Waiting on Health Care Reform

Matt Yglesias points to another right-wing ad attempting to scare people away from health care. The ad shows people standing in line to see a movie and says that if we had government-run health care, we’d have to stand in line to see a doctor.

The first comment: “So, with a true free market system, we’ll no longer have to wait to see a movie?”

Matt writes,

I’m fascinated as to what planet the maker of this ad lives on. Back in December I called my primary care physician’s office to schedule an appointment. I got one in mid-March. Such is life. Waiting times are, obviously, a function of supply and demand. The private sector could easily organize an insurance scheme that made it much quicker and easier to get in to see your doctor — your premiums and/or copayments would just need to be way higher. Similarly, just as a government-run subway system can reduce crowding by spending more money to run more trains, a government-run health care system featuring long waiting times for MRIs could . . . spend money and buy more machines.

A couple of weeks ago, an article in that shameless socialist rag Business Week argued that Americans already are waiting longer to get health care.

The lobbying group America’s Health Insurance Plans spells it out in a rebuttal to Sicko: “The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care.”

In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn’t clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. “I completely freaked out,” Susan says. “I couldn’t imagine spending the summer with this hanging over my head.” After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. “The system is clearly broken,” she laments. …

…There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.

The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. “Their wait might be uncomfortable, but it makes very little clinical difference,” he says.

The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.

Jane Bryant Quinn writes for Newsweek:

Prepare to be terrorized, shocked, scared out of your wits. No, not by jihadists or Dementors (you do read “Harry Potter,” right?), but by the evil threat of … universal health insurance! The more the presidential candidates talk it up, the wilder the warnings against it. Cover everyone? Wreck America? Do you know what care would cost?

But the public knows the American health-care system is breaking up, no matter how much its backers cheer. For starters, there’s the 46 million uninsured (projected to rise to 56 million in five years). There’s the shock of the underinsured when they learn that their policies exclude a costly procedure they need–forcing them to run up an unpayable bill, beg for charity care or go without. And think of the millions who plan their lives around health insurance–where to work, whether to start a business, when to retire, even whom to marry (there are “benefits” marriages, just as there are “green card” marriages). It shocks the conscience that those who profit from this mess tell us to suck it up.

I do agree that we can’t afford to cover everyone under the crazy health-care system we have now. We can’t even afford all the people we’re covering already, which is why we keep booting them out. But we have an excellent template for universal care right under our noses: good old American Medicare. When you think of reform, think “Medicare for all.”

Medicare is what’s known as a single-payer system. In the U.S. version, the government pays for health care delivered in the private sector. There’s one set of comprehensive benefits, with premiums, co-pays and streamlined paperwork. You can buy private coverage for the extra costs.

Health insurers hate this model, which would end their gravy train. So they’re trying to tar single-payer as a kind of medical Voldemort, ready to destroy.

Quinn argues that this expansion of Medicare would not require raising taxes. But even if it did, “your Medicare plan would probably cost less than the medical bills and premiums you’re paying now.”

Here’s what she says about waiting lines:

No advanced country has waiting periods for emergency surgery or procedures that are urgently needed. The United States has shorter waits than Canada and England for elective surgery. Still, queues are developing here, at the doctor’s door. In a study of five developed countries, the Commonwealth Fund looked at how many sick adults had to wait six days or more for an appointment. By this measure, only Canada’s record was worse than ours. But waits depend on how well a system is funded, not with the fact that it’s single-payer. Many countries that cover everyone, including France, Belgium, Germany and Japan, report no issue with waits at all.

How much longer will we have to wait for health care reform?

10 thoughts on “Waiting on Health Care Reform

  1. I just called my clinic to setup an appointment to see my doctor (Not really a doctor but a Physician’s Assistant.) wanting to wrap up somethings that we had been going through this spring. The soonest I could see her was September.

  2. I just tried to book my opthomologist today, and got an October appointment for a routine exam.

    I always attributed these long lines directly to the present for-profit system. My insurance carrier is (a) popular to local employers and (b) cheap, so most local providers don’t take them. Hence, there are a lot of people trying to get appointments with a limited number of providers, and the lines grow.

  3. WHY will it take longer to see a doctor after we have Universal Coverage? Because mopre people will be ABLE to see a doctor when they are ill, and none of the proposals does a good job of addressing increasing the supply of doctors. So the Neocon solution is to keep poor people AWAY from the health care system. There are people who are WORTHY of health care, and a bunch who are NOT. That’s the meaning of the ‘long line’ argument.

  4. Health care is already rationed: If you have a little bit of money, you can get a little bit of health care. If you have a lot of money, you get a lot of health; no money, no health care; etc.

  5. Where I live, it takes about three weeks to get your sick infant in to see the pediatrician (great if she survives her fever) and three or four months to get in to see you dermatologist to look at that weird possibly cancerous sore on your arm. When my elderly father passed out at a picnic, he waited in the emergency room for five hours before he went home in disgust.So I don’t want to hear that we don’t have waiting lists in the US. Millionaires can buy their way into to instant access but the rest of us have to wait. The difference between here and Canada is that the Canadians track it and we pretend it isn’t happening.

    My employer pays $3600 a year for my health insurance, and I pay an additional $4800 to cover my spouse. Of course I’d gladly pay an additional $8400 in taxes to get health coverage at Canadian standards. Right now, if I get sick or I get laid off, we’re screwed. COBRA coverage equivalent to what I have is $1500 per month, and that’s pretty hard to manage if your’re unemployed, especially if you’re unemployed because you have a serious illness. Plus it gives me a preexisting condition that means I can’t get future coverage if I find a job after after my 2 year COBRA runs out. Our current health system offers coverage for a lucky few, and the illusion of coverage for most. In 1994, most Americans believed they had usable health insurance. In 2007, we know we don’t.

  6. I saw Mike Moore on “Hardball” yesterday; he asked a very good question. Has anyone in this country ever seen a serious story (evening network news) on why universal health care works in countries like: Canada, United Kingdom, France, Germany, etc?

    Answer: No, we have not seen such reporting. All we see are big pharmacy advertisements for restless-leg syndrome, followed by “talking-heads” telling us that we cannot afford “socialized medicine”. Every man for himself, if you can’t afford to see a doctor then you will just have to believe in Jesus, heal yourself, or pull yourself up. And if that don’t work then you’re just to god dam lazy. If we socialize healthcare then we may have to fully fund social security, cause if those poor bastards get to see a doctor they may end up collecting?

  7. Two other data points:

    Every minute an ambulance is turned away from a hospital in the US.

    The closest emergency room is getting farther and farther away as emergency room closures are causing a domino effect of further closures as successive emergency rooms overflows for prolonged periods, and goes bakrupt. Med. vac. helicopter is used more and more often. And people are dying just getting to the emergency room.

  8. re #9 – True, and here’s an interesting wrinkle (told to me by my neighbor, an ER nurse). Because there’s LOTS of profit to those hospitals that do offer emergency services, they will often overbook – they’ll say YES to any ambulance or helicopter that wants to bring someone in for emergency care, even though said patient may be in for a loooooong wait due to understaffing / overbooking. It’s all about the Benjamins, folks.

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