Does No Access Count as Waiting

I've posted this argument on several other blogs so I've decided to add it to my own. I recently read a blog from the National Center for Policy Analysis (US based). According to the NCPA's web site "the NCPA's goal is to develop and promote private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector. "



Not surprisingly they've posted about the sorry state of affairs in Canadian Health Care. Specifically the lack of access to physicians and services throughout the country and the high cost of care. They use research from a Toronto (Ontario, Canada) based think-tank called the Fraser Institute (for the Fraser Institute's web site and other wait time references see this link).

Specifically they address the long health care wait times in comparison to the United States and limited access to physicians. Given the recent problems in Massachusetts where mandatory insurance coverage has caused a (roughly) 10% surge in the number of patients trying to access primary care. The result is a doctor shortage, waiting lists and similar problems to Canada in primary care.

I would argue that waiting is waiting for a patient. It does not matter to them whether they have to wait because of lack of funding, doctors or services in a publicly funded system or because they have to save enough money to get into the system in the first place. If the NCPA is going to argue the point that Canada is lacking in services and access I think they need to include the counter-point from the United States that wait time estimates need to include those that don't join the queue until money is available. If you look at the Commonwealth Fund estimates roughly 10% more Canadians have access to primary care than Americans even if it is delayed. I'm not sure how the math works but I'd suggest that whatever number you choose to estimate the wait times in the US needs to have a fudge factor of at least 10% added to it to estimate to account for those that can't even get in the door.