I'm not sure why we continue to let insurers make decisions for us on our care. I completely understand that an insurer wants to keep an eye on expenses and want preapproval so they can count their beans. But they should not be telling us what care we can get - with in reason.
I agree insurers should not need to pay for cosmetic procedures for example. If someone wants to fix their nose, they can pay for it (through the nose). But decisions which relate to life and death care should not be theirs to make.
A new study showed that women on Medicaid are much more likely to have a mastectomy instead of a lumpectomy - 60% of those on Medicaid had a mastectomy vs. 39% of those with other insurance.
Or are the surgeons making the decision for the patient? The study also points out that surgeons are reimbursed 40% less for a lumpectomy than for a mastectomy from Medicaid. The surgeon should provide the information and the advice to the patient to make the decision but they should let the patients think for themselves, not the doctor's wallet.
The patient should make the decision - no one else.