Coming Soon to the U.S.: Two-Day Waits for Doctors?

Remember back when Obamacare was still being touted as the next big thing that would both save money and create universal access to health care? You know, that false dawn before even the law's administrators were hoping it doesn't immediately degenerate into "a third-world experience"?

Stories abounded about how Canada and England showed just how it could be done. Here's the latest on basic care from Great Britain's fabled National Health Service (NHS), courtesy of the Guardian:

Patients are having to wait more than 48 hours to see a GP and often take time off work when they do because appointments are hard to get and at inconvenient times, a new report warns.

Research by the Patients Association also reveals deep dissatisfaction with out-of-hours care and widespread concern that weekend and overnight services may not deal with an urgent problem properly.

Six in 10 people who took part in a survey (60.5%) said they could not get to see a GP for at least two days, while 83.8% had to wait for more than 24 hours.

This sort of thing is a given when government rations care, either directly or indirectly. And there's this:

In addition more than one in three (37.6%) were unable to book an appointment for at least two days in advance and 57.4% said the process of booking an appointment was either "very difficult" or "could have been easier".

One in five (21.7%) – including 38.2% of 16-to-64-year-olds – had had to take time off work to attend an appointment. Of those who did, almost six in 10 (58.2%) had to take a day or more off to do so.

Health-care delivery in the United States already suffers from a lack of emphasis on customer service. You can schedule oil changes and haircuts with more precision than you can an appointment with the doctor. But keep a stiff upper lip, folks, because it can - and almost certainly will - get worse.

Read the whole story here.

For more links to just how rotten the NHS is, go here and here.

Hat tip: Jack Shafer.

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  • Stormy Dragon||

    Patients are having to wait more than 48 hours to see a GP and often take time off work when they do because appointments are hard to get and at inconvenient times, a new report warns.

    Is this really a socialized medicine problem? Or is it just a "doctors don't just hangout at the office at night with no patients scheduled on the off chance you might need to see them" problem?

  • ||

    Is this a dumb question? Or is it just a stupidly disingenuous one?

  • Hugh Akston||

    Is this a rhetorical question? Or is it just a poorly articulated response?

  • Stormy Dragon||

    My point being that having trouble getting in to see a doctor on short notice outside work hours is hardly limited to socialized medicine. There's plenty of legitimate problems with NHS to write about without having to pretend it's the sole source of every complaint people have about their doctors.

  • Another David||

    Yeah, I've had plenty of two-day waits for an appointment with my red-blooded capitalist American doctors. And for specialists? Jesus Christ, a two-day average would be *unbelievable*. My wife needed to see a neurologist last month, and the only way to get an appointment before April was to call around until we found somebody who had a cancellation. Which was at 1 PM. What was that about missing work?

  • Bill||

    It's true that to get a non-emergency appointment with your assigned primary care physician in an HMO that your company picked for you based largely upon what tax incentives they get and what restrictions their state has placed on what has to be offered may take a few days. What we have now is already much less than a free market. The number of doctors is limited due to the number of medical schools the AMA allows to be licensed. In the 70's and 80's when Osteopaths started becoming popular as a cheaper alternative to MD's, the AMA quickly convinced them to join them so they could continue to limit numbers of doctors.

    The more things are govt/ run the longer the waits. Look at the post office and drivers license bureaus.

  • VG Zaytsev||

    Employer paid HMOs are socialism lite.

  • Stormy Dragon||

    I'm not in an HMO. In fact I'm in one of those high deductible plans with an attached HSA that I donate my own money to. You know, the current libertarian "gold standard"?

    I still have to wait to see my doctor. Because he's a good doctor who has a lot of people who want to see him. It doesn't matter how you fund healthcare; the best doctors are going to be able to dictate their working conditions easily, so the consumers are always going to face a trade off between accessibility and competence.

  • KPres||

    In the NHS, you're not trading accessibility for competency, because all of their competent physicians have migrated to the US.

    http://www.nytimes.com/2012/03.....d=all&_r=0

  • ||

    I did not see anything about the NHS at that link. The doctors in the story are from Zambia. and the problems they were dealing with were about lack of resources due to poverty.

    The problems with health care institutions in the third world are not generally the same as those in rich countries with socialized medicine.

  • ||

    Patients are having to wait more than 48 hours to see a GP and often take time off work when they do because appointments are hard to get and at inconvenient times

    This doesn't mean outside work hours. It means "appointments during work that you have to take off work to go to". You know, which is something inconvenient, especially for hourly workers.

  • Stormy Dragon||

    And you think hourly workers in the US never had to take off to see their doctors before Obamacare passed?

  • ||

    What does this have to do with the fact that you were claiming they were night appointments?

    Go move goalposts on someone else. Your knee-jerk defense of socialized medicine is laughable, especially if you've never experienced it. I've actually been through the NHS. Have you?

  • General Butt Naked||

    I've actually been through the NHS.

    Hey, your pee doesn't burn anymore and they got rid of all the warts. What else do you want?

    Freakin' Americans.

  • ||

    I want free birth control, damn it!

  • A Secret Band of Robbers||

    I thought those were the pills Warty's been giving you.

  • Stormy Dragon||

    1) I said people have TROUBLE getting night appointments. As in they AREN'T able to get them. Did you go the socialized education too, since you apparently can't read English?
    2) Where did I defend NHS? Pointing out that the "Hitler was a vegetarian" argument is dumb doesn't mean you're defending Hitler.

  • ||

    Where did "night appointments" come into this? The appointments we're talking about are during work hours.

  • Night Elf Mohawk||

    Yes, and these appointments during working hours are not a function of socialized medicine. In order to avoid this problem, in socialized medicine or not, you'd need appointments available after hours, that is, at night. So this "problem" isn't limited to socialized medicine.

  • Chris Mallory||

    There are two GPs in my city with hours until 7pm. Both also take walk ins. So capitalism is working quite well.

  • Stormy Dragon||

    And is everyone in your city a patient of one of those two GPs? Do you think the people going to other doctors never complain about taking off work or waiting for appointments?

  • Chris Mallory||

    What part of "Anyone can walk in" do you not understand. The options are there, if you aren't bright enough to find them, that is your problem.

  • Stormy Dragon||

    If you read the article, anyone can walk in to urgent care too. That's not what it's about. It's about people who want to see "Their Doctor" and are pissed he doesn't appear like a summoned genie the second they want to see him.

  • Sevo||

    "Or is it just a "doctors don't just hangout at the office at night with no patients scheduled on the off chance you might need to see them" problem?"

    Gee, I'll make sure my illness/injury is scheduled for the doc's business hours.

  • Stormy Dragon||

    If it's the type of injury that can't wait two days, that's what urgent care or the emergency room is for. I have private insurance, but I wouldn't be able to expect to get in to see my doctor immediately and I would sure as hell have to take off work to do so when I did.

  • Sevo||

    Stormy Dragon| 3.22.13 @ 6:38PM |#
    "If it's the type of injury that can't wait two days, that's what urgent care or the emergency room is for"
    Maybe my mistake, but I thought that's what they were saying; ER care, 48 hours.

  • Stormy Dragon||

    No they're talking about people getting appointments to see their primary physician.

  • A Secret Band of Robbers||

    Yes, this is a socialized medicine thing.

    Most clinics and hospitals plan for a certain amount of time when they don't expect to have patients so that they can accommodate emergencies. The exact amount depends on the specialty, and capital costs factor in.

    Fair warning: Until recently, I worked in breast imaging systems, so I'm not entirely sure how far this applies in other areas. IANAD or medical billing professional.

    Medicare pays clinics based on their assumed (read: bullshit) utilization rate. They figure the average cost of running a facility--the number is higher for hospitals than standalone clinics--and figure out the utilization rate needed to make a profit. They adjust prices accordingly.

    Until recently, they assumed a 50% utilization rate for advanced imaging services (MR and CT). IOW, if you had only Medicare patients, you could had to be treating a patient no less than half the time to break even. Obviously, if you're in a specialty that has more elderly patients, this is more critical because you can't afford to decline all Medicare patients, and it's all or nothing.

    With the fiscal cliff deal, Medicare raised utilization rates for advanced imaging services to 90%. 10% slack is far less than most clinics realistically use. For a lot of standalones, especially in remote areas, you can expect reduced hours and possibly closings. Even in the best cases, overbooking may become standard practice.

  • DarrenM||

    breast imaging systems

    No jokes yet? I'm disappointed.

  • Auric Demonocles||

    I fear that two day waits for alt text are coming soon to Reason.

  • Auric Demonocles||

    Schedule oil changes and hair cuts? What kind of insanity is this? I just roll up and go. For oil changes I don't even get out of the car.

  • DarrenM||

    That's what we need. Drive-up medical care.

  • EnglishCuckoo||

    My UK primary care physician:

    Want a same day appt?
    Phone at 8.30 am. Keep redialling, since endless busy signal is caused by everyone else also phoning at 8.30 which is the earliest time you can get an appointment at short notice. Hope that all available slots are not filled by the time you get through, in which case repeat the following day.

    Feel like planning ahead?
    Phone after 11 am, attempt to negotiate an appointment sometime in the same millenium with a doctor, but oops, no can't go more than three months into the future, and no, there are no appointments left. Phone at 8.30 on the day you want to see the doctor.

    Solution:
    Have a mental illness, screw up your meds, make them phone you and get yourself added to the appointments on a day of your choosing.

  • Stormy Dragon||

    Yeah, if I call my primary care physician, I'll have the same problem. That doesn't mean I'm being screwed over by capitalism. I means a good doctor will attract more patients then they have time for, so if you want a good doctor, you're probably going to have to wait to see them.

    If my hand gets chopped off, I'll go to the emergency room. If I want someone to look at my sudden ass rash, I'll just have to deal with it for a few days.

  • SaltySeaCaptain(LAOL)||

    You are such a fucking retarded cosmotarian. Totally....fucking...retarded

  • KPres||

    "I means a good doctor will attract more patients then they have time for..."

    Not in an efficient market. A good doctor will raise their price until the workload is manageable.

  • Stormy Dragon||

    Depends what the price elasticity is. If the marginal utility for time is less than the marginal utility for money, an efficient market is going to result in lines instead of higher prices.

  • Ken Shultz||

    I know! Let's take a limited resource and hand it out to everybody regardless of their ability to pay!

    What could go wrong?

    You people just need to stop being so selfish.

    P.S. Sounds like ObamaCare could use a new marketing gimmick. Maybe a slick commercial?

    I suggest they use this as their theme song:

    http://www.youtube.com/watch?v=SGJFWirQ3ks

  • JeremyR||

    Lets take a limited resource and not give it out to people who can't afford it.

    I mean, hell, poor people don't deserve medical care, just like they don't deserve to eat, either.

  • Ken Shultz||

    Funny how the profit motive makes things that were once unaffordable more affordable over time, though, isn't it?

    I remember when cell phones were for rich people.

    Now your average teenager has a smart one!

    I remember when only rich people could afford to fly on airplanes.

    Now it costs me $90 to fly round trip between LA and Las Vegas.

    We don't live in a static world. What's unaffordable today won't be tomorrow. Laser eye surgery isn't just for rich people anymore--and neither are boob jobs.

    And do you know why?

    Because the only people who can get access to those procedures are the people who can afford to pay for them.

    Do you know why even middle class people in the UK have to queue in line for basic healthcare like a bunch of Russians circa 1987 in front of a grocery with empty shelves?

    Do you?

  • VG Zaytsev||

    Because of kkkorpoorashuns

    /progtard

  • KPres||

    "Lets take a limited resource and not give it out to people who can't afford it. I mean, hell, poor people don't deserve medical care, just like they don't deserve to eat, either."

    The only reason poor people can't afford medical care is because licensing restrictions have priced them out of the market.

    INOW, I agree! Why does the government keep restricting their access to medical care just because they're poor?

  • JeremyR||

    This has always been a stupid argument - there is only no waiting now because many people have no access to health care at all. Like what, 20% of the country?

    The solution is that not every gets to see a GP. Things like nurses and even pharmacists will have to do. No matter what system you have, there won't be enough doctors for everyone. There is too much training needed and a certain amount of intelligence.

    The other thing is that we've been poaching doctors from 3rd world nations for a long, long time. Like half the doctors in Nigeria.

    Yes, short term benefit for us, but in the long run it's better for everyone if 3rd world countries cease being 3rd world. Not draining away their best and brightest is a good way to start.

  • OldMexican||

    Re: JeremyR,

    This has always been a stupid argument - there is only no waiting now because many people have no access to health care at all. Like what, 20% of the country?


    Try 0%.

    The solution is that not every gets to see a GP. Things like nurses and even pharmacists will have to do.


    The solution should be to let people make those choices themselves; getting rid of the tax incentives that started the whole medical insurance-as-3rd-party-payment-system; getting rid of licensing laws and getting rid of the multiple regulations (like EMTALA) that only gum up the works.

    Either that, or enjoy your Soviet-style medical system. I heard they brought back herbal therapy after they ran out of medicines, before the final collapse...

  • A Secret Band of Robbers||

    Try 0%.

    Way to overstate your case, Old Mexican. Lack of access to medical services is a very real and life-threatening situation for literally several Americans each day as they wait for medical evacuation on whatever remote wilderness expedition they're on.

    Many find that insurance does not even cover the cost of the medivac helicopter.

  • Calidissident||

    And in the meantime, those people should be denied the chance to make a better life for themselves and their children?

  • Ken Shultz||

    "This has always been a stupid argument - there is only no waiting now because many people have no access to health care at all. Like what, 20% of the country?"

    Why don't they have access to healthcare?

    The correct answer is because the government forces providers to give so much healthcare away for free--by way of Medicare and Medicaid--that providers have to charge private insurers and the uninsured up the wazoo just to break even!

    Do you know why PPO's work so hard to persuade their patients not to go to hospitals that don't have a contract with the PPO?

    Are you aware that more than half the hospitals in this country are non-profit?

  • A Secret Band of Robbers||

    Are you aware that more than half the hospitals in this country are non-profit?

    You have to admit that with hospitals, as with all non-profits, their tax status has nothing to do with whether they actually make profits.

  • Ken Shultz||

    Hospitals being profitable certainly isn't a problem in urban areas with low private insurance rates.

    You show me a hospital with a relatively high population of people on Medicaid in a three and five mile radius, and I'll show you a hospital that isn't profitable.

  • A Secret Band of Robbers||

    I don't know, the fact that they get 50% more for the same procedure for Medicare patients has to factor in.

  • Ken Shultz||

    Medicare pays an average of about 25 cents per dollar billed.

    Medicaid pays about 12.5 cents.

    "From 1990 to 2009, the number of hospital emergency departments in non-rural areas in the USA declined by 27%, according to a study in today's Journal of the American Medical Association.

    ...

    Hsia says she and colleagues did a "survival analysis," much like researchers do for breast cancer patients. "In our study, we used the ER as the patient," says Hsia.

    They found that the number of emergency departments dropped from 2,446 to 1,779 — an average of 89 closings per year....

    Hsia says researchers wanted to examine the factors that led to closings. "Certain hospitals are at higher risk for losing their ERs than others," she says. ERs shut down were more likely to:

    •Have low profit margins;

    •Serve patient below the poverty level;

    •Serve patients with poorer forms of insurance, including Medicaid;

    •Be in for-profit hospitals;

    •Be in more competitive markets;"

    http://usatoday30.usatoday.com.....47264082/1

  • Ken Shultz||

    "From 1990 to 2009, the number of hospital emergency departments in non-rural areas in the USA declined by 27%"

    How's that for universal access?

    So what's the solution to urban hospitals that serve the poor being driven out of business by Medicaid's stingy reimbursement rates?

    Why add 20 million patients to the Medicaid roles by way of ObamaCare, that's what!

    ...don't worry, we'll just sic the IRS on poor people who don't buy insurance--that'll help the insurance companies survive all the gouging they're gonna suffer, and we'll regulate all their competition out of the market!

    See, we've got a solution for everything!

    ...except high insurance rates and accessibility--which is precisely what ObamaCare was supposed to fix. Instead, they're totally exacerbating the problem. Predictable as the sunrise.

  • OldMexican||

    Patients are having to wait more than 48 hours to see a GP and often take time off work when they do because appointments are hard to get and at inconvenient times, a new report warns.


    What's 48 hours when millions of children go on living without insurance?

  • phandaal||

    When London began masturbating with that NHS crap is about when my friends and I stopped watching the Olympics' opening ceremony.

  • lendapatricia||

    my neighbor's sister makes $87/hour on the laptop. She has been fired for 6 months but last month her payment was $17170 just working on the laptop for a few hours. Read more on this site
    http://JUMP30.COM

  • SumpTump||

    Sometimes dude we jsut have to get over it man. WOw.

    www.Anon-Today.tk

  • AlmightyJB||

    So you're for Obamacae then Nick? Cause seeing a GP within 48 hours outside an emergany would be awesome! I'm not sure what stats you're looking at but I know a Canadian who had a seriuos shoulder injury and he was scheduled at six months to get an apointment just to get it evaluated. Being the smart man that he was he "fell off a ladder" while visting the states and had it taken care of immediately and then the states billed it to the Canadian Govt. Worked out for him in the end but I would hardly call that a model of efficiency. Me, I'll be seeing my optomitrist in two weeks which is the soonest appointment he had available which is fine.

  • AlmightyJB||

    Same day appoinment other than an emergancy? Dude, my grandfather was a GP who would literally work for chickens or corn or whatever you had to pay him with and he made house calls with but I doubt that you would get a same day appointment unless you had some sort of an emergancy. Are people smoking crack here or are same day doctor appointments the norm outside of Ohio?

  • SaltySeaCaptain(LAOL)||

    Its just Ohio. Damn this state sucks.

  • AlmightyJB||

    Same day appoinment other than an emergancy? Dude, my grandfather was a GP who would literally work for chickens or corn or whatever you had to pay him with and he made house calls with but I doubt that you would get a same day appointment unless you had some sort of an emergancy. Are people smoking crack here or are same day doctor appointments the norm outside of Ohio?

  • AlmightyJB||

    Maybe i just haven't quite acheived that monacle wearing libertarian status where your doctor leaves the golf course to come straight to wherever you are every time you get the sniffles.

  • General Butt Naked||

    OT:

    Gun permit applications are up in Newtown, and across Connecticut. Guess some people would rather protect themselves from bad guys with a firearm rather than another ignored law.

  • Tony||

    Hashtag insured people's problems.

  • Brutus||

    And let's remember that your chance of being killed by the NHS through neglect and/or incompetence are something like 4-5 time your chance of being murdered in the United States.

  • Joe Emenaker||

    I would *jump* at the chance to have a 2-day wait for my GP here in the U.S.. Usually, when I call to make an appointment, the first opening is about in 10 days. For my dentist, it's a couple of months. And, just like the article warns about the future, my current appointments require me to take some time off of work to go (because, oddly, the doctor's office is only open during normal business hours).

    Good to see that things are going to get so much better under the ACA.

  • XM||

    You have to wait to see some sort of specialist everywhere.

    Our healthcare is "socialized medicine" lite, and we have 300 plus million people. For all intents and purposes, the largest democracy in the world, one that attracts a record number of immigrants.

    Obama really dropped the ball on this one. It's not even a true insurance mandate, since most of the uninsured can just opt out. Low income Americans are about to enjoy increased access to healthcare without paying into (or not as much) it as their socialist brethren in Europe.

    At a certain point, most Americans will have to pay separate taxes on healthcare. Or be forced to buy healthcare regardless of what they make. The politicians can't coddle the poor forever. The medical device tax will probably go away. Obama's already running out of ways to fund his scheme.

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