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April 21, 2009

HEALTH CARE RATIONING AND LONG WAITING TIMES.... Ceci Connolly has this story from Greensboro, North Carolina, where families apparently haven't heard the conservative talking point about the U.S. having the best health care system in the world.

It's right there on the wall, hectoring David Talbot as he races from one exam room to another.

"You want to see the recession? There it is," Talbot says, pointing to a row of multicolored graphs. "We began to spike in October 2008, and we're losing the battle now. We just can't keep up."

Recessions are tallied in numbers -- jobless claims, home foreclosures, plant closings and bailout dollars. Here at the HealthServe community clinic, Talbot, the medical director, tracks the recession in days -- the number of days that patients wait to see a doctor.

Just six months ago, the clinic delivered same-day care to most callers, the gold standard from a health perspective. But in October the delays crept to four days, then 19 in November and 25 in December. In January, HealthServe temporarily stopped accepting new patients, and almost immediately 380 people put their names on a waiting list for when the crunch eases.

I had the same reaction to this as Jon Chait, who said the horror story -- crowded clinics, overwhelmed medical professionals, long waits for care, health care rationing -- sounds like the dystopia conservative activists and Republican lawmakers use to describe a system of socialized medicine. The problem, of course, is that the crisis in North Carolina isn't in Canada, England, or any of the other countries whose health care systems are supposed to scare Americans.

In many parts of the country, we already have the scary developments we're supposed to fear.

Steve Benen 11:20 AM Permalink | Trackbacks | Comments (18)
 
Comments

are you kidding? long waiting times to see a doctor is nothing new in any part of the country.

between 1985 and 2002 appointments were 3 to 6 months out to see a dermatologist about "pre-cancerous" moles on my skin. and that was in massachusetts.

i will skip describing the astonishingly bad care i have received over that time with respect to these moles.

i fully expect to die of some "curable" form of skin cancer as a result of the inadequate and negligent care i have received and expect to receive in future.

Posted by: karen marie on April 21, 2009 at 11:25 AM | PERMALINK

No we don't.

And if we do, it's because we're failing to follow free-market principles.

And even if we are sorta following them, Obama is a socialist fascist communist, and that's why there's a problem.

If you love Canada so much why don't you go there?

Oh, and it's Hillary's fault too.

Posted by: bleh on April 21, 2009 at 11:25 AM | PERMALINK

Exactly, Steve.

I have been repeatedly told by the RW morons up here in Canada that the US's Free market healthcare system is the bestest ever unlike our "useless" socialized (single payer actually) system.

One thing that should be pointed out. In the "socialized death" care system of Canada, administrative costs are roughly an inefficient 7% when compared to the more efficient 25% (including CEO payouts) of the US free market healthcare system.

Posted by: Former Dan on April 21, 2009 at 11:33 AM | PERMALINK

Long waiting list in UK, France, etc ... eh, so-so and half-truth, but in the USA most people won't get the service at all due to the screening out by HI companies.
Lazy-fair v. Lousy-fare?

Posted by: Neil B ♪ on April 21, 2009 at 11:36 AM | PERMALINK

Some observant person once said, "these aren't failures of conservatism, they are features."

Posted by: Jim B on April 21, 2009 at 11:40 AM | PERMALINK

I've been lucky. Because of my HIV and being on COBRA, I'm still trying to find a decent doctor who accepts my insurance, is familiar with treating HIV patients, and is at least gay friendly. Not an easy job in a military town on the Kitsap Peninsula of Washington.

I came down with a nasty bronchial infection a few weeks ago, and went to one of the "urgent care" centers not far from my house. I was in and out in under an hour, with a decent doctor who listened to me and my past history with such infections, and was able to prescribe effective medications to treat the condition. In fact, I spent more time waiting for the pharmacy to fill the prescriptions than to get in to see the doctor and out again.

I think this might be more of a regional phenomenom, but I'm still looking forward to some form of nationalized health care.

Posted by: Michael W on April 21, 2009 at 11:41 AM | PERMALINK

I was shocked last week to find out a co-workers brother had died while on the waiting list for chemo-therapy. He was on the list since November.

That is unacceptable.

Posted by: ScottW on April 21, 2009 at 11:41 AM | PERMALINK

My partner has been dealing for months with a mysterious illness. She has been out of work for 2 months and is now waiting for surgery. Most of that time was spent waiting for approval from her insurance company for every diagnostic test.
We have had to pay 2000 out of pocket already and are really worried about the co-pay for the surgery.

Throughout all of this we joke frequently, "yeah, our health care system is GREAT! Wouldn't change a thing"

Posted by: zoe kentucky on April 21, 2009 at 11:42 AM | PERMALINK

All Americans should be entitled to the same health coverage our elected officials have.

Afterall, elected officials in our nation work for us - why should they get better bennies than us. End of the argument!

Mike Thompson is my Congressional representative and Sens. Feinstein and Boxer represent my state. All I want is a health package equal to theirs, and I think if they accommodate us with such coverage, our health care system will be on its way to recovery, our recession/depression will get more stimulus it needs, and we will become a healthier people.

The biggest benefit would be global competition as most other industrial nations are undercutting our overhead by providing their people with coverage already. Now's the time, reach for the sky! -Kevo

Posted by: kevo on April 21, 2009 at 11:51 AM | PERMALINK

Waiting times to see certain specialists have been common here in the U.S. for some time, but what this story is suggesting is that if you have to use a clinic (because you are uninsured or underinsured) in some areas of the country then you have long waits for any care.

Presumably this is due to people losing insurance and switching to community clinics from other providers because they have lost their insurance and hopefully emergency care is still getting attention.

Posted by: tanstaafl on April 21, 2009 at 11:55 AM | PERMALINK

In many parts of the country, we already have the scary developments we're supposed to fear.

And this is what is moving the vast American “middle” to a place (where it was not in ’94) needed to drastically change our system. These “images” need to be tattooed onto the calcified brains of Bayh and his ilk.

Posted by: Keith G on April 21, 2009 at 11:59 AM | PERMALINK

People who are against single payer(down to the private insurers and wingnuts at this point) always talk about red tape and government bureaucracy--but it would be nowhere near as bad as the red tape and bureaucracy that currently exists with the private insurers. Just ask any doctor, or the AMA which is now backing reform.
Or look at the administrative costs cited above.
The benefits would be amazing--in terms of better health, economic stimulus, huge cost savings and efficiency.
Some things simply should not be left to the whims of the free market.

Posted by: Allan Snyder on April 21, 2009 at 12:04 PM | PERMALINK

You don't say, (nor, in an example of sloppy journalism, did the original article) but I suspect this is a community health clinic for nonpaying patients, those with no insurance and unable to pay private providers. It does refer to one patient "seeking discounted health care" so this is not health care at large in the community. Not everyone is waiting 25 days or is on a waiting list, only those unable to pay.

This is a result of not having universal care, not what it would look like if we did. Only a few doctors are providing care here, the vast majority are taking care of those with insurance.

Posted by: Bill Heffner on April 21, 2009 at 12:14 PM | PERMALINK

I find some of these stories 'incredible but true', but then I have the good fortune to live in NYC. I'm on Medicaid -- near retirement age and have to take care of my wife, who is legally disabled becqause of emotional problems -- she's got both Medicare and Medicaid --the 'Gold Standard' of insurance according to local doctors.

We've had little problem with long waiting times. My wife has generally been able to schedule visits to specialists the same week, MRIs for my physical problems have come the same week as ordered, etc. This despite the fact that we began our medical treks under a Republican Gov (Pataki), but one who, by the nature of NY, was unable to cut back the way other governors did.

As for the Canadian system, my sister-in-law has lived there for many years and has had to deal with a case of ovarian cancer. Not only has she gotten great care, she has alraedy -- I think -- beaten the prognosis for the disease.

But if she'd been in America, her treatment would have bankrupted her, her long time partner, probably my father-in-law as well, and might have put me and my wife and her brother on the street because her parents would have had to sell the house we live in to cover the cost of treatment. And I don't see how she would have gotten better treatment.

Posted by: Prup (aka Jim Benton) on April 21, 2009 at 12:21 PM | PERMALINK

It's not at all uncommon in this country for someone diagnosed with cancer to have to wait several months to start radiation/chemotherapy treatment.

The issue of "wait times" has been grossly overstated by the wingnuts. As we all know, you don't get even routine care without making an appointment several weeks in advance. For emergencies or illnesses that just pop up, there's the emergency room, the walk-in clinic, or if you feel like taking your chances, you can go sit in a doctor's waiting room and hope they try to squeeze you in. Which I'm guessing is pretty much the same as it would be in Canada, the UK, or any other nation with public health care.

I had a scare a few months back - an apparent gall bladder attack, fortunately not acute enough to make me really sick, but enough that I was sore for a week, mostly because I didn't know what it was when it happened and so didn't know to modify my diet. About 3 days into it I figured out what was going on, and with just a little research determined that about the only medical treatment for gall bladder attack is "take it out" in a routine laproscopic surgery that doesn't even require an overnight hospital stay - at a cost of $30,000. I decided to see if I couldn't just "ride it out" given that I was unemployed at the time, since even with my insurance I fully expected my costs would come to over $5,000.

But this is insanity. Like I said, I self-diagnosed, since I had already determined that if it was indeed the gallbladder, which it seemed to be, the only thing a doctor was going to be able to do for me would be to recommend taking it out - and even worse, if I made a visit to a doctor, it would be in my medical records, which meant I could say goodbye to ever being self-employed again...had the unemployment dragged on much longer, I would have had to drop my coverage and anything like a gall bladder attack or surgery would have made me forever more uninsurable in the private insurance market.

How goddamned stupid is that? Seriously, those of us who are "fortunate" enough to be offered crappy coverage under a private policy live in fear of the idea that we'll ever have to USE our insurance, because if we do, we'll be forevermore "uninsurable". It's just crazy.

We need to start organizing RIGHT NOW to make sure they don't water down the already watered-down reform they've been discussing. There's already talk floating around about scrapping the public insurance component. We need to be ready to hit the streets if they try to pull that crap.

Oh, and as for the gallbladder...it's all good, I still have it, and no attacks since. Apparently it's possible to have an attack once and then never again, so I'm keeping my fingers crossed...

Posted by: Jennifer on April 21, 2009 at 12:59 PM | PERMALINK

Unfortunately, the situation you describe is just fine with the rich. They don't have to wait in clinics for the un- and underinsured, and they don't have to pay taxes to cover these people either (actually we all pay when these people end up in the ER, but nobody seems to think about that). This is rationing by income, which suits the wealthy and powerful.

Posted by: beckya57 on April 21, 2009 at 1:37 PM | PERMALINK

Rationing already takes place in the USA today! It's called "I can't afford insurance so, I'm won't go to the doctor until I really really need medical attention." It's also known by the name "My medical insurer won't cover this treatment," or "my medical insurer rejected my claim."

Even if you have insurance, unless maybe you have group coverage, you almost need to hire a lawyer once you get sick just to get the damn private insurance to pay-up.

Posted by: wtf on April 21, 2009 at 3:06 PM | PERMALINK

So, how long before we're told that the reason this clinic is so overburdened is *in anticipation of upcoming national health care reform*?

I remember similar kinds of arguments made about the economy tanking because Obama was *going to* become president.

Posted by: Daniel Kim on April 22, 2009 at 10:24 AM | PERMALINK




 

 
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