The thing is, all these jobs that do nothing but service our irrational health-insurance industry are why we pay so much more for our our healthcare in this country  --  and these pointless expenditures come directly out of consumers' pockets.  

Quite a few of those jobs have become globalized, too  --  I am not terribly concerned about how many "reviewing physicians" (the people who deny payment for the process your doctor wants, or who alter your ongoing prescriptions without ever having seen you) lose their jobs in Sri Lanka .

As to pharmaceuticals  --  right now, we American consumers pay the R&D costs for the whole world.  Drugs developed & manufactured by US companies cost significantly more in the US than anywhere else in the world.

Maybe you've heard  --  there's a shortage of doctors and nurses in our country.  I'd much rather pay for more of those jobs than for clerks and lawyers to tell me and my doctor that my insurance won't pay for the treatment I need.