4 ms·

You do not have to look at healthcare systems as a package. Each incorporate good and bad ideas that can be studied separately. I think overall the article was

You do not have to look at healthcare systems as a package. Each incorporate good and bad ideas that can be studied separately. I think overall the article was quite lacking in discerning the features of each healthcare system, especially considering that each is its own market with different market dynamics. For example the way each system delivers primary care is quite different. In some systems, GP visits are free but very bureaucratic. You have to make an appointment a week in advance. Does not matter if your appendix is bursting. If you go to the ER they will send you to get a referral from an emergency GP clinic. In other countries GPs are just private clinics and it works just fine without any insurance. I particularly do not like how employment is sometimes intertwined with health insurance. It is just a bureaucratic mess.

timr 9y ago
"In some systems, GP visits are free but very bureaucratic. You have to make an appointment a week in advance. Does not matter if your appendix is bursting. If you go to the ER they will send you to get a referral from an emergency GP clinic." These systems seem to exist primarily in the minds of conservative Americans. In years of traveling and living abroad, I have yet to encounter anyone who lives under one. I'm not saying that they don't exist. I'm just saying that they're most commonly encountered on Fox News.
- mikeash 9y ago
  I'll go ahead and say they don't exist. There are countries where the ER will kick you out if you can't pay, but none which require you to get an appointment a week in advance for a life-threatening emergency.
RobertoG 9y ago
Please, tell us where is that system where you have to wait a week even "if your appendix is bursting".
michrassena 9y ago
Which systems require you to get an appointment even in an emergency? I definitely want to avoid those countries when traveling if possible.
- FireBeyond 9y ago
  Well, tangential to this? The US may not require appointments, but US insurers will find themselves in the media on a regular basis for such gems as: "car accident victim flown to hospital denied insurance coverage because the flight wasn't pre-authorized"
martinald 9y ago
Not how it works in the UK at least. Go to ER even for the most mindnumbingly minor thing and you will be seen at ER, though you'll be triaged right to the back of the queue. Waits for GP appointments can be longer, but they all have slots open first thing in the morning if you need to be seen same day for something urgent. The US is by far the most bureaucratic system imo. So much time and money spent on billing, collections, insurance administration, etc. I genuinely do not think there is a single country in the world that would send someone out of ER if they had an appendix bursting. Not sure how you could actually believe that was the case.
gerdesj 9y ago
In the UK you have several options: If you are not sure and need some advice, you can ring 111 - they may direct you to A&E. If it is an emergency you ring 999 (which coves all emergency services. You can present yourself to the nearest A&E (Accident and Emergency) if you are able to get there on your own. GP visits do generally require an appointment and you may need to wait for some days. Prescriptions: Flat fee of less than £10 per prescription. There are many medical and means tested exemptions. NHS Dental Care can be hard to find but is generally available with a three tier flat fee structure for a full treatment not per visit, again loads of exemptions. Eg ~£56 for an extraction or root canal. Some anecdotes: A few years ago I had a wisdom tooth problem that hit on the weekend which is out of hours for dentists. I rang 111 and was referred across county (40 min drive). The tooth was extracted within 20 mins of me arriving. I don't remember whether I even had to pay but if I did then it would have been £50. If I'd been on benefits - no charge. A few weeks ago I fell in my garden and hurt some ribs. It bloody hurt. To be on the safe side I went to A&E. 20 mins later I was triaged to the front of the queue and X rayed etc. Three hours later (I was obviously non crit) I was seen by a doctor and then discharged. About eight years ago (very long story short) my dad was flown by helicopter from Exeter RD&E Hospital after a couple of weeks of stay to the Royal Brompton in London because the best cardiac surgeon for what he needed was based there. After a couple of months of care, surgery and recovery, his ticker is still going. Cost of care? who knows? A lot in six figures. It cost me a fortune in bus fares visiting the old boy. I have many more but that gives you some idea. We habitually whinge about the NHS (OK: everything) here in the UK about waiting times but when the shit hits the fan - it is always there to pick you up and stick you back together.
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timr 9y ago

"In some systems, GP visits are free but very bureaucratic. You have to make an appointment a week in advance. Does not matter if your appendix is bursting. If you go to the ER they will send you to get a referral from an emergency GP clinic." These systems seem to exist primarily in the minds of conservative Americans. In years of traveling and living abroad, I have yet to encounter anyone who lives under one. I'm not saying that they don't exist. I'm just saying that they're most commonly encountered on Fox News.

mikeash 9y ago
I'll go ahead and say they don't exist. There are countries where the ER will kick you out if you can't pay, but none which require you to get an appointment a week in advance for a life-threatening emergency.

RobertoG 9y ago

Please, tell us where is that system where you have to wait a week even "if your appendix is bursting".

michrassena 9y ago

Which systems require you to get an appointment even in an emergency? I definitely want to avoid those countries when traveling if possible.

FireBeyond 9y ago
Well, tangential to this? The US may not require appointments, but US insurers will find themselves in the media on a regular basis for such gems as: "car accident victim flown to hospital denied insurance coverage because the flight wasn't pre-authorized"

martinald 9y ago

Not how it works in the UK at least. Go to ER even for the most mindnumbingly minor thing and you will be seen at ER, though you'll be triaged right to the back of the queue. Waits for GP appointments can be longer, but they all have slots open first thing in the morning if you need to be seen same day for something urgent. The US is by far the most bureaucratic system imo. So much time and money spent on billing, collections, insurance administration, etc. I genuinely do not think there is a single country in the world that would send someone out of ER if they had an appendix bursting. Not sure how you could actually believe that was the case.

gerdesj 9y ago

In the UK you have several options: If you are not sure and need some advice, you can ring 111 - they may direct you to A&E. If it is an emergency you ring 999 (which coves all emergency services. You can present yourself to the nearest A&E (Accident and Emergency) if you are able to get there on your own. GP visits do generally require an appointment and you may need to wait for some days. Prescriptions: Flat fee of less than £10 per prescription. There are many medical and means tested exemptions. NHS Dental Care can be hard to find but is generally available with a three tier flat fee structure for a full treatment not per visit, again loads of exemptions. Eg ~£56 for an extraction or root canal. Some anecdotes: A few years ago I had a wisdom tooth problem that hit on the weekend which is out of hours for dentists. I rang 111 and was referred across county (40 min drive). The tooth was extracted within 20 mins of me arriving. I don't remember whether I even had to pay but if I did then it would have been £50. If I'd been on benefits - no charge. A few weeks ago I fell in my garden and hurt some ribs. It bloody hurt. To be on the safe side I went to A&E. 20 mins later I was triaged to the front of the queue and X rayed etc. Three hours later (I was obviously non crit) I was seen by a doctor and then discharged. About eight years ago (very long story short) my dad was flown by helicopter from Exeter RD&E Hospital after a couple of weeks of stay to the Royal Brompton in London because the best cardiac surgeon for what he needed was based there. After a couple of months of care, surgery and recovery, his ticker is still going. Cost of care? who knows? A lot in six figures. It cost me a fortune in bus fares visiting the old boy. I have many more but that gives you some idea. We habitually whinge about the NHS (OK: everything) here in the UK about waiting times but when the shit hits the fan - it is always there to pick you up and stick you back together.

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