> You might have to pay the difference for "nonessential upgrades"
This is exactly what happens in the US. It's just that in your case the nonessential upgrade is a $5 cast. Sometimes the nonessential upgrade is an expensive surgery. My grandfather had heart surgery at 86 shortly before he died. My relatives went to 3 surgeons who all refused to perform surgery on the grounds that he was too old and frail for the procedure. Then they went to a fourth who agreed to perform it. The first three doctors were right, and he died a few months later. The insurance company quite correctly denied the claim and my family ended up fighting them over a bill for open heart surgery north of $50,000.
Your government wouldn't (and shouldn't) have paid for that surgery either. I think the real difference is that since you have a government system, that in your country that unnecessary surgery just never would have happened in the first place. I will admit this is a more efficient system, but it is no different in that there is a cost benefit analysis being done over what gets paid for and what doesn't whether you see it happening or not.
This is exactly what happens in the US. It's just that in your case the nonessential upgrade is a $5 cast. Sometimes the nonessential upgrade is an expensive surgery. My grandfather had heart surgery at 86 shortly before he died. My relatives went to 3 surgeons who all refused to perform surgery on the grounds that he was too old and frail for the procedure. Then they went to a fourth who agreed to perform it. The first three doctors were right, and he died a few months later. The insurance company quite correctly denied the claim and my family ended up fighting them over a bill for open heart surgery north of $50,000.
Your government wouldn't (and shouldn't) have paid for that surgery either. I think the real difference is that since you have a government system, that in your country that unnecessary surgery just never would have happened in the first place. I will admit this is a more efficient system, but it is no different in that there is a cost benefit analysis being done over what gets paid for and what doesn't whether you see it happening or not.