One of the ways that health systems are measured is in terms of wait times for procedures. The knocks against government run systems is that wait times are painfully (literally) long due to inadequate doctor availability. This week, the New England Journal of Medicine published an article that predicts severe doctor shortages if ObamaCare is put into place. With the doctor availability (or lack thereof) side of the equation seeming to be inevitable, the question of wait times deserves a serious answer. If wait times truly will increase dramatically, the pain and suffering of American patients could increase proportionally. So, is it true that wait times are significantly longer in government run systems? I submit my gall bladder surgery as a case in point.
A few years ago, I finally had my gall bladder out. Although not life threatening, the status of my gall stones had come to a point where I was having painful attacks on almost a weekly basis. I could grin and bear it, but it had really come time to "get 'er done". I did not consider my situation urgent in a purely medical sense, nor did my physician consider it so. I will share the chronology of my surgery in our private health care system in a moment, but first let's look at how it might have been handled in another country.
It takes a little digging, but one can find average wait time statistics for surgeries in the various countries (or provinces) that have government run health systems. Here is a brief list of what I found for gall bladder removal (cholesystectomy):
New South Wales, Australia. Non-urgent, 3 months; urgent, 3 weeks. (2006/2007 data)
British Columbia, Canada. 3 months (No division by urgency. 2008 data)
England. 2-3 months (No division by urgency. 2004/2005 data)
Now, I know this is hardly an exhaustive study. But I think it is clear and very common knowledge that if you need an elective cholesystectomy in a government system, you are going to wait anywhere from a few weeks to a lot of months. So, what was my experience?
I had my gall stones diagnosis several years before my surgery. At that point in time, I was having only rare attacks and I could kind of manage things by diet. When the stones did cause irritation, it was often relieved with over the counter pain rememdies. That fairly quickly took a turn for the worse a few years ago. So I decided to go into the local clinic and see if I could have the problem taekn care of.
I called to set up an appointment with a general surgeon at the clinic. My wait for that appointment was...well...there was no wait. They asked if I could come in that day, and I could, and I did. The doctor did a standard physical and asked a few diagnostic questions. When he confirmed that I did indeed have gall stones and that it would be recommended that I have my gall bladder removed, we had the following conversation:
Doctor - "well I suppose you would like this done as soon as possible"
Me - "yup"
Doctor - "when are you available to have the surgery"
Me - "my schedule at work is pretty flexible, so really any time"
Doctor - "how about tomorrow"
Obviously, I agreed. Just as with my initial appointment, my wait time was virtually 0 days. But it gets even more impressive. The doctor said that I would need to have a pre-operative physical before surgery, and that would need to be done "today". He talked to the nurse coordinator, they scheduled the surgery at teh hospital of my choice (I had three to choose from), and then scheduled my pre-op physical at thier nearby sister clinic for an hour later.
Now, I know that my experience may also be a slight outlier. But I have no doubt it is fairly representative of how surgery gets handled here in America with our fully private system. My experience supports the anecdotal and statistical evidence that government run systems are far less responsive to patient needs, especially the needs for diagnostic testing and treatment. ObamaCare would change all of that, adversely altering wait times and a variety of other health care quality factors.
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