As I Predicted…

August 28, 2006

Comments

Previously I have argued that one way to control costs of health care in a nationalized system is to control access. And one way to do that is to control wait times (see here and here as well). Well, it now looks like the United Kingdom’s health care system is going to make my prediction are reality.

In March, Patricia Hewitt, the Secretary of State for Health, offered her apparent blessing for the minimum waiting times by announcing they would be “appropriate” in some cases. Amid fears about £1.27 billion of NHS debts, she expressed concern that some hospitals were so productive “they actually got ahead of what the NHS could afford”

[snip]

Andrew Lansley, the shadow health secretary, added that the minimum waiting times shed new light on the Government’s target that patients should wait no longer than six months. “It is outrageous that the purpose of the Government’s targets is not so much to drive down waiting times, as to impose a six-month wait.”

The measures also seem certain to add to the anger that erupted last week after Ipswich Hospital in Suffolk admitted it had forfeited £2.4 million because it treated patients too quickly, having already agreed a 122-day minimum waiting time with East Suffolk Primary Care Trust (PCT), its funding body. The hospital finished the last financial year £16.7 million in the red.

[snip]

The Sunday Telegraph has learned of five further minimum-waiting-time directives. In May, Staffordshire Moorlands PCT, which funds services at two hospitals and is more than £5 million in the red, introduced a 19-week minimum wait for in-patients and 10 weeks for out-patients. A spokesman said: “These were the least worst cuts we could make.” In March, Eastbourne Downs PCT, expected to overspend by £7 million this year, ordered a six-month minimum wait for non-urgent operations. Also in March, it was revealed that Medway PCT, with a deficit of £12.4 million, brought in a nine-week wait for out-patient appointments and 20 weeks for non-urgent operations.–emphasis added

Ahhh the joys of socialism. I tell ya’ I can’t wait till we get socialized medicine here in the U.S. and we don’t have to pay those big fat administrative costs.

Via Radley Balko.

9 responses to “As I Predicted…”

Mark

August 28, 2006 at 4:33 pm

What exactly are people waiting for with regards to this “wait-time” of 122 days? Surely anything deemed an emergency will be dealt with timely, right? I ask because I recently had pneumonia and had to get a cat scan (to confirm the pneumonia), which was done pretty much that same day. Are you telling me if I lived in England I would have had to wait over 4 months before getting the cat scan?

I am not being snarky, I just do not understand the English health care model.
Steve Verdon

August 28, 2006 at 4:42 pm

Mark,

Probably not. Emergency/life threatening attention is not usually postponed. Still, making someone wait for a non-life threatening/non-Emergency procedure/visit/etc. is a cost. A non-monetary cost which accountants and bean counters like. Real people on the other hand still suffer.
MarkT

August 28, 2006 at 7:13 pm

Ahhh the joys of socialism. I tell ya’ I can’t wait till we get socialized medicine here in the U.S. and we don’t have to pay those big fat administrative costs.

I don’t find this to be a compelling argument – although it is fun snark.

You could also point to Canada as a socialized medicine system that the US would not want to emulate. That doesn’t mean that all socialized medicine is doomed to failure.
John Burgess

August 28, 2006 at 7:56 pm

If you need an operation for a non-life-threatening condition (say, a hernia) then you will have to put up with the four-month wait. If a taxi disembowled you, you won’t have to wait. If it’s purely optional or cosmetic, you’ll have to wait a long time.

Most people in the UK I know who have full-time jobs use the NHS for routine stuff that can be done with no urgency: see the local OB/GYN for a Papp smear, the DDS for eyeglasses, the Nutritionist for diet advice. You can generally wait a month or two to see these people, particularly if you can plan ahead.

But they also hold private medical insurance that permits them to see a private, for-pay doctor when they think it’s urgent.

While I lived in London, I had an excellent private insurance plan. I had a strange something going on one morning and within hours I was at a top cardiac hospital. By 7pm, I had an angioplasty completed.
Steve Verdon

August 29, 2006 at 12:20 pm

You could also point to Canada as a socialized medicine system that the US would not want to emulate. That doesn’t mean that all socialized medicine is doomed to failure.

Ahh yes, here it comes, the “lets go with France’s approach”. The only problem is that in France people still have to pay a large part of their bill, and often buy seperate insuarnce. While their system is good, it isn’t really socialized medicine like you have in other countries like England, Canada, Germany, etc.
Tano

August 29, 2006 at 2:44 pm

So what is the wait time for an non-emergency surgery in the United States, if you dont have health insurance?
just me

August 29, 2006 at 4:20 pm

So what is the wait time for an non-emergency surgery in the United States, if you dont have health insurance?

Not sure about not having health insurance, not sure why it applies, since the people in the UK are covered by insurance.

When my kids had their tonsilectomies and ear tubes (not all at the same time, it was 6 different surgeries at two different places)-all of them could have had their procedures scheduled within a couple of weeks. Most of them took longer, because we opted, at least with tonsilectomies, to do them at a more convienient time for us.

Wait times do have a lot to do with the doctor and the surgery clinic being used.

While it wasn’t surgery, when my son was having various barium tests, and endoscopy (surgery for him, due to his age) the bariums were all scheduled with a week, I think the endoscopy was scheduled a month after the doctor recommended we have it done.

A friend of ours needed hip replacement surgery, and I think it took him three weeks to have surgery.
Steve Verdon

August 30, 2006 at 11:43 am

So what is the wait time for an non-emergency surgery in the United States, if you dont have health insurance?

Depends on the number of cases that are determined to be more serious when you walk in. Usually several hours is my guess. Cetainly not 122 days or six months.