Mary began to experience abdominal pain, but ignored it for several months. When she finally told me, I said, “I’m your husband, go see your doctor.” She called the doctor’s office and after 40 minutes working her way through the confusing, circular, and interminable phone tree, she got the next available appointment — seven months in the future. When she finally did get in to see her primary care physician, the diagnosis was inoperable pancreatic cancer. Twenty-two months later, my college sweetheart and wife of 54 years died. Might things have been different if she had been seen two years earlier?
Everyone in the world knows of the Covid-19 pandemic. Few have heard about a health crisis that has killed millions with no fanfare at all: death by queue. My wife was likely a victim.
Death by queue is a phrase coined in the United Kingdom, where “queue” describes a line of people waiting for something. Death by queue refers to dying while waiting in line for care that is technically possible but unavailable when needed. Death by queue has long been a feature of the much-vaunted British National Health Service (NHS), which was the model for President Barack Obama’s Affordable Care Act (ACA). Recent reports note heart attack victims dying for lack of care-in-time from the NHS and calls for private physicians (those few who remain) to provide timely medical care because NHS (government) physicians cannot.
Americans also experience death by queue. However, since that pandemic is politically unpopular with Washington, the complicit corporate media ignore it.
Prior to Obamacare, average maximum wait time was already unconscionable: 92 days. With ACA expansion of government-provided, no-charge Medicaid insurance, maximum wait times increased to 120 days.
In Illinois over three years, 752 Medicaid enrollees died waiting for desperately needed medical treatment. An internal Veterans Affairs Department audit concluded that “47,000 veterans may have died” waiting in line for care that was technically possible but unavailable. Veterans are covered by government-provided Tricare insurance.
An accurate estimate of death by queue for all of the U.S. is not available. In Great Britain, at least “117,000 die[d] on waiting lists for NHS” in 2020 and 2021, according to The Evening Standard.
My wife, who may have been another death-by-queue victim, is certainly not unique. Numerous studies prove that delay in diagnosis of life-threatening conditions such as cancer leads to deaths that could be prevented. What is killing these patients are wait times to see the primary physician and begin the diagnostic process.
Causes of Long Wait Times
The death-by-queue pandemic is anathema to Washington because federal regulations are the primary cause for the long wait times. First there is the regulatory burden on providers. Time and money that should be spent on patients are consumed with regulatory and administrative requirements.
Second, there is “bureaucratic diversion,” when money is taken from clinical care to pay for bureaucracy, administration, rules, regulations, compliance, and oversight. Each dollar spent on these non-clinical activities is a dollar that cannot be spent on patients. Estimates of this expense range from 31 percent to 50 percent of all health care spending. The U.S. expended $4.3 trillion on its health care system in 2021. Thus, Washington took roughly $2 trillion away from patient care to pay federal (and state) minions who provide no care. Imagine how short wait times could be — can you say 48 hours?! — with an additional $2 trillion available to pay for patient care. Possibly my wife would still be alive.
For decades, Washington has been “fixing” health care with federal programs such as Medicare and Medicaid (both created in 1965), the Emergency Medical Transport and Labor Act of 1986 (which created health care’s unfunded mandate), the Health Insurance Portability and Accountability Act of 1996, and the ACA (2010). Prior to 1965, the U.S. expended 6.5 percent of GDP on health care. Last year, it was 19.7 percent. The end result of all Washington’s fixes and all that spending is what we have now: death by queue and impending bankruptcy.
Washington’s solution to our failing health care system is more of the same, exemplified by the health care provisions in President Joe Biden’s self-styled Inflation Reduction Act of 2022. Federal regulation is why Americans suffer from a pandemic of death by queue. If we want to shrink wait times and get to see the doctor before it’s too late, get Washington out of health care.
