Well there you go, you don’t exactly know the probability of success for every given situation. It seems you want to sit and start your own best practices without actually knowing all the situations. You place a certain procedure and say, “is this luxury medicine or not?” Well in some contexts it may be, others it may not be. In some cases it may kill innovation well worth cost, and others cases it won’t.
I would say they are just like you, they can probably weigh the value of an outcome with the risk against the cost. All their years of education and clinical experience doesn’t reduce that capacity to do a cost vs. benefit analysis to figure out value. Now on the other hand if want to say they ought not be the only people that make that decision, I would agree. They do need their checks to balance out what may be optimum. There is no need to be so intellectually arrogant, they do have a special knowledge of the situation, along with those people who study the economics of health care. That is not to say though, that they are the ultimate authority, it should ahve its limits.