US dead last in health care

[On Guard for Thee]

One of my personal favorites....

"Access to a waiting list is not access to health care" - Supreme Court of Canada

Universal health care certainly is. I doubt you could find many Canadians who would trade. After all, you're still dead last.

[bush_cheney2004]

Ooo...another nugget from the past...and still Canada's present and future:

BC Government spokesperson and Associate Deputy Minister of Health, in 1995, on being asked about BC patients on waiting lists seeking care in the United States: “If we could stop them at the border, we would”

Thea Vakil

[On Guard for Thee]

Ooo...another nugget from the past...and still Canada's present and future:

BC Government spokesperson and Associate Deputy Minister of Health, in 1995, on being asked about BC patients on waiting lists seeking care in the United States: “If we could stop them at the border, we would”

Thea Vakil

My you are grasping at straws now.

[waldo]

Universal health care certainly is. I doubt you could find many Canadians who would trade. After all, you're still dead last.

as you can see, the principal deflector once again plays out the charade completely oblivious to the comparative failure of the U.S. health system. Within this thread the relative miniscule number of Canadians seeking health care in the U.S. was detailed, particularly in relation to the thousands upon thousands of U.S. citizens seeking health care outside the U.S.. Within this thread, the principal deflector flogged the issue of wait times while, of course, ignoring any discussion of the actual comparative failings of the U.S. health system. And, of course, as I just posted a few posts, the principal deflector has never qualified just what the "apparent U.S. reference benchmark" for surgery wait times actually is... notwithstanding completely ignoring the 50 million+ U.S. citizens on Medicaid and what wait times they may be subject to. Deflect, deflect, deflect!

[waldo]

My you are grasping at straws now.

a 1995 reference!

[On Guard for Thee]

a 1995 reference!

I don't know if you listen to CBC radio but I catch the Sunday Edition whenever I can. Not long ago Micheal Enright related a story of a friend of his who came to TO from east coast US for a visit and managed to trip and break his ankle while stepping over a curb somehow. He needed surgery and some pinds put in. He had no blue cross or other travel insurance so he had to pay the bill out of pocket. Came up to 2200 bucks or so. The doc here said make sure you go see your own doc when you get back home. When he did he was told A: the surgery was excellent, and B: at home the bill would have been in the neighborhood of 12K. I doubt they pay surgeons that much better in the US, but I'm sure it helps inflate the bottom line of "Acme" insurance corp.

[waldo]

my bad! Correction: the principal deflector didn't completely ignore the OP study. Apparently, to the principal deflector, those comparative U.S. failings hold inherent caveats... such as, the failings are due to the freedom Americans hold to be able to abuse themselves through life-style choices... freedom! And, of course, "cash is king", as in if you have the cash, no problemo... those failings do not apply to your America and your subset American health system! And, perhaps the best of all, according to the principal deflector, the American health system has no expection of delivering universal care, hence, you get what you get... lump it or leave it!

[waldo]

...but I'm sure it helps inflate the bottom line of "Acme" insurance corp.

speaking of that component within the comparitative failings of the U.S. health system relative to the impact of insurance companies/cost.... the following video speaks volumes. A quite lengthy vid but certainly addresses the 'true cost of U.S. healthcare', particularly driven by U.S. insurance companies:

[bush_cheney2004]

This Canadian doctor got tired of the wait times too...so he moved his skills to the USA:

Two years into his training as a neurosurgeon in Montreal, Michael Stoffman thought he saw the writing on the wall: Elective operations were often being postponed at the last minute, specialists had limited time in the OR and the job market looked to be dicey.

Worried about his future in Canada, the native of London, Ont., took a fateful step. He decided to do the last five years of his residency at Yale University, eventually becoming the Ivy-league school’s chief neurosurgery resident — and setting up practice in Niagara Falls, N.Y.

As predicted, Dr. Stoffman said he now performs many more operations than colleagues in Canada — and has ironically become a sort of safety valve for the system he left behind.

....Dr. Stoffman is the first to point out that both countries’ health-care systems have their pros and cons, but the 41-year-old and his personal journey appear to illuminate a glaring shortcoming in Canada’s.

“It seems that over the last few years, we have been seeing more and more [Canadians] who cannot get treatment in a timely fashion,” he said. “I guess I’m starting to think a little bit more like an American: It seems absurd to have to wait six months with shooting pain down your leg before you can get treatment.”

http://news.nationalpost.com/2013/08/23/no-time-to-wait-doctor-moves-his-practice-to-the-u-s-continues-seeing-lots-of-canadian-patients/

[waldo]

captain deflector! Still not addressing the comparative failures of the American health disadvantage... still not providing any qualification as to just what U.S. surgery wait times are..... for all Americans inclusive of all categorizations, including Medicaid! Still no provided qualification. Deflect, deflect, deflect.

[waldo]

my bad! Correction: the principal deflector didn't completely ignore the OP study. Apparently, to the principal deflector, those comparative U.S. failings hold inherent caveats... such as, the failings are due to the freedom Americans hold to be able to abuse themselves through life-style choices... freedom! And, of course, "cash is king", as in if you have the cash, no problemo... those failings do not apply to your America and your subset American health system! And, perhaps the best of all, according to the principal deflector, the American health system has no expection of delivering universal care, hence, you get what you get... lump it or leave it!

oh wait... I forgot one! Within this thread, when I previously provided actual American wait times for the largest American cities (just for appointments to see a specialist (a consult, not surgery) or a GP), highest wait times were experienced in Boston. In this matter, the principal deflector called this a representation of universal "Commie Care" (as in Massachusetts Romney Care)! Deflect, deflect, deflect.

[waldo]

as published in JAMA (the Journal of the American Medical Association) a relatively new study suggesting that U.S. health is "mediocre" compared to other wealthy countries:

High costs with mediocre population health outcomes at the national level are compounded by marked disparities across communities, socioeconomic groups, and race and ethnicity groups

.

.

per the study's summation findings: From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and healthy life expectancy increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations.

as quoted, a partial extract from the post that resurrected this thread... further to that relatively recent study highlighting the "mediocrity of U.S. health outcomes":

The latest study in JAMA compared 20 years of health data from a vast number of surveys, published studies and death certificates in the United States with similar records in 34 high-income countries in Europe, Asia and North America.

Overall, the United States fell in the rankings between 1990 and 2010 on nearly every major health measure.

"Compared to other high-income countries, U.S. health outcomes are pretty mediocre," said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, who led the study.

The researchers identified the leading causes of diseases, injuries and risk factors associated with disease over the past two decades. They found top causes of premature death in the United States still include heart disease, lung cancer and stroke, but suicide and road injuries also ranked among the leading causes of early deaths in the United States.

Among the leading diseases, the team found "a big and somewhat under recognized volume of disability in the U.S. that is related to bone and joint disease - things like low back pain - as well as mental disorders and substance abuse," Murray said.

As for the top risk factors that lead to ill-health, a poor diet is the No. 1 cause, followed by tobacco, obesity and high blood pressure, he said.

[bush_cheney2004]

Americans pay more for health care and Americans get more...much faster than in Canada.

Still, patients like Mr. Sullivan believe Canadian health care failed them, and leading surgeons acknowledge the delays are unacceptable. So the question remains: why can Dr. Stoffman treat so many more patients in America than he would in his native land?

Much of it comes down to economics, said Dr. Toyota, of the Neurosurgical Society. For-profit U.S. hospitals actually boost their bottom lines when more people get operations; Canadian hospitals, on the other hand, are mostly funded with lump-sum annual payments from their provincial governments.

They must pay for nurses, support staff and equipment to keep an operating room running, all of which chips away at that finite budget, noted Dr. Toyota.

“If you spend too much, you’re going to have a deficit at the end of year,” he said. “You have to control and ration your services.”

The model also limits how many specialists can be employed. Some newly trained neuro- and orthopedic surgeons have recently faced a bewildering problem: they cannot find work in Canada, said Dr. Fisher.

[waldo]

[waldo]

what! Not supporting the troops???

VA investigators: Delayed care is everywhere

Delaying medical care to veterans and manipulating records to hide those delays is "systemic throughout" the Department of Veterans Affairs health system, the VA's Office of Inspector General said in a preliminary report Wednesday.

"Our reviews at a growing number of VA medical facilities have thus far provided insight into the current extent of these inappropriate scheduling issues throughout the VA health care system and have confirmed that inappropriate scheduling practices" are widespread, the report said.

.

.

The inspector general probe released Wednesday found that 1,700 veterans who are patients at the Phoenix hospital are not on any official list awaiting appointments, even though they need to see doctors. Some 1,138 veterans in Phoenix had been waiting longer than six months just to get an appointment to see their primary doctors, investigators found.

[waldo]

what wait times? USA! USA! USA!

again, appointments/consults... not surgery wait times. Still waiting for the great deflector to provide U.S. surgery wait times... inclusive of all categorizations of coverage:

Need to see a family physician, dermatologist or an obstetrician/gynecologist? Get in line, because it could take weeks to schedule an appointment, a new survey indicates.

Conducted by Merritt Hawkins, a national physician search and consulting firm and a company of AMN Healthcare, the survey of 1,399 medical offices tracks the average time needed to schedule a doctor appointment in 15 large metropolitan areas. The survey reports average doctor appointment wait times in five different medical specialties: cardiology, dermatology, obstetrics/gynecology, orthopedic surgery and family practice.

Boston is experiencing the longest average doctor appointment wait times of the 15 metro markets examined in the survey: 72 days to see a dermatologist, 66 days to see a family physician, 46 days to see an ob/gyn, 27 days to see a cardiologist, and 16 days to see an orthopedic surgeon. On average, it takes over 45 days to schedule a doctor appointment in the Boston area, the survey indicates. In each of the three years Merritt Hawkins has released the survey (2004, 2009, 2014) Boston has averaged the longest physician appointment wait times among the 15 cities.

Other average physician appointment wait times tracked by the survey include 28 days to see a cardiologist in Denver, 49 days to see a dermatologist in Philadelphia, 35 days to see an ob/gyn in Portland, 18 days to see an orthopedic surgeon in San Diego, and 26 days to see a family physician in New York. Physician appointment wait times tracked in the survey varied from as little as one day to over eight months, with an overall average in all metro areas and all specialties of about 19 days.

"Finding a physician who can see you today, or three weeks from today, can be a challenge, even in urban areas where there is a high ratio of physicians per population," said Mark Smith, president of Merritt Hawkins. "The demand for doctors is simply outstripping the supply."

The survey also tracks how many physician practices accept Medicaid as a form of payment in the 15 metro markets. Boston has the highest rate of Medicaid acceptance tracked in the survey at 73%, while Dallas has the lowest at 23%. The overall average rate of Medicaid acceptance for all five specialties in all 15 markets is 45.7%, the survey indicates.

Many physicians are not accepting Medicaid because it often pays less than what it costs physicians to provide care, according to Smith. Medicaid patients, and patients with private insurance, often seek "convenient care" in hospital emergency departments when they cannot access office-based physicians in a timely manner.

The problem of physician access could become more pronounced as millions of previously uninsured patients obtain coverage through the Affordable Care Act, according to Smith.

again, within the above surveys, the overall average rate of Medicaid acceptance for all five specialties in all 15 markets is 45.7%... and what of the rest of the >50% of U.S. citizens covered through Medicaid? And, of course, all of this predates any impact on wait times that Obamacare will introduce to the U.S. health care system.

[waldo]

"People have access to health care in America. After all, you just go to an emergency room."

Edited June 9, 2014 by waldo

[bush_cheney2004]

Fun anecdote about the longstanding challenge of getting basic medical imaging services in Canada:

The problem with a single-payer system is that it is just that—a single-payer system. The government is the sole source for the financing of the entire healthcare system. Since there is a tendency for governments to trim budgets in tough economic times, rising healthcare costs and inflation tend to outpace the allocated revenues. Over time, it is inevitable that this will result in reductions in the level of care. This may not have been as much of an issue in the earliest days of the Canadian experiment, when technology was in its infancy, drug charges were modest, and hospitalization expenditures could be controlled.

However, over time these costs have exploded. Access to timely and appropriate care in Canada began to lag behind other industrialized nations because the governments (federal and provincial) were unwilling to recognize the need for investment in these new technologies. For example, during the 1990s and the first decade of this century, there had been an unofficial moratorium on the integration of magnetic resonance imaging (MRI) technology into the healthcare system. This resulted in a situation where a single Boston teaching hospital owned more MRI machines than the entire province of Quebec (population 7 million).

[cybercoma]

Canadians still travel to the "dead last" U.S. health care system because of stupid long wait times. I have asked for years, but there is no answer...what are Canadians waiting for ?

Tampa, Fla. — Already a destination for its beaches, palm trees and Disney parks, Florida can now add medical tourism to its list of attractions as more and more Canadians visit for surgery.

Long wait times are increasingly driving patients south, including two Albertans who underwent surgery on the same day last month, and commiserated about feeling abandoned by an ailing system back home.

Their Florida surgeon has seen the number of Canadian patients grow by a staggering 800 per cent in the past decade. Medical tourism has become big business for the sunny southern state, which is poised to spend $5 million next year in bid to lure more people for specialized procedures.

...“The Canadian medical system is premised on, it will treat you when there is a problem. But the whole idea of preventing downstream problems isn’t part of that model. It was a system built . . . out of treating acute illness,” says Emery.

“We wait for the disasters to happen before stopping them.”

Indeed. Florida is banking on it.

http://www.calgaryherald.com/news/calgary/Long+Canadian+wait+times+send+patients+south+surgery+Video/9702357/story.html

Do you have a source for US wait times that are measured the same way as we monitor them in Canada?

[cybercoma]

Americans pay more for health care and Americans get more...much faster than in Canada.

Still, patients like Mr. Sullivan believe Canadian health care failed them, and leading surgeons acknowledge the delays are unacceptable. So the question remains: why can Dr. Stoffman treat so many more patients in America than he would in his native land?

Much of it comes down to economics, said Dr. Toyota, of the Neurosurgical Society. For-profit U.S. hospitals actually boost their bottom lines when more people get operations; Canadian hospitals, on the other hand, are mostly funded with lump-sum annual payments from their provincial governments.

They must pay for nurses, support staff and equipment to keep an operating room running, all of which chips away at that finite budget, noted Dr. Toyota.

“If you spend too much, you’re going to have a deficit at the end of year,” he said. “You have to control and ration your services.”

The model also limits how many specialists can be employed. Some newly trained neuro- and orthopedic surgeons have recently faced a bewildering problem: they cannot find work in Canada, said Dr. Fisher.

You keep saying it's faster. Yet you've been completely silent on showing that it's faster. Put up a comparison of wait times. Put up a study that shows US wait times, measured in the same way as the wait times in Canada or with a reasonable methodological explanation that allows us to compare. It's time to show not tell. Your silence on this question over and over again is telling.

[cybercoma]

Fun anecdote about the longstanding challenge of getting basic medical imaging services in Canada:

The problem with a single-payer system is that it is just that—a single-payer system. The government is the sole source for the financing of the entire healthcare system. Since there is a tendency for governments to trim budgets in tough economic times, rising healthcare costs and inflation tend to outpace the allocated revenues. Over time, it is inevitable that this will result in reductions in the level of care. This may not have been as much of an issue in the earliest days of the Canadian experiment, when technology was in its infancy, drug charges were modest, and hospitalization expenditures could be controlled.

However, over time these costs have exploded. Access to timely and appropriate care in Canada began to lag behind other industrialized nations because the governments (federal and provincial) were unwilling to recognize the need for investment in these new technologies. For example, during the 1990s and the first decade of this century, there had been an unofficial moratorium on the integration of magnetic resonance imaging (MRI) technology into the healthcare system. This resulted in a situation where a single Boston teaching hospital owned more MRI machines than the entire province of Quebec (population 7 million).

You need to provide the source for your quotes per the Forum Rules and Guidelines. Please post the link from where you're copying and pasting your entire posts, which I might add is also against the forum rules.

[waldo]

Do you have a source for US wait times that are measured the same way as we monitor them in Canada?

You keep saying it's faster. Yet you've been completely silent on showing that it's faster. Put up a comparison of wait times. Put up a study that shows US wait times, measured in the same way as the wait times in Canada or with a reasonable methodological explanation that allows us to compare. It's time to show not tell. Your silence on this question over and over again is telling.

more of the great pretender's wait-time deflection routine... anything but actually discussing the 'by Americans, for Americans' study's, all speaking to the comparative American health disadvantage as compared to other representative countries... all speaking to the highest cost expenditures for health care in the U.S. with accompanying 'dead last'/near the bottom/mediocre' health outcomes as compared to other representative countries.

[waldo]

You need to provide the source for your quotes per the Forum Rules and Guidelines. Please post the link from where you're copying and pasting your entire posts, which I might add is also against the forum rules.

the prior linked reference offered had 1995 highlighted... and now 1990! The great deflector is on a roll!

of course, lost in all this wait time deflection is a focus on average wait times... without qualifying the fact that within the average wait times there are degrees of urgency that are prioritized. More pointedly, people who need emergency surgery or treatment receive it without delay, and are NOT entered or included in the wait time trends.

[waldo]

cyber, I expect you may have noted that my most recent post on wait times within large American cities (for appointments with GPs or specialist consults - not surgery) was completely ignored by the great deflector... as was my post concerning wait times for U.S. veteran military persons... as was my emphasis on questioning wait times for the >50 million American's with Medicaid coverage. As I said, I can find no shortage of analysis on the wait times for Americans seeking specialist consults or appointments with their/a GP (although there is never qualification as to what type of coverage is being included in those wait times)..... I simply can't find anything on American surgery wait times. As I've repeatedly challenged, just what is that supposed American benchmark for surgery, particularly one that factors all coverage categorizations for Americans. Your challenge is even more pointed... provide something comparative to how Canadian wait times are measured. As I said earlier in a post related to referencing OECD wait time analysis of OECD countries (that didn't include the U.S.), the OECD highlighted the difficulty in comparative measurements, country-to-country. In that regard, as I said, the OECD offered up Canada as the/a model for methodology/measurement in establishing representative wait times that could be more readily used between countries to offer more representative comparisons.

should we expect the great deflector to meet either my continued challenges... or your more recent one?

[bush_cheney2004]

Do you have a source for US wait times that are measured the same way as we monitor them in Canada?

No...we don't care how you measure wait times in Canada. Go find your own sources if that is the only response to stupid long wait lists for basic medical tests and services in Canada. Love those official wait time web sites that let suffering Canadians just click on a body part !