Mugshots are also designed to make people look bad because it used to be a way that criminals would use for self promotion. But if they look bad then it has the opposite effect making them seem more animalistic and thus more evil. Also often used in wanted posters if enough photos are available. This has been the case for long before photography was invented with drawings as well.
Otherwise, they’d look more like photo IDs, which have the same requirements and are bad compared to something framed specifically to flatter someone, but not as bad as mugshots. Doesn’t help that most mugshots are taken after long, abusive “interrogation” sessions or other situations that exhaust them rather than immediately upon arrest, but that’s on purpose.
But the tactic to use mugshots as self promotional got popular when photos first came around because if they could get in a good shot, it’s not like the police could afford to take multiple. Film was expensive. And they were put in newspapers and such, so they spread around for free. Just look at the famous criminals of the Wild West era. So police doubled down on making sure the photos looked as bad as possible and it became a popular tactic to use against “famous” criminals. Now it’s used against basically all criminals.
Yeah, “unnecessary” is the health insurance code word for “we can get away with not paying for it”. Because it’s executives and lawyers and not doctors that determine if something is “unnecessary”. Sure they have doctors as scape goats, but they have specific instructions not written by medical professionals that they are required to follow. Unnecessary doesn’t mean it won’t save a person’s suffering or life, it means it’s more expensive than relieving the persons pain is worth or the person’s life is worth (i.e. the likelihood that they would lose a lawsuit for significant damages if they die).