A friend from abroad said to me a few years ago that critical illness insurance would not be much of a seller in the U.S. market. Baloney.
CI insurance has an irresistible impact in America, in some ways because of how it compensates for medical care concerns highly prevalent in this country.
In the last few years, there has been an accelerating incidence of papers in the medical literature that make disconcerting distinctions between outcomes of therapies–most notably the more risky surgical procedures–in hospitals which do high volumes of the procedures as compared to hospitals where that intervention is performed markedly less often.
These reports are eye-opening.
They also have profound implications for the informed consumer's decision to purchase CI insurance.
Most Americans with private health insurance have access to their coverage by virtue of their employment. In many, if not most cases, the plans have limitations governing choice of doctor and/or hospital. By inference, these restrictions frequently would preclude participants from choosing the highest volume hospital–for that procedure–in their community, etc.
Therefore, to obtain the best level of care with lowest probability of complications or death, one might well need disposable funds at hand to provide for that care out of pocket.
Recent studies fill out the dimension of the problem. They detail how coronary bypass patients in low-volume hospitals face substantially greater risk of dying during hospitalization than those having the procedure at high-volume surgical facilities; how new breast cancer patients have much greater likelihood of undertreatment in low-volume institutions due to inadequate lymph node assessments; and, how high hospital volume correlates with lower risk of dying for various procedures.
Likewise with physician experience. One report from Canada shows fewer in-hospital deaths when the attending physician is a high-volume, rather than low-volume, doctor.
Does the quality of therapy also differ on the basis of hospital volume? You bet. There is research showing how much better patients fare when seen at high-volume medical centers–it is at those facilities that people are more apt to get the best-choice medications compared, once again, to low-volume centers.
