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66gardeners

@Schouten_B @QasimRashid
It is not the job of an insurance administrator to determine what medica, is necessary. That would be the treating doctor.

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Bas Schouten

@66gardeners @QasimRashid It is the job of an insurance administrator, and of course to some extent the IOM/SecHHS (or in the UK the NICE, Germany the G-BA, etc) to decide which treatments are worth the money. A doctor decides only if a treatment is appropriate for a patient's situation, not whether the treatment is cost-effective for society as a whole.

Plenty of millions of dollar cancer therapies that no industrialized nation pays for but a doctor could reasonable say are life-extending.

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