Doctors Warn: Insurance Companies Are Secretly Killing Patients by Denying Life-Saving Treatments

Health insurance companies in the United States continue to deny or delay doctor-recommended surgeries and treatments. This practice puts patients at risk and undermines the expertise of medical professionals. Physicians across the country are calling for stronger legislation to stop these predatory actions and ensure access to life-saving care.

Prior authorization requirements and claims reviews allow insurers to second-guess physicians. These processes often result in denials even when doctors determine a procedure or therapy is medically necessary. Patients and their families face prolonged battles that can lead to worsened health outcomes or death.

The Scale of the Problem

Insurance denials have become a major barrier in American healthcare. Recent studies and surveys reveal troubling statistics:

• According to the 2025 American Medical Association survey, 93 percent of physicians reported that prior authorization causes delays in care, and nearly one in four reported it leading to serious adverse effects for patients.

• In 2024, Medicare Advantage insurers denied 7.7 percent of prior authorization requests, totaling about 4.1 million denials.

• Initial claim denial rates rose to 11.8 percent in 2024, up from previous years, with commercial and Medicare Advantage plans showing notable increases.

• Over 80 percent of physicians describe the burden of prior authorization as high or extremely high, with many reporting patients abandoning treatment due to the process.

Appeals succeed in a high percentage of cases, often 70 to 80 percent or more when pursued. Yet few denied claims are appealed because the process is burdensome.

Real Harm to Patients: Case Examples

Stories of denied care illustrate the human cost. In one case, Tracy Pike of Illinois was diagnosed with cancer. His doctors at MD Anderson recommended a specific treatment, but Blue Cross and Blue Shield of Illinois denied coverage multiple times in 2024, calling it experimental. Pike's family fought appeals while his condition worsened.

Eric Tennant of West Virginia was diagnosed with cholangiocarcinoma in 2023. His doctor recommended histotripsy, a targeted ultrasound treatment. His insurer, through the Public Employees Insurance Agency, denied coverage repeatedly in 2025, claiming it was not medically necessary. Tennant died in September 2025 after months of delays.

Dr. Debra Patt, an oncologist, described a 40-year-old patient with metastatic breast cancer in 2023 whose recommended therapy was denied despite strong evidence. The patient experienced disease progression while waiting for approval.

Dr. Elisabeth Potter, a Texas plastic surgeon specializing in cancer reconstruction, faced interruptions during surgery in 2026 when UnitedHealthcare questioned an inpatient stay. She highlighted how such interference distracts from patient care.

Physicians Call for Reform

Medical organizations and doctors are pushing back. AMA President Bruce A. Scott, MD, stated in February 2025 that using AI to automatically deny care is not the reform physicians and patients seek.

Dr. René Bravo, a pediatrician and president of the California Medical Association, noted in 2026 that prior authorization drives burnout and early retirement.

Dr. Zeke Silva, a Texas radiologist and leader with the Texas Medical Association, advocated for gold card programs that exempt high-performing physicians from prior authorization. Texas passed its Gold Card law in 2021, with updates in later years.

Physicians argue for federal and state legislation that would:

• Make insurers liable when wrongful denials cause harm.

• Require clinical reviews by qualified physicians of the same specialty before denials.

• Increase transparency and public reporting of denial rates.

• Limit prior authorization for time-sensitive and high-need conditions such as cancer.

As of 2025 and into 2026, states like North Carolina, California, and others are advancing bills to regulate prior authorization and limit AI use in denials. Federal bills such as the Improving Seniors' Timely Access to Care Act continue to gain support.

Doctors are not seeking to remove all cost controls. They want balanced policies that protect patients from inappropriate interference. New legislation could hold insurers accountable and restore trust in the doctor-patient relationship.

Patients deserve confidence that their physician's expertise will guide treatment. Without reform, these practices will continue to endanger lives.

References

• American Medical Association. 2025 Prior Authorization Physician Survey. February 2025.

• NBC News investigation. "'Would he have lived?' When insurance companies deny cancer care." December 27, 2024. Features Tracy Pike case.

• KFF report. Medicare Advantage prior authorization determinations in 2024. January 28, 2026.

• AMA article featuring Dr. Debra Patt. "The life and death reality for cancer patients facing insurance denials." March 16, 2023.

• KFF Health News. "After Series of Denials, His Insurer Approved Doctor-Recommended Treatment Too Late." November 21, 2025. Features Eric Tennant.

• Stateline. "States try to rein in health insurers' claim denials." March 25, 2025.

• Texas Medical Association. Gold Card law advocacy, led by Dr. Zeke Silva. Updates through 2025.

• California Medical Association. Statements by Dr. René Bravo on prior authorization burdens. 2026.