Who is it that decides what treatments are necessary???
That’s just it. Government employees find out quickly that they often get in trouble for denying someone what they want, because the aggrieved citizen will complain to his Congressman or the Governor. The employee is then grilled about it, and, quite often, the aggrieved citizen gets his dough in the end. The bureaucrat is reminded that his job is to give stuff away, not protect taxpayers.
There is no incentive for government employees to rein in spending or to cut programs. Every government program and agency is rife with waste, fraud, and abuse. This is why we need government that sticks to its basic purpose - the legal system and national defense. Government doesn’t even do a good job at those.
The death panels that the Democrats assured us weren’t there, I would guess. They do have to bloat the system before crashing it, after all.