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The US health care wait times myth

theincidentaleconomist.com

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Re: The US health care wait times myth

#21

Post by dean »

That first graph is interesting. I would like to see their definition of "wait time when sick". Since the article separately mentions waiting to see specialists, and elective surgery, I'm going to assume wait times in the graph do not include these.

When we talk about wait times in Canada, most people mean the amount of time they have to wait when they walk in to a hospital or clinic, without an appointment. In other words, how long do you have to wait to see a doctor now. Not how long do you have to wait for an appointment with your GP. And that time is typically measured in hours, not days.

Frankly, I'm surprised to see that anyone in any of those countries has to wait 6 days to see a doctor when they are sick.

Re: The US health care wait times myth

#22

Post by zaidf »

CWuestefeld wrote: post #19
zaidf wrote: post #10

My siblings and I take a pill 3x day for life for a genetic condition. The pill(colchicine) cost pennies in its generic form. It isn't a pill that was made in a lab after millions in research. So there were plenty of generic brands available and it'd cost us 5 bucks/mo from Walmart. That was that. Last year a company came in and got an exclusive on it on the premise that they spent millions in testing the pill for qu…

Last year a company came in and got an exclusive on it... There is something seriously flawed about some things in our healthcare system. That doesn't sound like a healthcare problem. That sounds like an IP problem. Whatever it was that let the new manufacturer take the compound out of the public domain is where you should be directing your ire. Sounds like another indictment of patent law.

Semantics. Almost all problems related to healthcare have their root cause at something other than healthcare directly.

For example, defensive medicine can be traced to the way our legal system works.

It's a healthcare and ____ problem(insert IP, legal etc.)

Re: The US health care wait times myth

#23

Post by dalore »

CWuestefeld wrote: post #8

Data point: I live in the USA, and I've got Crohn's disease. I take medicine for the chronic condition, which keeps it in remission 99%+ of the time. But when it flares up, I need to see a doctor pretty quick -- not just because it hurts, but also because the pain is an indication of bad things happening to my intestines. The thing is, I can't get an appointment to my GI doctor right now , or even tomorrow. So I can'…

Wow, I live in the UK and when I need to see the doctor I just drop by with no appointment, wait my turn (depending on number of people in the surgery can take 10-60mins. Then the doctor sees me.

Re: The US health care wait times myth

#24

Post by yummyfajitas »

jbooth wrote: post #16

Yeah, I mean I can understand the philosophical place that one could come from that would make one skeptical of government-run anything. But every other industrial nation beats the crap out of us both in results and in results per $$, while spending far less money. This isn't a theoretical argument -- we could just copy one of those systems wholesale and get way better results than we're getting. At one point does th…

But every other industrial nation beats the crap out of us both in results and in results per $$...

What results? Please be specific. In particular, if you want to compare health outcomes, please make sure you controlling for factors like demographics, lifestyle, pollution, food quality, etc.

Also, how do you propose to pay US doctors the same salaries paid to doctors in poorer countries? Some numbers: the top 5% of income earners in Canada earn 40% less than the top 5% of the US. Are you proposing to knock doctors a few rungs down the income ladder?

http://www.statcan.gc.ca/pub/75-001-x/2007109/article/409688...

Re: The US health care wait times myth

#25

Post by CWuestefeld »

jbooth wrote: post #16

Yeah, I mean I can understand the philosophical place that one could come from that would make one skeptical of government-run anything. But every other industrial nation beats the crap out of us both in results and in results per $$, while spending far less money. This isn't a theoretical argument -- we could just copy one of those systems wholesale and get way better results than we're getting. At one point does th…

If we have to have this discussion again...

we could just copy one of those systems wholesale

Maybe. But when you do out the demographics, there are plenty of reasons to think that things here are not quite the same. With different sorts of problems, the same solution isn't guaranteed to work.

If you saw a better technique for doing something at your business, and didn't do it because "i don't like to see problems solved in that fashion, regardless of what the metrics tell me", you'd be an idiot, right?

Maybe. But maybe you're constrained because of what the Board of Directors will allow you to do. By analogy, the Constitution simply doesn't allow the federal government to do many of the things that your solution would require. Even if they're great ideas, it's simply not allowed. So you should be concentrating on changing the Constitutional restrictions that prevent those solutions, rather than getting the Courts to throw out ever larger chunks of the only thing that protects us from tyranny.

Re: The US health care wait times myth

#26

Post by mrkurt »

zaidf wrote: post #10

My siblings and I take a pill 3x day for life for a genetic condition. The pill(colchicine) cost pennies in its generic form. It isn't a pill that was made in a lab after millions in research. So there were plenty of generic brands available and it'd cost us 5 bucks/mo from Walmart. That was that. Last year a company came in and got an exclusive on it on the premise that they spent millions in testing the pill for qu…

If you don't value the testing Colcrys did (I probably wouldn't, colchicine's been around long enough), consider getting it from a "Canadian" pharmacy online. Generics of otherwise patented/exclusive drugs in the US are frequently legal in other countries. I know of a number of people who order from an online "Canadian" pharmacy for a generic version of Singulair, which is produced in India.

The legality of importing these for personal use is pretty murky. The FDA probably wouldn't like it, but it's not a blatant violation of any laws I'm aware of either.

More generally, I really struggle with patent protections for pharmaceuticals. It's difficult to imagine how they'd justify paying ginormous amounts of money to develop and/or test products to the FDA's standards without patent protection, but I find the idea of patents pricing people out of medication distasteful.

Re: The US health care wait times myth

#27

Post by mrkurt »

CWuestefeld wrote: post #19
zaidf wrote: post #10

My siblings and I take a pill 3x day for life for a genetic condition. The pill(colchicine) cost pennies in its generic form. It isn't a pill that was made in a lab after millions in research. So there were plenty of generic brands available and it'd cost us 5 bucks/mo from Walmart. That was that. Last year a company came in and got an exclusive on it on the premise that they spent millions in testing the pill for qu…

Last year a company came in and got an exclusive on it... There is something seriously flawed about some things in our healthcare system. That doesn't sound like a healthcare problem. That sounds like an IP problem. Whatever it was that let the new manufacturer take the compound out of the public domain is where you should be directing your ire. Sounds like another indictment of patent law.

Stringent FDA requirements that require extremely expensive testing are basically a health care problem. The fact that we have to give people monopolies so they can afford to do what the FDA wants is an unfortunate symptom of the problem.

Re: The US health care wait times myth

#28

Post by maxharris »

zaidf wrote: post #10

My siblings and I take a pill 3x day for life for a genetic condition. The pill(colchicine) cost pennies in its generic form. It isn't a pill that was made in a lab after millions in research. So there were plenty of generic brands available and it'd cost us 5 bucks/mo from Walmart. That was that. Last year a company came in and got an exclusive on it on the premise that they spent millions in testing the pill for qu…

This is the FDA's fault.

Without the FDA, you would keep buying the generic you had been buying, and the company would keep making it for you. But with the FDA, a company can come in and essentially buy a monopoly on a market that would otherwise be free.

Re: The US health care wait times myth

#29

Post by CWuestefeld »

raganwald wrote: post #17
yummyfajitas wrote: post #9

Earlier quoted context omitted.

But arguments that it's better than Canada should be accompanied by evidence that it exceeds what is actually an incredibly small amount of friction. Very true. Since very few people move from one industrialized nation to another for the health care, we should conclude that they all provide very similar services.

Well, we can conclude that they are not as important and/or as urgent as other factors, and only for those who are mobile. Between Canada and the US, for example, it is easiest to move if you are young, educated, and employable. So I might draw some conclusions about the lack of difference to those who are young, educated, and employable. I wouldn't assume that there's no difference for someone who is older, uneducat…

I wouldn't assume that there's no difference for someone who is older, uneducated, or unemployed, because the cross-border friction is WAY higher for them.

You might be right, but I don't think you can simply assume it.

For example, a well-educated, professionally employed person old enough to have an established family is highly immobile for those very reasons. Their jobs and their family ties are holding them in place. Who knows how these factors all net out.

Re: The US health care wait times myth

#30

Post by maxxxxx »

yummyfajitas wrote: post #24
jbooth wrote: post #16

Yeah, I mean I can understand the philosophical place that one could come from that would make one skeptical of government-run anything. But every other industrial nation beats the crap out of us both in results and in results per $$, while spending far less money. This isn't a theoretical argument -- we could just copy one of those systems wholesale and get way better results than we're getting. At one point does th…

But every other industrial nation beats the crap out of us both in results and in results per $$... What results? Please be specific. In particular, if you want to compare health outcomes, please make sure you controlling for factors like demographics, lifestyle, pollution, food quality, etc. Also, how do you propose to pay US doctors the same salaries paid to doctors in poorer countries? Some numbers: the top 5% of…

I think reducing doctors' salaries is a good idea.
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