I understand that quite well. I have relatives with careers in the health insurance industry, numerous friends and acquaintances who are medical professionals, and my SO worked for most of her career in our state’s social services department.
And no, it is not determined
solely by the insurance companies. But it is heavily influenced by their lobbying efforts and their negotiations with those contracting for coverage groups. It’s not a purely one-sided discussion with the service providers and government. Insurance companies have been very successful at capping what they need to pay out and what they’ll have to cover. They can also always walk away from a contract negotiation. Refusal to offer universal coverage, their ability to be allowed to retain pre-existing condition clauses, lifetime benefit maximums, restricted provider networks, employing primarily non-doctors to review and bless off on the initial determination of appropriateness of a service referral, restricted prescription formularies, etc.
The insurance industry is far from completely helpless in the face of negotiations with government agencies or the medical profession. Nor is it utterly innocent of any culpability for much of what goes on as far as eligibility and coverage of medical treatment goes.
I don’t see where there’s an untruth in saying the promotion of chiropractic alternatives over treatment by an orthopedic doctor, or a licensed physical therapist who works in cooperation and with the guidance of an orthopedic surgeon, os being done for any reason other than cost savings. Or why the insistence that therapeutic remedies be pursued first, and require that a person must first fail said therapy, before the medical treatment that was initially advised by a medical doctor be authorized.
With 43 years in the industry I’m sure you’d be aware of that.
As far as Trump goes I won’t discuss it because it will too easily stray into politics since the lines between politics and personal financial benefit have become do blurred as to now be impossible to keep separated. The success of some parties at turning everything into a political issue deserves full credit for that.
However, if you want to heed your own suggestion to follow the money (which is always a quick way of getting at the truth) take a look at who in the upper echelons of power either hold, or have recently taken, large stakes in various pharmaceutical companies. Interesting too how many also control or have a say in the doling out of Medicare and Medicaid payments. I’ll leave that as an exercise for the reader