Saturday, August 05, 2006

A cautionary tale 

Oh that darned Canadian medicare -- just so inefficient and bureaucratic!
I can hardly wait until some Canadian politician privatizes medicine again so Canadians can also get service like this:
. . . Kaiser is a very large and old HMO, with a huge presence in the Bay Area and northern California . . . in 2002, a transplant surgeon . . . proposed to Kaiser that it could save money, and increase the utilization of its hospitals’ surgical capacity, by bringing the kidney transplant program in-house . . . As of mid-2004, Kaiser patients on the waiting list were informed that they would no longer be covered for transplants at UCSF or UC Davis, though they were free to go ahead and have them if they could come up with the money (roughly $100,000) . . . then Kaiser completely screwed up the program . . . [the Kaiser patients] looked like new names on the list, and so all of their accumulated waiting time, one of the main determinants of priority, would vanish . . . Losing seniority on the transplant lists wasn’t the only problem. Kaiser did very few transplants, compared to the number of organs which were available . . . in part because of what seems to have been mis-placed perfectionism or caution. These combined to the point of repeatedly turning down “zero mismatch” kidneys, ones where the likely compatibility over-rode considerations of seniority. This happened several dozen times at least — twice for one patient alone. Again, needless to say, patients weren’t told about this. In a “it’s not a bug, it’s a feature” moment, Kaiser initially attempted to defend its program by pointing out how few patients had died after transplants — since they’d done so few . . . In most kidney transplant programs about twice as many patients receive transplants as die while waiting; Kaiser managed to reverse that ratio . . .
So if anyone is thinking that privatized health care invariably results in efficient, top notch service to everyone who pays their premiums, think again.

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