CDZ Question: If you had a possible meniscus tear, how long before you expected to get an ultrasound?

[shockedcanadian]

I don't like polls as they are too limiting for such a question. I will be back later and am interested in how Americans view their healthcare and expectations.

Long story short, my wife has a potential meniscus tear which she experienced at work. It happened last Tuesday, it will be a week tomorrow since the injury, she has finally been confirmed to have an ultra sound on Monday, which will be thirteen days since the original injury.

Question: would this type of healthcare meet your expectations in the U.S? If not, explain your expectations.

 

[Fishlore]

Up here in Northern New Hampshire, she would have gone to the ER and gotten whatever test and treatment needed within an hour or two. We have a great local hospital and a world class teaching and research facility at Dartmouth Hitchcock about an hour away. The reasons for this are historical, not economic. Our town is far from wealthy but our population has been stable for a long time and things are running pretty smoothly.

 

[Luddly Neddite]

When it happened to me, no ultrasound until more than a week later but had radiographs that day. My surgeon did not want to replace the knee until because I had some traveling planned. I had injections, made a couple of trips to Europe. Second one, I had really walked a lot and had to use wheelchairs in the airports. I don't know what the cost was for the treatment, injections or eventual surgery because I never saw the bills.

One trip to Brussels, I had an ear infection and could not fly. We were visiting friends, asked them what the hell I was gonna do and was told, just go to the doctor.

Went to ER first, no waiting, they all spoke excellent English, said I didn't need ER, sent me around the corner to what we would call 'urgent care'. I was seen immediately, again, everyone spoke English. Sent me to the pharmacy.

European pharmacies are incredible. They are very well trained, about what we would expect from a Physician's Assistant or even doctor.

No waiting, got the scrip and an OTC drug and enjoyed an extra week in Brussels.

Then I find out the airline won't let me fly without doctor's letter/release. So, I call the same doc at 7pm. He says he is giving a paper on the other side of Brussels at 8 pm and how soon can I get there? With our friends, because we want to go out to dinner, we jump into a cab and the doc opens the door himself.

Its a very nice office, he takes me and my husband into the exam room, has me sit on the end of the exam table, looks in my ear, says 'I'm going to do something very painful and I want you to hold very still'.

My husband rushes to hold my hand and I say, no, I'll do better on my own. He sits down, very watchful. doctor puts long tweezer down into the ear canal, which tickles like crazy.

He says, "I know, but if I had told you that, you would have moved".

He says I'm good, writes the letter, then calls a cab for us.
In Europe, calls from doctor offices go to the top and are answered immediately.

When the cab arrived, he came out and directed the driver to the closest open pharmacy for a scrip and then directs him to the best Indian restaurant I've ever been to.

When we get to the pharmacy, I'm aware of the cabby outside so ask "will this take long?". Very nice guy behind the counter hands me the drug and says "no" with a little smile.

Bottom line - no hassle, excellent care, two scrips, one otc drug, urgent care, and second visit to doctor all came to less than $150USD.

I would love to have that kind of care in the US.

 

[shockedcanadian]

Well my wife is walking around in extreme pain though she is trying to stay off of her feet. Any slight movement and she is in agony. It's absurd to me, and a reflection of the system we have. In a decade or too it will be unbearable. There are already suspicions that our new law that allows for doctor assisted suicide is being promoted to save the system money! A Godless system.

 

[Fishlore]

Comparing Health Care in Canada to the U.S. - FactCheck.org

Bottom line: wait times are shorter in the US, medical outcomes and general health are better in Canada, both nations are mediocre compared to Western Europe.

 

[yiostheoy]

Spinal injuries normally fuse and fix themselves eventually by themselves.

So take 2 aspirin for pain, as needed.

Aspirin would never hurt you.

It is the oldest drug in history dating back to prehistoric times from chewing willow bark.

 

[yiostheoy]

If you are not already paralyzed by a back injury then there is no hurry with this.

it's not like an appendicitis where you only have about 10 hours to live if they don't take it out right away.

 

[shockedcanadian]

If you are not already paralyzed by a back injury then there is no hurry with this.

it's not like an appendicitis where you only have about 10 hours to live if they don't take it out right away.

Huh? The Meniscus is in her knee, she has a potential tear in her knee not her spine.

 

[JakeStarkey]

Hope your wife gets better soon.

 

[shockedcanadian]

Hope your wife gets better soon.

Thanks Jake, that makes three of us.

 

[Scorpion]

She needs an MRI not an ultrasound.
My husband has a torn meniscus.
Getting around without surgery.

 

[shockedcanadian]

She needs an MRI not an ultrasound.
My husband has a torn meniscus.
Getting around without surgery.

Well, as I posted a couple o days ago. If you have cancer i some cases you are waiting months for an MRI, so maybe the doctor took this approach out of expediency. I'm don't know much about medical procedures tbh.

 

[Marion Morrison]

Probably a few days to a week.

Then you go to an orthopedist. They determine surgery or no.

There's ways to self-rehab as long as it's not completely torn.

 

[2aguy]

I don't like polls as they are too limiting for such a question. I will be back later and am interested in how Americans view their healthcare and expectations.

Long story short, my wife has a potential meniscus tear which she experienced at work. It happened last Tuesday, it will be a week tomorrow since the injury, she has finally been confirmed to have an ultra sound on Monday, which will be thirteen days since the original injury.

Question: would this type of healthcare meet your expectations in the U.S? If not, explain your expectations.

No...something like that you get the order and go right away........

 

[2aguy]

Comparing Health Care in Canada to the U.S. - FactCheck.org

Bottom line: wait times are shorter in the US, medical outcomes and general health are better in Canada, both nations are mediocre compared to Western Europe.

But the social welfare states are seeing their healthcare systems collapsing...

Britain....

NHS problems 'at their worst since 1990s' - BBC News


Services in the NHS in England are deteriorating in a way not seen since the early 1990s, according to a leading health think tank.

The King's Fund review said waiting times for A&E, cancer care and routine operations had all started getting worse, while deficits were growing.

It said such drops in performance had not been seen for 20 years.

But the think tank acknowledged the NHS had done as well as could be expected, given the financial climate.

Professor John Appleby, chief economist at the King's Fund, which specialises in health care policy, said: "The next government will inherit a health service that has run out of money and is operating at the very edge of its limits.

================



Iceland...


Iceland's Universal Healthcare (Still) On Thin Ice - The Reykjavik Grapevine

One year ago, Iceland’s lauded universal healthcare system seemed to be teetering off the edge. Doctors’ wages had stagnated after the economic crash, and following a bout of failed negotiations, they went on strike for the first time ever. While they coordinated their actions to avoid endangering patients’ lives, the doctors’ message was clear: if demands were not met, they would seek employment elsewhere.

Coupled with years of tough austerity measures, faltering morale, and an infrastructure in dire disrepair, there was not much slack to give. In an in-depth analysis, we at the Grapevine tried to figure out what, exactly, was going on, and where we were headed.
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New Zealand...


WHO | New Zealand cuts health spending to control costs
New Zealand cuts health spending to control costs
New Zealand’s health-care system is undergoing a series of cutbacks to reduce costs, but critics are concerned that the health of people on low incomes and in some population groups may suffer. Rebecca Lancashire reports in our series on health financing.
When Robyn Pope was diagnosed with breast cancer in 2008 she was told that she would have to wait two months for a mastectomy if she wanted breast reconstruction as part of her treatment in the public health system. “Two months may not seem like a long time,” says Pope, a mother of three, who lives on the Kapiti Coast of New Zealand, “but a day lived knowing that you have cancer in your body is like an eternity”.

The underlying reason for the delay was a familiar one – funding. Like other countries offering universal health care, New Zealand struggles to meet the steadily growing demand for a full range of high-quality health services offered largely for free to everyone, while remaining cost efficient. In the past eight years, New Zealand’s total health expenditure has doubled to 3.6 billion New Zealand dollars (NZ$) (US$ 10 billion). In the face of economic slow down, the government is calling for reform to rein in this expenditure.

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Sweden


'Sweden's healthcare is an embarrassment'



Swedish was once a health care model for the world. But that is hardly the case anymore.

This is not primarily due to the fact Sweden has become worse - rather it is the case that other countries have improved faster.

That Sweden no longer keeps up with those countries is largely due to its inability to reduce its patient waiting times, which are some of the worst in Europe, as the latest edition of the Euro Health Consumer Index (EHCI) revealed in Brussels on Monday.

The 2014 EHCI also confirms other big problems within Swedish healthcare.
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France....

France's Health-Care System Is Going Broke

Yet France’s looming recession and a steady increase in chronic diseases including diabetes threaten to change that, says Willy Hodin, who heads Groupe PHR, an umbrella organization for 2,200 French pharmacies. The health system exceeds its budget by billions of euros each year, and in the face of rising costs, taxpayer-funded benefits such as spa treatments, which the French have long justified as preventive care, now look more like expendable luxuries.
“Reform is needed fast,” Hodin says. “The most optimistic believe this system can survive another five to six years. The less optimistic don’t think it will last more than three.”
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Finland...

Why is Finland’s healthcare system failing my family? | Ed Dutton

Finland’s health service has been in a parlous state for decades and it is getting worse.
According to an OECD report published in 2013, the Finnish health system is chronically underfunded. The Nordic nation of five million people spent only 7% of GDP on its public health system in 2012, compared with 8% in the UK. In 2012, the report found, 80% of the Finnish population had to wait more than two weeks to see a GP. Finland’s high taxes go on education and daycare.
Finland has more doctors per capita than the UK but, at the level of primary care, a far higher proportion of these are private than is the case in Britain. And the Finnish equivalent of the NHS is far from free at the point of use.
A GP appointment costs €16.10 (£12.52), though you pay for only the first three visits in a given year. A hospital consultation costs about €38, and you pay for each night that you spend in hospital, up to a maximum of €679. And once you get to the chemist, there is no flat fee; no belief that you shouldn’t be financially penalised for the nature of the medicine you require.
The service is not national, but municipal, meaning that poorer areas of the country tend to have a bad health service and limited access even to private GPs, who set up practices in more affluent areas.

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Canada....

If Universal Health Care Is The Goal, Don't Copy Canada

Amongst industrialized countries -- members of the OECD -- with universal health care, Canada has the second most expensive health care system as a share of the economy after adjusting for age. This is not necessarily a problem, however, depending on the value received for such spending. As countries become richer, citizens may choose to allocate a larger portion of their income to health care. However, such expenditures are a problem when they are not matched by value.
The most visible manifestation of Canada’s failing health care system are wait times for health care services. In 2013, Canadians, on average, faced a four and a half month wait for medically necessary treatment after referral by a general practitioner. This wait time is almost twice as long as it was in 1993 when national wait times were first measured.
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Long wait times in Canada have also been observed for basic diagnostic imaging technologies that Americans take for granted, which are crucial for determining the severity of a patient’s condition. In 2013, the average wait time for an MRI was over two months, while Canadians needing a CT scan waited for almost a month.

These wait times are not simply “minor inconveniences.” Patients experience physical pain and suffering, mental anguish, and lost economic productivity while waiting for treatment. One recent estimate (2013) found that the value of time lost due to medical wait times in Canada amounted to approximately $1,200 per patient.

There is also considerable evidence indicating that excessive wait times lead to poorer health outcomes and in some cases, death. Dr. Brian Day, former head of the Canadian Medical Association recently noted that “[d]elayed care often transforms an acute and potentially reversible illness or injury into a chronic, irreversible condition that involves permanent disability.”

And more on Canada...


The Ugly Truth About Canadian Health Care

Mountain-bike enthusiast Suzanne Aucoin had to fight more than her Stage IV colon cancer. Her doctor suggested Erbitux—a proven cancer drug that targets cancer cells exclusively, unlike conventional chemotherapies that more crudely kill all fast-growing cells in the body—and Aucoin went to a clinic to begin treatment. But if Erbitux offered hope, Aucoin’s insurance didn’t: she received one inscrutable form letter after another, rejecting her claim for reimbursement. Yet another example of the callous hand of managed care, depriving someone of needed medical help, right? Guess again. Erbitux is standard treatment, covered by insurance companies—in the United States. Aucoin lives in Ontario, Canada.

When Aucoin appealed to an official ombudsman, the Ontario government claimed that her treatment was unproven and that she had gone to an unaccredited clinic. But the FDA in the U.S. had approved Erbitux, and her clinic was a cancer center affiliated with a prominent Catholic hospital in Buffalo. This January, the ombudsman ruled in Aucoin’s favor, awarding her the cost of treatment. She represents a dramatic new trend in Canadian health-care advocacy: finding the treatment you need in another country, and then fighting Canadian bureaucrats (and often suing) to get them to pick up the tab.

And the truth.......that Canadians don't see until it is too late.....

My health-care prejudices crumbled not in the classroom but on the way to one. On a subzero Winnipeg morning in 1997, I cut across the hospital emergency room to shave a few minutes off my frigid commute. Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care. I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic—with a three-year wait list; or the woman needing a sleep study to diagnose what seemed like sleep apnea, who faced a two-year delay; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks.
Norway.....
Government Health Care Horror Stories from Norway

I'll admit this: if, like me, you're a self-employed person with a marginal income, the Norwegian system is, in many ways, a boon – as long as you're careful not to get anything much more serious than a cold or flu.

Doctors' visits are cheap; hospitalization is free. But you get what you pay for. There are excellent doctors in Norway – but there are also mediocrities and outright incompetents who in the U.S. would have been stripped of their licenses long ago. The fact is that while the ubiquity of frivolous malpractice lawsuits in the U.S. has been a disgrace, the inability of Norwegians to sue doctors or hospitals even in the most egregious of circumstances is even more of a disgrace.

Physicians who in the U.S. would be dragged into court are, under the Norwegian system, reported to a local board consisting of their own colleagues – who are also, not infrequently, their longtime friends.

(The government health system's own website puts it this way: if you suspect malpractice, you have the right to “ask the Norwegian Board of Health Supervision in your county to evaluate” your claims.)

As a result, doctors who should be forcibly retired, if not incarcerated, end up with a slap on the wrist. When patients are awarded financial damages, the sums – paid by the state, not the doctor – are insultingly small.
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Take the case of Peter Franks, whose doctor sent him home twice despite a tennis-ball-sized lump in his chest that was oozing blood and pus – and that turned out to be a cancer that was diagnosed too late to save his life. Apropos of Franks's case, a jurist who specializes in patients' rights lamented that the Norwegian health-care system responds to sky-high malpractice figures “with a shrug,” and the dying Franks himself pronounced last year that “the responsibility for malpractice has been pulverized in Norway,” saying that “if I could have sued the doctor, I would have. Other doctors would have read about the lawsuit in the newspaper. Then they would have taken greater care to avoid making such a mistake themselves. But doctors in Norway don't have to take responsibility for their mistakes. The state does it.” After a three-year legal struggle, Franks was awarded 2.7 million kroner by the Norwegian government – about half a million dollars.

Another aspect of Norway's guild-like health-care system is that although the country suffers from a severe deficit of doctors, nurses, and midwives, the medical establishment makes it next to impossible for highly qualified foreign members of these professions to get certified to practice in Norway. The daughter of a friend of mine got a nursing degree at the University of North Dakota in 2009 but, as reported last Friday by NRK, is working in Seattle because the Norwegian authorities in charge of these matters – who have refused to be interviewed on this subject by NRK – have stubbornly denied her a license. Why? My guess is that the answer has a lot to do with three things: competence, competition, and control. If there were a surplus of doctors and nurses instead of a shortage, the good ones would drive out the bad. Plainly, such a situation must be avoided at all costs – including the cost of human lives.

Then there's the waiting lists. At the beginning of 2012, over 281,000 patients in Norway, out of a population of five million, were awaiting treatment for some medical problem or other. Bureaucratic absurdities run rampant, as exemplified by thisAftenposten story from earlier this year:

Japan....

Medical services in Tokyo area in danger of collapsing | The Japan Times

Medical services in the Tokyo metropolitan area are facing a serious danger of collapse as hospitals affiliated with private medical universities and private universities’ medical schools, the key players in the region’s medical services, are finding it increasingly difficult to make ends meet.

These institutions, long beset by higher labor costs than in other parts of the country, have been hit hard by the increase in the consumption tax from 5 percent to 8 percent in April last year. While they now have to pay higher taxes when purchasing pharmaceuticals and medical equipment, they cannot pass that incremental cost on to patients or health insurance associations. This is because medical services are exempt from the consumption tax, so patients and health insurance associations are not required to pay it.



Not all smiles



Like other service industries in Japan, there are cumbersome rules, too many small players and few incentives to improve. Doctors are too few—one-third less than the rich-world average, relative to the population—because of state quotas. Shortages of doctors are severe in rural areas and in certain specialities, such as surgery, paediatrics and obstetrics. The latter two shortages are blamed on the country's low birth rate, but practitioners say that they really arise because income is partly determined by numbers of tests and drugs prescribed, and there are fewer of these for children and pregnant women. Doctors are worked to the bone for relatively low pay (around $125,000 a year at mid-career). One doctor in his 30s says he works more than 100 hours a week. “How can I find time to do research? Write an article? Check back on patients?” he asks.

 

[shockedcanadian]

Socialism. Single payer healthcare and the like, is not the answer. I assure you, two-tier, or multi-tier systems within the free market is the answer. Let's face it, in almost all exchanges of goods and services, the free market is the answer.

One final thought. There are people recommended to see specialists here in Ontario. Be it a knee specialist or a back specialist. The wait times, again can be in the two month to "many" month frame and you have to be recommended by a doctor, you can't just call up a specialist and say, "I'd like to make an appointment".

In the free market, this simply doesn't happen, right? Money talks. As it should.

 

[yiostheoy]

If you are not already paralyzed by a back injury then there is no hurry with this.

it's not like an appendicitis where you only have about 10 hours to live if they don't take it out right away.

Huh? The Meniscus is in her knee, she has a potential tear in her knee not her spine.

That's even less important.

Just get a cane.

 

[task0778]

Most Canadians live near the US border, close enough so if they're wealthy enough they can go across the border and get specialized tests and treatments here. Even so, the Canadians still have long wait times for some health problems that require more than primary care can do.

 

[task0778]

Hope your wife gets better soon.

Thanks Jake, that makes three of us.

Make that four. And no doubt many more around here.

 

[depotoo]

You seem to have an answer for everything, and none well thought out, and no empathy. Must suck...

If you are not already paralyzed by a back injury then there is no hurry with this.

it's not like an appendicitis where you only have about 10 hours to live if they don't take it out right away.

Huh? The Meniscus is in her knee, she has a potential tear in her knee not her spine.

That's even less important.

Just get a cane.