Wait Times In Canada Or, Is This Our Future?

[poboy]

http://tinyurl.com/2txvd5

Wait times for procedures in Canada. Rich, any idea of wait times for hip, ct, bypass in the US?

 

[Cut-Throat]

I was wondering how the 'Free' Veterans Health Care in the U.S. compares to the Health Care in Canada for an Average Citizen?

Anyone have any information on that?

 

[Rich_by_the_Bay]

http://tinyurl.com/2txvd5

Wait times for procedures in Canada. Rich, any idea of wait times for hip, ct, bypass in the US?

Nothing authoritative. Personal experience: a matter of weeks for a hip, CT can be done in days or urgently, bypass in a week or two.

If you've got money.

If not, you may run into delays. Many doctors do not see Medicaid patients and when they do it takes months to get in to see them. Then you have to be financially scrutinized by the hospital. If you pass that test, often the surgeon and/or hospital have to get clearance from your payor in some cases, and that involves some sort of review process. If it's urgent the process can be done very quickly. If you are self pay but uninsured you may need to agree to a payment plan, and your financial status may be verifited.

Overall, we can deliver quickly to qualified patients. Other patients may need to wait or simply do not have stuff done cause they can't afford it.

 

[Cool Dood]

Welcome to Canada, where our pets get better medical care than we do.

And if you think Canada's wait times are bad now, wait until the US "nationalizes" health care and the Canadians who now go to America for treatment join the line too. Just kidding, if the US ever does that I'm sure Canadians will just fly to Costa Rica or Thailand or wherever instead.

I love (ok, hate) how everyone thinks they've found this clever way to overturn the laws of economics. And for the guys running the show, there are fewer better scams than "FREE HEALTHCARE!!!!!"

 

[mykidslovedogs]

Many doctors do not see Medicaid patients and when they do it takes months to get in to see them.

That's too bad. (Oh well... Let's look at the bright side...at least the insurance/healthcare is "free")

 

[lets-retire]

After the doctor decided my wife needed a CT she had one in less than an hour. The MRI wait for her was the next day, which I thought was rather amazing since he did not decide to do the MRI until after 5pm. The longest wait we had was from the MRI appointment until we went to see the doctor again, which was just short of a week due to the MRI being done on a Friday. Total time lapse from diagnosis, removal of a tumor to at home resting was 16 of the longest days I've seen.

Wait time for an MRI on my ankle could have been a day, but was three due to my schedule.


Edited to correct spelling

 

[Martha]

Where the US tends to have long wait times from what I have read is in emergency rooms, where waits in some cities can be 8 hours or more. (Of course, they triage, so if you are having a heart attack you should be seen sooner). The other place where the US does not compare favorably are long wait times in seeing your primary care physician for preventive care and in seeing specialists for non-emergency care.

If you want a source or more exact info, I can find it.

 

[Sandy]

Martha, you are correct, there are long delays in emergency rooms and the causes are many: closing of emergency rooms, lack of access to certain specialists for emergency services who don't want the life-style disruption and the mal-practice risk, and lack of access to other providers after hours. This last factor results in a very expensive and inefficient use of time and resources. Also, emergency rooms get backed up with patients waiting to be admitted. The hosital may have beds, but not enough nurses to provide care, so the patient waits for a bed. The nursing shortage is especially aggravated by a lack of teachers to train nurses. Because the problem stems from many sources, there is no easy fix.

As to the Medicaid system being free -- Medicaid is only available to the very poor, and only for certain categories of very poor individuals. Even as a LBYMer type, I don't want to try to live on the incomes that these families do. Medicaid eligiblilty for a family in Florida is 24% of the federal poverty level. That's an annual income of $4,120 for a family of three. Kids can get coverage at higher incomes, but not parents. And if you are just poor and don't have kids - not covered.

OTOH, Medicaid is a very rich benefit package compared to what the rest of us get, but then Medicaid recipients tend to be sicker than the general population, and they can't afford any out of pocket expenses for uncovered services. Because they are sicker, they are expensive to serve. One way states control this cost is by limiting provider reimbursements, resulting in reduced access and delays in care. Nevertheless, the program is expensive to states and the federal goverment, so it is not "free." We all pay.

I have no fixes, but tackling the Medicaid population is part of the uninsured problem, since Medicaid beneficiaries go on and off regularly, and as a result have intermittent time with no coverage and no access, which makes their conditions worse and more costly.

Thanks for listening. Having one of those days in the health care policy world.

 

[kramer]

I did read an article last year that mentioned that the statistics you see for waiting time on some of the Canadian sites include those who got treatment outside of the system. For instance, the waiting time at the time of this article was 13 weeks for hip replacement in B.C (I can't remember if this was just Vancouver or the whole province). But so many people were sent elsewhere (or sought treatment on their own) that for folks who actually stayed in the system the wait time for the operation was about 52 weeks, despite saying 13 weeks on the site.

Emergency rooms can definitely cause waits in the US and this is a problem. I have taken a family member in both 2004 and 2005 in North San Diego County (many illegal immigrants there being close to Mexico and a lot of agriculture). But both times the wait was pretty short and the care pretty good. One was a real emergency, the other was urgent but could have waited longer. The doctor who took care of my grandma turned out to have been in my Physics study group as an undergraduate, and he took good care of her

Kramer

 

[kramer]

I work for a Fortune 500, and in the UK we provide complete private medical coverage insurance for our employees. It is not considered acceptable by many to depend on the public system due to lower quality care. I don't know about other countries like Germany, I really have no idea.

On the other hand, the UK system is not necessarily meant to be a first-tier system, but an all encompassing fallback system with a lower standard of care that everyone can access. I do not know if this would fly in the US.

Also, the US already spends more government money per citizen on health care than the British government spends per citizen on health care. About 45% of all health spending in the US is directly funded by the government. It goes to about 55% when you include the tax deduction for employer-sponsored health care. Anyway, I thought these were interesting statistics, and I am just passing them on.

Kramer

 

[cute fuzzy bunny]

The biggest backup in the emergency room (according to my wife) is from people who dont need to be in the emergency room. No, they cant do anything for your cold/flu that you've exacerbated with your drinking/drug problem.

 

[lets-retire]

The biggest backup in the emergency room (according to my wife) is from people who dont need to be in the emergency room. No, they cant do anything for your cold/flu that you've exacerbated with your drinking/drug problem.

The area I currently live is the smallest place I've been for about 15 years, and it is the first place I've been that had urgent care clinics. Of all of my trips to the emergency room, I'd say maybe three or four were true emergencies. The rest could have been handled in an urgent care clinic, but because there weren't any and I couldn't wait until the doctor's office opened I was left with no choice.

 

[cute fuzzy bunny]

My favorite nationally broadcast "emergency room problem" was from Morgan Spurlock's tv show "30 days", which is quite interesting...for what it is.

In the pilot episode, yuppie liberal man and his girlfriend try to live for 30 days on minimum wage. Get unskilled labor jobs, an apartment, buy food and clothes, etc.

He sprains his wrist digging holes, she gets a bladder infection. Both rush to the emergency room, running up about (IIRC) $1200 in bills. He notes the $40 charge for the ace bandage he could have gotten in the drug store for $5.

Both of them should have called a local doctor for a visit or found a clinic.

 

[Rich_by_the_Bay]

On the other hand, the UK system is not necessarily meant to be a first-tier system, but an all encompassing fallback system with a lower standard of care that everyone can access.

Yes, I've heard this discussed. The problem is how to define a "lower standard of care." If that translates to inferior outcomes (survival, impairment, etc. after correcting for baseline status and risk factors) it's a big concern.

OTOH, if it means longer wait times, less comfortable facilities, lower convenience and other unpleasantries that still allow for comparable results it may be acceptable to many -- wealthier individuals could insure themselves to access the niceties, but know that in a crunch there will be a place they can get care, albeit less agreeably. And it is precisely that scenario (the health "crunch") that generate a large portion of our medical bills and premiums.

Not an easy tradeoff but something'll have to give.

 

[dumpster56]

My favorite nationally broadcast "emergency room problem" was from Morgan Spurlock's tv show "30 days", which is quite interesting...for what it is.

In the pilot episode, yuppie liberal man and his girlfriend try to live for 30 days on minimum wage. Get unskilled labor jobs, an apartment, buy food and clothes, etc.

He sprains his wrist digging holes, she gets a bladder infection. Both rush to the emergency room, running up about (IIRC) $1200 in bills. He notes the $40 charge for the ace bandage he could have gotten in the drug store for $5.

Both of them should have called a local doctor for a visit or found a clinic.

Bladder infection??

Look I am not a wimp and I must say after I had a cath and 4 days later I a MAN got a bladder infection whoa, Not being able to well PASS WATER and what was being passed was BLOOD well an Emergency room IT IS!!

 

[cute fuzzy bunny]

Never had one, but my dad walked around with one for four days until he relented, called the doctors office and went in the next day for the sulfur pills. Didnt look too happy for about 24 hours after that but...

I guess the point is that a clinic or regular doctor visit would probably have been faster, results the same, and costs 1/10th the amount. And leaves the emergency room open for people with heart attacks, limbs held on by duct tape and the like.

 

[kramer]

When I took my grandma in, she was in terrible pain. It had been off and on for a couple of weeks, and we had been trying to get her to go to the doctor, but so far she had refused. But at our holiday gathering it was so bad that we had to call an ambulance, and then I met her at the hospital emergency room. We realized then that she had almost not been eating for 2 or 3 weeks because of this problem and it was exacerbated by eating.

It turned out to be acid reflux, believe it or not, and a test showed something out of position with her tummy/esophagus, etc. She was much too old to operate, like they might have done for a younger person.

There used to be no cure for this problem without an operation, according to the doctor. But there was a prescription tablet (zantac? or something) developed by an evil pharmaceutical company. She went from being in ghastly pain daily to having absolutely no problem for the remainder of her lifes simply by taking 2 of these tablets daily.

I will be forever thankful that that evil pharmaceutical company was influenced by the profit motive and was willing to take a chance and develop that drug which saved my grandma so much pain for the rest of her life.

Kramer

 

[mykidslovedogs]

OTOH, Medicaid is a very rich benefit package compared to what the rest of us get, but then Medicaid recipients tend to be sicker than the general population, and they can't afford any out of pocket expenses for uncovered services. Because they are sicker, they are expensive to serve. One way states control this cost is by limiting provider reimbursements, resulting in reduced access and delays in care. Nevertheless, the program is expensive to states and the federal goverment, so it is not "free." We all pay.

My comments on Medicaid being "free" were sarcastic. Those that know me on the board know that I deeply oppose universal care. My sarcasm was pointed at the lack of doctors that accept Medicaid and the comment about the long wait times for Medicaid patients...a problem I fear will be all too real for EVERYONE once America breaks down and adopts a universal "Medicaid" system for all.

I guess the point is that a clinic or regular doctor visit would probably have been faster, results the same, and costs 1/10th the amount. And leaves the emergency room open for people with heart attacks, limbs held on by duct tape and the like.

Cute and Fuzzy - You are so right. As an insurance salesperson, I always point out to my clients to use an urgent and after hours care facility vs. an ER for minor emergencies. In my city, urgent care centers are readily available at all of the local hospitals. Anyways, it's not just that it frees up the ER for the more life threatening cases, but also that the cost to the insurance company and sometimes even to the insured is at least 1/2 the price (especially if you have an HSA vs. a copay plan). My son cut his chin open at the city pool a few weeks ago, and we took him to the urgent care center for his stiches. Literally, there was NO wait time, the facility was cleaner, the staff was much more relaxed, and the cost was only $250.00. It would have been $500 - $1000 had we taken him to the ER. I'm always surprised that very few of the clients I work with are even aware that there is such a thing as an urgent care center, and they are always so grateful that I point out the advantages of using urgent care centers instead of the ER. As I've pointed out before, the lack of understanding of how to better utilize our healthcare system is a symptom of the greater problem we have in our country of sheltering our people from the cost of their care with rich employer sponsored benefits and low copay plans with no incentives for consumers to look for better alternatives. The Bush administration's push for consumer-driven healthcare and HSAs will have an impact in the longrun. As employer's shift to consumer-driven healthplans like HRAs (health reimbursement arrangements where employers share part of the deductible with their employees), and HSAs (health savings accounts), consumers will think more carefully before making an unneccessary trip to the ER.

 

[cute fuzzy bunny]

My wife has also ingrained in me to NOT take our son to the emergency room unless its a dire emergency. Which initially raised my eyebrows because she WORKS in the emergency room.

Apparently theres a serious imbalance somewhere between the ER folks "over doing it" and the quality of the folks in that get put in the emergency room, coupled with the number of hours straight a lot of the care providers are working.

I was told I should call our doctors office, have them paged and advise on where to take him for anything short of a life threatening emergency.

Mmmm mmmm! Wait a long time to pay extra for possibly sub-standard care!

 

[Rich_by_the_Bay]

When I was in primary care private practice I advised my patients to always call me first barring true emergency. I would guide them as to whether an ER was needed, whether I needed to see them, and whether it could wait until office hours. Those who bypassed this were counselled repeatedly.

It was the right thing to do, and it almost ruined my life -- calls at all hours, some appropriate and many not. Expectations for over-the-phone prescriptions for problems (antibiotics for colds) which really needed to be checked in person for proper assessment. Of course, not reimbursed (the lawyers were smarter than we were in that regard).

Eventually, our group surrendered to using the Urgent Care clinic at the hospital where they would often get inconsistent, overly "CYA'd" care. But to this day, I feel the emergency is best considered a last resort for a lot of reasons. To this day, I try very hard to squeeze patients into my schedule if I sense they will go to the ER if I don't see them.

 

[mykidslovedogs]

When I was a new mom, I worked at a large company and had great benefits with Kaiser Permanente. The ER cost a mere $50 copay. I had never heard of an "urgent care facility". There were several times that I took my kids to the ER (they always happened to get sick with high fevers on Friday night, right?) Anyways, my pediatrician had never told me to call the triage first or even to use an after hours facility. It was only later when I got into the insurance business that I learned more about urgent and after hours care. I think insurance professionals and healthcare professionals really need to do a better job of teaching new moms about the ins and outs of what to do when baby gets a high fever. Now, I usually wait 3 or 4 days for the fever to subside before I do anything, and if it doesn't go away by then, I call the triage nurse to get instructions as to what to do next.

 

[cute fuzzy bunny]

A quick baby primer from the pediatrician would definitely be a plus, although we've read more than our share from various web sites and there are plenty of books on the topic. I'd imagine the average working class parents dont have the info.

First time Gabe woke up with a high fever I was a little wigged out. Of course my wife had just called to say she was leaving on one of her 3-4 time/year ambulance trips with an injured patient and would be out of touch for a few hours.

Fortunately my neighbor, an EMT and dad with two older boys, took a quick look and said "ear infection...give him some tylenol and take him to the pediatrician tomorrow".

Absent the free available medical advice, I can see a lot of parents whisking their kids off to the emergency room with a high fever.

Told my wife when she got home that I'd briefly considered a trip to the ER. She said "Swell, they'd have stuck an IV in him, intubated him, and THEN checked his temp, pulse and BP..."

 

[Caroline]

I was wondering how the 'Free' Veterans Health Care in the U.S. compares to the Health Care in Canada for an Average Citizen?

My mother (military veteran's dependent, 80 yrs old at the time) broke her hip 4-5 years ago, and was in surgery early the next morning. The doctors "out at the base" did a splendid job -- the care from nurses and medics was great -- and she had a problem-free recovery.

She's only one data point -- but one that's very satisfied.

 

[Zipper]

My mother receives a monthly cheque of ~ $1000 from the U.S. RR retirement board. My father had worked for the Wabash/Norfolk Southern RR that ran through St. Thomas. He died in 1982 when he was 65.

Mother Zipper broke her leg at Christmas of 2005 and was hospitalized. After about 6 weeks she was booted to a long term facility and had to pay about C$2700 out of pocket until she was discharged in March of 2006.

It was a long haul but after many letters and phone calls to the very professional RR retirement board in Chicago MZ was reimbursed for the full C$2700.

My point is all the Zippers extended family and friends have been treated quickly with no problem in the Canadian system. And we are very thankful for the U.S. RR retirement board for picking up an uninsured hospital stay in Ontario.

I've mentioned before Mrs. Zipper works for the London Regional Cancer Centre here in London.

To the OP, if you are sick in Canada you will receive timely first-rate care. No questions.

If it is elective, you might have to wait.

Ranked out of 10, healthcare costs rate a 10 for Canadians.

 

[W2R]

If Canadians "fixed" their health care system, a lot more Americans might consider expatriating to Canada. (That may or may not be a desirable outcome.) Here's a typical conversation between me and Frank, on the subject:

Frank: We could retire to another country. Lots of people do.
Me: I don't want to. Well, maybe Canada.
Frank: No way, not with their health care problems and wait times!
Me: OK, the U.S. it is, then!

Not to say that we don't have some huge health care problems in the U.S., especially concerning its expense. I have three more years to work until I qualify for lifetime medical benefits. There is no way for me to ER before then.