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High earners jump surgery queue: study

Vivian Tse · 3 Feb 2011, 12:24

Published: 03 Feb 2011 12:24 GMT+01:00

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In addition, wait lists for orthopaedic surgery are 27 percent shorter for the higher income earners, according to a doctoral thesis written by health economist Gustav Tinghög of Linköping University.

Tinghög used all of central Sweden's Östergötland county council's 4,634 wait lists in 2007 for his research, comparing the wait times of the patients to their socioeconomic backgrounds.

"We find unequal access in many aspects of society, such as queueing for an apartment, so we would be surprised not to see different queue times in health care. We thought we would find more inequality in access, but there is none in gender."

However, there was not a discernable difference in cardiology, gynaecology, urology and ophthalmology, nor did there appear to be discrimination due to ethnicity or gender.

"I haven't explicitly investigated why, but I have a theory. Those areas have shorter waiting times. Orthopaedic and general surgery are the specialisations with the longest waiting times," he said.

"With shorter waiting times, one can prepare family and work ahead of time, while some don't want to have surgery right away, so they aren't as active in getting the surgery," Tinghög added.

However, once the waiting time is longer than 100 days, the urgency elevates and patients attempt to "manipulate" the system, according to Tinghög.

"They know who to talk to, they have connections, they know what chord to strike to get priority. That's a possible explanation, I'm not saying that is the case," he said.

"They're in contact with the doctors and adminstrative personnel. The patient might be more powerful and equipped to know how the system works. These are issues, i'm just speculating," he added.

Tinghög noted that it is unavoidable that certain patients will be prioritised within the public system. The title of Tinghög's thesis is "The art of saying no."

One area Tinghög analysed was whether certain areas of health care should be paid for publicly or privately.

"It is not always crystal clear right now on what grounds it should take place. Glasses, for example, we pay ourselves, while the county council is responsible for hearing aids," he pointed out.

He also analysed the issue of responsibility, questioning whether obese individuals and smokers should pay for own care despite consciously contributing to their problems. Tinghög believes it is ethically difficult to retroactively impose such demands.

However, high tobacco taxes on tobacco or expensive insurance for risky activities as deep sea diving also prevent certain behaviours and lifestyles, he noted.

Story continues below…

Tinghög also covered organ donation, proposing a high level of financial compensation to entice more individuals to donate their relatives' organs.

"It is very repugnant that we should pay or exchange money for bodily parts. I'm not sure these rationales are based on reasons, they're more emotional. It's my job to questions these kinds of emotions," he said.

"I don't see any reason why we can't pay deceased donors or families to increase the level of organ donations. If we can get more people to donate, we will avoid immense amounts of suffering," he added.

Instead, people travel to poor countries to buy organs where there is a lack of professional health care to help the donors if they have problems later.

Tinghög is one of four graduate students funded by Östergötland county council to research the effects of priority lists for health care services introduced in the autumn of 2003, a move which generated a heated ethical debate at the time. He will defend his dissertation on Friday.

Vivian Tse (vivian.tse@thelocal.se)

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Your comments about this article

14:27 February 3, 2011 by Taxlady
If wealthier people pay more taxes,than low earners and welfare bums, why shouldn't they have a shorter waiting time than low income earners? After all they put more money into the system which indirectly subsidizes all the others who suck off the system including asylum seekers, refugees and the like.
14:29 February 3, 2011 by UScitizen
If I need any surgery, I go back to my doctors in America. No wait times at all. Right now, I'm waiting for a call from a dental specialist here. The regular dentist said they would call me to set up an appointment "sometimes within the next eight months." I guess I'm in the lower financial group.
14:49 February 3, 2011 by miss79
i never bother about that...queing late or not as long i get to see a doctor, thats enough..even i am working..be thankful for wat we have..
14:56 February 3, 2011 by Rick Methven
"Tinghög is one of four graduate students funded by Östergötland county council"

This is a crap thesis from one our local nut jobs who is being funded by MY tax money to do this study.

In essence he has found nothing concrete and started a new hypothesis which he hope will fund him for the next 5 years.

He makes statements like

"I haven't explicitly investigated why, but I have a theory "


"They know who to talk to, they have connections, they know what chord to strike to get priority. That's a possible explanation, I'm not saying that is the case,"

So after throwing around aspersions that 'some' people pull strings to jump the queue, he will now ask for more funding to do nothing for another 2 or 3 years to produce yet another theory and then...
15:03 February 3, 2011 by Syftfel
How many of these "high income earners" are in fact politically connected party hacks, and union honchos, tethered to the social democratic party? The story, as usual, is short on detail but I would really like to obtain a more fine tuned breakdown of these "high income earners". Hence, right now it's not easy to form an educated opinion.
15:29 February 3, 2011 by Rick Methven
"connected party hacks, and union honchos, tethered to the social democratic party? "

If they are Social Democrats around here nowadays, they would most probably be sent to the back of he queue
18:16 February 3, 2011 by Great Scott
This is just more signs along with child poverty and high unemployment, that Sweden is going to the dogs. If Sweden's right wing conservative government continues, Sweden will then be for the few.

The people that support this kind of party should get wise and see how they are being manipulated.
19:35 February 3, 2011 by reason
Off the top of my head I can see one obvious explanation for the results that is not covered in the article. Rather than "pulling strings" and manipulating the system, I find it very likely that a high income earner might use some of that income to seek private care if the wait for public care is too long. Thus the only high income earners who actually use public care would be those lucky enough to get a short wait time (and those too cheap to spend their money on their own health). Abracadabra! Discrepancy explained without accusing anybody of cheating.
20:52 February 3, 2011 by mojofat
People don't like waiting in line and will find ways around it if possible...shocking news I say...shocking!
23:50 February 3, 2011 by genova

completely agree
00:52 February 4, 2011 by laura ka baal

asylum seekers, refugees and the like=future citizen of sweden, who pays so muck tax that even you are born three times you wont be able to complete with one immigrant, be greatful to these asylum seekers, refugees and the like.
08:22 February 4, 2011 by BarCode
"All animals are equal, but some animals are more equal than others"

09:03 February 4, 2011 by RobinHood
Yet another poorly conducted survey with dubious and unsupported conclusions.

Previous rubbish includes: Sweden has the highest proportion of rapes in the EU, and one in ten Swedish children lives in abject poverty.

Keep them coming guys, even if those that actually live in Sweden don't believe them, we love to marvel at your stupidity.
09:35 February 4, 2011 by Nemesis
If you have connections in Sweden you get faster treatment. Social Democrats is fastest for that one, with moderates coming a close second.

It is the same in every country.

Ireland, Greece, Spain, Portugal, Iceland, UK, Italy and Sweden are all the same, in that regard.

Anyone who has not realised that, would have to have been living under a rock for the last 50 years.
10:50 February 4, 2011 by MarSi
"They're in contact with the doctors and adminstrative personnel. The patient might be more powerful and equipped to know how the system works. These are issues, i'm just speculating," he added.

Yeah, tell me about it... I'm really surprised that nobody has been mentioning, what this so called "equipment" consists of. Money, money, money. It's taboo subject thought, because "nobody in Sweden bribes":))) It's clear as a water according to this funny study, that it happens through a bribe
10:54 February 4, 2011 by Rick Methven
It has nothing to do with political clout but top up private insurance. In the major University hospitals such as Linköping where this so called study was carried out, there are a lot of specialists in most departments who work in both the public and private sector and just like in most other countries they reserve or make time for patients who pay more.

I have a friend who was a sportsman for many years which took its toll on his legs and especially his knees. He took out a medical insurance policy when still playing and now has had a lot of expensive treatment at both the local hospital and in Stockholm. He gets treated alongside everybody else and may even be in a public ward but his insurance company pays a higher fee for priority treatment. In most cases anybody can get quicker specialist treatment.

I have an ear complaint as a result of a flying accident. When it flairs up, I can go to the hospital ENT department pay 100kr and wait or I can go to the specialist ENT clinic, pay 250kr andsee the head honcho quickly.
13:51 February 4, 2011 by Kevin Harris
"Doctor I'm very rich, can I have an earlier appointment?"

"Yes of course, I'll put you down for next Monday then."

Never fails.
17:20 February 4, 2011 by T Murphy
So is this what we're in for when ObamaCare ramps up?
17:29 February 4, 2011 by RoyceD
@taxlady, why should paying more taxes mean you get the healthcare you need before someone else who pays less tax but needs the help more?
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