As anyone not in a coma knows, there is a great deal of debate in the US right now about Health Care Reform. During this debate, there are many references to the Canadian Health Care system, typically by Americans who have absolutely no idea what the hell they are talking about – including a former governor of Alaska. It is referred to as “socialized medicine”, and Americans argue that it reduces efficiency, costs the government great sums of money (note that the US government already spends more per capita on health care than the Canadian government does), reduces innovation, has longer wait times, and even leads to people dying while awaiting treatment.
I recently became ill while in Los Angeles for a conference. While being sick is never a fun experience, being diabetic and being sick while travelling in a foreign country by yourself is especially stressful.
However, this gave me an opportunity to experience the US health care system first hand, albeit a little superficially. Also, since my employer provides me with out-of-country health insurance, my experience is from the perspective of someone with health insurance, not someone without. In addition, my opinion of the US health care system is based on a single experience, not a broad sample.
Lets start with my arrival at the ER. I arrived at about 9 PM on a Tuesday evening.The first step was to fill out a little form with basic information – name, address, nature of my complaint. This form is passed through a little hole in the plexiglass partition, and my information is entered into their computer system. I then waited about an hour to see the triage nurse and be prioritized. Between myself, my wife and my kids, I have been at emergency rooms in New Brunswick, Ontario, and Alberta, and do not recall ever waiting more than a small number of minutes to be triaged. It should be noted that the triage process seemed to be mostly a “first in, first out” kind of process – I did not notice anyone being triaged faster based upon the nature of their complaint.
After being triaged, I guess I was ranked fairly low in terms of priority (hey, I was only vomiting up large amounts of blood), because I then sat from about 10 PM Tuesday evening until 4:30 AM Wednesday waiting to see a doctor. Many people came in, were treated, and left before I was seen, but I understand that once you are triaged, priority are based on who is at the most risk. I also understand that I was only seeing the “walk in” side of the ER – there was another whole flow of patients coming in through the ambulance entrance with a fair number of trauma patients. Still, 7 and a half hours of waiting to see a doctor is longer than anything I have seen in the Canadian health care system. And remember, I was at a private hospital in LA, not a public clinic. I would thus expect that this was on the good side with respect to performance.
Once I actually got to see the doctor, I was treated fairly quickly. Note that the goal was not to treat the root cause in my ailment, the primary intent was to stabilize my condition so that I could return to Canada for full treatment. At this, they were very efficient, and I was out in about 3 hours. It was also made much more smoothly because my out-of-country health coverage worked very well with the hospital’s admissions/accounting people with regards to payment. God only knows how the experience would have played out had I not had insurance.
In short, my visit to the ER in Los Angeles involved wait times which were significantly longer (for both triage and treatment) than anything I have ever experienced at a hospital in Canada.
To finish off the story, I will describe my follow-up treatment after returning to Canada. On the Wednesday following my return to Canada, I called my family doctor, and got an appointment to see her that afternoon. After that appointment, she referred me to a GI specialist, who I saw the next afternoon. He decided I needed an endoscopy, which happened the next day. Seems pretty efficient to me!
Perhaps Americans (especially American citizens) should educate themselves on the reality of the Canadian Health Care System rather than blindly believing the rhetoric of their politicians who are bought and paid for by the insurance companies and HMOs, or simply know nothing about the Canadian system which they are criticizing.