Now that we're talking about Q’s, let’s talk about health care queues.
Do governments deliberately manage the cost of their health care and single-payer insurance systems by restricting budget expenditures, thereby restricting capacity and forcing people to queue up and wait for health care services?
Persistent patient queues are evidence that the answer to this question is “yes.”
Many people claim that there are no meaningful queues in countries such as Canada and the U.K. That claim is false. The Canadian Supreme Court ruled in 2005 that "delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care."
In the U.K., complaints about waiting times for services continually comprise more than 25% of procedural complaints (i.e., excluding clinical complaints).
Many other people claim that there are no such problems in waiting for access to health care in the U.S. That claim is equally false.
Well, now, does that mean the objections to single payer because of waiting lines, are invalid because there are waiting lines in the U.S., too? Whoa, whoa, not so fast.
Two media reports just in the past week point to a major cause in the U.S. for people having to wait in line for health care. Irony of ironies, that cause is government-financed health insurance.
The first report appeared in the Wall Street Journal on July 19. This front-page article was about Medicaid, under which physician reimbursements are set so low that doctors say they lose money for most Medicaid services they perform. More and more doctors refuse to see Medicaid patients. Fewer participating doctors = waiting longer for an appointment.
The second report says that more than 25% of mammography centers in New York have closed since 1999, causing almost a tripling of wait times for appointments. Reason? Medicare pays only about 2/3 of the cost of a mammogram, and the centers are exiting that business. Fewer mammography centers = waiting longer for an appointment.
Is there any reason to believe either Medicare or Medicaid would do a “better” job if the government controlled 100% of health insurance in the U.S? I say no.
I think there are good arguments for single-payer, and there are good arguments against it. As a nation we are really not very close to resolving this debate on any rational basis. (We may be close to resolving it on some irrational basis – that’s a subject for another day). Meanwhile the queues in Canada and U.K. persist, and waiting lines are growing in Medicare and Medicaid. These events suggest that, while government-financed health insurance systems can be effective at reducing their budgets, they are much less effective at reducing health care costs. Accordingly, their strategy of reducing budget expenditures has the principal effect of reducing health care capacity. Less capacity = waiting longer for an appointment. Anyone think that's a solution? Not me. It's my idea of running thru Hell in gasoline pants. (thank you, Nipsey Russell).