It's not her clinic, it's the University clinic. So she does have to demand things. And having the patients wait is incredibly essential if they have ALS (they do), and they can potentially deteriorate significantly in the space of a few months.
Personally I've had to wait 3 months to get into a new rheumatology practice in a new city. I assume if I said it was an emergency they might have made it sooner, but even so it's a long time to wait. Granted, rheumatology isn't like cardiology or something, but 3 months is enough time for a disease to get pretty damaging.
No, I don't think that we have waits as long as in Canada. On the other hand, EVERY Canadian I know is extremely proud of their health system. Of course there are problems with it. I don't think we need to go and adopt the Canadian model. But it still works better than ours by all measures of healthcare outcomes. That's why the WHO lists us at like 30-something for average number of healthy years expected, way below any of the other "first world" countries. And our life expectancies really aren't as good as other countries. I understand all of the confounding variables that people will point out about our population being less healthy to begin with, but I think that's also partially a failure of the health system. Another very important thing to realize is that Canada has far less in the way of health infrastructure than we do. If we went to a single-payer system, adequately funded, our infrastructure (MRIs, etc.) wouldn't suddenly disappear. We would make the system so that we wouldn't have to face the same waits as in Canada. But did you know that countries like Italy have more MRIs per capita than the US? Many countries with a national health coverage have an even better infrastructure than we do, spend way less of their GDP on healthcare, and don't have the same problems with waits as Canada does. That doesn't mean there aren't problems. I'm sure every system has problems. But there has to be something better than what we have now.
I do agree that it's screwed up that the working poor don't get covered. And of course people should take responsibility for their own health. On the other hand, I don't think diabetics and others, for the most part, are noncompliant by choice. It's not just that they're lazy. Granted I dont have as much exposure as you do, but I have some, and in my experience in a significant percentage of these cases it's a lack of patient education. People just don't understand how to take care of themselves, nor do they understand the consequences of not taking care of themselves. I'm sure there are people who are just lazy and don't care, but I'd suggest that they are in the minority.
btw, Medicare operates on a 2.5-5% overhead, compared to 15-30% for private insurers. Not to mention the duplication of effort that goes into multiple billing codes, multiple billing departments, each insurer having to employ people to do the same jobs as the others. We could provide good insurance to everybody at or below our current level of spending by just reducing all of this crazy overhead. Even something incredibly simple like making all billing codes the same would have an impact! Of course this falls on the individual doctor who has to hire enough staff to cover billing and insurance. We'd all be better off with a more streamlined system.
Of course I don't have the answers. Based on what I've read and heard and experienced I believe single-payer to be the best solution. I'm active in groups who are fighting to make it happen. But I can change my mind if I see a better suggestion. So far I just haven't.
