American Patients, Get Ready to Wait

Real Clear Politics, December 22, 2009
USA Today, December 24, 2009

With the health reform debate moving apace in the Senate, the president and his political allies appear to be well on their way to implementing a government remake of the U.S. healthcare system. The situation for ordinary patients isn’t so rosy, as they may soon find themselves stuck waiting to get the care they need from insurance plans they still can’t afford.

Democratic politicians, liberal leaders, and the mainstream press are fond of criticizing America for spending a greater share of GDP on health care — 16 percent — than other countries do. Their remedy for “fixing” our country’s high-cost system is more government control.

Yet they rarely disclose the high nonmonetary costs posed by government-controlled healthcare systems. Countries like Canada only spend less on health care by consigning their citizens to waiting lists and depriving them of access to effective cutting-edge treatments.

As of this year, 694,161 Canadians are on a waiting list for medical procedures. Assuming one person per procedure, that means 2.08 percent of the population is queued up for “free” care, according to the Fraser Institute’s annual survey on wait times.

These Canadians pay for their health care in both taxes and the hard currency of pain, anguish, and lost wages.

The Canadian Medical Association pegs the annual cost of waiting for care including total joint replacement surgery, cataract surgery, coronary artery bypass graft surgery, and magnetic resonance imaging (MRI) scans at nearly $15 billion. The government’s narrow focus on keeping spending down ignores these real costs.

Worse, an incredible 16 percent of the population — five million people — is waiting to get a primary care doctor.

Once they get one, they have to wait yet again. On average, Canadians waited 16.1 weeks from the time their general practitioner referred them to a specialist until they actually received treatment in 2009, according to the Fraser Institute. That’s 73 percent longer than the wait in 1993, when the Institute first started quantifying the problem.

Some specialties fare particularly poorly. Seniors should take note. In the United States, the average wait to see an orthopedic specialist is 16.8 days, according to a survey by medical consulting firm Merritt Hawkins and Associates. Canadians wait 17.1 weeks for the same appointment.

Canada also lags behind much of the world in its adoption of and use of high-tech diagnostic equipment — another result of managing costs through budgets set by government officials. Canada ranks 19th out of 28 countries for CT Scanners per million people and 14th out of 25 on MRI Scanners, according to the Organization for Economic Cooperation and Development (OECD).

The result? It takes 4.6 weeks to get a CT scan and 8.9 weeks for an MRI.

Even the Canadian government now finds this intolerable. In August the Minister of Finance invited me to attend a meeting of a small group of experts to address Canada’s spiraling health care costs and long waiting times. The conclusion? Canada must put competition back into the healthcare system by creating private alternatives.

At the same time, Democratic lawmakers would like to move America in the opposite direction by undermining private competition in the healthcare marketplace. Given the endemic wait times associated with Canada’s government-controlled healthcare system, it makes little sense to transform the American system by putting government in charge.

If the Democrats are successful, we can look forward to more government control, higher taxes, waiting lists, and rationed care in a system constrained by global budgets. As with our neighbors to the north, be prepared to wait.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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