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April 1, 1998

The Cost of Instant Access to Health Care

Author Affiliations

From the Institute for Health & Aging, University of California, San Francisco.

JAMA. 1998;279(13):1030. doi:10.1001/jama.279.13.1030

IN THIS ISSUE of THE JOURNAL, Bell and colleagues1 report a comparison of waiting times and charges for several well-defined and commonly used health care services in acute care hospitals in Canada and the United States. The authors conducted a telephone survey of 18 Canadian and 48 US hospitals in cities having a population of more than 500000 and inquired about the availability and cost to consumers for 7 diagnostic and therapeutic procedures (prothrombin time measurement, 12-lead electrocardiography, screening mammography, screening colonoscopy, magnetic resonance imaging of the head, a session of hemodialysis, and total knee replacement surgery), assuming that patients in both countries would be willing and able to pay out-of-pocket for such services. The authors found that compared with Canadian hospitals, US hospitals had significantly shorter median waiting times to obtain 4 of these services and had significantly higher median charges for 6 services.