Didn’t, in this case, the insurer care precisely about the average—setting reimbursement at the average rate for people receiving masectomy care in the state?

Didn’t, in this case, the insurer care precisely about the average—setting reimbursement at the average rate for people receiving masectomy care in the state? Doesn’t it say that most people post-masectomy get “a relatively straightforward surgical procedure using implants filled with silicon or another gel,” which, judging by how unusual the article makes out this surgical center to be, seems to have medically reasonable outcomes? One big argument missing here is why the “natural reconstruction” option is different from the normal option, aside from the patient who explained that “the idea appealed” because she “felt like [she] was taking something foreign out of my body, cancer, and [she] did not want to put something foreign back in.” So it seems like, faced with this medical need, some people want a procedure that involves “five operations” in a setting “combining the luxury feel of an upscale plastic surgery practice with the mission-driven zeal of a medical clinic,” where instead of the implants the proprietors do “lengthy and complex operations [that] can last up to 12 hours with big medical teams involved.” It’s true that the latter probably costs more than the average—and it’s more than reasonable that, when it comes to their own care, anybody might prefer the luxury (or just humane) setting and the dozens of hours of painstaking hand-reconstruction. It’s also obvious (and settled in court) that the insurer got up to some shady business in this particular case (not least the “for me but not for thee” stuff). In the general case, though, I have a hard time making the case that it’s fair for a patient’s preference alone to be enough to justify bumping the cost by an order of magnitude or two—especially since insurance spreads those costs out among all the other people paying for insurance, not the dastardly execs directly. If you can afford luxury then pay extra for luxury, fine. But the insurance feels to me like it’s there to meet the basic medical part of the requirements.