It just means that rather than "trust doctors" or "evaluate care" it's cheaper to hire a random doctor who evaluates and sets limits based on arbitrary reasonin

It just means that rather than "trust doctors" or "evaluate care" it's cheaper to hire a random doctor who evaluates and sets limits based on arbitrary reasoning about "excess" and that reasoning follows from what crimes they've gotten way with previously (lawyers). This is not a system of care; it's a system of squeeze the turnip, with a parade of MBAs who constantly need to turn the screws to ensure they can climb the latter. It's sociopathy, like the entire business capitalism. It's just that in this case, the consumers arn't directly the costumers.