January 25th, 2010 by RyanDuBosar in Better Health Network, News
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California debuted new rules that specify patients in health maintenance organizations (HMO) see a doctor within 10 days of asking for an appointment. Calls must be return within a half-hour, and health professionals must be available 24/7. Urgent care must be seen in 48 hours.
Richard Frankenstein, FACP, former president of the California Medical Association, told the Los Angeles Times that this places pressure on the HMOs to have a big enough network to deliver what they promise. Critics contend this will force doctors to rush patient care even more, or be especially damaging to rural areas already facing a shortage. Read more »
*This blog post was originally published at ACP Internist*
June 28th, 2009 by Happy Hospitalist in Better Health Network, Health Policy
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You may think all is well in Canada. A land where FREE=MORE has been granted a birth right. It has been said many times before: You have three endpoints for which to strive for. Cheap, Quality or Quick. Pick any two. You can not have all three. It seems that Canada has decided to sacrifice Quick. You can always guarantee cheap health care. You simply stop paying for it. That’s called rationing. Getting in line and waiting is a classic form of rationing used by governments all across this land of ours.
In fact, as a resident in training at a VA facility, I saw first hand how rationing of care occurred using waiting as the tool of choice. Schedules blocked at 5-8 patients. Leaving when the clock struck 4. Scheduling dead patients. Yes folks, that actually happened. As an inpatient, technologists would finish their day on their terms. Getting studies after hours was impossible. Patients would wait for days to get an echo or a doppler. I once had an xray technologist refuse to come in, from home, in the middle of the night to take a chest xray on a crashing ventilator patient. The fact that the VA would not staff an overnight xray technologist was simply ridiculous. Try to get anything done on a holiday. Not only impossible but the hoops one had to travel through to attempt it would make Obama cry if he had any idea what the government run care was doing to his Vets.
Wait times is rationing, no matter how you look at it. You can find the link to the Fraser Institute on Canada’s Wait times here at Dr Hal Dall’s blog. I want to thank him for pointing it out. It is a fascinating look into the discrepancies in Canada’s health care, in spite of the equality for all mantra of social solidarity. Here is an excerpt from the research.
Finally, the promise of the Canadian health care system is not being realized. On the contrary, a profusion of research reveals that cardiovascular surgery queues are routinely jumped by the famous and politically-connected, that suburban and rural residents confront barriers to access not encountered by their urban counterparts, and that low-income Canadians have less access to specialists, particularly cardiovascular ones, are less likely to utilize diagnostic imaging, and have lower cardiovascular and cancer survival rates than their higher-income neighbours. This grim portrait is the legacy of a medical system offering low expectations cloaked in lofty rhetoric. Indeed, under the current regime—first-dollar coverage with use limited by waiting, and crucial medical resources priced and allocated by governments— prospects for improvement are dim. Only substantial reform of that regime is likely to alleviate the medical system’s most curable disease—waiting times that are consistently and significantly longer than physicians feel is clinically reasonable.
*This blog post was originally published at A Happy Hospitalist*
