When New York Times personal finance columnist Ron Lieber and his wife, Jodi Kantor, faced a last-minute insurance denial just days before Jodi's scheduled cancer surgery, the experienced journalist was caught off guard. But rather than accept defeat, Lieber decided to investigate the flaws in the prior authorization system - and share what he learned to help others avoid the same scramble.
A Costly Surprise
It was December 2024, and Jodi Kantor, a prominent New York Times investigative reporter, had been preparing for major surgery at Memorial Sloan Kettering to treat her breast cancer. Less than 36 hours before the procedure, the Liebers received an unwelcome letter from their insurance provider: the plan was denying prior authorization for the surgery.
With no time to appeal the decision, Lieber and Kantor made the risky decision to proceed with the surgery, betting that Jodi's doctors could reverse the insurance denial post-op. Fortunately, their gamble paid off - but the experience left Lieber troubled. "Why had no one warned us sooner?" he wondered. Lieber set out to find answers that could help others avoid the same last-minute scramble.
Exposing the Flaws in Prior Authorization
In his subsequent New York Times series, Lieber uncovered the deep flaws in the prior authorization system that insurance companies use to control costs. As KFF Health News reported, these denials can be "confusing, burdensome, and devastating" for patients, while also frustrating doctors who must navigate the bureaucratic maze.
What this really means is that the prior authorization process - designed to prevent unnecessary or ineffective treatments - has become an opaque system that often denies or delays medically necessary care. As the "Deadly Denials" investigation found, these denials can have life-or-death consequences for the sickest patients.
Empowering Patients to Fight Back
Lieber's reporting didn't just expose the problems - it also offered solutions. In a step-by-step guide, he advised patients on how to navigate the appeals process and fight back against unfair denials.
The bigger picture here is that Lieber's personal experience and subsequent investigation has shone a light on a broken system that needs urgent reform. By arming patients with the knowledge and tools to challenge denials, he's empowering them to hold insurers accountable. And by highlighting the human cost of these denials, he's putting pressure on policymakers to finally address this long-standing issue.
As personal finance experts like Vivian Tu have emphasized, mastering your healthcare costs is a crucial part of building long-term wealth. Lieber's crusade against prior authorization abuses is a valuable service to all consumers struggling to navigate our complex, often opaque healthcare system.