Category: Waiting Times

Thomson Reuters Survey Finds Cancer Patients Forgoing Treatment

Thomson Reuters Survey Finds Cancer Patients Forgoing Treatment: “cancer treatment decisions of individuals.

Entitled “The Cost of Cancer,” the report aggregates survey responses from 1,767 adults currently being treated for cancer. It finds a clear link between patients’ annual income and their decisions to curb cancer treatments due to cost — even among patients with late-stage cancers.

The report notes that among the 569 survey respondents with late-stage cancer, 12.3 percent said they have passed up recommended treatment because it was too expensive. This figure varies dramatically by patient income level. Twenty-five percent of late-stage cancer patients who earn less than $40,000 a year said they have chosen not to undergo a recommended treatment due to cost — compared with 11.2 percent of those earning between $40,000 and $80,000 per year and 4.8 percent of those earning more than $80,000 annually.

Similarly, 65 percent of all respondents with late-stage cancer said the out-of-pocket cost of treating their cancer has caused them distress. Among all cancer patients earning under $40,000 per year, that number jumps to 77 percent.

“The physical and emotional burden of illness is not the only challenge cancer patients face,” said Bill Marder, PhD, senior vice president and general manager for the Healthcare business of Thomson Reuters. “Many also struggle to cope with medical costs. This survey shows that the cost of cancer treatment is affecting patients’ ability to get the care they need.””

I think this research speaks volumes about the American healthcare system. This is why I have it categorized under so many topics (see links below and to right). It speaks to the de facto rationing by income in the US, it speaks to how consumers “drive” healthcare (i.e., decision making is not rational), how our waiting times are trimmed by not including those who don’t seek care due to financial concerns, and how those who love to try to compare anecdote horror stories just don’t geet how bad our system is for so many people.

International Comparison: Access & Timeliness

From the Commonwealth Fund:
International Comparison: Access & Timeliness:

“U.S. patients reported relatively longer waiting times for doctor appointments when they were sick, but relatively shorter waiting times to be seen at the ER, see a specialist, and have elective surgery. Specifically:

The percentage of U.S. patients who waited six days or more for a doctor appointment when sick was not significantly different from the rate in Canada (23% v. 36%), the worst-performing country.

Only 47 percent of U.S. patients were able to see a doctor on the same or next day when sick, versus 61 percent to 81 percent of patients in the four better-performing nations.

U.S. patients were less likely than patients in Canada (12% v. 24%) but more likely than patients in Germany (4%) to wait four hours or more to be seen in the emergency department.

U.S. patients were less likely than patients in four countries (except Germany) to wait four weeks or longer to see a specialist (23% v. 40%–60%) or to wait four months or longer for elective surgery (8% v. 19%–41%) (Schoen et al. 2005).”

Additionally, Americans are less likey to have a regular doctor, less likely to get prescriptions filled, less likely to get follow-up care, less likely to keep a doctor long-term, and have a harder time getting taken care of nights and weekends.

It speaks for itself.

CITY HEALTH CLINICS NEED A BOOSTER SHOT | Philadelphia Daily News | 04/04/2008

CITY HEALTH CLINICS NEED A BOOSTER SHOT Philadelphia Daily News 04/04/2008:

“How they don’t work: The system is far from perfect. According to a report released by the Philadelphia Unemployment Project last year, it can take up to five months to schedule an appointment with a doctor at a health center. Advocates say the centers need to extend evening hours and add staff to shorten waiting times. The mayor’s proposed funding increase is supposed to deal with some of these issues.
One of the biggest challenges that health centers face is offering competitive salaries to attract qualified staff.

The salaries offered by the city for three critical positions – pharmacists, dentists and physicians – are relatively low when compared to industry averages.

The highest-paid pharmacist working for the city makes $77,013 – well below the national median of $103,000. The same is true for dentists who work for the city. A typical dentist makes $130,000 a year. That’s significantly more than the $95,630 made by the highest-paid dentists at city health centers.

The largest discrepancy can found in the salary paid to doctors. The average physician working in a family practice makes $204,000. The highest-paid physician working for the city makes $109,820 – a difference of more that $94,000.”

Just had to post this for all of those who insist we don’t have to wait for healthcare in America and that “everyoine in America has access to health care.”

AlterNet: 10 Myths About Canadian Health Care, Busted

AlterNet: 10 Myths About Canadian Health Care, Busted:

“2008 is shaping up to be the election year that we finally get to have the Great American Healthcare Debate again. Harry and Louise are back with a vengeance. Conservatives are rumbling around the talk show circuit bellowing about the socialist threat to the (literal) American body politic. And, as usual, Canada is once again getting dragged into the fracas, shoved around by both sides as either an exemplar or a warning — and, along the way, getting coated with the obfuscating dust of so many willful misconceptions that the actual facts about How Canada Does It are completely lost in the melee.

I’m both a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border. As such, I’m in a unique position to address the pros and cons of both systems first-hand. If we’re going to have this conversation, it would be great if we could start out (for once) with actual facts, instead of ideological posturing, wishful thinking, hearsay, and random guessing about how things get done up here.

To that end, here’s the first of a two-part series aimed at busting the common myths Americans routinely tell each other about Canadian health care. When the right-wing hysterics drag out these hoary old bogeymen, this time, we need to be armed and ready to blast them into straw. Because, mostly, straw is all they’re made of.”

Read on…

delawareonline ¦ The News Journal, Wilmington, Del. ¦ Patient increase, limited medical school slots make seeing doctor tougher to do

delawareonline ¦ The News Journal, Wilmington, Del. ¦ Patient increase, limited medical school slots make seeing doctor tougher to do:

“Some doctors say the problem lies not with a doctor shortage, but with an uneven distribution of MDs. New doctors gravitate toward more lucrative specialties, such as sports medicine. Specialties that require surgery, such as ophthalmology, also attract doctors because Medicare and insurers reimburse surgical procedures at a far higher rate than evaluations. Cooper said young doctors are turning to these profitable specialties at the expense of Medicare patients, who largely suffer from diabetes and arthritis and are in need of endocrinologists and rheumatologists. Medical school students also may be dissuaded from primary care. Dr. David Krasner, who works at Family Practice Associates in Wilmington, said the existing reimbursement system pays too little for cognitive evaluations by primary care physicians. ‘For physicians to go into primary care in this day and age, it’s akin to committing financial suicide,’ he said. ‘The shortage in my opinion won’t get better until Medicare changes the way it reimburses.'”

Please click on some of the tags below: physician income, in particular to learn more about this topic…

The Reality-Based Community: Rationing health care

The Reality-Based Community: Rationing health care:
Rationing health care
Posted by Mark Kleiman

“All this, let’s recall, with the Chancellor breathing down the neck of the boss of the medical area on behalf of a full professor at the university that owns the hospital. So my experience with the system was probably about as good as it gets except for corporate executives using places like the Mayo Clinic or family members of people on the boards of directors of hospitals. (Apparently it’s generally understood that if you stump up enough in the way of contributions to get on the board of the hospital, you’re entitled to priority care; that’s how not-for-profit hospitals raise capital.) It was only later 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. The process is designed to get very sick or prosperous patients to pay to jump the queue. I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero. “

The Doctor Will See You—In Three Months

The Doctor Will See You—In Three Months: “It’s not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. ‘Waiting is definitely a problem in the U.S., especially for basic care,’ says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy. All this time spent ‘queuing,’ as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn’t get in to see their regular doctor, a significantly higher rate than in other countries.”

Waiting Times for Care? Try Looking at the U.S. – Nurses, Doctors Say It’s Time to Debunk the Myths

Waiting Times for Care? Try Looking at the U.S. – Nurses, Doctors Say It’s Time to Debunk the Myths: “‘There’s been a lot of clamor lately about delays in care in some other countries. But if you want to see some really unsightly waiting times, look at U.S. medical facilities,’ said Deborah Burger, RN, president of the 75,000-member CNA/NNOC. While the problem has been largely overlooked by the major media, it was quietly exposed by the chief medical officer of Aetna, Inc. late in Aetna’s Investor Conference 2007 in March. In his talk, Troy Brennan conceded that ‘the (U.S.) healthcare system is not timely.’ He cited ‘recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable,’ Brennan said. Brennan also recalled that he had formerly spent much of his time as an administrator and head of a physicians’ organization trying ‘to find appointments for people with doctors.’ While Brennan’s “

Angry Bear on OECD Waiting Times Study

Angry Bear:

“The data shows that many countries with ‘nationalized’ health care systems have little or no waits for elective medical procedures. A 2003 OECD working paper entitled ‘Explaining Waiting Times Variations for Elective Surgery across OECD Countries’ by Luigi Siciliani and Jeremy Hurst provides some survey evidence of actual waiting times in various OECD countries. The results of that survey are presented below.”

Two nice tables here explain a lot…