This year I was in a bike race and broke my collarbone. The surgeon assured me I would heal with or without surgery but urged me to get surgery because the healing process would be faster and I wouldn’t have a bump on my shoulder. Pre approval process was seamless and for the general anesthetic, outpatient procedure I paid nothing. I’m doing the PT now that I would have to do either way and I pay 20% on each visit ($15 or so).
Compare this to diabetic supplies which, like everyone from the US on here, I pay my fair share of. I generally figure it works out to at least ~5k for me a year between copays, premiums, visits, etc. The incentives are absurd! Insurance should want to reconsider risky activities and choose the more cost effective treatment option for an injury, but theres zero conversation of cost when making the decision on surgery. Yet nothing I can do will change how much I need in pumps or insulin, but I pay tons of money with little rhyme or reason.
Thats to say nothing of end of life care, which is often an order of magnitude more expensive.