Interesting article. I agree with other commenters that change in medical science over time probably necessitates changes in the industry, but I don't think this precludes making the work of medical professionals less onerous and expensive. Prior authorizations in particular seem like a uniquely wasteful and American phenomenon, whereby time (and thus money) is burned just so doctors and insurance can try to get on the same page. That cost, we can be sure, is then passed along to patients, on both the service and insurance ends. But more interesting to me, the broad picture in this article is of a world in which insurers have steadily clawed away more and more diagnostic and prescriptive responsibilities away from doctors, because the economic logic of a world with private health insurance allows them to do so, to the detriment of doctors' lives (as the article describes) but more saliently (for an American non-doctor like me) to that of all Americans trying to receive healthcare via insurance. I think it's pretty hard to dispute this phenomenon is real and harmful. The question, which this article doesn't really address, is what to do about it?