Ugly Health Care Waiting Times? Look at the U.S

What country endures such long waits for medical care that even one of its top insurers recently admitted that care is "not timely" and people "initially diagnosed with cancer are waiting over a month, which is intolerable?"

If you guessed Canada, guess again. The answer is the United States.

Scrambling for a response to the popular reaction to Michael Moore's SiCKO and a renewed groundswell for a publicly-financed, guaranteed health care, single-payer health care solution like HR 676, the big insurers and their defenders have pounced on Canada, pulling out all their old tales of people waiting years in soup kitchen-type lines for medical care.

But, here's the dirty little secret that they won't tell you. Waiting times in the U.S. are as bad as or worse than Canada. And, unlike the U.S., in Canada no one is denied needed medical care, referrals, or diagnostic tests due to cost, pre-existing conditions, or because it wasn't pre-approved.

U.S. waiting times are like the elephant in the room few of the critics care to address. Listen to what the chief medical officer of Aetna had to say in March.

Speaking to the Aetna Investor's Conference 2007, Troy Brennan let these nuggets drop:

• The U.S. "healthcare system is not timely."
• Recent statistics from the Institution of Healthcare Improvement document "that people are waiting an average of about 70 days to see a provider."
• "In many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable."
• In his former stint as an administrator and head of a physicians' organization he spent much of his time trying "to find appointments for people with doctors."

Brennan's comments went unreported in the major media. But some reports are now beginning to break through, spurred by the debate SiCKO has spawned.

Business Week, no great fan of a national healthcare system, reported in late June that "as several surveys and numerous anecdotes show, waiting times in the U.S. are often as bad or worse as those in other industrialized nations -- despite the fact that the U.S. spends considerably more per capita on health care than any other country."

A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times were worse in the U.S. than in all the other countries except Canada.

But, there's something else you probably don't hear about Canada. Substantial progress is being made.

Most of the wait times problems derive from funding cuts by conservative national or provincial governments, or from the siphoning off of resources by private providers. But precisely because the Canadian system is publicly administered, Canadians are able to force their elected officials to fix problems, or get voted out of office.

Throughout Canada, there are multiple pilot programs that have succeeded in slashing wait times. "a new approach of targeting investments to reduce waiting times combined with transparent reporting of wait times is having a substantial impact on access in the Canadian system," wrote Robert Bell, MD, of Toronto's University Health Network, with several of his RN and physician colleagues in a letter to the Wall Street Journal Monday.

Statistics Canada's latest figures show that median wait times for elective surgery in Canada is now three weeks -- that's less time than Aetna's chief medical officer says Americans typically wait after being diagnosed with cancer.

Canada also has no waits for emergency surgeries. It also doesn't have 44 million people who are uninsured because everyone has a national healthcare card guaranteeing health care from any doctor or hospital they choose. And it doesn't burden those with insurance with rising deductibles or co-pays.

Canada also surpasses the U.S. in a broad array of health barometers, including life expectancy, infant mortality rates, adult mortality rates, deaths due to HIV/AIDS, mortality rates for cardiovascular diseases, and years of life lost to injuries and communicable diseases, according to data from the World Health Organization and the Organization of Economic Co-operation and Development.

No wonder some people are so afraid we'll learn the real comparative story about Canada's system -- and our own.