Consider the following case:
A baby is born with severe congenital defects. The doctors say that if nothing is done to address them, the baby will die within days. They also say that there's a series of operations that, if done, have a 5% chance of granting the baby up to two months of life in intensive care. The operations and the intensive care require highly specialized personnel and equipment, with an estimated total cost of $500,000.
1) Assume that there's no such thing as medical insurance or state-funded care. If the parents choose to have the operation done, the hospital will bill them for the full cost. Are the parents required to choose to have the operation done?
2) Assume that the parents have medical insurance that will cover the cost of the operation. Are the parents required to choose to have the operation done?
3) Is a medical insurance company (assuming it intends to follow Halacha) required to have a policy that would pay for the operation in this case?
4) Assuming that such a choice exists, are would-be parents required to carry insurance whose policy would pay for the operation in this case?
I'm primarily interested to know if there's any difference between the answers to 1 and 2. In other words, is our implementation of the Halachic requirement to preserve human life affected by the existence of health insurance?
If there's no difference given the case as presented, but there would be a difference if the parameters of the case are changed (e.g. $10B instead of $500K or years of life instead of months), feel free to change the parameters.
Of course, people who have to consider these questions practically should consult their Rabbi.