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Posted on July 10, 2007

On Health Care Reform

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Long waits are really SiCKO

Deborah Burger
SF Chronicle
Tuesday, July 10, 2007

What country endures such long waits for medical care that even one of its top insurers has admitted that care is “not timely” and people “initially diagnosed with cancer are waiting over a month, which is intolerable?”

If you guessed Canada, guess again. The answer is the United States.

Scrambling for a response to the popular reaction to Michael Moore’s “SiCKO” and a renewed groundswell for a publicly financed, guaranteed single-payer health care solution, such as SB840, the big insurers and their defenders have pounced on Canada, pulling out all of their old tales of people waiting years in soup kitchen-type lines for medical care.

But, here’s the dirty little secret that they won’t tell you. Waiting times in the United States are as bad as or worse than Canada. And, unlike the United States, in Canada no one is denied needed medical care, referrals or diagnostic tests due to cost, pre-existing conditions or because it wasn’t pre-approved.

U.S. waiting times are the elephant in the room few critics care to address. But, listen to what the chief medical officer of Aetna had to say in March.

Speaking to the Aetna Investor’s Conference 2007, Troy Brennan let these pearls drop:

The U.S. “health care system is not timely.”

Recent statistics from the Institution of Healthcare Improvement document “that people are waiting an average of about 70 days to see a provider.”

“In many circumstances, people initially diagnosed with cancer are waiting over a month, which is intolerable.”

In his former stint as an administrator and head of a physicians’ organization, he spent much of his time trying “to find appointments for people with doctors.”

Brennan’s comments went unreported in the major media. But some reports are now beginning to break through, spurred by the debate “SiCKO” has spawned.

Business Week reported (www.businessweek.com/technology/content/jun2007) that “as several surveys and numerous anecdotes show, waiting times in the United States are often as bad or worse as those in other industrialized nations — despite the fact that the United States spends considerably more per capita on health care than any other country.”

A Commonwealth Fund study of six highly industrialized countries (www.commonwealthfund.org), the United States and five nations with national health systems (Britain, Germany, Australia, New Zealand and Canada) found waiting times were worse in the United States than in all the other countries except Canada .

There’s something else you probably don’t hear about Canada. Substantial progress is being made.

Most of the wait-time problems derive from funding cuts by conservative national or provincial governments, or from the siphoning off of resources by private providers. But precisely because the Canadian system is publicly administered, Canadians are able to force their elected officials to fix problems, or get voted out of office.

Throughout Canada, there are multiple pilot programs that have succeeded in slashing wait times. Canada’s latest statistics show that median wait times for elective surgery in Canada is now three weeks — that’s less time than Aetna’s chief medical officer says Americans typically wait after being diagnosed with cancer.

Canada also has no waits for emergency surgeries. It also doesn’t have 44 million people who are uninsured because everyone has a national health-care card guaranteeing health care from any doctor or hospital they choose. And it doesn’t burden those with insurance with rising deductibles or co-pays. A study reported by Health Affairs, a policy journal, for example, found that out-of-pocket costs to U.S. consumers jumped 76 percent this year over last year alone.

Canada also surpasses the United States in a broad array of health barometers, including life expectancy, infant mortality rates, adult mortality rates, deaths due to HIV/AIDS, mortality rates for cardiovascular diseases and years of life lost to injuries and diseases, according to data from the World Health Organization and the Organization of Economic Co-operation and Development.

No wonder some people are so afraid we’ll learn the real comparative story about Canada’s system — and our own.


Deborah Burger, R.N., is president of the California Nurses Association.

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/07/10/EDG6QQ4VGD1.DTL

This article appeared on page C - 11 of the San Francisco Chronicle