Would you like to wait till you're blind before having cataract surgery?

[John C Hagan III, MD, FACS, FAAO]

As single payer Government mandated health care is discussed in the USA I suggest that interested USA citizens read this article:
John C. Hagan IIIMD

http://www.calgaryherald.com/Health/Wait+times+soar+cataract+surgery+Calgary/1605816/story.html

Wait times soar for cataract surgery in Calgary

CALGARY - Calgary ophthalmologists say waiting times for cataract surgeries in the city have skyrocketed since the cash-strapped Alberta superboard slashed the number of the procedures it purchased this year.  One major Calgary clinic, Gimbel Eye Centre, said the number of cataract patients on its waiting list doubled to 2,290 from 1,124 six months ago.  A second facility, Mitchell Eye Centre, said delays were growing so long it had to cancel all mild and moderate cataract cases and is now concentrating only on nearly blind patients.  "About a year ago, we had almost no waiting list. It was terrific,"said Dr.Robert Mitch-ell, an ophthalmologist who owns the Calgary clinic.  "It's a bit scary how fast that can turn around . . . We only now book the severe cases."  The growing wait times follow Alberta Health Services' decision to buy about 2,000 fewer local cataract surgeries in 2008-09 compared to the previous year in an effort to cut costs.  In Calgary, the public health system does not perform cataract operations, instead contracting out the procedure to surgeons at private clinics such as Gimbel and Mitchell.  In recent years, the former Calgary Health Region paid for additional cataract surgeries at the private clinics--beyond the surgeons' regular quota --in a bid to cut waiting lists.  But the practice required the health authority, which has since been replaced by the superboard, to spend over its budget.  This year, in the face of a $500 million deficit and a smaller than usual increase in its operating budget, Alberta Health Services said it would stick to its budget for cataract surgeries.  The superboard estimates it bought about 8,500 of the procedures in 2008-09 -- a significant drop from 10,340 the year before.  Dr. Howard Gimbel, medical director of Gimbel Eye Centre, said his waiting list was only a few weeks long at this time last year. He said many patients are now facing a year-long wait because of the cutbacks and it doesn't appear the situation will improve soon.  "There's no promise or expectation of anything more than last year, particularly with the economic times," said Gimbel.  In addition to reducing the number of cataract surgeries the superboard purchased, Alberta Health Services has also cut back on buying Calgary foot surgeries in recent months.  Local podiatrist Dr. Brent Haverstock estimates the surgical waiting list at the clinic where he works has grown to about 1,600 patients from about 1,200 at the beginning of the year. The clinic performs foot operations for people with arthritis, bunion removal and other problems.  "Everyone just gets pushed further and further back on the wait list," he said.  Alberta Health Services representatives said it's not yet clear how many surgeries it will buy this year from private clinics.  "The board will be reviewing and approving a new budget," said Mark Kastner, a spokesman for the superboard. "As part of that budget we'll be having discussions with all the contractors."  But Calgarians like Linda Williams, whose husband John has been waiting for more than eight months for cataract surgery on both eyes, said the situation is unacceptable.  "We're all victims of a system we have no control over," she said, noting her husband is only 57 and is still working, but has serious vision problems because of his cataracts.  The decision to buy fewer cataract surgeries is not the only cost-cutting measure at the superboard.  A political debate heated up last week after Alberta Health Services placed tight new restrictions on hiring health workers. Edmonton's Royal Alexandra Hospital also said it would cancel 15 per cent of its elective surgeries in a bid to slash costs.  Doctors said the result will be longer waiting times for hip and knee replacements, and other procedures.  The Alberta Medical Association has called on the government to eliminate the deficit at the superboard.  Dr. Noel Grisdale said the growing cataract surgery wait list in Calgary is another reason to give the organization a cash infusion.  "It's creating more wait lists and not providing service," he said. "It's a no-win situation."  Health Minister Ron Liepert has said government will consider how to handle the superboard's deficit when the final figure is available.  

[John C Hagan III, MD, FACS, FAAO]

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[walkietalkie]

I browsed other communities and forums here and its no wonder healthcare cost here is astronomical b/c people expected answers to their seemingly endless coughs and runny nose and drips, and ringing ears; and despite many tests and xrays and visits to various specialists nobody could find  whats wrong with them (or if theres anything wrong with them in the first place). In trying to avoid litigation doctors are performing unnecessary tests thats driving up costs but whos to blame?      

[John C Hagan III, MD, FACS, FAAO]

The American Medical Association is committed to health reform that covers the uninsured this year. Every American deserves affordable, high-quality health care, and the AMA is calling for reforms that build on what works and fixes what’s broken.

A government-run health care plan is certainly not the only option on the table, and there are alternatives we are actively considering. The AMA is engaged in continuing discussions with President Obama and members of Congress about how to make health care coverage for all a reality.

We are focused on reform that covers the uninsured, makes private insurance more affordable, increases the value we receive from our health care spending and enhances prevention and wellness for all patients. We look forward to the day when all Americans have health care coverage.

Nancy Nielsen, MD
President, American Medical Association

[berrywoo]

Sure, any of the single payer systems will have its share of problems, actually, virtually any health-care system has its own share of problems! As the saying goes "you can please some of the people all the time and all of the people some of the times, but you can't please all of the people all the time"! This truly applies in this situation. Yet, pointing out the ills of one system does little to solve our problems here in the U.S., because the fact is our current health-care system is broken. To fix it, there are many issues to consider and there won't be an easy solution. However, something needs to be done now! (A good article about how it is possible was posted on the New Yorker on Jan. 26 by Dr. Atul Gawande titled "Getting There From Here". Actually, all of Dr. Gawande's writings are really thought-provoking and should be read)

Personally, I believe that the whole idea of medicine is to help people. So it should be a non-profit service industry, that is geared to help people, not make obscene amounts of profit while providing little help to those who truly need it. I think the doctor-patient relationship is supreme and would like to see all others: drug companies, insurance companies, malpractice lawyers, etc. step back and stop intervening. The costs of medicine is sky-high and continuing to soar because such industries dig deep into our pockets and that of the doctors'. And when did the science of medicine become such a mega-business valuing monetary rewards over more intrinsic ones (I'm not saying that those in the medical field should live in poverty, but neither should they be in the top 1% of the income bracket)? For such a great nation how can we afford to let the idea of for-profit medicine continue?

[John C Hagan III, MD, FACS, FAAO]

Another thing I find very disturbing is that provnces are moving to kick Canadians "opting out" out of the system. Thus if they want to go to Detroit for a MRI, brain tumor surgery, experimental cancer medicine and pay their own money they lose coverage.

JCH MD

[cdn_glenn]

My experience with Provincially-run health care has been generally positive.  The above article and its comments (thanks for the link) shows a well functioning system can break down.  Very sad.  It looks like the new Alberta Health "Superboard" has over-administered a previously simple system.  Quote from eric on May18, "We went from 18 different health region managers to 108 Executive vice presidents".  Oh so wrong.