Diary

I got to see the doctor right away

For some unknown reason, I developed some significant pain in the pall of my right foot last Friday. I was simply toughing it out, when my darling bride (of 36 years, 5 months and 24 days) noticed it and insisted that I make an appointment to see the doctor. She’s a registered nurse, so I do listen to her about these things.

On Monday, I called the physician’s office and asked for an appointment with Dr E______ as late in the day as could be scheduled. I was told that Dr E______ wasn’t in the office that day, but one of the other physicians could see me late that afternoon; my doctor wouldn’t be in until Tuesday. Well, since Dr E_____ already knows me, and she has the prettiest green eyes in the world,¹ I said that I’d wait until Tuesday, and an appointment was scheduled for me for 4:40 PM. Simply put, I could have seen the doctor that day, but chose to wait one additional day.

Then there is single=payer Canada and this report is from the Canadian Institute for Health Information:

Access to care—particularly wait times—is often the focus of intense media coverage and public debate. Although still far from perfect, the information available on wait times today is much better in terms of quality and quantity than in early 2006 when CIHI released its last overview report on the subject. Health Care in Canada, 2012: A Focus on Wait Times presents what is known about wait times in Canada, within the context of access, across the continuum of care.

The report opens by acknowledging that Canada’s current wait time performance is poor compared with that of other countries, and presents a brief history of the evolution of wait time measurement in Canada. A discussion about waits for routine care follows. Although access to primary care is important for preventing and managing most conditions, Canada fares poorly when compared with other countries. For example, a 2010 comparison of 11 countries showed that Canada ranked lowest for wait times to see a doctor or nurse when sick. Canadians also reported the longest waits for a specialist appointment, with 41% reporting waits of two or more months.

Despite access to and waits for family physicians in Canada being long by international standards, most Canadians report that their wait times are acceptable. It is access to and waits for specialists where Canadians were more likely to report challenges. Despite the best preventive efforts, many people still require care in hospitals. The report next presents information on waits in emergency departments (EDs) and acute care settings. Waits in Canadian EDs are longer compared with those in other countries, and compared with ideal response times recommended by the Canadian Association of Emergency Physicians. Among 11 international comparators, Canada has the largest proportion of adults waiting in the ED for 4 hours or more before being treated (19% higher than the international average). Overall lengths of stay in the ED are just over 4 hours, with 90% of visits completed within 8 hours.

And the numbers²:

Although not alone in its challenges to providing appropriate and timely access to health care services, Canada lags behind other countries. A 2010 survey ranked Canada lowest among 11 countries for wait times in the following areas:

  • Seeing a doctor or nurse when sick: 33% of patients surveyed reported waiting six days or more for an appointment, 5% more than the country ranked second-lowest;
  • Seeing a specialist: 41% reported waiting two months or more, 7% more than the country ranked second-lowest; and
  • Having elective surgery: 25% reported waiting four months or more, 3% more than the country ranked second-lowest

The government’s own inspector general recently reported that over 300,000 veterans have died while awaiting care from our own single-payer Veterans’ Administration, but Democratic presidential candidate Hillary Clinton doesn’t really think it’s all that serious. From The Wall Street Journal:

Hillary Clinton Vows to Fight VA Privatization

But Democratic hopeful says private providers should deliver some care

By Laura Meckler and Ben Kesling | Updated Nov. 10, 2015 9:11 p.m. ET

Democratic presidential candidate Hillary Clinton offered her vision for veterans’ health care Tuesday, promising to fight full-fledged privatization while allowing the government to contract with private providers for a range of health services.

In her proposal, Mrs. Clinton struck a balance between support for traditional government-run veterans health programs while acknowledging that many veterans want to access care from private providers as well, given the system’s failings.

The former secretary of state also promised a continued push for changes in the management of the embattled Department of Veterans Affairs, which has been excoriated for long waiting times, inconsistent care, and a bloated bureaucracy.

After appearing to play down problems in a recent television interview, Mrs. Clinton is now describing the agency’s troubles as deep-rooted.

“These problems are serious, systemic and unacceptable,” Mrs. Clinton said at a discussion with veterans in Derry, N.H., a day before the nation marks Veterans Day on Wednesday. “They need to be fixed and they need to be fixed now.”

There’s a lot more at the link, but these two paragraphs further down indicate her mind-set:

At the same time, she emphasized her opposition to outright privatization, as some Republicans have proposed.

“Privatization is a betrayal, plain and simple, and I’m not going to let it happen,” she said.

Remember, this is the same Hillary Clinton who wanted to impose penalties for wealthy people using their money to “get around” waiting times in the system in her 1993 health care plan proposal! Yet we are supposed to trust her to put together a plan to reduce extended waiting times at the VA, for veterans who have served our country, while I was able to get an appointment almost immediately in the private care system.

Here is Mrs Clinton telling us that the problems have “not been as widespread as it has been made out to be:”

The problem is really very simple: in a single-payer system, the government has to attempt to control costs, and that is why appointments at the Veterans’ Administration have been dragged out so long. If a veteran who needs four appointments in a year can have his appointments stretched out so that he is seen only thrice, the VA saves the money his fourth appointment would have cost in that fiscal year. And, to be blunt, if the patient happens to die, the VA saves even more money. This can’t be “fixed,” because it isn’t something wrong with the system but an essential part if it: that’s how single-payer systems work!
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¹ – Hey, I’m a normal male, and I notice and appreciate things like that!
² – Found on page 20 of a 108 page report.