Helping make the health care system work for you

Prior authorization: Valuable cost-saver or bureaucratic black hole?

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Thousands of requests for prior authorization of prescriptions arrive daily in doctors' offices across the country, Danielle Ofri writes.

Last month we heard from an Impatient reader who won a battle with his health insurer over its refusal to authorize a particular medication. But consumers aren't the only ones who find themselves yelling into the phone at a service rep -- your doctor most likely spends time doing it on his or her patients' behalf. 

In an op-ed in the New York Times, Dr. Danielle Ofri, an associate professor at New York University School of Medicine, writes that thousands of letters requesting a doctor's prior authorization for medication arrive daily in medical offices across the country.

She explains that insurance companies require prior authorization as a cost-saving measure: Doctors must provide a compelling reason why their patients need more expensive treatments, rather than less costly medications. She writes:


Are some veterans exaggerating or lying about their PTSD?

A retired American soldier salutes to th


Are some veterans exaggerating or lying about their post-traumatic stress disorder, in a bid to secure benefits from the Veterans Administration?

Reporter Alan Zarembo poses that question in an investigation in the Los Angeles Times. He notes that over the last 13 years, the number of veterans on disability for PTSD has increased from 133,745 to more than 656,000. Depending on the severity of their condition, he writes, veterans can receive up to $3,000 a month, tax free, for PTSD-related disability.

According to Zarembo, a VA psychologist from Florida estimated that about half the veterans he evaluates for PTSD are exaggerating or lying about their symptoms. He quotes Christopher Frueh, a University of Hawaii psychologist with 15 years of experience treating PTSD in the VA system:


Would you use an app to share your STD test results?

STD Status App - 1

Maya Sugarman/KPCC

Zoë Klar, 23, of Los Angeles has used both Tinder and OkCupid for online dating.

Pretend you meet someone you really like – be it at a bar, on a mobile dating app like Tinder, or on an online dating site like OkCupid – and you want to become more intimate with this person.

Do you ask about STD status? If the response is, "oh yeah, I just got tested, I’m good to go," do you ask for proof?

It’s an awkward conversation. But it’s a critical one, especially when an infection like gonorrhea – which has no symptoms – increased 13 percent between 2012 and 2013 in California. Chylamida - which also has no symptoms - decreased slightly during that period, but it’s still the most common STD in the state.

"I'll show you mine"

Today I reported on an app, called Healthvana, that allows users to access their STD test results online or on their phones, and share them with prospective partners, if they choose. The company bills itself as the modern version of, "if you show me yours, I’ll show you mine" for STD test results.


Take a bite: Are processed foods a vital part of your diet?

The soup isle at a grocery store in Washington, D.C, Tuesday, November 22, 2011.

Maggie Starbard/NPR

A paper in the American Journal of Clinical Nutrition says processed foods are a vital part of our diet.

We've all heard the healthy eating advice: Shop the perimeter of the grocery store, avoid eating processed foods. Only buy foods with ingredients you can pronounce.

So would it surprise you to read that the American Society for Nutrition considers processed foods a vital part of the American diet?

In a new paper in the American Journal of Clinical Nutrition, the Society argues that processed foods contribute to the health of the U.S. population:

"We conclude that processed foods are nutritionally important to American diets. They contribute to both food security (ensuring that sufficient food is available) and nutrition security (ensuring that food quality meets human nutrient needs.)"

Critics jumped on the paper for lumping everything from roasted nuts and hummus to Lucky Charms and Cheez-Its when discussing processed foods. The authors do point out that diets rich in nutrient-dense foods – whether processed or not – are more likely to meet nutrition guidelines:


Timely care at VA surprises young veteran

Long Beach VA

Rebecca Plevin

Lance MacNiven visited the emergency department at the VA medical center in Long Beach when he tore his Achilles tendon.

The Department of Veterans Affairs is back in the headlines this week: Lawmakers in Washington are considering a $17 billion proposal to overhaul the department and improve health services for veterans.

Meanwhile, a young veteran from Los Angeles is still navigating the VA system. When Impatient readers first met 25-year-old Lance MacNiven in May, he was frustrated with the long wait times at the VA facilities in Los Angeles and Long Beach.

"When I call for an appointment," MacNiven said at the time, "it's never been weeks; it's always been months."


MacNiven recently tore his Achilles tendon playing flag football. This time around, he's been pleasantly surprised by how much smoother and more timely his care and treatment has been.

"It was definitely more timely, I think because of the severity of the injury," MacNiven told me, when I visited him yesterday at his apartment in Playa Vista. He has a thick cast on his leg, which he propped up on a chair.