The difference is that patients in the US are being denied by people lining their own pockets with the savings. In sane countries, there’s at least some basis of trying to do the most good with the resources at hand, which sometimes means denying care for person A because those resources would be better spent on person B. With private insurers in the US, it means denying care for person A because they think they can get away with it and it will increase their profits.
If you actually trace the cashflows, the "people lining their own pockets with the savings" are mainly not the insurers but rather the executives and shareholders for other large companies with self-funded employee health plans. Most insurance companies no longer provide much real insurance but rather primarily administer health plans on behalf of self-funded employers. Due to the minimum medical loss ratio rule, insurers actually make more profit the more claims they approve.
If employers wanted it, insurers would be happy to offer health plans that fully paid every claim with zero denials. This would be enormously profitable for the insurers because they could run those health plans with minimal work. But instead, most employers are constantly looking for ways to cut employee health benefit costs. This means incentives aren't aligned.
> With private insurers in the US, it means denying care for person A because they think they can get away with it and it will increase their profits.
The person at the insurer who denies a claim is not making more money because they denied it. The company as a whole might, but not the person denying it.
