This post has been cited in the 3 March 2011 edition of Health Wonk Review.
It constantly amazes me how entrenched many people get in opposing health care reform. I’ve been getting a strange number of emails defending the health care spending seen in my post yesterday. Please understand, that spending is what’s bankrupting us. You can hate the PPACA, you can hate single payer, you can hate any form of government regulation at all, and stil recognize that we spend too much on health care.
But forget that for a second. Many of you are defending the high costs of our health care with the usual “wait times” meme. You defend our very, very high level of spending by accusing other systems of having long wait times. You believe that we are buying “no wait times” with our spending.
No.
First of all, what do you mean by wait times? Perhaps it’s “do you have to wait to see a doctor when you’re sick”?
Let’s own something right up front. We beat Canada. Let me say that again: WE BEAT CANADA. There’s a reason people always cherry pick Canada to talk about wait times. But many, many other countries do better in terms of getting people in to see the doctor when they are sick. We also do better in terms of getting people in to see specialists (although we’re not #1), and we do better in how long people need to wait to get elective surgery (which is ELECTIVE), but that’s not the same.
Here’s another telling metric, however:
People in the US feel like their doctors don’t know them. Why could that be?
One reason is that more people feel like they don’t get enough time with the doctor. Since we’re so obsessed with wait times (even though we don’t do very well in winning that battle), doctors are forced to see more patients every day in order to avoid them. So, yes, you might not wait as long to see your doctor, but when you get there, he or she won’t have much time for you.
One of the reasons for this is that we have so few doctors in this country:
And that’s after spending way, way, way more money than anyone else.
How is this defensible? We’re failing. We really are. I have no problem with disagreement on how to fix the system, but it’s hard to believe some many of you want to defend the status quo.
UPDATE (from Austin): Colleague and occasional co-blogger Steve Pizer has co-authored (with Julia Prentice) a recently published paper on wait times and diabetes care. They conclude, “Decreasing wait times has the potential to reduce A1C levels by 0.18 percentage point for patients with baseline A1C levels exceeding 8%. This effect is roughly one-third of what is achieved with the most successful existing quality improvement strategies.” I will encourage Steve and Julia to write a blog summary of their paper.
UPDATE #2 (From Aaron): Fixed a denominator problem in the title of the GP chart.
