Fuck insurance companies. Fuck prior auths.

However, their point is not completely invalid - as the payor they want a say in care. If insurance is covering it, then the pt doesnt care about costs, unlike most purchases in their life. The hospital ofc is happy to bill for expensive treatments - it can be a money maker, even if there is a near equal alternative. Private practice physicians similarly have incentive to recommend the most expensive option.

So how can insurance companies ensure care is necassary and cost effective? Like id genuinely like to completely take insurance companies out of the decision making process, im just not sure what process-wise the best outcome is.

MFA is not a fix on its own, as they also want to cut costs on care. Trying to get a newer treatment on medicaid was 3 years of BS I hope to never repeat. I pay a lot more, but my specific employer provided insurer is miles better

If you controlled the system, how would you pull it off?