My friend's daughter died today from suicide.  She suffered from chronic pain that started about ten years ago while finishing a university degree. 

We were hopeful when she finally received a diagnosis for thoracic outlet syndrome after two years. It had a relatively simple treatment, a botox injection every three months.  The insurance company rejected the claim.  The health center wouldn't perform the operation even if her father paid the several thousand dollars (a highly-inflated cost suffered by the non-insured).  The procedure was tricky enough that they wouldn't do it without the backing of an insurer. The company said the procedure was "experimental."  It took months of research for her father to show that the procedure had been performed for 80 years and was classified "experimental" only because the number of cases was so small, no drug company would pay the expense of a trial as required by the US Food and Drug Administration - the market wasn't big enough.  After getting expert testimony, the insurer relented.  We were hopeful again.  It was a long roller-coaster ride.

Her chronic pain was related to chronic anxiety, and the insurer provided plenty of that. During her treatment, the insurance company balked at the health center's documentation for the botox treatment, so her appointments - and pain relief - would be delayed; her doctor prescribed physical therapy and psychological counseling, but while the insurer allowed the counseling, it refused to pay for physical therapy; her father started taking her to an osteopath for the equivalent of the physical therapy, but the insurance company figured that out and began rejecting those charges, and then the company refused to cover counseling after a period of time; she watched as her father exhausted his retirement savings and accumulates tens of thousands of dollars of debt.  Things spun out of control when she contracted covid last spring, which became long covid, and then she developed an intestinal condition. 

By the time she took her life today, she had lost hope. WE all had  This is the business model of the US health care system. If treating you cannot be made profitable, if you're chronically ill, then you should die.  Rationing health care is profitable, but it means that part of the population will go without treatment, and some must die to preserve the system.

Mark