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      Insurance Companies and the Prior Authorization Maze

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      More from our inbox:Elect the U.S. Attorney GeneralFriendship MemoriesA Leadership GapInsurance companies have weaponized a seemingly benign process to protect their profits, and it’s putting patients at risk.To the Editor:Re “‘What’s My Life Worth?’ The Big Business of Denying Medical Care,” by Alexander Stockton (Opinion video, March 14), about prior authorization:Mr. Stockton’s video captures a current snapshot of an important truth about medical insurance in our country and in doing so does a service to all citizens by making them aware of this threat to themselves and their families.The immediate truth is that medical insurance companies are inadequately regulated, monitored and punished for their greed. In their current iteration they are bastions of greed, power and money. They need to be reined in.But there are other truths as well. Some physicians, just like some pharmaceutical companies, are unable to contain their greed and allow avarice to cloud their judgment, compromise their ethics and in some cases cross the line to Medicare fraud or other illegal activity.Medical care in our country is very big business involving billions of dollars. Without proper controls, regulation and monitoring, malfeasance follows. The challenge in such a complex and multifaceted context is how to implement such controls and monitoring without making things worse.Ross A. AbramsJerusalemThe writer, a retired radiation oncologist, is professor emeritus at Rush University Medical Center in Chicago.To the Editor:The Times’s video exploits tragic outcomes and does not mention basic important facts about the limited yet key role of prior authorization in ensuring that patients receive evidence-based, affordable care.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Sherrod Brown Embarks on the Race of His Life

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      Ohio will almost certainly go for Donald Trump this November. The Democratic senator will need to defy the gravity of the presidential contest to win a fourth term.Senator Sherrod Brown, Democrat of Ohio, has always had the luxury of running for election in remarkably good years for his party. He won his seat in 2006, during the backlash to the Iraq War, won re-election in 2012, the last time a Democrat carried the state, and did so again in 2018, amid a national reckoning of Donald J. Trump’s presidency.His campaign in 2024 will be different, and most likely the toughest of his career, with a Republican Party determined to win his seat and a Democratic president hanging off him like one of his trademark rumpled suits. In an election year when control of the Senate relies on the Democratic Party’s ability to win every single competitive race, an enormous weight sits on the slumped shoulders of the famously disheveled 71-year-old.“I fight for Ohioans,” Mr. Brown said in an interview on Wednesday. “There’s a reason I win in a state that’s a little more Republican.”Mr. Brown’s tousled hair and gravelly voice have spoken to working-class voters since he was elected Ohio’s secretary of state in 1982. His arms may be clenched tightly around his chest, but he projects a casual confidence that he can win once again in firmly red Ohio, where he is the last Democrat holding statewide office.But beneath that image is trouble. On Monday, he had just received an endorsement from the 100,000-strong Ohio State Building and Construction Trades Council, when a retired bricklayer, Jeff King, pulled him aside in a weathered union hall in Dayton.Mr. Brown has had plenty of achievements to run on, Mr. King, who made the trip from his local in Cincinnati, told the senator. But, he asked, would workers in a blue-collar state that has twice handed Mr. Trump eight-percentage-point victories understand who should get the credit?We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Potency of Trump’s ‘Lost Cause’ Mythmaking

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      At an Ohio rally this month, Donald Trump saluted the insurrectionists who stormed the Capitol on Jan. 6, 2021, calling them “unbelievable patriots” and referring to those who’ve been locked up for their involvement on that terrible day as “hostages.”This was a continuation of Trump’s “Lost Cause” mythmaking that began during his successful presidential campaign in 2016 and was ramped up in service of his efforts to remain in power despite his 2020 loss and the deadly riot that those efforts stoked.More than 1,200 people have been charged related to Jan. 6. And though it shouldn’t have to be said, let’s be clear: Those who’ve been tried, convicted and imprisoned for storming the Capitol aren’t hostages, they’re criminals.But Lost Cause narratives aren’t about truth. They’re about negating the truth.Which is what happened when the Lost Cause mythology was constructed after the Civil War. The cause of the war was framed as “Northern aggression” rather than slavery. A lore about happy slaves and benevolent enslavers proliferated. The narrative valorized those who seceded from and fought against the United States.And it has survived to some degree for over 150 years, tucked into the cracks of our body politic. It still surfaces in ways that may seem remote from the Confederate Lost Cause myth, but that definitely promote it.It manifested itself last year when Florida changed its African American history standards to say that the enslaved “in some instances” benefited from their enslavement, and in Nikki Haley’s hesitance on the campaign trail to state the obvious, that slavery was the cause of the Civil War.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Texas Migrant Law Is Latest Test of America vs. Its States

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      The partisan gridlock gumming up Washington has prompted states controlled by one party to set off on their own.The face-off between Texas and the federal government over whether the state can enforce its own immigration policy reflects a broader and recurring feature of American politics: a number of hot-button issues have become proxy battles over who gets to decide.During the Trump administration, Democratic-run states like California and blue cities like New York waged legal fights over their right to pass sanctuary laws to protect migrants. Now, the conflict over whether Texas can arrest and deport migrants is just one part of a larger campaign that red states have directed at the Biden administration.A coalition of Republican state attorneys general has also gone to court to thwart the administration’s efforts to regulate methane emissions from oil and gas drilling, to block a program that allows humanitarian entry to migrants from specific countries, and to halt an effort to crack down on gun accessories, among others.The balance of power between the national government and states has been a source of tensions in the United States since its founding, leading to the Civil War. But in the 21st century, as partisan polarization has intensified, it has morphed into a new dynamic, with states controlled by the party opposed to the president regularly testing the boundaries.The political issues run the gamut — and include topics like abortion, gun control, same-sex marriage and even marijuana legalization — but the larger pattern is clear: Whenever one party wins control of the central government, the other party uses its control of various states to try to resist national policies.“We’re seeing stuff we’ve never seen in the modern era,” said Heather K. Gerken, the dean of Yale Law School who has written about contemporary federalism. “It’s really stunning what kind of proxy war is taking place. It’s all because the vicious partisanship that has long been a feature of Washington has now filtered down to the states.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Trump Seeks to Delay Jan. 6 Civil Cases

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      The former president’s lawyers told the judge overseeing the proceedings it would be unfair to put on a defense now because it might reveal his strategy for the criminal case on related charges.Lawyers for former President Donald J. Trump asked a judge on Tuesday night to pause a group of civil lawsuits seeking to hold him accountable for the violence at the Capitol on Jan. 6, 2021, until after his federal criminal trial connected to the same events was over.The request by the lawyers to pause the civil cases was the latest example of Mr. Trump trying to pit his multiple legal matters against one another in an effort to delay them. In the past several weeks, the former president and his lawyers have managed to gum up each of the four criminal cases he is facing, sometimes by persuading judges that the timing of the various proceedings were in conflict with one another.In their request for a pause in the civil cases, Mr. Trump’s lawyers told Judge Amit P. Mehta, who is overseeing the proceedings, that it would be unfair to the former president to be forced to defend himself against the suits at this point. They said that in so doing, he might reveal his strategy for defending himself against related criminal charges brought against him by the special counsel Jack Smith.“Given the substantial overlap in factual and legal allegations between these cases and the D.C. criminal case,” the lawyers wrote, there is “a substantial risk that proceeding in this matter now will expose the defense’s theory to the prosecution in advance of trial.”The lawyers added, “This would prejudice President Trump’s ability to effectively defend himself in both these civil cases and the special counsel criminal matter.”In the months after Jan. 6, a half-dozen lawsuits were filed against Mr. Trump by members of Congress and police officers who served at the Capitol that day, accusing him of inciting the mob that stormed the building. The lawsuits, which all are being heard in Federal District Court in Washington, have sought unspecified financial damages from Mr. Trump.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Melania Trump Avoids Saying Whether She Will Hit Campaign Trail

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      When the former president cast his vote in the Florida primary election on Tuesday, the former first lady was by his side.This was notable for a few reasons.Former President Donald J. Trump has said for months that his wife, Melania, would join him on the campaign trail. And for months, Mrs. Trump remained absent from campaign events and victory celebrations — after Mr. Trump cruised to a victory on Super Tuesday, his wife did not join him onstage to greet supporters at Mar-a-Lago, their home in Palm Beach, Fla.Always more content to be a cipher to the curious public than she is to gamely field questions, Mrs. Trump did something out of character when she replied to someone who asked whether she planned to be a more regular presence going forward.“Stay tuned,” she said.It was a reply, but not an answer.(“That’s the answer she gives when she doesn’t want to commit to anything,” Stephanie Grisham, her former communications director who wrote a memoir about the Trump White House, said in a text message.)Mrs. Trump, 53, has formally been a political spouse for almost a decade, but she has shown little interest in campaigning, despite her popularity as a surrogate for her husband.Her public appearances in recent months have been sparse, and they have not been in the service of her husband’s campaign.One of her most notable was to deliver a eulogy for her mother, Amalija Knavs, who died in January. In that rare speech, Mrs. Trump, who was close enough to her mother that Mrs. Knavs and her husband, Viktor, often lived in a suite at the White House, described her mother as “a ray of light in the darkest of days.”Before that, Mrs. Trump, a naturalized U.S. citizen, attended a naturalization ceremony in December and told participants that citizenship “means actively participating in the democratic process and guarding our freedom.” (Mrs. Trump received an immigrant visa reserved for “individuals with extraordinary ability” in 2001, when she was a model, and the circumstances surrounding her immigration process came under scrutiny when she was first lady.)And in November, she joined the other living first ladies at a memorial service for the former first lady Rosalynn Carter.On Tuesday, Mr. Trump told people gathered outside the polling location in Palm Beach that he had voted for himself. A spokeswoman for Mrs. Trump did not immediately respond to a request for information about the former first lady’s vote. More