Commentary on medical news by a practicing physician.

  • Epocrates MedSearch Drug Lookup


    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

    email: medpundit-at-ameritech.net

    or if that doesn't work try:


    Medpundit RSS

    Quirky Museums and Fun Stuff

    Who is medpundit?

    Tech Central Station Columns

    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews


    Medical Blogs


    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc




    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It


    SOAP Notes


    Cut-to -Cure

    Black Triangle



    Kevin, M.D

    The Lingual Nerve

    Galen's Log



    Doctor Mental



    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House



    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day


    The Business Word Inc.

    Point of Law

    In the Pipeline


    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station





    The Skeptic's Dictionary

    Recommended Reading

    The Doctor Stories by William Carlos Williams

    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn

    Intoxicated by My Illness by Anatole Broyard

    Raising the Dead by Richard Selzer

    Autobiography of a Face by Lucy Grealy

    The Man Who Mistook His Wife for a Hat by Oliver Sacks

    The Sea and Poison by Shusaku Endo

    A Midwife's Tale by Laurel Thatcher Ulrich



    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info



    Sunday, September 12, 2004

    Tales from the North Country: The doctor shortage continues in Canada:

    "If you are not bleeding all over the place, you are put on the back burner," Ms. Pacione said, "unless of course you have money or know somebody."

    Despite what politicians and academics say, I'm convinced that we have a superior system to Canada's. Very few people are unable to find a doctor here in the States, and our waiting times to see one for an acute problem are much lower - usually one or two days. When people complain about the uninsured, what they're really complaining about is the fact that they have to pay for their healthcare, not that they can't get an appointment with a doctor. The Canadians pay for their healthcare in spades through higher taxes, but they still can't get an appointment.

    UPDATE: From a reader:

    Let's be clear, Americans are paying in spades--the highest per capita expenditure in the world --whether you are paying in the form of taxes, employee contributions, reduced employer/corporate profits or lower wages we are paying--in some parts of the country the cost of a family plan now substantially exceeds one's gross earnings at the minimum wage. Let's not even discuss the lack of a correlation between our high per capita expenditure and health outcome/status (and on many independent polls we are not more satisfied than other industrialized countries).

    And for many of the uninsured it isn't just a complaint that now they have to pay for health care--it is a complaint that it is either unaffordable or unobtainable. Realistically, tell me how a single mom or couple with one child affords health insurance when there is no employer contribution or they are self employed and make $13.00 per hour (not an unrealistic wage for many jobs). Imaging trying to squeeze it out at $6-10.00 per hour or if you only work part time, are an emancipated student, recently unemployed, etc.. Do the math after taxes, housing, food, transportation, and utilities--And remember, not every one lives in Ohio--how about Boston or SF where housing may well be double this.
    Gross wages 26,000
    Less taxes 4-6000 (state. local, sales, fica, federal, etc)
    Housing + Utilities 6000-7,200
    Transportation (for work) 4,000
    Food 4-5,000
    Medical insurance 6,000 to 9,000

    Yes, we do pay in spades - for health insurance. That's because there aren't many catastrophic plans out there, and because it's extremely difficult to get insurance as an individual. Things would be better if the risk were distributed more evenly across the population rather than through employment pools. For one, it would increase the competition for different health plans. People would be much more willing to purchase catastrophic plans and pay out of pocket for the simple things (an office visit with a primary care doctor is generally around $50-$60, cheaper for cash-only practices that don't have to process insurance claims.) But when an employer is paying the bill for the insurance, which is the case for most people, there's no incentive to purchase catastrophic plans. Everyone wants comprehensive plans that cover as much as possible. Unions demand them. Employees of small businesses expect them, or they'll find work with larger employers. As a result, few insurance companies offer catastrohpic coverage, but they all offer comprehensive coverage - at very hefty prices, of course.

    As I said in the original post, divorcing health insurance from employment would be a major step forward in correcting this, and in making health insurance more affordable. Of course, that means giving up some benefits for the majority of people, which never sits well.

    posted by Sydney on 9/12/2004 08:29:00 AM 0 comments


    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page


    Home   |   Archives

    Copyright 2006