Thursday, November 5, 2009

Pelosi Plan: Wait for That Surgery, and Wait, and Wait, and Wait . . .


Want to see the future of health care under Madame Pelosi's latest scheme? Open Thomas Sowell's recent book, Applied Economics: Thinking Beyond Stage One, to the chapter entitled, "The Economics of Medical Care." Or read that chapter in nine parts in Investor's Business Daily. Sowell explains the why behind the bureaucratic decisions that seem senseless from the standpoint of anyone who wants to promote good, affordable medical care.

Because government care by definition is a system in which the money used to pay for "maintaining health or curing sickness" is "routed through political institutions and government bureaucracies," it goes without saying that that once that money leaves taxpayers' hands, it is concealed from public view forever.

Out of sight, out of mind, and the natural tendency of people is to get as much medical care as they can when it is paid for by "the government." As a matter of survival, any government operating a socialized health-care program has to impose price controls. And it is also a given that price controls hidden in government bureaucracies don't lend themselves to examination by doctors and patients. In government care, we can't forget, the careers of medical care bureaucrats will be at stake.

One popular government care "price control" is limiting the amount of time you can spend with your doctor. As reported in the Wall Street Journal in 1987, in the now-defunct Soviet Union: "the norms call for physicians to see eight patients an hour. That is 7.5 minutes per visit, and Soviet studies show that five minutes of each visit is spent on paper work. . . . 'Our heads spin from rushing,' said Pavel, the silver-haired chief of traumatology at a Moscow clinic." In Japan, Korea, Canada, and elsewhere, government care, once instituted, reduced time per visit and necessarily increased the number of visits per patient (which, incidentally, also increased the incomes of doctors getting paid per visit).

When it comes to wait times to see primary care physicians and surgeons, Sowell points out, U.S. medical care is way ahead of the pack:

A study by the Organisation for Economic Co-operation and Development found that 23% of the patients having elective surgery in 2001 in Australia waited more than 4 months for that surgery. So did 26% of the patients in New Zealand, 27% of patients in Canada, and 38% of the patients in Britain. In the United States, only 5% of patients had to wait that long. The conclusion:

Waiting lists for elective surgery generally tend to be found in countries which combine public health insurance, with zero or low patient cost sharing and constraints on surgical capacity. Public health insurance and zero cost sharing remove the financial barriers to access to surgery.

Constraints on capacity prevent supply from matching demand. Under such circumstances, non-price rationing, in the form of waiting times for elective surgery, takes over from price rationing as a means of equilibrating demand and supply.

Elective surgery, incidentally, was not limited to cosmetic procedures but included cataract surgery, hip replacements and coronary artery bypass surgery.

Moreover, although a four-month waiting period was used by the OECD as a benchmark for collecting statistics, in Britain 3,592 patients waited more than six months for a colonoscopy and 55,376 waited more than six months for an audiology diagnosis, according to a report in the British Medical Journal in 2007.

In Canada, according to a provincial government website, 90% of Ontario patients needing hip replacements waited 336 days. In Britain, the wait is a year.

I'm certain Nancy Pelosi doesn't wait 4 months for her life-saving botox injection appointments, never mind a year. Although, judging by her ability to respond to the voices of the American people, she might not consider a six-month wait for a hearing test to be any inconvenience at all.

And how about government investment in diagnostic technology under the Pelosi Plan?

As for technology, a 2007 study by the Organisation for Economic Co-operation and Development (OECD) showed that the number of CT scanners per million population was 7.5 in Britain, 11.2 in Canada and 32.2 in the United States.

For Magnetic Resonance Imaging (MRI) units, there was an average of 5.4 MRIs per million population in Britain, 5.5 per million population in Canada and 26.6 per million population in the United States.

You might have your Congress Critters' phone numbers memorized by now, but, if not, you can find them here.

Pelosi wants a vote on Saturday.

I say, make her wait.

If a long wait for medical attention is good enough for us, a very long wait for a vote is good enough for her.

One more thought: After Tuesday's demonstration of the redistribution of voter sentiments on the invincibility of Obama's judgment, it might be worth a phone call or two just to find out whether those Congress Critter staffers have gotten a memo to treat ObamaCare opponents a little less like rich, illiterate Morlocks attempting to harvest the latest crop of speaking-truth-to-power Eloi.

Maybe they'll be nice to you.
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2 comments:

  1. I've read stories about the vote scheduled for Staurday, but I've heard rumors of the bill being tabled until some time in 2010.

    I say melt the phones. Only after an official statement is released saying the bill is postponed, should we stop calling.

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  2. I agree. At this point, most of what we hear from Congress is likely to be misinformation designed to put us to sleep.

    ReplyDelete