A psych issue is very different from a standard medical issue. The law states that if I try to kill myself, I can be declared incompetent. A case of an asthma patient...who understands their condition and refuses transport to the ER after an breathing treatment....is a completely different case.
As for the insurance issue, no one is required to do anything they say. The free market is still in place. The insurance company has the right to refuse payment, but the patient can flip the bill if they choose.
Granted......almost no one can afford to do that. However, the patient can then change insurance companies or pay on their own. My point is simply that there is no LEGAL requirement to do what the insurance company tells you to do.