Coyote Blog

They say that the recession is a chief cause for the increase in average wait times in 2008. Yet this is going back from 2002.

Would a totalitarian statist lie to you in order to get their way? Perish the thought.

A real story from a real Canadian. It is more than the wait times, it is the lousy service.

Whatever you do, don't follow our pattern. The Euros & Aussies have a much better model.

http://tinyurl.com/lnuuj3

One thing that popped into my head: given the clear superiority of the state run system in Canada dealing with the day to day health issues of their subjects, emergency rooms should generally not be where one goes when one has the sniffles, like the uninsured in the US might.

So that 8 hour wait is possibly for more serious health issues.

Which is why I'm putting myself in a position financially to not need the state. I suggest everyone do the same.

Fred Z, I'm sorry to hear about your mother in law. The sad thing is at 78, she very well could live another decade or more these days.

Your example about going to the emergency room for tests is classic "for every action, there is an equal or greater reaction".

What frustrates me the most about addressing health care is that very few of the solutions out there such as single payer have better outcomes than what we're doing now. Yet instead of taking the time to look at the problem(s) at hand and come up with new solutions, too many folks turn to outdated "solutions" that we know are just as bad if not worse.

I guess I shouldn't be surprised, often times the same crowd pushing for single payer is the same one touting 18th century rail technology as being a transportation solution.

Still stewing. Read NRO and mark Steyn to calm down. Didn't work.

http://corner.nationalreview.com/post/?q=YzYwYmM2NGI3NGViODEwOTc1NTkwMmRmMDk2NTY2ZDk=

Steyn's father "is currently ill, and the health "system" is doing its best to ensure it's fatal. When an ambulance has to be called, they take him to a different hospital according to the determinations of the bed-availability bureaucrats and which one hasn't had to be quarantined for an infection outbreak. At the first hospital, he picked up C Difficile. At the second, MRSA. At the third, like the lady above, he got septicaemia. He's lying there now, enjoying the socialized healthcare jackpot - C Diff, MRSA, septicaemia. None of these ailments are what he went in to be treated for. They were given to him by the medical system."

Wealthy successful columnist, pundit, author and the best his father can get is crap. I expect Steyn the elder will soon be in the USA, although my own father frequently refused to go there for treatment. That's part of the trap - as we age we hate and fear travel more and more. My father, my mother in law and no doubt Steyn's dad have the money to go to the USA for treatment, but it's a damn hard thing for an old person to do.

Just wait my American friends, until some civil servant tells you that your fathers and mothers must go to a facility you know is dirty and incompetent, and any attempt to do otherwise is a criminal offense. Coming at ya, baby.

frankania, you must be nuts, proposing such a solution which is entirely correct, perfect and proper. Don't you know that everyone from the Democratic Party to the American Medical Union, I mean Association, will fight your idea to the death?

Be careful frankania, I expect there are black CIA helicopters coming for you right now.

I was in Mexico in 1994 with two sick kids and received fabulous medical service. That experience was probably the start of my ever increasing hatred for the Canadian system. Before then I was a young guy in good health - never needed the system much and when I did it was minor and being young I was naive, stupid, pig-ignorant and silly. God forgive me I voted for the local liberal party.

Then marriage and two kids, which involves lots of interaction with the medical system. It was bad but until Mexico, I had no idea there was anything different.

"We often hear that one of the reasons health care “reform” is necesary in the US is because the uninsured overwhelm emergency rooms. We hear horror stories of overcrowded emergency rooms with long wait times, which would only be better if we had a national health care system like Canada"

Why are the emergency rooms crowded, and why would that improve under universal healthcare? Isn't it likely that it will lead to even more usage, not less?

Canada's e-rooms must also be jammed up with illegal immigrants.

Frankania, Mexican doctors rarely deserve the title. Almost none could pass the qualifying exams and get through a US residency program. Also, we aren't "AMA doctors." The AMA represents less than 25% of physicians, and the AMA has no control over licensing (states), board exams (dozens of specialty boards), medical schools (federal government plus a private accrediting board), etc.

I do favor letting in many more qualified physicians. England, Canada, Germany, France, Spain, Italy, Israel, Australia, and a few other countries have equivalent medical training. Most US clinicians work 60-80 hours a week, and many of them won't mind losing some patients (to immigrant MDs) and gaining some free time.

Anecdotal evidence: the two times that I had to take advantage of emergency care in Germany, I saw a doctor within 10 minutes of arriving at the hospital and got treated right away. (Abscess in the elbow bone, needed opening, draining, suturing, intravenous antibiotics, 3 day hospital stay; fixing and setting a broken clavicle).

The one time I drove myself to an ER in Seattle, I had to make a detour to a private parking lot because the hospitals lot was closed due to construction, walk 5 minutes back to the ER, got my blood pressure taken by a nurse, sat in the waiting room with 3 other people from 10PM until 4AM, all the time doubled over with pain, saw a doctor at 4, got some painkillers, went into surgery at 11AM the next day. I had to wonder if someone in Administration had pointed out that burst appendices can generate an order of magnitude more income than an ordinary appendectomy.

I saw the bills to my insurance in all cases; cost of care was 3600 and 1200 Euro for the procedures in Germany and 46000 USD for the appendicitis in the US. Off the net and for a more current comparison, the maximum cost for an appendectomy in Germany was up to 2740 Euro in 2005 (state run system with a master list for max cost). Germans tend to complain a lot about the unreasonably high cost of these procedures, so clearly nobody is ever real happy with the cost of healthcare, but there's a marked difference here.

While in my case, both quality and cost of care were atrocious compared in the US compared to a European socialized system, I realize that it's a rather small sample base.

My personal impression derived from these and many Dr visits is that the US healthcare system is neither particularly great on waiting times, quality of care, efficiency or cost of care. I'd be interested in opinions about why that is - how do the costs typically break down on the hospitals side?

My layman view of things is that I believe that emergency care represents a problem where the typical interplay of market forces is concerned - by the time a patient has made it to an ER, their bargaining power is rather limited ("Ha - you want to charge me what? I'll take my broken leg to a hospital in Florida instead unless you give me at least a 10% discount" (limps out)). There is no backpressure in the system - the parties in the system administer cost based on standard rates and don't mind those creeping higher because the cost is passed on.

Honestly, part of the answer (following a strictly economical line of argument, not involving ethics) would be to create a much simpler licensing system for professionals charged with treating bacterial infections, simple flesh wounds, burns and abrasions, backpain, the common cold, sinusitis, measels, mumps and rubella and fractures. Add another line of simplified certification for the 10 most frequent surgeries. You'll get less qualified and more specialized people trained on the common medical activities at a substantially lowered cost and swamp the system with them, which should lower the price and increase availability of the most commonly required care. For anything further reaching, yes, you'll continue to have to see more specialized professionals at a higher cost; and yes, there'll be a few cases where something more severe is misdiagnosed as a simple common case by less trained personnel. I'd guess that the numbers here will be in favor of the most common cases, especially if taking into account that misdiagnoses of uncommon causes as frequently occuring illnesses with similar symptoms is probably already a common occurence because of the reinforcement effect.

It's likely that you could replace 90% of the work of today's practicioners with a simple computerized decision tree (with a few nodes reading 'go fetch a specialist') and a nurse.

Anecdotal, but this is what I know for the Canadian system (southern Ontario, as each province manages it's own, and you cannot make blanket statements about a Canadian system, as there is not one).

My mother-in-law went for colonoscopy on a Friday morning, they found cancer, gave her a cat scan and two blood transfusions, had surgery by noon the next day, and also removed a hernia.

My Dad had leukemia, had my aunt in the UK tested, discovered she had a blood disorder, found a match in germany, flew the bone marrow stem cells over, and cured my Dad. Sure, he has ongoing issues (it's been 5 years) but he is alive.

Never saw a bill, have no clue on the cost for either of these.

Just two of many shining examples of what the Ontario Health Insurance Plan health care can do.

As a side note, I broke my hand early in the year, waited two hours in emergency (they were busy) and my issue was less severe than some of the later arrivals who (rightly) were looke at first.