passed the old temp record at 8am today

you do, to an extent. you can either choose 'what the state offers' or 'nothing at all'.

Yes i can agree to surgery on my shoulder, or can opt to live with the fact my shoulder can re-dislocate from any significant force. Is that what you are saying? I don't get what you are trying to say, is your statement not true for any hospital?

"this guy is an adult and I exist to facilitate the choices he has made for himself" that's exactly how I want people who are providing me a service to think

Sounds like how a crack dealer would justify what he does to feed his family. I'd prefer if my doctors used their education to tell me what is actually best for me and not what I want



Also your anology isn't really applicable because most things not provided are elective surgeries, like boob jobs.