A person needs to be at least a nurse, veterinarian, or pharmacist to meaningfully double-check a physician's orders. Accountants and actuaries can provide hel

A person needs to be at least a nurse, veterinarian, or pharmacist to meaningfully double-check a physician's orders. Accountants and actuaries can provide helpful inputs, but they lack both the training and patient familiarity to make those decisions medically that they are currently effecting through the back door, by controlling the payments. As a society, we trust the government to employ lawyers as circuit judges, appellate judges, and supreme court judges. It would be little difference for it to employ double-check nurses to review diagnoses and treatment plans against published standards and procedures, triple-check physicians to review contested or flagged cases, and quadruple-check physicians to ensure that the patients involved in difficult cases are receiving the best available standard of care, and to establish or modify standards for future cases that may be similar. A lot of people don't even have enough money to visit a first doctor. And aside from that, families may have enough money to send one member to one doctor, and everyone else with perceived-to-be-lesser medical problems then has to forego treatment altogether. The diabetic gets improved insulin, while the asthmatic has to make do with too-frequent use of rescue inhalers, because the maintenance inhalers are too expensive, and the beesting-allergic person panics every time something flies nearby, because then there's no money left over for epinephrine autoinjectors. The system does not currently consider whole-family finances as a medical consideration. It attempts to maximize profit on a per-patient basis, ignoring that at some point, that strategy may force a parent to choose which one of their children gets to survive. That's something that not only influences votes, but also creates activists. The voters might not want the government to do it, specifically, but they are clearly not satisfied with the status quo.