The Daily Mail reports that Mercedes Curnow, a 23-year-old Englishwoman, has died of cervical cancer. Since 2003, the National Health Service has denied routine Pap tests to women under 25. Her grieving mother believes that an earlier Pap test would have saved her daughter’s live, and has started the Mercedes Curnow Foundation for the Detection of Cervical Cancer. Its goal is to bring back routine Pap testing for women at age 20.
We were above Dublin. “Hon, you’re looking pale,” my mom said. It’s not like I could call my doctor—or could we? Again we buzzed the attendant, who returned with a satellite phone. I said, “Thank you, now I can call my physician.”
She looked at me sternly. “You’re not calling your doctor,” she said. “I’m calling our doctor.” We were stunned…
“I have a Nexium,” a male voice said from two rows back.
I exhaled. “You are a life-saver,” I said.
“You can’t give it to her,” the flight attendant told the man.
I turned to Nexium Man. “You’re going to give it to me, right?” I pleaded.
“No.”
“No?”
“No. I’m a pilot for this airline and whatever she says…goes.”
Almost 60 percent of those with ongoing health concerns have below-average household incomes, making it difficult to afford certain types of care and medications. Secondary costs such as paying for transportation to appointments, child care and lost wages from time away from work can also present obstacles to care, the Health Council said.
In fact, 12 percent of sicker patients reported not visiting a doctor due to cost concerns, compared with just four percent of other Canadians. Over a quarter of health-care services are paid for through private sources, either out-of-pocket by patients or through private insurance.
The survey also found that this group of patients fares worse when it comes to coordination of care. People with chronic conditions are likely to see multiple providers and specialists, yet many said they didn’t always receive help from their doctor’s office in coordinating that care.
About half of patients had to wait a month or longer to see a specialist, while almost one-quarter said test results or medical records were not available when they arrived for their appointments.
Full article on reduced access to care for Canadians.
Canadians seeking surgical or other therapeutic treatment faced a median wait time of 19.0 weeks in 2011, the longest wait time since 1993 when the Fraser Institute first began measuring wait times. According to the report:
What counts as “essential health care” that ObamaCare promised all Americans would have access to? The administration has decided to punt and leave the decision up to the states. That will mean that people in different states will have different benefit packages. The left is furious.
So almost 20% of people need to wait at least a week to see a doctor when they are sick. Try getting a same day appointment if you can. Or, even better, try getting an appointment before or after work. Or on a weekend …
Almost two thirds of Americans have trouble getting care on nights, weekends, and holidays. You know what? A significant amount of the week is filled with nights, weekends, and holidays….
It’s fine to believe that people should try and see the doctor in the office. But if you want that to happen, then you need the office to be available. If retail clinics do a much better job in that respect, you can’t complain when people make use of them.
Full post on the convenience of retail clinics here.
Charlotte, N.C.-based Carolinas HealthCare System, for example, operates 32 hospital emergency departments, four freestanding ERs with five more planned, and 19 urgent-care centers. It is considering starting retail clinics in grocery or drugstores. “We can integrate care across a broad spectrum of settings and we have an electronic medical record that links all our patients no matter where they go,” says president and chief operating officer Joseph Piemont.
Full article on urgent care clinics.
More than one in four people with private health insurance visited a retail medical clinic over a three year period (2007 – 2009) and the total number of visit grew tenfold over the period. Sarah Kliff (Ezra Klein blog) writes:
One disappointing finding in the RAND study had to do with patients of retail clinics in federally designated Health Professional Shortage Areas, places the government deems to have too few medical providers. There has been some hope that, with retail giants like CVS and Walmart being more ubiquitous than doctor’s offices, they could help bridge that gap in medical care. The study found no association, however, between primary care physician availability and retail clinic use.
Yet this problem might well be solved if Medicare adopts the advice given by Tom Saving and yours truly and pays market rates for seniors. Similar advice should be followed by Medicaid. See our previous post and additional links.
The study was published in the American Journal of Managed Care.
From The Incidental Economist by Austin Frakt:
Persons with disabilities report having much poorer access to care as those without disabilities. This is true even among those with health insurance. Those are some of the findings from the latest paper of which I am a coauthor with Lisa Iezzoni and Steve Pizer. It appears in the Disability and Health Journal.
Public health care’s strained finances have created a large private system, widely used by wealthier Greeks, as well as a shadow system built heavily on bribes—the envelopes of cash known in Greece as fakelaki. Generally, €20 to €50 buys a fast, basic office visit; surgeries can be thousands of euros, according to figures from Transparency International, the anticorruption group, which rates Greece the European Union’s most corrupt country.
“The state has exchanged public funding for private, under-the-table payments,” said Lycourgos Liaropoulos, a professor at the University of Athens and a prominent health-care economist. A study by Mr. Liaropoulos and his colleagues found that Greeks spend nearly as much on bribes and other “informal” payments as they do on “formal” costs such as insurance co-pays
