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You really really don't want to compare with the rest of the worlds universal coverage systems to the U.S.. Many places have way more significant wait times for

You really really don't want to compare with the rest of the worlds universal coverage systems to the U.S.. Many places have way more significant wait times for treatment... Canada: https://torontosun.com/2017/02/16/canada-has-worst-erreferral-wait-times-in-11-developed-countries-report/wcm/2f7966f0-0daa-4589-aba7-68e54e0a056e https://torontosun.com/2017/02/16/canada-has-worst-erreferra... Ireland: https://www.irishtimes.com/news/health/new-record-of-more-than-718-000-patients-on-waiting-lists-1.3628584 https://www.irishtimes.com/news/health/new-record-of-more-th... There's more, but lets get real. The U.S. system has it's problems, but at least I can get treatment. That's why it's a difficult subject and why we should be cautious on how to proceed. Perhaps run trials per state or something as well.

bertil 8y ago
> at least I can get treatment I’m assuming that you realise the singular first person in that statement is very much that: singular. > Let’s get real The New York Times sees “real” as under a Rawlsian veil: they imagine being any citizen. You seemingly disagree with that approach.
patmcc 8y ago
>>Many places have way more significant wait times for treatment... Canadian here - yep, there are sometimes wait times, especially for specialists, especially if it's something that is unpleasant but not urgently life threatening. That sucks. I'd still take that over some percentage of the population just not having access to care, or having a huge number of medical bankruptcies. As for the ER - it even says in the article you link, that's largely people who could have gone to their primary care physician. Those are the people waiting. If you go in with a stroke, you're not waiting. I've (luckily) never been to the ER for a life-threatening situation, but I have for injuries where I needed urgent care, and got excellent treatment - and yes, once I had to wait for the guy ahead of me who had a stroke. I'm ok with that.
- AlexandrB 8y ago
  > That sucks. I'd still take that over some percentage of the population just not having access to care, or having a huge number of medical bankruptcies. Yup. I'd rather wait 10 hours in ER for something non-life-threatening than get immediate care and spend the next 10 weeks fighting with insurance companies or filing for bankruptcy.
asnrk 8y ago
Since most of the other OECD states are representative democracies of one sort or another, and since pretty much all of them have some form of universal health coverage, if the US system's an improvement over any of those in other OECD states, I expect there are strong, popular reform movements in at least some of them looking to move their system closer to that of the US. Right? Not to improve their systems in other ways, but specifically to move closer to that of the US. Since that'd be a clear improvement if they just "get real".
- moorhosj 8y ago
  I’ve raised this exact question and never seen an honest response. Why aren’t politicians in other OECD countries trying to make their system more like ours? Why aren’t their citizens demanding it?
taoistextremist 8y ago
So, according to your article, 29% of Canadians had to wait 4 or more hours, whereas 24% of Americans did, so I'm not seeing much comparative improvements and I'd hypothesize that long ER wait times are not to do with which healthcare model you have, it has to do with misuse of ER. Meanwhile, France, Germany and the Netherlands all had outstanding numbers, and as far as I know they all have universal coverage.
- cbhl 8y ago
  Having used the ER twice in fifth grade in Canada, it seemed fine? Like, yes, sure you have to wait 12 hours to see a doctor if you're not bleeding out the chest. But also, I didn't have to face the prospect of paying $300 for a 15 minute consult, or going to jail to receive treatment. If you have a cold, you find a PCP or a "health clinic" and make an appointment for same-day or later-that-week. And sure it's hard to find that PCP, but with my PCP in the US I have to book appointments three weeks in advance! I'd argue "75%ile time waiting in the ER" is not a great metric. That neither tells you how easy it is you are to get preventative or routine treatment, nor how well your ER is able to handle a mass-shooting type catastrophe.
  - citilife 8y ago
    _Without insurance_ you can see a doctor in the U.S. for relatively cheap. I'm talking, $100 for a clinic visit. I've done it plenty of times for less. The healthcare in the U.S. seems nuts because you are _billed_ for hundreds of dollars, but that's because they have to subsidize medicare patients AND insurance companies have negotiated rates based on percentages. So, they may only pay 40% of what is billed, but you are shown much more. It's a scam everyone is involved in, which is why we need open pricing and open "how much insurance actually paid".
    - cbhl 8y ago
      Without insurance, a 15-minute consult in Canada is, like, $40 CAD. That's like $20 USD. Factor of 5x or 10x savings.
- 8y ago
Brakenshire 8y ago
You can always buy private medical insurance to give you fast access to specialists for non-urgent care, or it can be provided through your work, in exactly the same way as the American system. The difference between America and somewhere like the UK is that in the UK expensive private medical insurance is optional, and there is a baseline of decent medical care available to everyone. And that baseline universal care is provided for the same amount of taxpayer spending (as a percentage of GDP) as the US spends on providing Medicare, Medicaid, and those partial programmes. The US spends about 8% of GDP on private medical care, and another 8% on public care. Universal healthcare is about making the public, taxpayer-funded part of that expenditure more efficient, not about abolishing the private part of it.
jellicle 8y ago
US stats don't include the 25%+, more like 50% really, of the population who are financially excluded from medical care (even though some are "insured"). Anybody who does this: "I have a medical issue but I'm not going to seek treatment for it because I'll get a bill for $10K" should be viewed as having infinite wait times, and counted in the stats thusly. But they aren't. "Oh, I've got this giant infected cut on my hand and I'm not going to go to the doctor because I'll end up broke" simply doesn't exist in Canada or Ireland, or any other first-world nation. And hey poster, I guess you didn't get to the bottom of your linked article: "Almost three-quarters of Canadians rated their quality of care as very good or excellent, well above the international average of 65%, she said."
erentz 8y ago
This comparison is flawed if it excludes those who have to wait indefinitely due to not having sufficient coverage. Put those in and wait times wouldn’t look so great in the US anymore.
Amygaz 8y ago
You're cherry picking, and the US is getting worse every year in that metric, while other countries have started tackling that. But the main thing is this has nothing to do with the universality of healthcare, more about how it has been implemented in those two countries. Go look at the UK, France, Germany, Australia.

bertil 8y ago

> at least I can get treatment I’m assuming that you realise the singular first person in that statement is very much that: singular. > Let’s get real The New York Times sees “real” as under a Rawlsian veil: they imagine being any citizen. You seemingly disagree with that approach.

patmcc 8y ago

>>Many places have way more significant wait times for treatment... Canadian here - yep, there are sometimes wait times, especially for specialists, especially if it's something that is unpleasant but not urgently life threatening. That sucks. I'd still take that over some percentage of the population just not having access to care, or having a huge number of medical bankruptcies. As for the ER - it even says in the article you link, that's largely people who could have gone to their primary care physician. Those are the people waiting. If you go in with a stroke, you're not waiting. I've (luckily) never been to the ER for a life-threatening situation, but I have for injuries where I needed urgent care, and got excellent treatment - and yes, once I had to wait for the guy ahead of me who had a stroke. I'm ok with that.

AlexandrB 8y ago
> That sucks. I'd still take that over some percentage of the population just not having access to care, or having a huge number of medical bankruptcies. Yup. I'd rather wait 10 hours in ER for something non-life-threatening than get immediate care and spend the next 10 weeks fighting with insurance companies or filing for bankruptcy.

asnrk 8y ago

Since most of the other OECD states are representative democracies of one sort or another, and since pretty much all of them have some form of universal health coverage, if the US system's an improvement over any of those in other OECD states, I expect there are strong, popular reform movements in at least some of them looking to move their system closer to that of the US. Right? Not to improve their systems in other ways, but specifically to move closer to that of the US. Since that'd be a clear improvement if they just "get real".

moorhosj 8y ago
I’ve raised this exact question and never seen an honest response. Why aren’t politicians in other OECD countries trying to make their system more like ours? Why aren’t their citizens demanding it?

taoistextremist 8y ago

So, according to your article, 29% of Canadians had to wait 4 or more hours, whereas 24% of Americans did, so I'm not seeing much comparative improvements and I'd hypothesize that long ER wait times are not to do with which healthcare model you have, it has to do with misuse of ER. Meanwhile, France, Germany and the Netherlands all had outstanding numbers, and as far as I know they all have universal coverage.

cbhl 8y ago
Having used the ER twice in fifth grade in Canada, it seemed fine? Like, yes, sure you have to wait 12 hours to see a doctor if you're not bleeding out the chest. But also, I didn't have to face the prospect of paying $300 for a 15 minute consult, or going to jail to receive treatment. If you have a cold, you find a PCP or a "health clinic" and make an appointment for same-day or later-that-week. And sure it's hard to find that PCP, but with my PCP in the US I have to book appointments three weeks in advance! I'd argue "75%ile time waiting in the ER" is not a great metric. That neither tells you how easy it is you are to get preventative or routine treatment, nor how well your ER is able to handle a mass-shooting type catastrophe.
- citilife 8y ago
  _Without insurance_ you can see a doctor in the U.S. for relatively cheap. I'm talking, $100 for a clinic visit. I've done it plenty of times for less. The healthcare in the U.S. seems nuts because you are _billed_ for hundreds of dollars, but that's because they have to subsidize medicare patients AND insurance companies have negotiated rates based on percentages. So, they may only pay 40% of what is billed, but you are shown much more. It's a scam everyone is involved in, which is why we need open pricing and open "how much insurance actually paid".
  - cbhl 8y ago
    Without insurance, a 15-minute consult in Canada is, like, $40 CAD. That's like $20 USD. Factor of 5x or 10x savings.
8y ago

Brakenshire 8y ago

You can always buy private medical insurance to give you fast access to specialists for non-urgent care, or it can be provided through your work, in exactly the same way as the American system. The difference between America and somewhere like the UK is that in the UK expensive private medical insurance is optional, and there is a baseline of decent medical care available to everyone. And that baseline universal care is provided for the same amount of taxpayer spending (as a percentage of GDP) as the US spends on providing Medicare, Medicaid, and those partial programmes. The US spends about 8% of GDP on private medical care, and another 8% on public care. Universal healthcare is about making the public, taxpayer-funded part of that expenditure more efficient, not about abolishing the private part of it.

jellicle 8y ago

US stats don't include the 25%+, more like 50% really, of the population who are financially excluded from medical care (even though some are "insured"). Anybody who does this: "I have a medical issue but I'm not going to seek treatment for it because I'll get a bill for $10K" should be viewed as having infinite wait times, and counted in the stats thusly. But they aren't. "Oh, I've got this giant infected cut on my hand and I'm not going to go to the doctor because I'll end up broke" simply doesn't exist in Canada or Ireland, or any other first-world nation. And hey poster, I guess you didn't get to the bottom of your linked article: "Almost three-quarters of Canadians rated their quality of care as very good or excellent, well above the international average of 65%, she said."

erentz 8y ago

This comparison is flawed if it excludes those who have to wait indefinitely due to not having sufficient coverage. Put those in and wait times wouldn’t look so great in the US anymore.

Amygaz 8y ago

You're cherry picking, and the US is getting worse every year in that metric, while other countries have started tackling that. But the main thing is this has nothing to do with the universality of healthcare, more about how it has been implemented in those two countries. Go look at the UK, France, Germany, Australia.