With either public or private healthcare a 'bureaucrat deciding whether your life will generate a sufficient "return"' will be the case. At least in the case of

With either public or private healthcare a 'bureaucrat deciding whether your life will generate a sufficient "return"' will be the case. At least in the case of public government run insurance, they have an incentive to keep you alive and healthy. In the US private system, their incentive is only to profit. In other words, their incentive is that you die and save them having to pay for care.