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A month after the killing of UnitedHealthcare CEO Brian Thompson prompted many Americans to share personal horror stories of the company's coverage denials and other practices, a doctor in Austin, Texas on Wednesday shared her own experience that she said exemplified how the for-profit health system "just keeps getting worse."
In a TikTok video, Dr. Elisabeth Potter shared that she recently received an extraordinary phone call from UnitedHealthcare regarding a patient who was already anesthetized and undergoing surgery.
Potter, a plastic surgeon focused on reconstructive procedures for breast cancer survivors who have undergone mastectomies, recounted an incident where she was in the middle of a bilateral deep inferior epigastric perforator (DIEP) surgery when she received a call from UnitedHealthcare right in the operating room.
She was informed that the call was urgent and required an immediate response.
"I reached out to UnitedHealthcare after stepping away from my case, and the representative informed me that he required specific details regarding her," Potter explained. "He inquired about her diagnosis and whether her hospitalization was warranted."
Potter discovered that the individual making the call was unaware that the patient in question, who was undergoing care, had breast cancer and was currently in the operating room. This crucial information was held by "another department" within UnitedHealthcare.
Potter's account, said Nidhi Hegde, managing director at the American Economic Liberties Project, was "another horror story from a doctor dealing with United Healthcare's terrible authorization process."
Hegde stated, "It's absurd that healthcare professionals are dedicating their time to explaining their roles to an insurance company rather than concentrating on patient care."
As Common Dreams reported last month, cancer patients have become disproportionately affected by "prior authorizations" demanded by for-profit health insurers, which require doctors to get approval for treatments. Prior authorization can delay lifesaving care and one survey of oncologists in 2022 found that patients experienced "disease progression" 80% of the time an insurance company's bureaucratic requirements delayed their treatment.
Potter needed to notify the UnitedHealthcare representative that the company had previously granted her authorization for the procedure.
She mentioned that she told him, "I have to return to my patient now," and then she was able to carry on with the procedure.
"But it's completely unmanageable," she remarked. "The insurance situation is chaotic. I can't describe it any other way."
Prior to Thompson's death, UnitedHealthcare faced significant backlash due to the various tactics it employs to deny patients access to healthcare coverage.
A Senate investigation found the company intentionally denied claims submitted by nursing home patients who suffered strokes and falls, in order to increase profits. The company also faces a class-action lawsuit for using an AI algorithm with a 90% error rate to deny coverage to senior citizens with Medicare Advantage plans,
In December, ProPublica published an investigation that found the company is one of several insurers who repeatedly relied on the advice of company doctors who have wrongly recommended denying care.
In a recent video update, Potter mentioned on Wednesday that insurance companies have established "a fear-driven system where, if I receive a call from an insurance company urging me to return their call immediately, I worry that they might refuse to cover my patient's surgery, leaving the patient facing an unexpected bill."
Potter toldNewsweek that the experience confirmed for her that "there is no room in healthcare where the pressure of insurance isn't felt by both patients and doctors. Not even the operating room."
UnitedHealthcare suggested in a comment to Newsweek that it did not call Potter during surgery, saying, "There are no insurance related circumstances that would require a physician to step out of surgery and it would create potential safety risks if they were to do so. We did not ask nor would ever expect a physician to interrupt patient care to answer a call and we will be following up with the provider and hospital to understand why these unorthodox actions were taken."
In the wake of Thompson's death, Potter, alongside numerous Americans, voiced his opposition to the for-profit health insurance system, sharing insights from his experience as a physician.
"In a TikTok video, Potter stated, 'It's important for you to understand that insurance companies are influencing the quality of care you receive by exerting pressure on doctors through their policies. We're currently facing a very troubling period in healthcare, and unless we address this issue, we risk heading down an irreversible path.'"
