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cancer
'Out of Control': Insurance Giant UnitedHealth Calls in Middle of Cancer Surgery to Question Necessity
Dr. Elisabeth Potter shared "another horror story from a doctor dealing with United Healthcare's terrible authorization process."
Jan 09, 2025
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 video posted to TikTok, Dr. Elisabeth Potter said she recently received an unprecedented phone call from UnitedHealthcare about a patient—one who was already under anesthesia and having surgery.
Potter, a plastic surgeon who specializes in reconstructive surgery for breast cancer patients who have had mastectomies, said she was performing a bilateral deep inferior epigastric perforator [DIEP} surgery when UnitedHealthcare called her in the operating room.
The call was urgent, she was told, and needed to be returned right away.
"So I scrubbed out of my case and I called UnitedHealthcare, and the gentleman said he needed some information about her," said Potter. "Wanted to know her diagnosis and whether her inpatient stay should be justified."
Potter found that the person calling wasn't aware that the patient whose care he was questioning had breast cancer and was in the operating room—that information was known by "a different department" at 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."
"Ridiculous that doctors/nurses are spending time explaining their work to an insurance company instead of being able to focus on care," said Hegde.
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 had to inform the UnitedHealthcare staffer that the company had already given her approval for the surgery.
She said she told him, "I need to go back and be with my patient now" and was able to continue the procedure.
"But it's out of control," she said. "Insurance is out of control. I have no other words."
Even before Thompson's killing, UnitedHealthcare has garnered outrage for the numerous methods it uses to deny healthcare coverage to patients.
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 follow-up video, Potter said on Wednesday that insurance companies have created "a fear-based system where, if an insurance company calls me and says I've got to call them right back, I'm afraid they're not going to pay for my patient's surgery, that patient is going to get stuck with a 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."
Potter joined many Americans in speaking out against the for-profit health insurance system in the days after Thompson's killing, offering a doctor's perspective.
"I want you to know that insurance companies are affecting the kind of care that you're getting, because they're applying pressures to physicians through their policymaking," said Potter in one video posted on TikTok. "This is a dark, dark time for healthcare, and we have to fix this or we're gonna go down a path that we can't get back from."
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'People Are Dying': Air in 'Cancer Alley' Louisiana More Toxic Than Previously Thought
Ethylene oxide, a carcinogenic gas, is nine times more prevalent than the EPA estimated, a study shows. And inside petrochemical plants, workers are likely subjected to much higher concentrations, an author said.
Jun 11, 2024
The presence of a dangerous chemical in the air of southeast Louisiana's "Cancer Alley," which has a substantial Black population, is far greater than the U.S. Environmental Protection Agency estimated and exceeds safe limits, a study published Tuesday found.
The levels of ethylene oxide, exposure to which can cause lung, breast, or other cancers, are nine times higher than the EPA estimated, the study, which was published in the journal Environmental Science & Technology, shows. Ethylene oxide is a gas used in plastic production and in the sterilization of medical equipment. Long-term exposure is exceptionally dangerous: The EPA regards it as unsafe, due to cancer risk, at a level above about 11 parts per trillion (ppt) in the air.
The new study found that the gas' presence averaged about 31 ppt in Cancer Alley, and was far higher in certain locations within the industrial corridor, which runs alongside the Mississippi River from Baton Rouge to New Orleans. In each of the census tracts the researchers studied, the level of the gas was higher than the EPA had estimated for that area, in most cases significantly, with a median discrepancy of about 21 ppt.
"We expected to see ethylene oxide in this area," Peter DeCarlo, an associate professor at Johns Hopkins University and an author of the study, toldThe Guardian, noting that it was "worrisome," especially for children. "But we didn't expect the levels that we saw, and they certainly were much, much higher than EPA's estimated levels."
Concentrations of ethylene oxide could be much higher "inside the fenceline" of petrochemical plants—areas which couldn't be studied—where workers are "getting much, much higher concentrations over the course of their day," DeCarlo toldGrist.
A groundbreaking study by @JohnsHopkins in @EnvSciTech has uncovered alarming levels of ethylene oxide emissions from petrochemical facilities in Cancer Alley, Louisiana. #BeyondPetrochemicals #PeopleOverPollution pic.twitter.com/s9vygj8RlV
— Beyond Petrochemicals (@BeyondPetrochem) June 11, 2024
People in Cancer Alley are nearly twice as likely to get cancer as other Americans, and ethylene oxide accounts for most of the known carcinogenic risk there, roughly 68%, if EPA estimates are correct. "The fact that so much of the environmental risk in this area seems to come from a single chemical is remarkable," the study authors wrote.
DeCarlo said this is why the authors deemed it important to study the amount of ethylene oxide in the air there. However, he cautioned that ethylene oxide is far from the only problem.
"The reality is people aren't just breathing ethylene oxide, they are breathing a whole soup of chemicals," he told The Guardian. "When you start to add everything up it becomes a much more problematic picture."
The risk to human health is likely not limited to facilities that are emitting ethylene oxide, as the researchers found plumes of gas that were miles long. East Ascension High School in Gonzales, Louisiana, is about five miles from an ethylene oxide hotspot, the study notes.
In 2021, United Nations experts called for an end to environmental racism in Cancer Alley, and the organization's special rapporteur on the issue of human rights called the area a "sacrifice zone" the following year. In January, Human Rights Watch released a report on systemic injustice there.
Sharon Lavigne, the founder of Rise St. James, a community organization in St. James Parish, said the findings were a "step in the right direction" but must lead to accountability and change.
"These monitors are good, but in the meantime, people are dying," she toldGrist.
Earlier this year, the EPA announced new ethylene oxide rules that could cut Louisiana emissions of the gas by nearly 80%—"the first time that federal regulations for chemical plants have been updated in decades," Gristreported in April. Cancer Alley had been among the places that EPA Administrator Michael Regan visited on his 2021 "Journey to Justice" tour. Yet the new study may lead to calls for further action.
"The EPA's new rule was necessary but should only be the start of how we begin to make things right here," Heather McTeer Toney, who leads a Bloomberg Philanthropies campaign to end petrochemical plant expansion, told Grist. "I'm hopeful to see levels go down, but the data suggest we have a long way to go."
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WHO Chief Demands Swift Medical Evacuations for 9,000 Injured, Sick Patients in Gaza
Israel is currently attempting to send several patients back to the besieged enclave from East Jerusalem, where they have been receiving cancer treatment.
Mar 30, 2024
The head of the World Health Organization on Saturday demanded that Israel speed up approvals for medical evacuations from Gaza as the number of people who urgently need life-saving healthcare reached roughly 9,000—and as Israeli officials threatened to send several Palestinian patients back to the besieged enclave from the East Jerusalem hospital where they've received cancer treatment.
Tedros Adhanom Ghebreyesus, director-general of WHO, warned that with only 10 of Gaza's 36 hospitals "minimally functional" following repeated attacks on the enclave's healthcare system, "thousands of patients continue to be deprived of healthcare."
At the beginning of March, WHO assessed that about 8,000 patients needed to be immediately evacuated from Gaza to receive treatment for cancer, kidney failure, and other chronic diseases as well as injuries from Israel's relentless bombing of civilian infrastructure.
That number has grown by about 1,000 in recent weeks, Tedros said.
More than 3,400 sick and injured people have been taken abroad via the southern border town of Rafah since Israel began its bombardment on October in retaliation for a Hamas-led attack.
"But many more need to be evacuated," said Tedros. "We urge Israel to speed up approvals for evacuations, so that critical patients can be treated. Every moment matters."
As Tedros called on Israel to swiftly approve medical evacuations, human rights advocates condemned Israeli authorities who aim to deport patients with cancer back to Gaza from an East Jerusalem hospital where they've been receiving advanced treatment since before the October 7 attack on southern Israel.
"Returning residents to Gaza during a military conflict and a humanitarian crisis is against international law and poses a deliberate risk to innocent lives," Physicians for Human Rights (PHR) said in a statement. "All the more so when it concerns patients who may face a death sentence due to unsanitary conditions and hunger, along with the unlikely availability of medical care."
At least 22 patients from Gaza, including several children, have been receiving treatment at Augusta Victoria Hospital, having received authorization from Israel prior to the Israel Defense Forces' (IDF) current escalation.
"I arrived here in Jerusalem with my son Hamza on September 27 last year," Qamar Abu Zoar toldThe Guardian on Saturday. "Hamza, who is four and a half years old, has a brain tumor and needs treatment that he couldn't receive in Gaza. While we were here, the war broke out. And since then, we have been stranded in this hospital, while my other two younger children are in the north of Gaza with my husband."
The Coordination of Government Activities in the Territories (COGAT), which oversees civilian affairs in the occupied Palestinian territories, has urged hospital officials to provide a list of patients who could be sent back to Gaza, where patients in the remaining hospitals are suffering from infections due to the use of improvised and unsterilized medical equipment, as well as from worsening malnutrition.
Israel's near-total blockade of humanitarian aid into Gaza has affected food and medicines, and CNN reported earlier this month that anesthetics, anesthesia machines, oxygen tanks, and ventilators are frequently rejected by Israeli inspectors who examine aid trucks.
Last week, the Israeli High Court of Justice halted an effort by COGAT to send 10 patients from Augusta Victoria Hospital back to Gaza, where in many cases their homes and hometowns have been decimated by Israeli bombing and shelling.
COGAT claimed the patients had finished their treatment and said it would work with aid agencies if they had a need for more medical care, coordinating "their stay with the hospitals to safeguard their health."
But as Tedros warned Saturday, the vast majority of hospitals in Gaza are no longer operating.
Israel's High Court has until April 21 to issue a final ruling on whether officials can deport patients to Gaza.
"The hospitals and the medical staff must strongly oppose the release of the patients from their custody," said PHR, "unless a guarantee is given that they will not be returned to Gaza where their lives are in danger."
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