Thinking about what constitutes "medical necessity" in the context of the current USA health care climate and debate. In the USA, traditionally, medical necessity has been defined as "I want it and can use it and a doctor says I can benefit from it." We don't have tight or clearly defined criteria for "medical necessity." As we move closer (I hope) toward universal health care, it is inevitable as well as reasonable that "medical necessity" be more clearly and uniformly defined, and that there be a reasonably cogent systemic method to prioritize "medical necessity." A system that offers more universal coverage is going to have to prioritize and in some instances limit publicly funded coverage more stringently than is currently the case with either private or public insurances and payor systems in the USA.

Wondering what those priorities look like in countries that do provide for universal health coverage. If anyone here works in the health care industry in a country that provides for universal health coverage or insurance, would be interested in pms from you about the strengths and weaknesses, as well and your personal experiences.