# healthcare crisis out of control **URL:** \ **Category:** Great Debates\ **Created:** [July 8, 2015, 11:24am UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566 "2015-07-08T11:24:49Z")\ **Posts on this page:** 19\ **Page:** 4
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [July 9, 2015, 9:13pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/61 "2015-07-09T21:13:11Z")
> [@Grim\_Render](#): > > Well. There is a reason emergency rooms in the USA has such issues. For a large number of people emergency care through the emergency rooms is the only form of health care they can get. > > Other countries have better access to healthcare for the whole population, and therefore do not sluice a large number of people whos conditions have gone critical through their emergency rooms. > > Mostly, that is why. > > Actually, [US healthcare costs are sky high above other countries](http://kff.org/slideshow/health-spending-in-the-u-s-as-compared-to-other-countries-slideshow/). > > 18 % of GDP, 8800 per citizen per year. As opposed to other nations that average 9-10 % of GDP and about 4400 per person per year. Of course, other nations get healthcare for their entire populations for that. In fact, the 4 600 $ that is the governments share of US healthcare spending, and which covers 28 % of the population, is more per citizen than most other developed nations spend to provide universal health care. > > A minor part of the reason for this, is the inherent inefficiency in allocating resources according to ability to pay rather than medical need. Something you see in US emergency room, with patients suffering from conditions that could have been adressed much cheaper and more effectivly at an earlier stage. > > As regards nurses, no. The US has [fewer nurses and midwives per head of population than most other developed countries.](http://gamapserver.who.int/gho/interactive_charts/mental_health/psychiatrists_nurses/atlas.html) (intersting spot though: The only country I can spot further down on the list than the US is the Nederlands, which runs for-profit insurance as their healtcare delivery vehicle) > > As regards doctors, no. The US [has fewer doctors per head than most other developed countries.](https://www.cia.gov/library/publications/the-world-factbook/fields/2226.html#us) > > Interesting fact though: While the US 2.45 physicians per 1000 population may seem very low compared to other developed countries, it is actually worse than that. In the US it is so lucrative to specialize that there are a much lower proportion of GPs than in other countries. You do realize most other countries doctors and nurses get dirt pay compared to doctors and nurses in the US. Some one getting $200,000 to $300,000 year would be unheard of in most other countries. The US also has large number of bureaucrats and administrators being paper pushers getting $500,000 to $1,000,000 year. ---
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [July 9, 2015, 9:24pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/62 "2015-07-09T21:24:57Z")
> [@Grim\_Render](#): > > Well. There is a reason emergency rooms in the USA has such issues. For a large number of people emergency care through the emergency rooms is the only form of health care they can get. Look at the new link he replied to me saying most ER wait times are under 30 minutes!!! Even the old chart I posted was from 2009 with ER wait times 4 hours. These are very good ER wait times. It was false when I said ER wait times where longer. I think I read some wrong information on the internet of very long ER wait times or was talking about ER wait times in the UK or Canada. The US has very low ER wait times. I think I’m getting confused of a article I read that probably was talking about the UK or Canada. It also true that like some of the posters above some local problems out side of norm may have long ER wait times and have problems. But stats of most hospitals in the US ER wait times are under 30 minutes!!! Even the old 2009 average stats of 4 hour ER wait times is much lower than what I was saying. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [July 9, 2015, 9:28pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/63 "2015-07-09T21:28:41Z")
They’re not called ERs in the UK. It’s “casualty departments.” ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 9, 2015, 9:31pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/64 "2015-07-09T21:31:04Z")
Why would you think ER waiting times in the UK and Canada are longer? Those countries have free at the point of delivery healthcare, so people can see a doctor long before the smurf hits the fan, whereas the US leave millions of people with the emergency room as the only option. I’m curious as to what kind of reasoning gets you from “more efficient systems with more doctors and nurses, with many more options” to “longer waits in the ER” ---
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [July 9, 2015, 9:36pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/65 "2015-07-09T21:36:19Z")
> [@Gyrate](#): > > Assuming I’m deciphering this incoherent gabble correctly, you appear to be saying that in the UK and Canada one may have to wait 8-12 hours in A&E for non-urgent treatment and four hours for urgent treatment. > > If so, this is about as accurate as your statement about US waiting times, which is to say it’s taking a minority of extreme cases and portraying it as the norm. At present about 6% of A&E cases in England take more than four hours from arrival to admission, treatment or discharge ([stats here](http://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/statistical-work-areasae-waiting-times-and-activityweekly-ae-sitreps-2015-16/)). This varies by which week, quarter or year you’re looking at and it certainly could be better, but it’s not the hell-on-earth you seem to think it is. If you are in the UK and go to the ER and the ER wait times is 4 hours that seem not bad. Lot lower than 6,8 or 12 hour ER wait times I was saying. Also what is A&E? ’ > [@](#): > > Assuming I’m deciphering this incoherent gabble correctly, you appear to be saying that in the UK and Canada one may have to wait 8-12 hours in A&E for non-urgent treatment and four hours for urgent treatment. A priority one patient or priority two patient of a one or two hour ER wait and a priority three patient or higher of a 4 to 6 hour ER wait bit more borderline if that how it is in UK??? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [July 9, 2015, 9:45pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/66 "2015-07-09T21:45:27Z")
> [@sweat209](#): > > Also what is A&E? The other UK equivalency for an ER. ---
**Author:** ![DMC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dmc/32/18049_2.png) [@DMC](https://boards.straightdope.com/u/DMC)\ **Post date:** [July 9, 2015, 10:00pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/67 "2015-07-09T22:00:57Z")
> [@Voyager](#): > > So the worst times in NJ are significantly below the average times he gave. Maybe those numbers are for the entire emergency room visit, and not for the wait to see the doctor. Who knows? But you are arguing against incorrect statistics. One of the major problems with the wait-time data that **sweat209** provided is how it is collected. It’s based purely on patient surveys, which are mailed days later and only a small subset are returned. Additionally, if the patient is actually admitted or transferred to a different hospital, they are not counted. So, the survey results are from people who were not so sick as to require actual admittance and therefore were likely bumped by those who were and they also had to either be pissed enough (or happy enough) to want to share their experience. Oh, and it also assumes that their memory of how long they actually waited is accurate. Additionally, due to the small sample size hospitals have been known to go from the 1st percentile to the 99th percentile in various rankings in a single month. Based on the above, I’m going to go out on a limb and call the numbers inflated until I see evidence to the contrary. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [July 9, 2015, 10:13pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/68 "2015-07-09T22:13:35Z")
> [@sweat209](#): > > You do realize most other countries doctors and nurses get dirt pay compared to doctors and nurses in the US. > > Some one getting $200,000 to $300,000 year would be unheard of in most other countries. Most other countries the doctors and nurses don’t have crushing medical education debt, either. Some other countries, like China or India, have a much lower cost of living so that what you call “dirt pay” might actually buy a pretty good lifestyle. > [@](#): > > The US also has large number of bureaucrats and administrators being paper pushers getting $500,000 to $1,000,000 year. If we went to a UHC model like the UK NHS or what is in play in other first world nations we could get rid of most of those bureaucrats and administrators, which would save us all a lot of money and let us pay decent wages to actual doctors, nurses, and other personnel providing actual medical services. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 9, 2015, 11:01pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/69 "2015-07-09T23:01:45Z")
> [@sweat209](#): > > There should be doctor at the very least for every 100,000 people!!! At the moment in the USA, you have not 1, but 245 doctors to every 100 000 people. This is one of the lowest numbers in the developed world. Almost every developed nation have more physicians per person. > [@sweat209](#): > > You do realize most other countries doctors and nurses get dirt pay compared to doctors and nurses in the US. > > Some one getting $200,000 to $300,000 year would be unheard of in most other countries. Lad, that is utterly untrue. Back when I was doing medical administration in Norway, I frequently paid nurses up towards 100 000, and doctors made more. Of course, the real money is in the private secotr and specialising, where wages of 200 000 $ is hardly unusual. Everyones tax returns are public here after all. What is more, I am pretty sure that specialists in the UK make six-figure salaries with the right specialization. I am not sure of the relevance though. Being a doctors in most first world countries is to be among the best paid professions. > [@sweat209](#): > > The US also has large number of bureaucrats and administrators being paper pushers getting $500,000 to $1,000,000 year. Roughly 600 000, yes. ---
**Author:** ![bump](https://avatars.discourse-cdn.com/v4/letter/b/7c8e57/32.png) [@bump](https://boards.straightdope.com/u/bump)\ **Post date:** [July 10, 2015, 1:04am UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/70 "2015-07-10T01:04:50Z")
> [@sweat209](#): > > So you all know about the major shortage of doctors and nurse’s and long very long wait times in the ER 4 to 8 hours and soon to be 8 to 12 hours. > > About a month to see family doctor or specialist. And many months for hip and knee surgery. What are you talking about? I was in the ER about a year and a half ago, and I was seen by an intern in like an hour, and by an actual ER doc about an hour after that. Had knee surgery the following day. And I could easily go to my doctor’s website right now and schedule an appointment for next week. Maybe not in the exact time slot I want, but he’s not _that_ booked that I couldn’t get in on a planned appointment next week. And I know his practice holds out a certain percentage of appointment slots for urgent problems as well, so if I was really sick, I could call and get an appointment that day, I’d bet. And wait time metrics are total bullshit. Trust me; I do db work for one of the nation’s largest providers of work site urgent and primary care clinics, and our wait time stuff is only as accurate as the people behind the desk are in diligently moving people between the stations in the system. So if the clinic’s slammed, the desk staff may be checking a bunch of people out at once, or batch moving people from “waiting room” to “exam room” at the same time. Or forgetting entirely and moving them from waiting room to checkout or something like that. Surveys are even worse as far as wait times go; they’re going to self-select for either the usually small group that had an issue, or for assholes who are never satisfied with anything other than a tiny wait time. People who come in, have a short wait and a good visit have no incentive to bother to fill out the surveys. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [July 10, 2015, 10:26am UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/71 "2015-07-10T10:26:42Z")
> [@sweat209](#): > > Also what is A&E? “Accident & Emergency”, which is what ERs are called in the UK. They are also known as “Casualty departments” although that’s largely fallen out of use (the long-running “Casualty” television show notwithstanding). Some areas also have “Urgent Care Centers” to deal with medical issues that aren’t critical but can’t wait until the GP’s office opens in the morning; this frees up A&E from dealing with minor emergencies. And many areas have an out-of-hours walk-in clinic on weekends and evenings. Finally, the NHS has a non-emergency telephone number (111) if you have a medical condition that you need advice on how to deal with - it’s basically an informal triage service. They take your details, an appropriate healthcare professional calls you back (often a nurse) and they tell you to go to the A&E or the UCC or a walk-in centre or to your GP or a late-night pharmacy or just to take a couple of paracetamol and go back to bed. I’ve always found it (and its predecessor “NHS Direct”) very helpful. FTR, I think the longest I’ve had to wait in A&E in the UK was about an hour. It was fine, if boring. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 10, 2015, 9:41pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/72 "2015-07-10T21:41:14Z")
> [@sweat209](#): > > The US also has large number of bureaucrats and administrators being paper pushers getting $500,000 to $1,000,000 year. Cite that anyone except high level managers of insurance companies get pay like this? And the chart that you posted had ER waiting times by state - so unless Canada annexed Texas and Virginia, the crap data is for the US. Where is the horrible hospital you go to again? ---
**Author:** ![HoneyBadgerDC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/honeybadgerdc/32/1033_2.png) [@HoneyBadgerDC](https://boards.straightdope.com/u/HoneyBadgerDC)\ **Post date:** [July 11, 2015, 10:28pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/73 "2015-07-11T22:28:12Z")
UCLA medical center a county hospital in Carson Ca has wait times of up to 24 hours. The very sick or emergencies get treated promptly though. My ex wife was a triage nurse and she said that a good share of them would just leave if they sat in the waiting room long enough. Bad out comes were not unsusual but never reported according to her anyway. ``` I often wondered how accurately one could judge the pain tolerance of the patient. My ex claimed that she could tell if they were exageratiing or not. ``` ---
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [July 12, 2015, 12:44am UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/74 "2015-07-12T00:44:08Z")
> [@Grim\_Render](#): > > \*\*At the moment in the USA, you have not 1, but 245 doctors to every 100 000 people. This is one of the lowest numbers in the developed world. Almost every developed nation have more physicians per person. > \*\* > Lad, that is utterly untrue. Back when I was doing medical administration in Norway, I frequently paid nurses up towards 100 000, and doctors made more. Of course, the real money is in the private secotr and specialising, where wages of 200 000 $ is hardly unusual. > > Everyones tax returns are public here after all. > > What is more, I am pretty sure that specialists in the UK make six-figure salaries with the right specialization. > > I am not sure of the relevance though. Being a doctors in most first world countries is to be among the best paid professions. > > Roughly 600 000, yes. So where is this information coming from that there is a shortage of doctors? I’m starting to think does the US have a shortage of doctors or not? Or was this in the UK or Canada that has a shortage of doctors? ---
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [July 12, 2015, 12:54am UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/75 "2015-07-12T00:54:22Z")
> [@bump](#): > > What are you talking about? I was in the ER about a year and a half ago, and I was seen by an intern in like an hour, and by an actual ER doc about an hour after that. > > Had knee surgery the following day. > > And I could easily go to my doctor’s website right now and schedule an appointment for next week. Maybe not in the exact time slot I want, but he’s not _that_ booked that I couldn’t get in on a planned appointment next week. And I know his practice holds out a certain percentage of appointment slots for urgent problems as well, so if I was really sick, I could call and get an appointment that day, I’d bet. > > And wait time metrics are total bullshit. Trust me; I do db work for one of the nation’s largest providers of work site urgent and primary care clinics, and our wait time stuff is only as accurate as the people behind the desk are in diligently moving people between the stations in the system. So if the clinic’s slammed, the desk staff may be checking a bunch of people out at once, or batch moving people from “waiting room” to “exam room” at the same time. Or forgetting entirely and moving them from waiting room to checkout or something like that. > > Surveys are even worse as far as wait times go; they’re going to self-select for either the usually small group that had an issue, or for assholes who are never satisfied with anything other than a tiny wait time. People who come in, have a short wait and a good visit have no incentive to bother to fill out the surveys. I think it false information or some local hospitals problems that have long ER wait times!! The stats of 2009 say 4 hours average and the new stats by poster above saying average under 30 minutes. So base on that the US has very low ER wait times!! So don’t know what I was reading that there is a major crisis now of long ER wait times getting out of control and a shortage of doctors unless the article was talking about the UK or Canada. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 13, 2015, 4:29am UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/76 "2015-07-13T04:29:52Z")
> [@sweat209](#): > > I think it false information or some local hospitals problems that have long ER wait times!! The stats of 2009 say 4 hours average and the new stats by poster above saying average under 30 minutes. > > So base on that the US has very low ER wait times!! > > So don’t know what I was reading that there is a major crisis now of long ER wait times getting out of control and a shortage of doctors unless the article was talking about the UK or Canada. Could you give a link to the article, not just the table please? The title says time spent in the ER, while the column head says wait time. I’d count wait time as time until a doctor sees you. If you are given some treatment and are lying in a bed waiting for it to work, I wouldn’t consider that waiting. Some regions of the US, especially poor rural ones, are under-served in terms of doctors. As mentioned there is a shortage of GPs. But the number of doctors depend on how many are allowed in medical schools. And there are many cases (I know a few) of people who were physicians in Russia, say, who are physical therapists here. That happened before ACA. I can believe an ER in an urban area where few people are insured would have higher wait times than average. More insurance through ACA should mean more people see a regular doctor, and wait times decrease. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 13, 2015, 6:47pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/77 "2015-07-13T18:47:26Z")
> [@sweat209](#): > > So where is this information coming from that there is a shortage of doctors? I’m starting to think does the US have a shortage of doctors or not? > > Or was this in the UK or Canada that has a shortage of doctors? It comes from your own OP, where you stated: > [@sweat209](#): > > So you all know about the major shortage of doctors and nurse’s and went on to state: > [@sweat209](#): > > Countries with universal health care like UK,Canada so on and countries with no universal health care all having run away healthcare costs and major shortage of doctors and nurse’s. as well as: > [@sweat209](#): > > And med schools are not bringing out enough doctors,specialists and nurse’s. I then pointed out that health care costs are incredibly much higher in the US than in UHC countries, and that the US has one of the lowest numbers of physicans, nurses and midwives among developed nations. Whether the UK and Canada has a shortage of doctors, depends on how many doctors is considered enough, but they certainly have more doctors per 1000 population than the USA. ---
**Author:** ![SeniorCitizen007](https://avatars.discourse-cdn.com/v4/letter/s/8baadc/32.png) [@SeniorCitizen007](https://boards.straightdope.com/u/SeniorCitizen007)\ **Post date:** [July 14, 2015, 6:37pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/78 "2015-07-14T18:37:35Z")
I’m 72 and super fit. Most people here in the UK over the age of 50 believe that vigorous exercise is dangerous. Anything that causes their heart to pound worries them. I can still outsprint most teenagers and a 100 mile bike ride, especially over a hilly route, really gets me feeling good. ---
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [July 25, 2015, 8:46pm UTC](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566/79 "2015-07-25T20:46:41Z")
> [@Grim\_Render](#): > > It comes from your own OP, where you stated: > > and went on to state: > > as well as: > > I then pointed out that health care costs are incredibly much higher in the US than in UHC countries, and that the US has one of the lowest numbers of physicans, nurses and midwives among developed nations. > > Whether the UK and Canada has a shortage of doctors, depends on how many doctors is considered enough, but they certainly have more doctors per 1000 population than the USA. It probably was some article I read or opinion piece of reason US major opposition to universal health care. Saying do you want be like the UK or Canada of long wait times and so on. Even fact the US spend more on GDP on health care than any other country and have run away health care cost. [Previous page](https://boards.straightdope.com/t/healthcare-crisis-out-of-control/724566.md?page=3)