest of the patient when making decisions...not best interest of the insurance company.