Critics of the current health care reform efforts have consistently pointed to the longer wait times to see a specialist when one is ill in Canada or Europe, compared with the US (of course, for people with no health insurance at all, wait times are probably considerable here too). Jason Shafrin has written an interesting article about wait times to see a specialist in Europe, and the role that socioeconomic status plays. I tend to think of European health care delivery systems being much less influenced by money than our American system, so I was surprised by the results of the study he described – basically, more educated Europeans had significantly lower wait times to see a doctor than did their peers with less education.
Jason came up with several possible explanations, all of which are likely contributors to the disparity in wait times. I’m sure that a similar disparity is seen in America. People on Medicaid definitely don’t have access to as many doctors as people with private health insurance. The shortage of doctors who accept Medicaid is likely to lead to longer wait times for those individuals when they are ill. People who don’t have any health insurance at all are likely to wait much longer to visit a doctor than someone with health insurance, simply because they don’t know how they will pay for the care.
Another factor might be finding time to visit a doctor. A person with little education is more likely to be working at a low paying job (or three), often with no paid vacation or sick leave. Taking an afternoon off to visit the doctor in that case would result in lost pay and in some cases, the loss of a job. People with a high level of education are more likely to be working in jobs that offer more generous benefits and paid sick leave, allowing them to schedule a doctor’s appointment during their work day.
It was interesting – and a bit disheartening – to see that even in countries where everyone has health insurance, a lower socioeconomic status results in longer wait times to see a doctor when one is ill.
Jason’s article was included in the Cavalcade of Risk, hosted this week by Jaan Sidorov of the Disease Management Care Blog.