>(2) Determine if the treatment is medically necessary. >You are not hiring insurance companies to do the second part but they do it any way in order to increa

>(2) Determine if the treatment is medically necessary. >You are not hiring insurance companies to do the second part but they do it any way in order to increase their profits. They should be removed from this role via legislation. Okay, but in any system, even the beloved European ones, someone does this -- they can't just spend bottomless money on everyone, but draw a line based on the relative costs and benefits. US insurers are just unusually random, kafkaesque, and inconsistent about how they do it. There is never one platonically optimal "medically necessary" treatment; everything's a tradeoff, and the calculation will always depend on considerations other than "maximize this patient's health/lifespan as a much as physically possible".