Wait times are merely the tip of the iceberg

One of the widely held notions about our health care system is that unlike patients in countries with nationalized medicine, Americans are not subject to lengthy delays in treatment.

A recent study by the Commonwealth Fund, a New-York based foundation that focuses on health care, found wait times in America to be much worse than in the Netherlands and Britain — countries with publicly funded national health systems.

But we tend to wait for different types of procedures. Americans are more likely to wait for office-based medical appointments that are not good sources of revenue for hospitals and doctors. In contrast, patients in other countries tend to wait longest for expensive elective care — joint replacement, for example — which is readily available in the U.S.

A front-page story in Sunday’s Sentinel ascribes this flip-flop to America’s market-based system which is driven by payment incentives. Countries with nationalized medicine focus on dispensing preventive care in a timely manner to forestall expensive hospital treatment because they’re spending government money.

Even with Obamacare, health care in America is still being delivered by private practitioners and paid for largely by private insurers. In an ironic twist, notes Michael Smerconish of the Philadelphia Inquirer, those who were quick to level the socialist charge at Obamacare, “were advocating for the right of people to remain uninsured and burden everyone else.”

The president, with a filibuster-proof Senate at his disposal, certainly could have attempted to ramrod a health-care reform bill that would have dismantled health insurance as we know it and replaced it with a national health-care system publicly funded by taxation. Something on the order of Medicare writ large.

But he didn’t. He chose instead to utilize the existing framework of our market-driven system in which 1 out of every 6 dollars in the economy goes toward health-care expenditures. He focused on the uninsured, universal coverage and an individual mandate to make it workable. But he ignored government regulation of pricing that might actually have put the “affordable” in the Affordable Care Act.

We’ve been critical of the Obama administration for the disastrous rollout of the Obamacare website and the president’s dithering on his promise that Americans could keep their plans. That led to a delay in the implementation of the individual mandate and penalties for those who opt out, which is straining the immediate carrying costs of the overhaul.

But something needed to be done. When people who don’t have insurance end up in a hospital emergency room, we all pay anyway, through higher premiums and higher costs per procedure or visit.

If Obamacare craters, we’ll be looking at a bigger slice of America’s GDP going toward health expenditures. Health care professionals may benefit, but the rest of us will pay the price.


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