Friday, May 16, 2008

Waiting

One of the good aspects of life is anticipation. Optimists like setting themselves goals. Looking forward to something is often as enjoyable as the event. But 'waiting' can be quite a different story.

Having endured a fair bit of pain recently I finally succumbed yesterday and went to the doctor. Beginning the process of eliminating possibilities she referred me to a specialist. Thank goodness for the private system. She could secure me an appointment within 24 hours. When you can't sleep without painkillers you do not want to hang around.

So I read this piece about waiting times in the Canadian public health system with great sympathy for the individuals who cannot afford private care. Of course, the same applies in New Zealand.

Excessive waits for health care services endured by Canadian patients have imposed huge costs on the nation's citizens according to a study from the Centre for Spatial Economics.

Other major findings:

* The study of medical wait times in all 10 of Canada's provinces found excessive delays for four key procedures--total joint replacement surgery, cataract surgery, coronary artery bypass graft surgery, and magnetic resonance imaging (MRI) scans--cost the nation an estimated $14.8 billion in 2007.
* This in turn lowered federal and provincial government revenues by a total of $4.4 billion, the report noted.

However, it is individuals who bear these costs. When the government controls all of health care, it looks for ways to save money, and the easiest way to save is to deny care or ration care through long waits, says Charles M. Arlinghaus, president of the Josiah Bartlett Center for Public Policy.

Rationing care by using waiting lists puts a heavy strain on an economy by incurring high costs through reduced worker productivity, says Devon Herrick, a senior fellow at the National Center for Policy Analysis. Canadian Medicare uses rationing by waiting because the cost of lost productivity is borne by the individual and employer, whereas the cost of actually providing needed care falls on the public system.

For example:

* Excessive waiting for total joint replacement surgery was the most expensive byproduct of Canada's health care rationing, at nearly $26,400 per patient.
* That was followed closely by MRIs ($20,000), coronary artery bypass graft surgery ($19,400), and cataract surgery ($2,900).

Herrick disagrees with the study's policy prescription, saying private care options would be more effective than increased government investment in the system.

"Canadians should be allowed to pay for care privately if they so choose. It is unconscionable to forbid patients from paying for care the public system cannot provide them in a timely manner," he says.



Absolutely unconscionable.

8 comments:

Mark.V. said...

The reason a private health system works better than a public health system is simple economics. For the public health system every patient is a cost. For the private health system every patient is a source of revenue.

Anonymous said...

It's even more basic than that.

Private health systems are systems designed to make ill private citizens well again.


Public health systems are systems designed to ensure the government is re-elected

mawm said...

Anon - you are just too cynical.

Mark - As you said, in private each case done means money to the provider.
- In public each case means extra work for the employee payed by the hour.

What would happen if it was a fee for service system in public? That extra case or two that could be done each day would translate into extra money for each and every employee involved.

Anonymous said...

Anon - you are just too cynical.


Nope I simply understand economics and basic mathematics.

What's your excuse: state schooling?

Anonymous said...


What would happen if it was a fee for service system in public? That extra case or two that could be done each day would translate into extra money for each and every employee involved.


This is just like the system in --- China!

What happens is that public care is run down, and time and effort goes to the paying patients. You end up with a worse mess than the one we already have - especially when there is a clear and simply solution that avoids these costs, maximises marginal utility and removes all moral hazard: privatize the lot!

mawm said...

Anon - you are just too cynical.


Nope I simply understand economics and basic mathematics.

What's your excuse: state schooling?


My comment was 'laced with irony'. Geddit?

Schooling? - Mmmnnnn... a very expensive private school, but not in NZ. Must be because of that. ;)

Anonymous said...

Hope you get better soon Lindsay.

As an aside, my eldest daughter has been ill for the past 10 days or so. They don't know what's wrong with her and have to look at various things under an electron microscope - a hospital procedure. And with all those greedy bastards on strike we can't get a result.

Over 80k and 6 weeks a years holiday straight out of uni doesn't sound too bad to me.

The more privatisation of health care the better for all of us.

mawm said...

under an electron microscope - a hospital procedure. And with all those greedy bastards on strike we can't get a result.

Ruth - you don't understand too much about hospitals ,do you?

They claim that they are working at least double the hours that the average wage earner does and that they have racked up enourmous debt to get where they are.

Seems as if they have a case but I don't agree with how they are going about it - and it is more about the personality who is the secretary general of their union than their greed.