Wednesday, January 6, 2010

Politics: The US Health Care System

KENNEWICK, WASHINGTON - Canadians are constantly told that their health care system is superior to that of the United States. It's so close to a sacred cow that commentators cannot even question the premise for fear of being unpatriotic. Typical of how far one can go was Jian Gomeshi's monologue on the CBC radio show Q the day after a health care compromise was reached in the US Senate, talking about how relieved Canadians were that the proposed reforms would still result in less than universal coverage in the United States and that cost-cutting measures were minimal. Those two differences--universality and cost--are those most often cited as the aspects that most distinguish the two systems. But, these are largely macroeconomic issues for policy makers--assuming a person has access to medical services, all that the "consumer" cares about is the quality of those services.

I had a chance to see the US health care system in action this week when a family member that I was visiting showed some acute symptoms. The situation was well-handled on the phone, with the symptoms regarded as serious and instructions to call 911 until it became clear that I was around to provide a ride to the doctor's office. Upon arrival at the doctor's office, it was less than five minutes before a nurse invited us back to a room, and the doctor came around just minutes after vital signs were taken. We were given a direct admit to the hospital, so there was no wait, just the standard admission interview.

Arguably, this was the only egregious part of the entire process. The insurance check is something that wouldn't happen in Canada once a health card was shown, but it took only seconds, probably no longer than verifying a health card. All the other forms that lawyers require to be signed were the issue. There were four forms that had to be explained and signed. For someone in pain being admitted to a hospital, this is not welcome. Does anyone actually ask for more information on organ donation as they are entering a hospital with an acute condition? The only other major issue in the experience came immediately thereafter, as the volunteer (yes, volunteer) who was to lead us to the hospital room left us in the hallway for about five minutes before guiding us there.

After that, there was little to quibble with in the experience. Tests were soon performed and a procedure was scheduled for the first thing the next morning. While it was delayed a bit this was communicated during breakfast, and release from the hospital came about 26 hours after admission. An issue brought up late during the release process was dealt with by the nurse, resulting in a prescription phoned in to the pharmacy for pickup before the end of the day.

There are plenty of problems with the health care system in the United States. None of them were obvious in my experience of it earlier this week. It worked quite well.

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