They are private, opaque, all-powerful, and unquestionable.

https://www.fresnobee.com/news...rticle232478212.html

Yes, there's also the scam called "the formulary." If your drug isn't on your insurance company's list of covered drugs (the formulary), they will not cover it.

So what's not on the list? Expensive drugs. New drugs. Specialty drugs that work a bit better than generics. Etc. You get the idea.

So there might be a new drug out there that would provide instant help to you, but if there's a cheaper alternative or, better yet, a generic that is kinda OK, that's what you get.