Maybe I'm just not understanding what you're saying here, but it seems pretty straightforward that you can't run an insurance system without reviewing claims. That's true whether it's a for-profit, not-for-profit, or government run insurance provider.
There's broad consensus that there is a ton of unnecessary and unwarranted care being done in the US. Doctors are not all experts in population health. Even the most well-meaning doctors are still subject to incentives that can lead to excessive testing and expensive treatments that have a low likelihood of improving patient outcomes.
Obviously it is also true that having a profit motive to deny claims incentivizes improper denials. But to simply say "no claim should ever be subject to review or denial, and anyone working to make the system efficient is evil" is deeply ignorant and fundamentally incompatible with the concept of insurance.
> But to simply say "no claim should ever be subject to review or denial, and anyone working to make the system efficient is evil" is deeply ignorant and fundamentally incompatible with the concept of insurance.
There's broad consensus that there is a ton of unnecessary and unwarranted care being done in the US. Doctors are not all experts in population health. Even the most well-meaning doctors are still subject to incentives that can lead to excessive testing and expensive treatments that have a low likelihood of improving patient outcomes.
Obviously it is also true that having a profit motive to deny claims incentivizes improper denials. But to simply say "no claim should ever be subject to review or denial, and anyone working to make the system efficient is evil" is deeply ignorant and fundamentally incompatible with the concept of insurance.