Of course there are laws and regulations. In practice, a patient that will cost millions of dollars probably won't live that long. So it's advantageous to simply delay a decision. Deny coverage, get sued, go to court. If the process takes 6 months the patient will just die and the problem goes away. How do you prove someone is acting in bad faith? Short of an email that says, "Let's fuck this guy over and save 5 million dollars" it's not going to happen.

I'm sure the vast majority of people in insurance are honest, hard working, ethical, respectable people. But the system is inherently corrosive to those qualities. Saying "no" to a marginal case can save the company millions. Health insurance in critical cases is pretty much the definition of perverse incentives.

edit

so, appending crazy rant. sorry.

Healthcare in the US is insane. Something like 60% of people are already covered by a single payer system with medicare, medicaide and the VA systems. it's pretty much just 20ish year olds to 65 year olds who aren't poor and weren't in the military that are out on their own. I find it baffling that medicare, which takes care of retirees, wasn't just extended to cover everyone. Old people get sick. we already handle the really expensive part of health care via socialized medicine. Are there horror stories? yes, absolutely, but 200 million people are handled by those systems. For what they are, they work pretty well.

There are literally books with lists of all the things we know that can go wrong with people, and protocols for how to resolve those problems. I really wish there was a minimum floor for people. You break your arm, we follow protocol A. It's a compound fracture? Protocol B. Paid for by everyone's taxes (bigger pool of money is more resistant to random fluctuations) perhaps we can't afford to treat non-life threatening conditions quickly. That is indeed a risk, and the major complaint about socialized medicine.

However, that can be mitigated by supplemental insurance or out of pocket payments. Not many 40 year olds get cancer. it seems like we can spring for some basic coverage. If wealthy people want more, they can pay the difference one way or the other.

The current state of affairs is shameful. People who ought to be at their peak of earning potential are most at risk for being destroyed by illness. We, collectively have invested vast resources so those people at their peak can earn a living, raise a family, and generally make the world a better place by their labor. It's a rare event to be knocked out by illness, we ought to get those people back to health as quickly as possible. But, we don't. But hey, on the upside, CI is at 137 a share. so that's good, i guess.