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July 19, 2007

Oh, and about those wait times for medical treatment. . .

When all their other arguments about the advantages of the current US health care system compared to universal, single-payer systems in France, Canada, England, Germany, etc. are shown to be false, apologists for the US health care system turn to their trump card: alleging that wait times to see a doctor in those countries is longer than it is in the US. This statement by the lobbying group America's Health Insurance Plans is typical: "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."

The problem with this type of allegation is that the US does not systematically collect data on wait times, whereas the other countries do collect the data and make them public. The assumption seems to be that in the US, if there is no data, then the wait times must be zero. No data, no problem!

But using the scant data that is available, BusinessWeek points out that except in a few selected, non-emergency situations, even this charge is false: "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."

As Paul Krugman points out in his New York Times July 16, 2007 column:

[B]y and large, opponents of universal health care paint a glowing portrait of the American system that bears as little resemblance to reality as the scare stories they tell about health care in France, Britain, and Canada.

The claim that the uninsured can get all the care they need in emergency rooms is just the beginning. Beyond that is the myth that Americans who are lucky enough to have insurance never face long waits for medical care.
. . .
[N]ot all medical delays are created equal. In Canada and Britain, delays are caused by doctors trying to devote limited medical resources to the most urgent cases. In the United States, they're often caused by insurance companies trying to save money.

This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. ''It was only later,'' writes Mr. Kleiman on his blog, ''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.''

He adds, ''I don't know how many people my insurance company waited to death that year, but I'm certain the number wasn't zero.''

(You can read about Kleiman's plight here, which occurred despite having what he calls "fancy-dancy health insurance through my employer, which as it happens also owns one of the world's dozen best medical centers".)

And what about that favorite of US health care apologists, the waiting time for hip replacements? Krugman looked at that too:

On the other hand, it's true that Americans get hip replacements faster than Canadians. But there's a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That's right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that's what they call their system) because it has more lavish funding -- end of story. The alleged virtues of private insurance have nothing to do with it.

Krugman's conclusion is right on target:

The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America.

POST SCRIPT: Déjà vu

As usual, cartoonist Tom Tomorrow succinctly captures how the media is colluding with the administration in fanning the flames for war with Iran, exactly the way it did with Iraq.

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Comments

I don't see why so many people are wanting a universal health care plan. This type of plan would cause more problems than its worth. It would take away our freedome to choose providers, doctors etc. We would be stuck with whatever coverage they give us which is typicall minimal and many things have to be paid out of our own pockets.

Posted by Health Insurance on April 17, 2008 04:24 PM

It's not just hip replacements. In Canada people wait on average 48 days for a bypass surgery, 62 days for a CAT scan, and 105 days for a MRI. This are all procedures that can save a life if performed promptly and correctly.

http://www.infohealth.info/node/2279

The most current (2007) data shows the average waiting time for bypass surgeries in Ontario is 55 days.

http://www.waittimes.net/waittimes/en/wt_proximity.aspx?city=*ont&pc=&dist=0&site=8

Posted by bob on May 4, 2008 09:59 PM

I just read that business week article you quoted. The first example named a woman who saw a doctor in late May, found an abnormality and tried to reschedule, only to find out the wait time would be until August 25th. She called around and found another doctor willing to see her June 25th.

In Canada you are not allowed to visit other doctors or provinces to "jump the line". Why should she villify the system? If she was in Canada, she would have waited until August 25th, no ifs, ands or buts.

The other thing that disturbs me is the other wait times this system quotes. It's funny...although we have some queuing, we have 10 times the population Canada does, and we still manage to have more efficient wait times. I think the major thing to look at is the bigger picture.

Also, the per-capita arguement that Canada spends less per-capita than America...we also have an estimated 20 million illegal immigrants living in this country. How many of them benefit from the system without paying taxes? Of course, this is just a fact to cogitate. I think people are using bombast to distort the true virtues of our system.

Posted by Fred on June 14, 2008 10:46 AM

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