July 5, 2014
IT'S JUST ANOTHER CONSUMER GOOD:
The Health Care Waiting Game : Long Waits for Doctors' Appointments Have Become the Norm (ELISABETH ROSENTHAL, JULY 5, 2014, NY Times)
Posted by Orrin Judd at July 5, 2014 6:52 PMThe Commonwealth Fund, a New York-based foundation that focuses on health care, compared wait times in the United States to those in 10 other countries last year. "We were smug and we had the impression that the United States had no wait times -- but it turns out that's not true," said Robin Osborn, a researcher for the foundation. "It's the primary care where we're really behind, with many people waiting six days or more" to get an appointment when they were "sick or needed care."The study found that 26 percent of 2,002 American adults surveyed said they waited six days or more for appointments, better only than Canada (33 percent) and Norway (28 percent), and much worse than in other countries with national health systems like the Netherlands (14 percent) or Britain (16 percent). When it came to appointments with specialists, patients in Britain and Switzerland reported shorter waits than those in the United States, but the United States did did rank better than the other eight countries.So it turns out that America has its own waiting problem. But we tend to wait for different types of medical interventions. And that is mainly a result of payment incentives, experts say.Americans are more likely to wait for office-based medical appointments that are not good sources of revenue for hospitals and doctors. In other countries, people tend to wait longest for expensive elective care -- four to six months for a knee replacement and over a month for follow-up radiation therapy after cancer surgery in Canada, for example.In our market-based system, patients can get lucrative procedures rapidly, even when there is no urgent medical need: Need a new knee, or an M.R.I., or a Botox injection? You'll probably be on the schedule within days. But what if you're an asthmatic whose breathing is deteriorating, or a diabetic whose medicines need adjustment, or an elderly patient who has unusual chest pain and needs a cardiology consultation? In much of the country, you can wait a week or weeks for such office appointments -- or longer if you need to find a doctor who accepts your insurance plan or Medicare.
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