The shrillest professor unloads on waiting times:
A cross-national survey conducted by the Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice (although Canada was slightly worse), and that America is the worst place in the advanced world if you need care after hours or on a weekend.
We look better when it comes to seeing a specialist or receiving elective surgery. But Germany outperforms us even on those measures — and I suspect that France, which wasn’t included in the study, matches Germany’s performance.
What’s more, as Krugman goes on to point out, it’s one thing to have your procedure delayed because the equipment or personnel are needed to treat someone else’s more acute condition. It’s another thing entirely for the delay to be caused, as it typically is in the United States, because a company is trying to earn more money:
his can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. “It was only later,” writes Mr. Kleiman on his blog, “that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments. [...]
To be fair, Mr. Kleiman is only surmising that his insurance company risked his life in an attempt to get him to pay more of his treatment costs. But there’s no question that some Americans who seemingly have good insurance nonetheless die because insurers are trying to hold down their “medical losses” — the industry term for actually having to pay for care.
We also see further demolition of hip replacement myths. It’s worth saying, of course, that people who kill people in exchange for money in the US health care sector aren’t, on some level, bad people. If you worked for an insurance company and construed your job as facilitating the delivery of medically useful health care to patients in need, you’d rapidly find yourself unemployed. Similarly, a doctor whose practices don’t serve the insurance company’s needs will find himself off the roster and useless to anyone. A company that cared more about helping sick people than earning profits would see its stock value decline to the point where it would be taken over by some other company that was willing to kill for money.
It’s the logic of the system and on some level it’s no different from any other business. But whereas Apple or Toyota or Starbucks make money by delivering their products to people, insurance companies make money by not delivering health care to sick people.