Perhaps BOTH the "money-grubbing hospital admin" and the "very well-respected and honor-bound doctor" are wrong for not involving their patients in these decision? And their insurance for that matter.

Recently my US-system, world-ranking university hospital complex was first convinced that my insurance would not pay for XXX (and consequently did not recommend it and delayed it). Then after I insisted and got that done, they told me how surprised they were (1) that my (US) insurance did in fact cover every single bit of everything we eventually got done and (2) how MUCH that same US insurance in fact paid them for each of the bits. On the first try. That insurance company has horrible problems, but I can't complain that they didn't cover the hell out of the thing. You know - on the same year we read everyone else's horror stories.

The whole system is very sick.