That "medical professional" has literally 90 seconds to review your case and say yes/no. They've never met you. They don't know your doctor. All they have are some notes on the case, a billing code, and a quota to reach every day. They get bonuses based on how much money they save the insurance company.
All of that cost savings makes US healthcare cost double what it does anywhere else in the world.
I think you're a little confused about causality. All healthcare systems, including fully socialized ones, perform similar types of case review to ration care and hold down costs. US healthcare costs might be high now but would be even higher if the payers (including the Medicare / Medicaid government payers) paid every claim that came in without denying those that fail to mean plan coverage rules.
If we want to hold down costs then we'll have to put a greater focus on preventative care, stop expensive treatments for terminal patients, impose price controls on providers, and stop subsidizing drug development for the rest of the world. None of those measures are politically popular.
Yes, exactly. Since demand for healthcare services is essentially unlimited, creating artificial shortages is one way to ration care and hold down public spending. The US government already creates healthcare shortages in other ways, such as constraining the number of residency slots to limit Medicare spending. (I don't support this, but it is somewhat effective from a fiscal policy perspective.)
