Merry Christmas and Happy Holidays.
Our system of private insurers is fatally flawed. The fiduciary responsibility of the insurance company and it’s executives is to maximize profit for it’s investors–and also maximize bonuses and stock options. It will never be clear that a high cost denial of care is warranted as long as this conflict of interest is in play. We need a third party adjudicator with no financial interest, non-profit companies or some type of government run scheme to remove the profit incentive.
Money makes people do funny things.