Category: Rationing Health Care

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…

Doing Battle With the Insurance Company in a Fight to Stay Alive – New York Times

Doing Battle With the Insurance Company in a Fight to Stay Alive – New York Times: “Obstacles to Care
Doing Battle With the Insurance Company in a Fight to Stay Alive “

Thank goodness we don’t ration care here in the good ol’ US of A!

Aged, Frail and Denied Care by Their Insurers – New York Times

Aged, Frail and Denied Care by Their Insurers – New York Times

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Business
Aged, Frail and Denied Care by Their Insurers
By CHARLES DUHIGG
Published: March 26, 2007
Many long-term-care policyholders say that years of premiums have resulted in only excuses about why insurers will not pay.

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging – New York Times

As Canada’s Slow-Motion Public Health System Falters, Private Medical Care Is Surging – New York Times
By CLIFFORD KRAUSS
Published: February 26, 2006

Article about waiting times in Canada: below are responses from Physicians for a National Health Plan’s Nicholas Skala:

1. This writer is well known for peddling fake data, and this story is no exception. For his outrageous waiting time estimates, he uses data supplied by the Fraser Institute, an ultraconservative PR firm that masquerades as a legitimate research institution. Dr. Robert McMurtry, the Canadian orthopedic surgeon who is a former dean of a Canadian medical school and served on the national waiting times commission tells me that not even the right wing Canadians take them seriously. Their “scientific” method of determining wait times consists of bulk-mailing a list of pro-privatization physicians and asking them how long they think their patients will have to wait to see them. If they return the mailing they are entered in a drawing to win a $2,000 cash prize. It’s pathetic. Unsurprisingly, Fraser comes up with outrageous waiting time estimates (17.8 weeks last year, as I recall), and is quite adept at publicizing them in the American media. Wait times are scientifically measured every year by Statistics Canada (the counterpart to the U.S. Census Bureau). I’m sure most Americans would be surprised at the results of scientific measurement: In 2005, median wait times were 4 weeks for elective surgery, 4 weeks for specialist care, and 3 weeks for diagnostic tests.

http://www.statcan.ca/Daily/English/060131/d060131b.htm

Also, the Canadian Health Services Research Foundation has done a short, scholarly critique of Fraser’s methods and compared them with real studies. (In fact, I think they’re far too kind to Fraser).

http://www.chsrf.ca/other_documents/newsletter/qnv1n4p4_e.php

2. The Supreme Court decision was bad for a number of reasons, and since has been near universally derided in the Canadian press. Follow this link:
http://www.pnhp.org/single_payer_resources/Canadian%20Supreme%20Court%20Ruling.pdf

3. As far as proposals to create a parallel private system, compelling evidence shows that more private participation leads to longer waiting times and lower quality care because 1) private insurers “cherry pick” healthy and profitable patients and leave the sick and poor to the public system and 2) physicians have a perverse incentive to move to the private sector (where they make more money), draining the public system of capacity and resulting in lower-quality care (and eventually creating a self-fulfilling prophecy for the right wing, because they then say the public sector can’t do anything right).

The Canadian Health Services Research Foundation has a couple of great fact sheets on this too.
http://www.chsrf.ca/mythbusters/pdf/myth17_e.pdf
http://www.chsrf.ca/mythbusters/pdf/myth13_e.pdf
http://www.chsrf.ca/mythbusters/

Finally (and kind of philosophically), there is a reason that rationing in Canada gets so much attention in the media. Its because the Canadian health system is held publicly accountable. Grievances aired in public are likely to be addressed by policymakers (and in many cases have, as waiting times for many procedures have dropped dramatically). This is a foreign idea to us in the U.S., where the operation is exactly reverse: no one is ultimately accountable, and the forces that profit from the system have every reason to keep problems quiet. And so, although rationing (based on the ability to pay) in the United States kills at least 18,000 Americans every year (according to the Institute of Medicine’s most conservative data…Himmelstein and Woolhandler estimate it may be 10 times that many), our media acts as though Canada’s the place with the problems.

Hope this helps.

nick

Nicholas Skala
PNHP Staff