Wednesday, July 18, 2007

The Waiting Game

No Economist's View, um extracto de um artigo de Paul Krugman sobre, entre outras coisas, o tempo que os doentes nos EUA esperam para serem tratados:

The claim that the uninsured can get all the care they need in emergency rooms is just the beginning. Beyond that is the myth that Americans ... lucky enough to have insurance never face long waits...

Actually, the persistence of that myth puzzles me. ...Fred Thompson ... declared recently that “the poorest Americans are getting far better service” than Canadians or the British... [H]ow can they get away with pretending that insured Americans always get prompt care...?

A recent article in Business Week put it bluntly: “In reality,... the American people are already waiting as long or longer than patients living with universal health-care systems.”...

[T]he Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice... [and] is the worst place ... if you need care after hours or on a weekend.

We look better when it comes to seeing a specialist or receiving elective surgery. But Germany outperforms us even on those measures...

In Canada and Britain, delays are caused by doctors trying to devote limited medical resources to the most urgent cases. In the United States, they’re often caused by insurance companies trying to save money.

This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. ... [T]here’s no question that some Americans who seemingly have good insurance nonetheless die because insurers are trying to hold down their “medical losses” — the industry term for actually having to pay for care.

On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding — end of story. The alleged virtues of private insurance have nothing to do with it.

The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America.

Os leitores poderão perguntar "E o que é que isso nos interessa?". Afinal, em Portugal não há ninguém a propor um sistema de saúde de estilo norte-americano - dá-me a impressão que, mesmo os liberais portugueses o que propõem é mais o menos o mesmo que a "esquerda" norte-americana (que lá também se chamam "liberais"...) propõe (o sistema single-payer). Mas, como a respeito do Sicko apareceram montes de artigos a elogiar o actual sistema norte-americano e a criticar os sistemas europeus e canadiano...

1 comment:

Filipe Brás Almeida said...

Excelente post.