If you were designing a legal system you probably wouldn't want for profit insurance companies to decide who gets to determine if a patient needs treatment, due to the obvious conflict of interest.
But that doesn't mean applying the same "malpractice" framework to the people deciding what's covered under the program is necessarily the right approach either.
We're fine with insurance companies sending adjusters out to inspect property damage or collision damage. We don't just expect them to pay for whatever the contractor or body shop says was necessary.
And if their adjustment conflicts with the body shop, but it turns out the body shop was right and I die as a result? Who gets that liability? That's what I'm talking about. You can make adjustments, but you are practicing medicine when you do so.
But that doesn't mean applying the same "malpractice" framework to the people deciding what's covered under the program is necessarily the right approach either.