Chicago Tribune:Oversight patchy as sleep centers proliferat

[howkim]

http://newsblogs.chicagotribune.com/tri ... ation.html

[OwlCreekObserver]

I've wondered how long it will be before we see some sleep lab director doing the perp walk in handcuffs. As fast as new labs are opening up, it probably won't be long.

OCO

[packitin]

They should all be accredited. If not, no doctor should recommend one.

Also, the home sleep study technology should be improved to the point that it determines as much information. I don't think we are far off now.

Also, why are they (the clinical sleep lab tests) so high? When I went the last time, one person was monitoring 6 sleep rooms. So he was doing all the monitoring, watching the film (presumably), and supervising the entire operation. So six people pay $20,000 for one night. Why so much? Does it cost that for all the expensive equipment? That's conservatively 5 trillion a year paid to one sleep lab. I don't get it. Multiply that by all the sleep labs. Now we see why health care is so expensive.

If it weren't for members of my family telling me I had a sleep problem, I would never have gone (to a sleep lab).
I wonder how many persons went because of their doctor (maybe good for a poll sometime).

Jay

[apnez]

Americans have the most expensive and one of the less efficient health system in the world.

You are spending nearly 20% of your GDP for health care (which is a terrible burden for the individual and corporations and one of the reason of the American bankruptcy- check the US$ who lost already half of its value within 5 years and more to come!). This is to be compared to the other great occidental nations like France, Germany, U.K. Japan, Canada etc... who only spend 10-12% of their GDP.

Half of the 20% spent in USA is pure profit or administrative costs which reduce the real money spent for health to something between 8-10% of GDP.

Other health systems in occidental countries (most of them are public non profit) have a 4-6% administrative costs and profit. They really spend about 9-11% of their GDP for health services. As a matter of fact more real money goes to health services in those countries than in USA. And they get the best results, the American health system generally "cruise" in the 10-25 level as far as health indicators are concerned.

Moreover the American system is not equally accessible to American citizens with more or less difficulties for about 75% of them, 40% of them are not covered or barely covered. Everyone knows that health accessibility is more difficult to black people, elderly people, un married women etc...

If we take into consideration the reality of sleep apnea clinics it is more than obvious that this is a business with money as the top priority, run by a majority of non competent technicians and doctors. Prices are unbelievable and absolutely not related to the reality of costs.

Good luck!

[Catnap]

I looked at the accompanying article on sleep centers and saw that U of C offers a "streamlined" study where patients spend half the night being diagnosed, half the night on a CPAP machine, and then take the machine home in the morning. What a great way to do it! I went almost two months between initial testing and diagnosis of OSA to finally having a machine. Once I knew I had OSA, I was so frustrated that I kept having to go to bed every night worrying about it while the wheels of the medical establishment s-l-o-w-l-y turned.

[Slinky]

I've wondered how long it will be before we see some sleep lab director doing the perp walk in handcuffs. As fast as new labs are opening up, it probably won't be long.

OCO

Probably a long time - there's so much fertile ground for prosecution of the crooks on Wall Street .... Dade count, FL "is" cracking down on the local DME suppliers tho ...

[Plowboy]

Moreover the American system is not equally accessible to American citizens with more or less difficulties for about 75% of them, 40% of them are not covered or barely covered. Everyone knows that health accessibility is more difficult to black people, elderly people, un married women etc...

I personally work with several African Americans, single women, and "elderly" people who have excellent medical care in the US. I also work with several Canadians on green cards who will swear by the American system as opposed to the socialized system in Canada. When you make claims based on data from the left wing news sources that it seem most non-US citizens go by you get a very skewed sense of what goes on here. Are the pharmaceutical companies corrupt? Yes. Is there to much administration within the medical communities? Absolutely. Do I have to wait 6 months to see a specialist in this country? Hell no!! The current system needs some work but I for one as a US citizen do not want socialized health care.

[Slinky]

Nor do I. I've never known government to do ANYTHING efficiently!!!

[dowen]

Americans have the most expensive and one of the less efficient health system in the world.

apnez

How is the health care in Canada? I ask because down here when conservative politicians try to scare us away from implementing any kind of "government health care," they often cite Canada as an example of how bad government health care can be. They say there are lots of quality problems and rationing and you sometimes have to wait years for procedures. What's your experience with the Canadian system?

[carbonman]

Also, why are they (the clinical sleep lab tests) so high? Jay

It's the same as $3.00 for glass of ice tea in a resturant....

pure profit.

[Froro]

Americans have the most expensive and one of the less efficient health system in the world.

apnez

How is the health care in Canada? I ask because down here when conservative politicians try to scare us away from implementing any kind of "government health care," they often cite Canada as an example of how bad government health care can be. They say there are lots of quality problems and rationing and you sometimes have to wait years for procedures. What's your experience with the Canadian system?

Dowen. I can speak only for my own experiences.

I've never ever ever had a problem with wait times for critical issues, and if I do need to wait for a specialist it's never been for something urgent. If I've needed a specialist for an urgent care issue there has always been one available instantly. Do I have an issue with the way the whole sleep apnea issue is dealt with? YES, but it's about a lack of communication, not about lack of facilities, equipment, or wait times. I was in and out of sleep lab first time within days of the referral, and back immediately for titatration.

I've had to wait to get into a new obgyn as mine retired and the new doctor was only seeing obstectrical patients. Again...it's nothing urgent so I'm fine with waiting. If there was an urgent matter I would have been in already. There are wait times for hip/knee replacements and patients are seen in order of need, not necessarily in order of appearance. I've heard of people needing to wait for MRI's but honestly have never met anyone who has had to. I think my longest wait for an MRI was a couple of days for a nonurgent issue.

Have people been bumped from heart surgeries? Sure. I'm sure the fellow who was scheduled for a bypass the day my dad fell into the ER was not amused, but turns out my dad was rushed in for emergency quintuple bypass. The fellow who was put on hold was not in as dire a need and got it done the next day.

The ONLY time I ever had a problem was once when my son was quite ill several years ago. This was more of a doctor issue though as opposed to an establishment issue. We were referred to Sick Children's from our local hosp, with scans in hand when our local hosp ER was concerned that he had chrone's disease. We could have stayed there but they thought it best we go to Sick Kids to ensure timely and more expertise. Our local hosp stayed in constant communication with me through what turned out to be a horrific ordearal. The doc in Emerg at Sick Kids was less than pleasant, condiscending, patronizing, did not even look at my son's scans and tried to send us home with literally a pat on the hand telling me not to come back. I didn't budge, insisted on seeing a gastrointerologist and made a phone call to a friend who is well connected at the hosp. The ER doc was even less than amused with me at this point. The gastro doc literally blinked at the scans and said there was nothing wrong with my son. (The fact that he had been in the ER 6 days in a row at our local hosp in agony meant nothing). At that point I threw up my hands knowing we could go back to our original hosp. The ER doc again gave me a little pat and told me not to come back now dear. I left angy, frustrated and with a kid who was still in agony and sick, and scared.

No sooner did I get home did I get a call from a surgeon at Sick Kids who had come down to check my son (after my phone call) to find him discharged. He insisted I come right back and to his office. He took the lead and ordered numerous tests/diagnostics for my son immediately. While it was a struggle to figure out what was going on with him we finally got to the bottom of it and he has a very very rare blood disorder. Through all of this though, I had written a letter to the president of the Hosp, and the medical board over the ER doctors actions. She was reprimanded, I was sent official apologies across the board, but it wasn't quite over. My next visit to our pediatrician proved what a small world it can be and I was again summarily admonished for being neurotic (which I never have been with the kids stuff, (other than head injuries which I've always stated up front since day one with our doctors that I would be, I've actually been told generally I'm a little too laid back and wait a little too long before bringing them in for things, by this same doctor). Our pediatrician was associated with Sick Kids, and felt I was too harsh, and wrong (which obviously I wasn't considering the diagnosis). What did I do....walked out of his office, said thank you very much but we would no longer be requiring his services. I had a new pediatrician lined up with hours, who has since retired, but now have a wonderful family doctor.

That has been my only issue. (The same son is the one with the head injury at the moment and while he should not have been released from the ER on that first night, truth is, we live about a minute drive from the hosp, and they did tell us to bring him back immediately if his condition worsened, and I was given very specific instructions with a letter on what to look for)

We don't use the ER unless it's an actual emergency so we've never had long waits when there. Never had to wait for care for anything we've ever needed. My parents are in a small community and I grew up there, and can't say we've ever had to wait for anything either. Has my dad travelled for some of his heart stuff? Yup, is it because of lack of doctor or facility? Nope...he just can't stand the surgeon on a personal level and would rather go elsewhere.

Do some people run into issues with the healthcare system here? Yup, but for every tale of woe you hear from here, realize that we hear just as many if not more from the US side of the border. Are some areas underserviced? Yes, but does every small town in the US have specialists from every field working in it? Somehow I doubt it. Are there improvements that can be made? Of course, but that's just the way it is. Do some travel to the US for treatment? Yup, but there are also others who travel to Canada from around the world for treatment at specialized hospitals here.

[-SWS]

Americans have the most expensive and one of the less efficient health system in the world.

Be prepared to back up your controversial statements with facts, sir...

Do you have any proof whatsoever there are less efficient systems out there?

[lanndi]

Americans have the most expensive and one of the less efficient health system in the world.

apnez

How is the health care in Canada? I ask because down here when conservative politicians try to scare us away from implementing any kind of "government health care," they often cite Canada as an example of how bad government health care can be. They say there are lots of quality problems and rationing and you sometimes have to wait years for procedures. What's your experience with the Canadian system?

I can speak only for my own experiences.

Do some people run into issues with the healthcare system here? Yup, but for every tale of woe you hear from here, realize that we hear just as many if not more from the US side of the border. Are some areas underserviced? Yes, but does every small town in the US have specialists from every field working in it? Somehow I doubt it. Are there improvements that can be made? Of course, but that's just the way it is. Do some travel to the US for treatment? Yup, but there are also others who travel to Canada from around the world for treatment at specialized hospitals here.

No system is perfect. You can always find examples of people who have horrible experiences and those who have great stories to tell in every country. Thanks for sharing what Canadian healthcare is like for most people.

[dowen]

...We don't use the ER unless it's an actual emergency so we've never had long waits when there. Never had to wait for care for anything we've ever needed. My parents are in a small community and I grew up there, and can't say we've ever had to wait for anything either. Has my dad travelled for some of his heart stuff? Yup, is it because of lack of doctor or facility? Nope...he just can't stand the surgeon on a personal level and would rather go elsewhere.

Do some people run into issues with the healthcare system here? Yup, but for every tale of woe you hear from here, realize that we hear just as many if not more from the US side of the border. Are some areas underserviced? Yes, but does every small town in the US have specialists from every field working in it? Somehow I doubt it. Are there improvements that can be made? Of course, but that's just the way it is. Do some travel to the US for treatment? Yup, but there are also others who travel to Canada from around the world for treatment at specialized hospitals here.

Froro

Sounds pretty good to me. Thank you for your detailed reply. I had a hunch that some of our politicians were greatly exaggerating the flaws in the Canadian system in order to scare us.

Biggest flaw in the US system IMO: people who need insurance the most are often denied it because insurance companies don't want people with pre-existing conditions. And for typical middle class people, No insurance means we are just one major medical event away from spending the rest of our lives paying off a medical bills, or filing for bankruptcy, or simply being denied care. That is messed up if you ask me.

[BlackSpinner]

So far I have not met any of my canadian friends who have had issues with our health care. However I know several americans who due to getting cancer had to get divorced in order to get care without destroying the family home. My neighbour across the street where I used to live did not lose the family farm because his wife got cancer. My brother in law got sent to Buffalo at the expense of ontario medicare and his insurance so his lap band surgery could be done more quickly.
When Canadians get medical work done in the US we had better have extra travel insurance because we only get re-embursed the Canadian amount which can be 75% to 50% below the US rate so yes the price of your medical care is much higher. And Yes we do have excellent research facilities.

My personal experience with my apnea testing was that it took time to get referal, it took too long to get a test but it was free. The only thing I have had to pay for was my CPAP machine. All my tests are free.