A friend works for the largest insurer here, the stories she tells, how everyone's eyes alight with greed as soon as the level of insurance is disclosed. She has seen them drop what they were holding, usually a standard schedule for treatment, grab a quick chat with admin, and come back with a whole new regime of pre-op tests that are in no way related to the problem. It's so accepted that nobody says anything.
It's a feedback loop, everyone is trying to shaft everyone else. and not in the good way