"Just drop dead already-- those expensive treatments eat into our $$profits and we've not found any of these new-fangled gizmos to be ROBUSTLY proven "cost effective" for even 1/3 of diabetic Pts.. We think that "pissing papers" are plenty good enough for you, now stop arguing with your Internet-researched "study documents" and non-ROBUST FDA Approvals and Journal Reprints and University Studies. It's up to us-- you pushy Woodstock-generation people, with your oh-so-personal Medical Records and your "treat, treat, treat" money-spending MD's really ought to leave these decisions to the experts. Which is us. We don't care about YOUR medical records, we've got cool statistics from studies WE LIKE BETTER, which say that we don't have to spend the money.
(Even if the study explicitly excluded people like you from the Trials, we
get to say it's relevant. We say the 70% don't get any benefit, so we ain't gonna bother with you insignificant minority people.) Anyway, diabetics are really all the same, it makes our profit/loss spreadsheet math a lot easier to make the "ROBUST" assumption that your body works exactly like the Median person in our favorite study-- humankind is just like a factory, every widget is exactly the same, and hey, no one lives forever! It's nothing personal, you're just being rejected by QA, you're just too expensive to bother with trying to repair or maintain in such a NEEDLESSLY sophisticated way.
SO you see, I don't find your medical records, or your MD's statement of medical necessity, or the FDA's approval for pts. exactly like you, to be "robust" enough for me. And it's my money now. I don't have to spend it on you, because your evidence isn't "ROBUST". Regardless of what an insurance contract should
say about medically necessary and effective treatment, my reasonable reward for making the "hard decision" to keep you from driving up Health Spending is to let me spend the money on a new LearJet. That's much more productive for the economy, you sick people are just a WASTE AMERICA'S MONEY
. Oh, and have a nice day.