Two Good Healthcare Related Items

Revere busts another myth about the Canadian healthcare system--ER waiting times:

But 70% [in Canada] saw someone within 15 minutes. In the US, wait times for cases requiring immediate attention as determined by a triage nurse are almost that long -- 14 minutes according to a recent study. Average wait times for heart attack victims? An average of 20 minutes, with one quarter of them waiting 50 minutes or more in the US. Heart attack victims. One quarter wait almost an hour to be seen. One reason is that US emergency rooms are crowded with patients that otherwise would see their primary care providers -- if they had one.

But TEH SOCIALLISMZ!!! Speaking of which, Robert Kuttner in NEJM:

Relentless medical inflation has been attributed to many factors -- the aging population, the proliferation of new technologies, poor diet and lack of exercise, the tendency of supply (physicians, hospitals, tests, pharmaceuticals, medical devices, and novel treatments) to generate its own demand, excessive litigation and defensive medicine, and tax-favored insurance coverage.

Here is a second opinion. Changing demographics and medical technology pose a cost challenge for every nation's system, but ours is the outlier. The extreme failure of the United States to contain medical costs results primarily from our unique, pervasive commercialization. The dominance of for-profit insurance and pharmaceutical companies, a new wave of investor-owned specialty hospitals, and profit-maximizing behavior even by nonprofit players raise costs and distort resource allocation. Profits, billing, marketing, and the gratuitous costs of private bureaucracies siphon off $400 billion to $500 billion of the $2.1 trillion spent, but the more serious and less appreciated syndrome is the set of perverse incentives produced by commercial dominance of the system.

Markets are said to optimize efficiencies. But despite widespread belief that competition is the key to cost containment, medicine--with its third-party payers and its partly social mission--does not lend itself to market discipline.

Go read 'em.