So by now, in our quest with Academy Health, to fix the US health care system, we've talked about why wait times happen and how policy decisions shape them.

Now it's time to talk about. Well, the way we talk about them wait times as a political talking point.

That's the topic of this week's Healthcare Triage. If you've ever listened to a political debate, or let's be honest, if you scroll the internet for five minutes, you probably heard wait times used as a kind of rhetorical weapon. System X has terrible wait times.

System Y will cause terrible wait times. Wait times prove this whole thing is a disaster. And all of it sounds very confident, even though it's usually very wrong.

One of the biggest problems is that wait time sounds like a simple, obvious thing. Like we're all talking about the same number. We are not.

Wait times can mean a lot of different things. It could mean how long it takes to get a primary care appointment, or to see a specialist or get elective surgery. It could also mean how long you sit in a waiting room, how long it takes between a referral and actual treatment, or how long people delay care before they try to get in at all.

Those are all very different experiences, and they're measured in very different ways. If they're measured at all. There isn't one standardized definition that everyone uses.

So when someone says wait times are longer, somewhere, a very reasonable follow up question is for what exactly? Because you can absolutely have a system where it's quick to get a primary care visit, but slower for elective surgery or the reverse, or a system where wait times are shorter for people who can pay more, and effectively infinite for people who can't access care at all. That last one is important because the longest wait time is forever.

And that's the wait time for someone who doesn't seek care because of cost, or can't find a provider who takes their insurance. But does that show up in official wait time reports? Usually not.

Even though it's very much part of access. And isn't access the whole point of our obsession with wait times? So right away.

We're dealing with the metric that's fuzzy, inconsistent, and very easy to manipulate to prove a point. Which brings us to how it gets used in political conversations. Wait times are incredibly effective as a talking point because they're relatable.

Everyone has a wait time story, and because they're so relatable, they're easy to use as a stand in for an entire health care system, even though that's just ridiculous. Different sides of the political aisle will point to wait times in other countries, or even within the US, as evidence that a particular system either works or doesn't. Common refrain here in the United States is that we don't want to switch to a single payer system like Canada, because we'll be waiting months to see a doctor.

If you ever want to see me lose my mind in real time, bring that up within earshot of me at a dinner party. I'm practicing so much restraint right now. Those same systems, plural.

Because Canada's system is not the only other option outside the United States, often have policies in place to prioritize urgent care, and in many cases, people face fewer financial barriers to accessing services in the first place. So again, it's about trade offs, not a single, all encompassing measure of performance like wait times. On the flip side, discussions about the United States sometimes downplay wait times entirely, focusing instead on other strengths. as we've talked about, wait times exist here too, and they can be significant depending on the type of care and where you are. you end up with a situation where everyone is technically saying something that has some truth to it, but no one is really telling the whole story because it's all out of context You'll hear comparisons between countries that don't account for differences in how wait times are defined or measured, or differences in which services are included, or differences in how systems prioritize care.

It's a little like comparing airline specific flight delays, without specifying whether we're talking about regional and international airports flights out of Denver in the dead of winter, or just how long you sat on the runway with your low cost carrier questioning your life choices. All of those are real experiences. They're just not the same metric. just as flight delays are never as simple as which airline you choose, wait times are never as simple as which health care system you choose.

Wait times show up in all kinds of system, so when they get used as a political argument, they're often doing a lot more rhetorical work than actual analytical work. That doesn't mean wait times don't matter. They absolutely do.

Long delays can affect health outcomes, patient satisfaction, and trust in the system. That's real, and it's important. But if we talk about them in a way that's oversimplified or selectively framed, we end up making it harder to actually address the problem.

So what would better communication look like? For one, being more specific, instead of saying wait times are long, we can ask for what kind of care? For which patients?

Measured how? Compared to what? doesn't make for catchy soundbites, but it does make for a more honest conversation. Better communication would also mean acknowledging trade offs.

Expanding access can increase demand, and in some cases, waiting Reducing financial barriers might mean more people are in line. Prioritizing urgent care might mean longer waits for less urgent services. Those aren't failures, they’re choices, and that's how they should be discussed. most importantly, better communication involves recognizing that wait times are just one piece of the puzzle.

They sit alongside cost, quality, equity, and outcomes. So when you hear a sweeping claim about wait times in healthcare, especially in a political context, pause if we can be more precise, more honest, and maybe a little less dramatic about it, we might actually get somewhere useful. Academy health is all about making research matter, turning evidence into real world impact on health and health care.

That's exactly what Healthcare Triage is about, too. Breaking down the complex, sometimes messy health policy and research stories that affect all of us. Basically, we're tired of the nonsense.

And that's why we've teamed up to bring you this important series. Let's fight the nonsense together. We'd appreciate it if you'd like the video, subscribe to the channel down below.

Go on over to Patreon.com where you can help support the show. Make it bigger and better. We'd especially like to thank our research associates, Edward Liljeholm and Christopher Learn and of course our Surgeon Admiral Sam.