Augie Lindmark, a resident physician at Yale University prepared for an onslaught of Covid-19 patients last week, he noticed something at his hospital: there were still patients without the virus, completely stable, in the beds.
These patients, many of whom should have been moved to a rehab facility or released, were stuck waiting until their private health insurance company authorized the next steps, which can take days.“Any sort of slowing in the health system has dire consequences,” Lindmark said.
But with a history of restrictive and confusing policies, private health insurance companies have lagged behind: making incremental changes to plans even as health providers seek to change course.
“They’re doing healthcare to make money, not to take care of people,” said Dr Judd Hollander, an emergency medicine physician and associate dean at Thomas Jefferson University in Philadelphia. “Insurance companies are not beholden to the patient, they are beholden to the shareholder,” Hollander said.
Riddhi Shah, the director of operations at a mental health clinic in Michigan, said insurance companies are hard to contact right now, and while the plans have dropped the prior authorization restrictions, the clinic still has to navigate new billing codes and financial loss.
Many private doctors, meanwhile, are burdened by the restrictions that insurance companies have placed in the past, said Shabana Khan, a child psychiatrist at NYU Langone.
With the bureaucracy standing in their way, some doctors are trying to work around private insurance altogether.
The pandemic hasn’t stopped insurers from charging patients for other Covid-related charges. AHIP confirmed that out-of-pocket expenses for the treatment would not be waived, and could cost patients thousands of dollars. The average amount for someone admitted to the hospital with pneumonia, a respiratory condition that many coronavirus patients are facing, was $20,000 in 2018 for patients covered by private insurance, according to an analysis by the Kaiser Family Foundation and Peterson.
That could leave many people falling back on the age-old American dilemma: get healthcare or lose all financial security. And it could leave physicians finding loopholes and workarounds to stay afloat.