More often though, the bureaucrat making life-and-death decisions is in the employ of a private insurer. Private insurers are corporations driven exclusively by the profit motive. Their incentives are to maximize what they charge for coverage while minimizing services rendered. Every claim denied means more dividends for stockholders. How's that working out? Health insurers are making record profits even as patient outcomes trail those in other countries with single-payer systems.
The bottom line is that healthcare access is determined by wealth, not by need, and it always will be until the distorting incentives of for-profit healthcare are removed from the system. If you think need, rather than ability to pay, should determine access to healthcare then you de facto support healthcare as a fundamental human right, just as Panderbear does. Unfortunately, in the United States, poverty kills. That fact should be an embarrassment for the richest nation in history.