Recently I had my knee operated on to repair my torn ACL and meniscus. To anyone who hasn't had a major surgery, the process is a lot longer than it seems and doesn't just happen overnight. By far one of the biggest hurdles to jump over was getting the surgery approved by my health insurance company. I would have never been aware of the battle between doctors and insurance companies if my surgeon had not expressed his concern for the issue himself.
He, along with this article I found said that insurance companies are given the authority to tell us, the patients, whether or not they will pay for proper care. What experience do they have in the medical field? Sure, they might have advisors that inform them of the severity of the patient's condition, but wouldn't it make more sense for the doctor to call the shots on what their patient needs or doesn't need? Personally, I don't think this is ethical to have the opinions of a medical specialist placed under the opinions of an insurance company. I would assume that if they used the Role Exchange Test, insurance companies would trust their doctor's professional opinion. While I was lucky enough to get the surgery partially covered, others with more important procedures that are life threatening are paying their lives away to survive.
Insurance companies are some of the nastiest out there. My dad regulates that industry for a living, and always comes home ranting about how horrible they are. You can be assured that anything they might recommend about a medical procedure that they will have to pay for will be cheaper, and probably worse than the alternative.
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