I have a lot of information about my primary care physician (GP to British readers). Because the private insurance company publishes it, I’m aware of what university she attended, what degrees she has and I even know her hobbies. But we’ve never actually met.
There have been many trips to see the doctor over the past year that I have lived in Los Angeles, but I’ve never managed to get an appointment with the US equivalent of my GP when I needed it, instead being directed to the equivalent of a locum. The shortest waiting time offered to see my designated doctor was five weeks. Otherwise it’s been over two months. And that’s after I’ve forked out hundreds of dollars every month in insurance premiums – plus up-front cash fees equivalent to £20 and £35 for each visit and referral.
In the UK, there are certainly plenty of reports about how overstretched and underfunded GP and A&E services are. Who knows how bad things will get for the health service under the Tories, not least, its rush to privatise. But when I was in England I never had to wait anywhere near as long to get an appoitment with my GP as here in the US. It’s fine to see an alternative practitioner sometimes but there is a real value to the continuity of care that comes from seeing the same doctor – and within a reasonable time frame. Anything that undermines this is bad for all concerned.
When it comes to healthcare – primary or otherwise – waiting times are never far from public consciousness, especially in the UK where targets are built into the system and fluctuations or strains on access regularly hit the headlines. NHS waiting times have also been a bit of an obsession for commentators in the US over the years, most notably when president Obama began rolling out reforms that led to 30 million more Americans gaining access to health insurance as a result of the Affordable Care Act. Some of the US media’s more ideological outlets on the right have relished using exaggerated or inaccurate statistics about NHS waiting times to scaremonger against “socialised” medicine – whatever that is – and it has led many people in the US to view provision in the UK as inferior.
That the two countries’ health systems differ in many and complex ways is a given. For one thing, the US system’s per capita spending in 2011 was $8,508 (£5,425) compared with the UK’s $3,405 (£2,171). But, bearing in mind how important waiting times are to people (including those peddling false stats), it is genuinely interesting to see how they stack up. There are no centralised statistics for waiting times in the US but that doesn’t mean there isn’t data out there – including some comparisons with other countries showing that plenty of Americans wait quite a while to be seen. For example, the consulting firm Merritt Hawkins, which regularly tracks how long people in 15 major US cities wait for non-emergency appointments across five different specialties, including primary care, found wide disparities between specialties and between locations. In the city of Boston it took on average 66 days – more than two months – to get an appointment to see a family doctor.
In 2013, the healthcare foundation The Commonwealth Fund examined waiting times across 11 countries, including the US. It reported that in the US a quarter of adults surveyed (26%) said they waited six or more days for primary care appointments “when sick or needing care”. The figure for the UK was just 16%. The US also underperformed on same-day or next-day appointments compared with the NHS – 48% access versus 52%. According to Robin Osborn, a researcher at the foundation, longer-term comparative trend data over a decade (2003-2013) shows “dramatic” improvements in the NHS on waiting times, including for specialists.
It is sensible to apply some caution when comparing markedly different health systems. For example in the US if you have an expensive, top-tier insurance policy (and many people do) you are likely to have a lot shorter wait than people with cheaper policies, or indeed those in other countries. However I have what would be regarded as a pretty good policy in terms of US private health insurance, and my own experiences on waiting times are markedly worse than under the NHS. So, assumptions that private systems automatically translate to greater efficiency and shorter waiting times for the majority are simply unconvincing and need to be assiduously challenged.