Prior authorization was once defended as a limited tool for unusual situations: very expensive drugs, dangerous combinations or treatments where careful review might prevent real harm. The American Medical Association recently reported that 95% of physicians say prior authorization delays access to necessary care, 79% say patients abandon treatment because of authorization problems and 26% say prior authorization has led to a serious adverse event. “Prior authorization.” Every prior authorization asks the doctor to stop being a doctor and start being a claims processor. Prior authorization, as now used for ordinary and inexpensive care, is not reform.