How long, O Lord? How long?
Friday 3 April 2009


In pouring over tons of health policy stuff over the years I am amused and saddened by the consistent failure of all the PhDs and JDs to say anything about waiting times for appointments as a gold standard barometer for evaluation of health care quality. But when did these highpriced “advocates” ever have anything useful to tell us about quality?

I am on a rare diseases networking site where a woman in Ontario Canada with a serious endocrinology problem has just reported

“Most of the endocrinologists here have a wait time of 5 months.”

This was not concocted by some right wing think tank demonized by the far left and the “family” doctors. It was written last night by a perfectly ordinary and desperate person an Email away.

My own wait in January for a rare disease doctor to replace an assembly-line mutt who had declared me a lost cause was about a week ... standard at academic medical centers in New York City for access to world class MDs by people with traditional Medicaid.

Expecting the worst, the first question I asked his senior RN was
Does he take Medicaid? “Yes.”
Which of his fellows in training will I see and will that trainee do the surgery?
“You will see the doctor. He does all his surgery.”
And he did, with total success, ten days later.

The longer the health reformers in the US ignore these realities and continue to promote lowest common denominator health “plans” ... single payer, Conyers, “community” clinics, heavy-handed Preventative Primary Managed Care etc... the more likely it is that the reform process will grind to an even longer halt than the halt that has occurred already. (The latest is that the Sebelius nomination has been stalled for another two weeks by a Republican Senator’s objection.)

The “advocates” just cannot get it through their etc that they will not be able to preserve the privileges of their own political class while imposing a regressive program on others.

As more people begin to smell the all-too-familiar stench of politically correct “reform,” any and all of these proposals will sink into the mud. No amount of lies of the left about The Canadian System will work. No amount of caterwauling about asthma, diabetes and mammograms will cut the ice, let alone the mustard.

People will not agree to covering the uninsured by having their current coverage downgraded, no matter what the cost. The coalition of Paterson sycophants and HMO interests in NY can get away with it today. But woe to them tomorrow. Period. The sooner the “advocates” get it, the better for all of us.