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Wednesday, March 29, 2006

Socialized Medicine and Miscellany

I know why some are so in favor of a Canada-esque medical structure. It's because of all the equality and understanding that would spring from diverse groups of people standing in line for 17 weeks to get basic medical care! Here's an interesting study on wait times in Canada. From the executive summary: "The Fraser Institute’s fifteenth annual waiting list survey found that Canada-wide waiting times for surgical and other therapeutic treatments fell slightly in 2005, making this the first reduction in the total wait for treatment measured in Canada since 1993. Total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, fell from 17.9 weeks in 2004 back to the 17.7 weeks last seen in 2003. This small nationwide improvement in access reflects waiting time decreases in 5 provinces, while concealing increases in waiting time in Manitoba, Ontario, New Brunswick, Nova Scotia, and Newfoundland. Among the provinces, Ontario achieved the shortest total wait in 2005, 16.3 weeks, with Manitoba (16.6 weeks), and Alberta (16.8 weeks) next shortest. Saskatchewan, despite a dramatic 7.8 week reduction in the total wait time, exhibited the longest total wait, 25.5 weeks; the next longest waits were found in New Brunswick (24.5 Weeks) and Newfoundland (22.3 weeks)." (hat tip, Fraters Libertas).

Also, I had the opportunity today to see Ward Connolly take on the Minnesota law school (though it looked like some undergrad classes showed up to take issue as well). I thought the discussion was necessary, and generally good. However, it got pretty contentious at points, and people weren't listening to each other as much as attempting to spout some ideas they'd heard elsewhere for which they had little factual basis. I wish we could get to the common ground that there are problems in our society, including with race (which some conservatives don't wish to admit), but that there are other (arguably much much better) ways to deal with our problems other than foisting them off onto a government that will (as it usually does) do no more than to institutionalize and industrialize what is a problem we should be attempting to end not marginally mitigate. I know it's a contentious issue, but in CrimLaw today, we discussed rape (which must also be a contentious issue), and the discussion was (in my view) much more respectful and valuable.


I loved the "I pay just as much to be here as anyone else" comment (part of a longer rant). Except that law school tuition (comparing in state to in state) is, oh, roughly ten thousand dollars more than undergrad tuition. And when was the last time a law student at an undergrad event got up and said "I pay over twice your tuition to be here, so that I deserve to interrupt to my heart's content"?
(a) How long a wait is it to see the general practitioner? That seems to me to be a far more important question than waiting time between GP and specialist.

(b) I'm sure it's great consolation for people who don't have health insurance that those like you and me who do can see our specialists more quickly than people in Canada.

That is all.
The question (in my mind) is how people who don't have health insurance react to "the privileged" having lower waiting times. Because I think the stats show that many if not most of the people who are uninsured are in that condition by design. When I come off my parents' health insurance plan (i.e. graduate from law school), I plan on going without insurance for a while. And nobody in this country goes without the medical care they urgently need. You can talk about preventitive medicine (although I think that's largely something that can be controlled without state funding), but the fact is that basic medical care is available to all, including the uninsured, which is a large part of why medical bills are so high in the first place.
Second, I disagree that it is far more important to see the waiting times to see a GP (and I have no idea what that data looks like). The simple fact is that the specialist is often the most important piece of the puzzle. The question could be why should the man with cancer delight in the fact that he was quickly able to see his GP, and that if he could have seen his specialist he could've gotten treatment because he had the money to pay for the procedure, if the specialist's wait time is so long that he'll perish long before the treatment.
You think the specialist wait times are static? As in, two people go to the General Practitioner, the first says he has some discomfort, the second has some lumps under his skin, the first arriver will be the first to see the specialist? No, of course not. What's important is the initial screening for how serious the problem is.

I have anecdotal evidence, for whatever that's worth, in terms of a relative who saw her doctor, and was being seen by a neurologist within a very short time thereafter because of how serious it was. Average wait times until specialist means very little.

Finally, define "by design." I went without health insurance for over a year, even though my job offered it. Why? I was making $250 a week and the health insurance cost $300 a month. I "chose" not to have health insurance, but if it cost around $50 or $100 a month I would have "chosen" otherwise. Just saying that most people are without health care by choice means nothing.
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