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Waiting, Here and There

Posted By Russ Roberts On February 27, 2006 @ 1:50 pm In Health | Comments Disabled

From an OECD study [1] of mean waiting time for elective surgery in developed countries (with thanks to reader Anthony Batty):

Evidence. Survey data suggest that there are very low waiting times for elective surgery in the  U.S. Blendon et al. (2002) reported the percentage of respondents to a phone survey in 2001, who had  experienced elective surgery in the last two years and who said they had waited longer than four months  for elective surgery. It was found that 5% of patients had been waiting for at least 4 months in the United  States, as opposed to 23% in Australia, 26% in New Zealand, 27% in Canada and 38% in the United  Kingdom. Carroll et al. (1995) found that the percentage of the respondents in need of elective coronary  bypass who had been waiting for more than three months was 0% in U.S., 18.2% in Sweden, 46.7% in  Canada, and 88.9% in the United Kingdom. Similarly, Coyte et al. (1994) found that surveyed patients in  need of knee replacement had a median waiting time of three weeks in the United States and eight weeks in  Canada (Ontario). 

Read this sentence again:

the percentage of the respondents in need of elective coronary  bypass
who had been waiting for more than three months was 0% in U.S., 18.2%
in Sweden, 46.7% in  Canada, and 88.9% in the United Kingdom.

I guess one man’s "elective" is another man’s "emergency," but I am still comforted by that 0% figure.

The conclusion of the study:

Conclusion. The United States spends much more on health care compared to all other OECD  countries. Although bed capacity is lower compared with countries without waiting times, day surgery  capacity is probably comparable or higher. The majority of providers of surgery is private and is highly incentivised to meet demand by activity-related payments.

Highly incentivised.  Yes.  It does make a difference.

I posted earlier [2] on the demise of Canada’s all-public system as reported in the New York Times.  I forgot to mention this remarkable quote from Dr. Brian Day, the medical entrepreneur who has been opening private clinics:

"This is a country in which dogs can get a hip replacement in under a
week and in which humans can wait two to three years."

The incentives are changing.  Good news for human Canadians.  Let’s  hope the United States moves toward a health care system where incentives play a larger rather than a smaller role and where people spend their own money rather than the money of others.

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[1] an OECD study: http://www.oecd.org/dataoecd/31/10/17256025.pdf

[2] posted earlier: http://cafehayek.com/2006/02/the_death_of_th.html

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