Yes, medicine is a huge subject with constant new developments......that is why one goes to the person who is dedicated to staying on top of all the new developments in a specific area.
And insurance companies are first of all profit driven...they have a bottom line and shareholders they answer to. Medicare is far more cost effective than US insurance companies. I remember my Medigap policy brochure that said they returned 67%premium cost in services to beneficiaries....but Medicare pays back 90% and more. Just look at the financial documents of an insurance company - marketing costs, administrative costs. CEO pay, cost of salespeople, need to negotiate every year with providers and customers, advertising etc. Medicare doesn't have to do all that. All these plans are not choice but confusion.