Arch asked her insurer, Blue Cross and Blue Shield of Louisiana, for approval to go to the center for her care, and the company granted it, a process known as prior authorization. Then, a week or so before her surgery, Arch was wrangling child care and meal plans when she got a call from the insurer. The representative on the line was trying to persuade her to have the surgery elsewhere. She urged Arch to seek a hospital that, unlike the center, was in network and charged less. “Do you realize how much this is going to cost?” Arch remembered the agent asking. Arch did not need more stress, but here it was — from her own health plan. “I feel very comfortable with my decision,” she replied. “My doctor teaches other doctors around the world how to do this.” Over the next year, Arch underwent five operations to rid herself of cancer and reconstruct her breasts.

It’s unnecessary to point out the glaring issues with U.S. health insurance.