Anybody who’s ever dealt with a serious illness is likely to understand that getting your medical insurance company to approve everything your doctor would like to can be a bit sticky at times. The lines of communication and decision making between physician, patient, and insurance carrier are not always clear, and patients are often left guessing whether or not their insurance will cover a particular treatment.

But who should be making our medical decisions. It’s easy to just say that we should be making the decisions between ourselves and our doctors. And ultimately, that’s what happens anyway. Medical insurance companies don’t ultimately decide what treatments you will or won’t receive. They just decide which ones they will or won’t pay for.

Of course, with the sky high costs of many medical services, the distinction can be paper thin at times. The fact that you can opt to pay for and receive any service you want doesn’t help the overwhelming majority of us. So, we should take the medical insurance companies out of the decision making loop, right?

On the surface that sounds like a great idea. The only problem with it is that you’d be killing the goose that laid the golden egg. If insurance companies accepted every medical suggestion out of hand, they couldn’t operate profitably. And insurance companies are not run entirely by pocket protector wearing bean counters with actuary tables. You’d better believe that medical insurance companies retain some of the finest medical minds in the country to advise them concerning which treatments they should and should not consider viable.

That’s not to say insurance companies always get it right. Usually, the one closest to the action makes the best call. With your health, that’s you and your doctor. But with that said, if insurance companies didn’t put some controls on what treatments they will accept and pay for, they would soon be bankrupt and unable to pay for anything for anyone.

Of course, in some countries, the government controls those kinds of decisions. There are arguments for and against that, to be sure. But ultimately, whether it’s a panel of bureaucrats or a panel of actuaries, at some point, bean counters somewhere are going to have their say about what will and what won’t be paid for. In the end, it comes down to picking your poison.

Photo via Eva Blue