Sure, "in the US". Obviously you don't want to be as ham-fisted as to directly reference the liability dynamic, or to pop the doctor's ego by reminding them that most of their job is pushing paperwork. The point is to take the medical system off the pedestal in your own mind, such that there is one less thing holding you back as you have to repeatedly advocate for yourself. And I would think the need to advocate for yourself applies everywhere (Sturgeon's law), regardless of whether the system is as antagonistic as the one in the US or not. The US system just drastically increases the possible damage from failing to do so.
"the need to advocate for yourself" isn't the only thing you said. I was referring to "the first line of offense for the health management companies whose whole function is to deny healthcare" doesn't apply everywhere. I also don't think it particularly applies in the US, although I'm happy to see evidence of that.
Despite all that, as you say, you won't be sued for saying that stuff.
"Evidence" is a pretty high bar to clear, especially considering one of the reasons the healthcare industry was able to get so callous is exactly by focusing on top-down whole-cohort metrics while ignoring individual patients. I'm sure everything looks great from inside the system.
Anecdotally, healthcare management companies insist on individuals getting referrals from "primary care providers", who take several weeks to provide an appointment, a few weeks more to issue a referral, and will only do one referral at a time even for unknown problems despite it taking several months to get an appointment with a specialist. And finding an available new primary doctor is most certainly not easy, either. This has been my experience for myself and a handful of other people I've advocated for, across several different "insurance" companies. Obviously none of those requirements are necessary, except for expanding the bureaucracy to meet the needs of the ever expanding bureaucracy, but it has the net effect of constructively denying healthcare.
Might there be some regional healthcare system in the US where patients are seen promptly and where the bureaucratic procedures create efficiency rather than functioning as mechanisms to stonewall and run down the clock? Sure, of course. But given the terrible dynamics that are allowed to fester, it feels like a working system is the exception rather than the norm.
