Stop Prior Authorization to Empower We the Patients

Stop Prior Authorization to Empower We the Patients

A new survey reveals that prior authorization is now the greatest hurdle to obtaining health care; but there is a solution.

Deanne Waldman for American Thinker 

Despite the much ballyhooed sticker shock of health insurance price hikes, unaffordability is not considered the biggest obstacle to getting medical care.  According to a just-released KFF survey, the U.S. public considers prior authorization (PrAuth) the “greatest hurdle” to obtaining the care they need when they need it.

PrAuth is a process that third-party payers use to decide if they will pay for care recommended by your doctor. If the answer is yes, the third party decides how much to pay and to whom, all pre-arranged by contract.

There is a way to remove the PrAuth barrier and at the same time, solve the unaffordability crisis.

Repeal the ESI.

Shortly after the attack on Pearl Harbor, Congress passed the Stabilization Act of 1942 that imposed strict wartime wage and price freezes. Since employers could not increase wages to recruit, retain or reward workers, Congress passed an accommodation, the employer-sponsored [health] insurance provision (ESI), that allowed employers to offer employees a non-monetary benefit: paying for employees’ health insurance tax-free to the employer. After the war, Congress repealed every element of the 1942 wage freeze act, except one: the ESI.

For 84 years, U.S. employees have been denied their full wages, with the missing portion being paid to insurance companies for insurance policies in employees’ names. In 2025, the average amount paid to an insurance company — of wages denied — was $26,993.

Repealing the ESI will restore full compensation to more than 80 million American workers and their families. Median household income in 2025 was $83,592. If workers were paid full wages by repealing ESI, they would receive a 32 percent increase is take-home pay.

Repeal of the ESI would eliminate the objectionable PrAuth obstacle as the person “authorizing” payment would not be a third party but the consumer himself/herself.

With consumers paying providers directly and immediately, there will be no delay in either service delivery or payment to the provider as currently occurs with PrAuth.

Note: One other legislative act should accompany repeal of ESI: creation of a no-limit HSA. All accounts currently available — Health Savings Accounts, Medical Savings Accounts and Flexible Spending Accounts — have numerous restrictions including contribution limits well below $10,000.  Americans would need a no-limit HSA to make the full amount of $26,993 available to spend tax-free on medical needs.

Putting more money in consumers’ hands through repeal of ESI would create a free market for healthcare goods and services with more than $1 trillion for consumers to spend.

By injecting free market forces — buyers’ need to economize and competition among sellers — repeal of ESI would produce dramatic results for five stakeholders in healthcare.

Patients who spend their own money rather than other people’s money (as patients do now) would have a powerful incentive to spend less. They would demand lower prices from sellers of both care and insurance as well as more timely service than is currently available. Wait times for care would plummet as consumers would flock to those who provide prompt service and avoid those who don’t.  Insurance companies would no longer be able to use PrAuth to make medical decisions for their clients (patients.)  Put more succinctly, patients’ medical autonomy would be restored.

Providers as well as care facilities would have to adapt — compete, lower their charges, and offer prompt service — or have empty waiting rooms and vacant operating suites. Physicians would be paid more than at present because patients would pay their full albeit reduced charges, which still would be more money than the small fraction of their charges that Washington’s Allowable Reimbursement Schedule allots to them.

After repeal of ESI, insurance companies will no longer be able to use PrAuth to activate their “3-D Strategy:” delay, defer, or deny payment for care. Just like providers, insurers will have to compete for consumer dollars. They will either offer policies consumers want — from short-term “junk” insurance to high-deductible, full-pay catastrophic coverage — at prices consumers can afford, or they won’t buy.  Elimination of PrAuth will produce large savings for consumers and providers in time, money, and lives, but lower profits for insurers.

Washington politicians will initially oppose repeal of ESI repeal as they will lose the support of the powerful insurance lobby along with a modicum of power. However, there are several positive outcomes for politicians.

First there will be millions of Americans grateful for the large increase in compensation and the gain in personal control. Second, the federal budget will no longer be at the mercy of whatever price hikes insurance companies choose. Third are the optics – Congress will be seen as doing the right thing, completing a necessary and long overdue legislative/bureaucratic oversight.

Taxpayers gain, not only as patients, but also by lessening their tax burden. Repeal of ESI, canceling current HSAs, MSAs, and FSAs, and creation of a remarkably simple no-limit (no oversight other than IRS) HSA will reduce the hassle and particularly the massive cost of healthcare BURRDEN: bureaucracy, unnecessary rules and regulations, directives, enforcement, and noncompliance activities. As bureaucrat jobs become unnecessary, there will be a sizable reduction in force, saving Americans billions in taxes.

Repeal of ESI combined with a new no-limit HSA will begin the process of restoring power to We the Patients. Medical care will become both affordable and available. Empowering patients will require actions in addition to repeal of the ESI such as Medicaid block grants, reduction in all manner of federal BURRDEN, and senior no-limit HSAs, all detailed in the Empower Patients Initiative released by Americans for Tax Reform.

Deane Waldman, M.D., MBA, is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; former director of the New Mexico Health Insurance Exchange; and author of “Empower PATIENTS – Two Doctors’ Cure for Healthcare.” Follow him on X.com@DrDeaneW and visit his website, www.empowerpatients.info.

Image: Free image, Pixabay license.

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Iran Introduces New Ayatollah

 

World·Mar 1, 2026 · BabylonBee.com

TEHRAN — The Iranian government has officially announced a successor to Ayatollah Khamenei, introducing today the new Supreme Ayatollah, Tucker Carlson.

Ayatollah Carlson will immediately take the helm as the foremost political leader for the longstanding Muslim theocratic dictatorship.

"All bow before Ayatollah Carlson. Praise Allah!" cried Iranian government officials as Ayatollah Carlson took the stage. "Truly, Allah has chosen Ayatollah Carlson to end the scourge of infidel Christians in our land once and for all. No one loves jihad more than he. Praise Allah!"

In his opening address, Ayatollah Carlson confirmed that he will continue the hard-line Islamic extremism of his predecessor. "I inherited such clean public transportation and well-stocked supermarkets from my predecessor," said Carlson. "Rest assured, if I too must kill 32,000 civilians to keep it that way, I will not hesitate. In order to keep this nation so peaceful and tranquil, we will conduct the most terrible jihad the world has ever seen."

At publishing time, Ayatollah Carlson had introduced his new Hezbollah liaison, Megyn Kelly.

Mass Shooting in Austin, Texas Bar Killing 3 Injuring 14 Likely a Terrorist Incident

A former New York City resident and U.S. citizen immigrant originally from Senegal, opened fire at a crowded Austin, Texas, bar, killing three people and injuring 14 others. Sources have told media the attack may have been motivated by recent U.S. strikes on Iran. {UPDATE: Shooter Pictured Below Fold}

The shooter was found to have a Quran in his vehicle and was wearing what is described as Islamic attire. The FBI is probing the incident as a potential act of ideologically driven terrorism. (PROMPTED)

(Fox 7 – Austin) – At a press conference early Sunday, Austin Police Chief Lisa Davis said police received a call around 1:40 a.m. for reports of a “male shooting” at Buford’s, a beer garden in the city’s busy entertainment district.

When police arrived at the scene, they confronted a man with a gun and then “returned fire, killing the suspect,” Davis said. According to EMS Chief Robert Luckritz, three people died at the scene and 14 people were taken to hospitals. Three of those injured were in critical condition.

A spokesman for the FBI said at a news conference later Sunday morning that the gunman appears to have ties to a terror group, but that is still under investigation.

“Obviously, it’s still way too early in the process to determine an exact motivation, but there were indicators on the subject and in his vehicle that indicate potential nexus to terrorism,” the FBI spokesman said. “Again, it’s still too early to make a determination on that, but we are investigating that very closely with our partners at the Austin Police Department.”

Davis said that the gunman had two weapons during the shooting, but that he never entered the bar.

“He drove by, was firing outside the window with a pistol,” Davis said. “Once he exited the vehicle after parking on Wood, he exited with a rifle at that point.”

Davis said an explosives team was called in to evaluate the gunman’s vehicle after investigators found concerning items inside. No bombs were found, however. (more)

UAE Confirms They Shot Down 541 Drones, 165 Ballistic Missiles and 2 Cruise Missile Fired by Iran – 21 Drones Hit Civilian Targets

The United Arab Emirates (UAE) is a very popular tourist destination in the middle east with most travelers traveling to the playground of Dubai.  Their economy and image as a safe and secure country are very important.  As a result, they are keenly sensitive, proactive toward negative impressions and highly focused on international opinion/security.

Iran has been sending drones and cruise/ballistic missiles into the entire region; hitting Kuwait, Saudi Arabia, the UAE, Bahrain, Qatar, Jordan and Israel.

The UAE is sharing how intense they are being targeted along with the network of defense systems being deployed to intercept the attacks.

UAE Ministry of Defense confirms we successfully shot down: 165 ballistic missiles, 2 cruise missiles and 541 drones fired by Iran.

On day 2, we shot down 20 ballistic missiles (8 fell in sea), 2 cruise missiles, and 311 drones. 21 drones hit civilian targets. {SOURCE}

This is a remarkable amount of Iranian firepower being targeted toward one regional nation.  The air defense system of the UAE is highlighting the value in very proactive defense positioning.  Quite remarkable.

[SOURCE]

“[…] – The UAE’s air defense today achieved a success rate of more than 96% in intercepting missiles after destroying 132 out of 137, and more than 93% in intercepting drones after intercepting 195 out of 209, for a total of 327 threats intercepted out of 346 with a success rate of around 95%. This is a figure that places it among the highest interception rates globally, which typically range between 85% and 95% depending on the type of threat and the conditions of engagement.” (source)

Senator Tom Cotton Discusses U.S. Military Operation Against Iran – Video and Transcript

Senate Intelligence Committee Chairman Tom Cotton appears on CBS Face the Nation to discuss the ongoing U.S. military operation against Iran.  Video and Transcript Below

[TRANSCRIPT] – MARGARET BRENNAN: Imtiaz Tyab reporting from Muscat, Oman. We turn now to the chairman of the Senate Intelligence Committee, Arkansas Republican Tom Cotton, who joins us from Bentonville. Good morning to you, Senator.

SEN. TOM COTTON: Good morning, Margaret.

MARGARET BRENNAN: The President of the United States warned the American public that there could be casualties, American casualties. Does that mean the U.S. is putting boots on the ground?

SEN. COTTON: No, Margaret, the president has been clear that what we should expect to see is an extended air and naval campaign that’s designed not only to continue to set back Iran’s nuclear ambitions, but most importantly, to destroy its vast missile arsenal. Many more missiles than the United States and Israel have air defenses combined, as well as the missile launchers and its missile manufacturing capability. Now obviously one risk of that kind of campaign is that an aircraft could be shot down, and the president would never leave a pilot behind. So no doubt we have combat search and rescue assets in the region that are prepared to go in and extract any downed pilot. But barring that kind of unusual circumstance, Margaret, the president has no plan for any kind of large scale ground force inside of Iran.

MARGARET BRENNAN: The New York Times is reporting that it was the CIA that provided the intelligence in regard to the exact location of the Supreme Leader and then he was subsequently killed. You’re smiling as I say that. Are you confirming that it is true that it is the United States that pinpointed his location leading to his death?

SEN. COTTON: No, Margaret, I can’t confirm anything about the intelligence that the United States intelligence community collects. I can tell you that, of course, we have exquisite intelligence collection methods, that the location and the intentions of the Supreme Leader and the other Ayatollahs in Iran, or for that matter, the leaders of other adversaries around the world, is obviously one of the highest priorities of our intelligence community. But clearly, this operation is driven by intelligence collected by Israel and the United States that has once again proven that our nations have capabilities that no other nation on earth has.

MARGARET BRENNAN: Indeed. There are questions, though, about what happens next. Secretary of State Marco Rubio testified to Congress last month and was asked specifically, what happens if Iran’s regime fails. Take a listen.

[ON TAPE]

DATE: JANUARY 28, 2026 SECRETARY RUBIO: So I don’t think anyone can give you a simple answer as to what happens next in Iran if the Supreme Leader and the regime were to fall, other than the hope that there would be some ability to have somebody within their systems that you could work towards a similar transition.

[END TAPE]

MARGARET BRENNAN: That was a month ago. We’re seeing some succession planning happening inside Iran. Is this a managed regime change here, or is the United States betting on regime collapse?

SEN. COTTON: Well, Margaret, first, I want to stress what happens next in the days ahead and probably the weeks ahead. Iran does have a vast missile arsenal, and that’s going to be the prior- prior- priority objective for this military campaign. It is destroying that arsenal that threatened American troops from bases as far flung as the Indian Ocean to Western Europe, and making sure Iran can’t rebuild it–

[CROSSTALK]

MARGARET BRENNAN: –Many of those are being fired right now–

SEN. COTTON: –As far as the future- well, but we’re stopping a lot of them from being fired before Iran can fire them. It’s much easier to kill the archer on the ground than it is to shoot his arrows out of the sky. As far as the long term future of Iran’s government, Secretary Rubio is right, I don’t think anyone can give you a simple answer. There’s probably a lot of jockeying inside of Iran right now, they have a very consultative, deliberative process to replace the Supreme Leader. There’s a reason why he didn’t want to have a clear succession plan in place. It’s hard to do that when the United States is pummeling their leadership every moment of the day. I’m sure, though, that there are also some supreme- or there are also some leaders inside of Iran who might be jockeying to audition for the role of Iran’s Delcy Rodriguez.

MARGARET BRENNAN: Okay, but what you just described in terms of Delcy Rodriguez sounds like it is a managed transition, not regime change. Is that accurate?

SEN. COTTON: Margaret, again, as Secretary Rubio said, it’s not a simple answer–

MARGARET BRENNAN: –Right, but we’re in the middle of it now. So don’t you need an answer?

SEN. COTTON: –We’re going to continue to hit not just their military capabilities–

MARGARET BRENNAN: –At least an outcome, a goal?–

SEN. COTTON: –But we’re going to continue to hit their military capabilities, and we’re going to continue to hit their senior leadership, the ayatollahs, who have also been complicit in 47 years of heinous crimes, not only against Americans but against their own people. Again, there’s no simple answer for what’s going to come next. But as President Trump promised last month when the Iranian people were rising up against their own regime, help is on the way. Help has arrived.

MARGARET BRENNAN: Well, exactly. You’re talking about what comes next, but then you’re also telling me you don’t know what comes next. So do you believe that regime change is possible from air support alone? Has a leader of the opposition been identified? Is the opposition unified to deliver in a way that President Trump is calling on the people to do? Are we arming anyone to actually challenge the regime?

SEN. COTTON: Margaret, the opposition is 90 million Iranians who have suffered under the brutal Islamic Republic Revolutionary regime for the last 47 years.

MARGARET BRENNAN: Yes, and the president–

SEN. COTTON: –We’ve seen in recent months that there’s–

MARGARET BRENNAN: –called them to take over their government.

SEN. COTTON: And we would all celebrate if the Iranian people were able to rise up and reclaim their freedom and reclaim their destiny. And as the president said when he promised help is on the way, help has arrived. And that’s why you’ve already seen some protests out celebrating the death of the supreme leader, the man who has brutally repressed his own people for almost 40 years. Now, we can’t necessarily dictate what course that is going to take, but the help that the president promised is on the scene, and it’s going to continue to be on the scene for probably a few weeks, as we make sure that Iran’s military is no longer capable of threatening our own troops, our Arab friends in the region and Israel, and also repressing its own people.

MARGARET BRENNAN: This is a big gamble by the president. Before the strikes, according to CBS polling, 74% of Americans said that Trump would need approval from Congress for military action against Iran. He did not seek that. If this operation takes weeks, which is how you described it, do you believe the administration has effectively made its case to the American public to expect casualties to support this action?

SEN. COTTON: Margaret, I thought the president’s eight minute video yesterday was outstanding. It laid out Iran’s 47-year campaign of terror and revolutionary violence against the United States and our people and really, the civilized world. I’m sure the president will speak more in the coming days, will have briefings to Congress–

MARGARET BRENNAN: –47 years, he did not describe imminence or justify that in that video. Do you believe that the American public is owed something more than a Twitter video?

SEN. COTTON: Margaret, I think an eight minute address to the American people, whether the president posted on social media or whether it happens on your network, is in keeping with presidential custom of addressing the American people. Again, I’m sure that he’s going to be speaking more in coming days. The administration will be briefing Congress, and we’re going to have a vote in the Congress. The Democrats are forcing a vote–

MARGARET BRENNAN: –On the War Powers Act.

SEN. COTTON: I expect there’ll be overwhelming Republican support for our troops, for the, for our troops, and for the president’s decision to finally eliminate the threat of Iran. And I would invite Democrats in the Congress to join their Democratic colleagues like John Fetterman and Josh Gottheimer and Greg Landsman in supporting our troops, in finally putting America’s foot down against the Islamic Republic of Iran.

MARGARET BRENNAN: Senator Cotton, we appreciate you in your role in oversight of the Intelligence Committee, making the case for the administration. We have more questions, and we would love to put them to the administration as well. Thank you very much for your time this morning. Face the Nation will be back in one minute. Stay with us.

[End Transcript]