Draft Letter From Patient to Legislator

To my Congressional representative:

As a patient and a citizen, I am very concerned about the policies of my health insurance company [name company]. It’s beginning to look more and more like my health plan is working to prevent people like me from getting the medical care I need, rather than helping me stay healthy (which is what they always say in their brochures or on their websites).

Not only do I [or “many people,” if this isn’t true for you] need permission to see a specialist in the first place, my doctor also needs permission to give me the care I need. This isn’t really health care any more. It’s becoming health neglect.[It would help to state here in a few words what has been happening if you have been denied a treatment or test.]

This isn’t true only for treatments that cost thousands of dollars a month! I have learned that pre-approval may sometimes be needed even for common treatments that are well-accepted by medical experts.

It’s time for our elected officials to consider the following questions about the health insurance industry:

Who is telling our doctors what is the best care for patients? (I wonder whether the insurance company representatives who are saying yes or no to my doctor’s treatment recommendations even have medical degrees themselves.)

Are these insurance company policies based on the best knowledge about medical care, created by experts and medical societies, or are they based only on trying to save money for insurance companies?

How many people are being harmed by these policies, or by simple delays in getting treatment? While our insurance plans let time slip away avoiding approvals for the treatments we need, our health continues to fail.

It’s time to get control of the situation! And only you can help.

I would like to suggest that you consider drafting new laws that require insurance plans to follow certain simple principles in deciding whether or not to approve medical treatments: 

1. Every pre-approval policy must be consistent with the best knowledge about effective medical care.

2. Pre-approvals must be completed in days,not weeks or months. People could suffer or even die, just waiting for the paperwork!

I am sure the local medical society [add specifics here] would be more than happy to help you to write such legislation.

I suspect that many thousands of people, quite a few of them in your own district, are suffering from these policies. If you pay attention to this critical problem, you can count on our support in the future. Please do what you can to help.

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