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News of the Day ... In Perspective

2/21/2007

Rationing of necessary services under “universal” care

Single-payer advocates consistently defend the Canadian system by claiming that waiting lists are almost exclusively for patients who want elective procedures, such as hip and knee replacements. Not so. Patients also wait for vascular surgery because surgeons are barred from operating more than a certain number of hours per week. Stuart Browning of On the Fence Films presents a form provided by a vascular surgeon—along with A Short Course in Brain Surgery and other film clips.

The waiting time to see a specialist or to be admitted for invasive test is the time it takes to get looked at—not the time to treatment.

Tim Worstall makes an effort to calculate the cost of waiting, in the system he is most familiar with, the British National Health Service (“Wait Wait, Don’t Help Me,” TCSDaily.com 1/25/07).

The statistics he has to work with are far from accurate. “In order to meet those targets [for maximum waiting times] there’s been a very large amount of fiddling around with figures, as there always is with instructions coming down from central planning.”

The National Institute for Health and Clinical Excellence (NICE) uses a number called a QALY (quality-adjusted life year) in deciding whether to pay for payment. A QALY—or being healthy for a year—is valued at £30,000. So, six million man-months of waiting costs £15 billion. Another branch of the very same government uses the value of £63,000, which would give a waiting cost of £31.5 billion.

Worstall points to another method the NHS uses to keep costs down, especially for the elderly in their last year of life. One 91-year-old woman died after one month on a subcutaneous drip that delivered only one-quarter of the caloric intake defined by the World Health Organization (WHO) as a short-term starvation diet.

“We starve them to death. Truly, single payer, single provider health care might not be as cheap as you think.”

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