One of the weird quirks of the American medical system is that, for all our consumerist ethos, it's not very convenient. If you've got money, you can get very good treatment, but compared to Western Europe, you have notably less flexibility in who your HMO will let you see, or when you can pop into primary care. Part of that trend is an absurd over-reliance on emergency rooms which, after 5PM, become the only place you can still obtain medical advice. So rather than being reserved for trauma and pneumonia, little Julie's young parents rush her into the ER because she's got the sniffles, everyone waits around for five hours, and someone really does get sick, because hanging out in the ER isn't particularly sanitary. It doesn't have to be that way:
Forty percent of U.S. primary care doctors said they had arrangements for after-hours care, according to the survey of more than 6,000 physicians in seven countries. That compared with 95 percent in the Netherlands, 90 percent in New Zealand, 87 percent in the United Kingdom, 76 percent in Germany and 47 percent in Canada.
The study, published online by the journal Health Affairs, also found that the United States trails other countries in adopting electronic medical records and computerized systems to remind patients about follow-up care, prompt physicians to give patients test results and warn of potentially harmful drug interactions. It found that primary care doctors in America were less likely to have financial incentives to improve the quality of the care they provide.
"Although the U.S. pays more for health care than any other country, we are under-investing in our primary care system," Karen Davis, president of the Commonwealth Fund, the foundation that sponsored the survey, said in a statement. "Other countries have made high-quality primary care a priority by putting into place the financial and technical systems that support access to, and delivery of, such care."
As a country, we've invested an enormous amount in trauma care, which is used comparatively rarely and is astonishingly expensive. We've done comparably little, however, for the first line responders, the primary care givers, the nurses and NPs and physicians who handle the most frequent complaints. And because of that, our trauma structure, the emergency rooms, has had to pick up the slack, degrading their performance, uselessly increasing their volume, and harming everyone's health.
And yes, Canada sucks too. They suck at half the cost, but since someone will doubtlessly bring it up, let's just get it out of our systems now.