More than 80% of appealed Medicare Advantage prior authorization denials are overturned, yet fewer than 0.2% of ACA Marketplace denials are ever appealed. The problem is not only denial. It is a system that profits when patients run out of time, energy, and hope.

At the 2026 Robert A. Winn Clinical Investigator Symposium, hundreds of medical students received We the Patients and were challenged to see healthcare from the patient side of the bed rail, including the burden, bureaucracy, and hidden labor that medical training too often ignores.

A retired firefighter’s denied cancer treatment reveals a larger truth about American healthcare. Administrative friction has become an economic strategy that shifts costs onto patients and physicians while delaying care in ways the system rarely measures but patients always feel.