[jmspamerton]

Physician and Hospital resources is a real zero sum game, how do you fairly regulate the medical landscape so those who's lives will benefit most from a procedure will receive the procedure?

Who decides this? You?

Should we allow everyone in the world who needs a procedure to receive one free and get ahead in line for Americans who need the same procedure? That's what the current climate looks like with unbridaled immigration under progressives.

These are hard questions. What's the answer?

[throwway120385]

Why not pay for these things out of taxes? I don't think you'll be so quick to defend the system if you ever find yourself needing care beyond a checkup once a year. It's designed to make the insurance carrier money by constantly having little costs slip through the cracks that should be covered. Get a dental checkup? Sorry one of your X-Rays wasn't covered but the other ones were. Now you get to spend hours fighting for a $13.00 cost. Oh you're at the max for this service for the year because we accumulated the estimated cost when you started calling doctors about what the after-insurance cost will be. Wait a minute this out-patient consult is actually a surgery because you saw a surgeon so it must have been a surgery, and it's not medically necessary to have the surgery without the consult.

[ben-johnson]

Because there are a finite number of doctors and hospital beds and you can't create either by throwing more money at the problem. You didn't actually read the content did you

[array_key_first]

You can most definitely create both hospitals and doctors using money.

[freeone3000]

The doctor has already managed to find time for the service - she’s seen you. Potentially even done the procedure. The hospital has made room for you. The resource is already consumed by you, like a restaurant meal. The question is who is picking up the check, when you already have a subscription service paid for.

[tt24]

The service is not “free healthcare for any procedure ordered by a doctor all the time without limits”, they have the right to refuse something they feel is unnecessary

[freeone3000]

Why isn’t it “any procedure performed by a doctor all the time with no limits”? Do you think there’s a cabal of doctors doing medical procedures for funsies? And that if such a thing did exist, it would be a bigger problem than some company who has never seen you, never examined you, and you’ve already paid money to, denying the claim because they judge it “unnecessary” when the doctor who did see you claims it is?

[ceejayoz]

And the doc is also spending a shocking amount of their time on the phone yelling at the insurance company flacks, as a bonus.

[hdgvhicv]

Every other country seems to solve it

[AlotOfReading]

I guarantee you that the insurance company has zero clue or consideration for any physician and hospital resource constraints.

Gating access to medical care is the job of the patient's PCP and or other doctor. If the care is truly, meaningfully rationed (like transplant organs and blood banks), there are triaged priority lists managed by medical organizations.