“Insurers authorize surgeries, but deny materials,” assures surgeon Rafael González

“This is not just a complaint; I want to help, because in the end the most harmed are the poor patients in hospitals, people who pay insurance and are still denied the right to live,” expressed the doctor. Santo Domingo.– Bariatric surgeon doctor Rafael González García launched a forceful denunciation with deep human feeling against several health insurance companies operating in the country, which he accuses of authorizing surgical procedures while denying the essential materials to perform them, a practice that, he warned, is costing human lives. “They approve the surgery, but not the materials. That is not an administrative failure: it is a serious irresponsibility that directly endangers the patient’s life”, stated the specialist, making an urgent call to the Dominican Government, the National Council for Social Security (CNSS) and the Superintendency of Health and Occupational Risks (SISALRIL) to intervene immediately. The doctor assured that this situation is not isolated, but recurrent and systematic, pointing to insurance companies such as SeNaSa and ARS Futuro, while others, such as La Universal, have even refused patients, despite the fact that the procedures were previously approved, by refusing to cover the necessary medical supplies. González García maintained that thousands of patients face a cruel paradox: they have an approved surgery in documents, but impossible to perform in practice. “They tell the patient: ‘your operation is authorized, but we don’t cover the materials’. That is playing with people’s lives“, he denounced.

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The surgeon warned that these practices hit the poorest and most vulnerable patients the hardest, as they do not have the resources to afford high-cost materials. As a dramatic example, he cited the cases of people diagnosed with abdominal aortic aneurysm, a silent and lethal disease that, if not treated in time, causes death by internal bleeding.

“When the aneurysm bursts, the patient dies. There is no second chance. The medical solution is to replace the aorta with a special prosthesis made of polytetrafluoroethylene (PTFE). However, in recent months SeNaSa has repeatedly denied authorization for this prosthesis,” he explained.

“An untreated aneurysm is a death sentence. Denying that material is to condemn the patient”, he emphasized. He recounted the case of a patient admitted to the Padre Billini Hospital, who has been waiting for months for authorization for a vital surgery. During that time, he explained, doctors have been forced to alter diagnoses and propose alternative procedures to try to get the insurance company to approve the intervention. The patient has required multiple blood transfusions, surviving in critical condition. The situation is repeated at the Salvador B. Gautier Hospital, where at least three patients with aneurysms have remained on the waiting list; some are still awaiting a response, while others have already died after the aneurysm ruptured.

“It is devastating for a doctor to know exactly what to do, to have the technical ability to save a life, and yet not be able to do it because an insurer decided not to authorize a material,” he lamented.

Dr. González García described these practices as inhumane and dangerous, and warned that the social security system is failing in its essential function: to protect human life. He demanded an immediate investigation, exemplary sanctions, and a thorough review of the authorization model, to prevent administrative decisions from continuing to become death sentences, especially among those who have the least.