Meh. I'm American and also a middle class tech worker. I've never had concerns about insurance denial and also never been denied (or anyone in my immediate family). I feel like the care we've gotten has been excellent and I don't sweat it. My anecdote is worth at least as much as yours.
The pop discourse is myopic and sensationalist. I've never personally dealt with an outright denial. When I've called "insurance" companies, they've been generally helpful. However, this is what I have experienced:
Primary care repeatedly rescheduling appointments further down the road, 2-3 months at a time. At one point it got so bad for my elderly aunt that I straight up asked if they were just trying to "run down the clock".
Primary care doctors saying they will put in a referral to a specialist. Then a month later just getting a photocopied list of specialists in the mail for us to call directly. Go down the line and most are closed or not accepting new patients. Some were even straight up dead (... like rigor mortis, habeas corpus).
One of the two remaining specialists booking 8 months out for an initial consult, the other 5 months.
Billing departments that don't feel it necessary to do the work of completing insurance claims, yet feel entitled to still continue sending fraudulent bills to us personally instead.
Medical equipment providers outright lying about the validity of their fraudulent bills even when challenged with concrete reimbursement rates, and then doubling down with bullying - aka willful fraud.
Needing to put in a bunch of paperwork, then follow up with appeals, merely to see the second geographically closest in-network provider (closer one was having issues) due to living near a state border.
And none of this covers the harder-to-capture dynamics of getting shortchanged on time talking to a doctor because the bureaucrats have deemed that 15 minutes is enough time for an appointment, or having to continually make sure the ball doesn't get dropped on care due to the proliferation of different moving pieces.
The problem isn't all on insurance companies themselves. The real problem is the entire system is broken due to poor incentives where these gigantic entities have been allowed to pass blame back and forth instead of having to own any responsibility themselves. This puts patients in the middle (often when they're in pressing need of healthcare), to get ground up in an ever-growing runaround, rather than any of these businesses having an incentive to minimize the administrative complexity. The "approval/denial" charade for in network care is just one of the most galling games they've made up, so it gets focused on.
