Yesterday I had the opportunity to participate in the harlequinade that we Americans choose to call “health care”. A woman with top-of-the-line insurance had an infection and, before prescribing an antibiotic, her doctor wanted an ultrasound to rule out a 1 in 1000 chance that there was an abscess. The doctor suggested that she visit the emergency room at Emerson Hospital in Concord, Massachusetts, though in practice any clinic with a machine and a radiologist on-site or connected via the Internet could have done the scan. She arrived at the E.R. at 2:00 pm, was seen about 7:00 pm, and was discharged around 8:00 pm (I delivered emergency supplies of food at 5:30 and stayed until 7:30). Had she gone to a veterinarian, her odyssey in the health care system would have been complete, but hospitals and doctors aren’t generally able to send patients home with the required medications. So our exhausted patient had to make a trip to a separate pharmacy a few miles away.
One complicating factor yesterday was Patriot’s Day, a holiday for some folks in Massachusetts. Most personal service industries add staff during holidays. If a customer came into a restaurant on a weekend or holiday, he or she would not likely have to wait 5 hours for service “because it is a holiday and our waiters and cooks wanted to stay home with their families”.
The most painful knowledge for me was that there was almost surely an ultrasound machine and radiologist waiting idle somewhere in eastern Massachusetts but there is no Web-based system for finding facilities with short waiting times. This is presumably because customers’ time has no value in our health care system, but I reflected that even the Massachusetts Registry of Motor Vehicles took mercy on its victims and posted facility waiting times on the Web starting in the 1990s.
So… by spending a greater percentage of working hours paying for health care than any group of humans in the history of the world we Americans have managed to create an industry that is less customer-friendly than the DMV.
One exciting positive: Thanks to the heroic efforts of Barack Obama, a gay couple can pay the same $17,000 per year and wait the same 6 hours for a 20-minute procedure as a straight couple. Egalitarianism seems already to have been implemented at Emerson. I was not asked to explain my sexual orientation (if any) when visiting.
More: my own health care reform plan
[How would this have played out in countries that spend less than our $8500/year per person on health care? She would have gone to a pharmacist rather than a doctor, described her symptoms, and been handed the antibiotic 5 minutes later at a cost of between $5 and $50. Had there been an abscess she would have gone to a doctor a couple of weeks later.]
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