I mentioned yesterday that, in this slack economy, every part of the service sector seemed poised for instant response at the slightest chance of business -- with one exception. When I called to get a back-from-China physical from my doctor, the first opening was more than three months away. (Among his other virtues, my doctor subscribes to the magazine -- but does not frequent the web site!)
Two reader-hypotheses about the difference: that it's simple medical economics, and that it's because America is not Canada.
1) From the "medical economics" reader:
My girlfriend (spanish/japanese, lives in Spain) is always amazed by the service sector when she visits... It is almost always quick, efficient and relatively cheap (compared to Europe). That is changing in Europe with cheaper labor, but the sophistication of the US service markets (24 hour call lines, next day delivery) can never be matched.
On the pricing note, the delay in office visits is mostly price related, no? My father (a GI) makes about $50 an hour on office visits, before taxes and overhead. That is a lot less than all the other wonderful service experiences you describe. [Plumbers, electricians, tree-trimmers, etc.] At that price point, what incentive do you have to make yourself available? Given access to doctors is the biggest interaction most healthy people have with the medical system, increasing those basic services would make most people feel better about reform, no?
2) On the Canada front, from Parker Donham:
I live in a tiny Nova Scotia community, about 45 minutes from the nearest small city. When I want to see my "good-but-normal" doctor (the same one I've had for 35 years), I don't make an appointment. I call and ask what hours he will be in the office that day, then show up at a time convenient for me. I bring The Atlantic to read for the 10-20 minutes it takes to see him.
As we watch Americans debate the future of their health care system, it's galling for Canadians to hear opponents of reform demonize our single-payer system with discredited tales of health care denied. I am in good health, and enjoy excellent medical care. A close relative whose serious congenital heart condition leads to frequent, sometimes grave emergencies and occasional surgical interventions likewise receives superb care.
Yes, Canadians sometimes wait months to see certain specialists, a problem that varies from place to place, from speciality to speciality, and by degree of emergency. A lot of effort is now focused on reducing wait times, with some progress.
Canadians live three years longer, on average, than Americans; we have lower infant mortality, less chance of dying before age five, and much less chance of dying between 15 and 60. We spend barely half what you do, per capita, on health care, and no one loses their home to pay for needed medical care. Except for American ex-pats, no one stays in a Canadian job for fear of losing health coverage without it. Our system is very popular, and in our perennial, rather touching quest to identify cultural factors that distinguish us from Americans, single payer health care always ranks near the top of the list.
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