Why does going to the doctor feel harder than it should? Why do claims get denied? What exactly is a prior authorization? What is a pharmarcy benefit manager and how do they accept drug costs? In Inefficient on Purpose, practicing physician J. Benjamin Proctor, M.D., takes readers inside the machinery of American healthcare and examines the forces that stand between patients and the care their doctors recommend. Drawing on his experience as both a physician and a cancer survivor, Dr. Proctor explores insurance denials, prior authorizations, pharmacy benefit managers, pharmaceutical pricing, administrative costs, and the incentives built into a system that spends extraordinary sums while too often frustrating the people it is supposed to serve. Rather than offering a simple attack on medicine or pharmaceutical innovation, Dr. Proctor makes a more nuanced argument. He examines where profit can encourage lifesaving research, where middlemen and administrative barriers can drive waste, and why reform must distinguish between innovation worth protecting and inefficiency that harms patients. Accessible, provocative, and grounded in a physician’s firsthand perspective, Inefficient on Purpose asks readers to reconsider what health insurance is supposed to do, where America’s healthcare dollars actually go, and what meaningful reform could look like. For patients, healthcare professionals, policymakers, and anyone who has ever wondered why getting necessary care can be so complicated, this book offers a candid look at a system in urgent need of change. But it doesn't stop there. Dr. Proctor proposes solutions that could be implemented now as well as an idealist situation that would lower healthcare costs and improve patient outcomes!
