[staticman2]

Being an expert doesn't mean you are "practicing medicine". Suppose the medical standard is "you must examine the patient in person when creating a treatment plan."

We're going to apply that to some insurance job function operating outside standard medical practice how exactly?

[ceejayoz]

> Being an expert doesn't mean you are "practicing medicine".

Sure, but being paid by someone to make the final call if the patient should or should not receive their treatment team’s desired procedures should.

[staticman2]

It's not that I'm defending our medical system, it's just that applying "medical malpractice" concepts to the practice of financing of procedures seems to me to be a bit of a stretch.

A doctor at an insurance company isn't deciding the "final call" on anything. The patient can pay for it without insurance, insurance company management could say "ignore the doctor and pay for it", the patient's medical team could say "You can't afford the procedure and insurance won't pay for it, that's okay we'll do it for free!"

It's not that I'm arguing against some way of holding insurance companies accountable, I just don't think what doctors are doing there is practicing medicine.

[DangitBobby]

If I hired a Hitman, if that fact were discovered I'd be prosecuted for murder or attempted murder, despite not pulling the trigger, despite not knowing if the intended target actually dies.

I don't think I can accept that people knowing or almost certainly knowing the outcome of their actions and taking those actions regardless should not responsible for the outcome under our legal system.

[ceejayoz]

For a vast majority of people, and especially so with the sort of things that a) save lives and b) make the bean counters cringe, “won’t pay” is the same as “won’t get”.