6 ms·

NPR has a fetish, like many liberal media, that if only americans better understood healthcare, we would all live in an egalitarian utopia. I am absolutely hap

by Gunax 6y ago

NPR has a fetish, like many liberal media, that if only americans better understood healthcare, we would all live in an egalitarian utopia. I am absolutely happier having american healthcare than canadian. Admittedly, that's because I am of the 80 percent of people who get decent health coverage via my employer. A significant minority of Canadians agree with me, so it's not like this is some radical position. There is a famous story in canada where you could get CT scans for your pet the same day, but non-urgent scans for humans had like an 8 month waiting list. My great grandfather had to wait 6 months for cataract replacement. He considered going to North Dakota to have it done, as it was preventing him from working. So now canada has inadvertently fallen to the same trap as everywhere else: if you're wealthy enough you can just go to the us for care. Everyone else has to wait. I've tried to say these sorts of views on reddit, but just get called a troll or a liar. I'm not trying to argue that public healthcare isnt better in some ways, or even that americans shouldn't consider it. It's just that these sorts of outlets tend to have a rosey view and give this impression that dissent arrises only from ignorance, and I must be some evil, Mr Burns-esque robber baron.

ganlaw 6y ago
As a Canadian living in the US, I have to disagree. The fact that 27 million people (1) live in the US without health insurance alone is a big enough reason to know that that US system is not working. People should not die or go bankrupt due to not having insurance. The current system might work for the rich and privileged but that is not good enough. 1. https://www.census.gov/library/publications/2019/demo/p60-267.html https://www.census.gov/library/publications/2019/demo/p60-26...
- flubert 6y ago
  The thing that always makes we wonder in these types of online health care discussions, is why Medicaid and Medicare are ignored. This is a genuine question, since I'm privileged enough to have a job with good health insurance, and I don't have personal experience with those programs.
  - dragonwriter 6y ago
    > The thing that always makes we wonder in these types of online health care discussions, is why Medicaid and Medicare are ignored. They aren't; they are expressly included in GPs coverage statistics.
- mrmuagi 6y ago
  I don't think having everybody insured would be the criteria for it being working either. I came across a lecture about how metabolic syndrome treatment accounts for a large chunk of health care spending (75% [0]), and there's a lot of blame put on added sugars and processed foods. A large push for preventative care would be ideal. [0] https://www.youtube.com/watch?v=ceFyF9px20Y https://www.youtube.com/watch?v=ceFyF9px20Y
- Gunax 6y ago
  I'm not really disagreeing. I'm just trying to say that there are valid and rational reasons to prefer private healthcare. Listening to NPR and their ilk would lead you to believe anyone else is some ignorant simpleton (the word 'deplorable' comes to mind)
- TMWNN 6y ago
  >The fact that 27 million people (1) live in the US without health insurance alone is a big enough reason to know that that US system is not working. That's 91-92% coverage of a country of 330 million. 91% of Americans have medical insurance, whether through their employers, or government programs like Medicare/Medicaid. That's compared to 95-97% in other developed countries because there are always some people who fall through cracks, like (say) a Canadian who doesn't get a new provincial health care card after moving, or a German who neglects to buy into a new sickness fund after changing careers. The only such systems with actual 100% (or as close to it as possible) coverage is something like the UK NHS, which does not have a requirement to show a membership card (because, well, there isn't one) to receive treatment. PS - Obamacare did not greatly expand coverage. 85% of Americans had medical insurance pre-Obamacare. There are things I'd certainly improve about the US system—decoupling primary healthcare coverage from employment, for one—but the way people online ~~lie~~ exaggerate it's not surprising that so many non-Americans believe that every American is one hangnail away from bankruptcy. >People should not die or go bankrupt due to not having insurance. Only 4% of US bankruptcies are because of medical bills (https://www.washingtonpost.com/blogs/post-partisan/wp/2018/03/26/the-truth-about-medical-bankruptcies/ https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0...). A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.
apta 6y ago
> I've tried to say these sorts of views on reddit, but just get called a troll or a liar. Just in this thread people are downvoting anyone praising the US system and talking about the shortcomings of the Canadian one. I've had a Canadian doctor tell me first hand that the US healthcare system is far superior provided you have insurance.
- woggy 6y ago
  I don't think anyone doubts that American healthcare is technically of good quality. Its the insurance system that is broken.
  - gnusty_gnurc 6y ago
    Maybe it’s the legal regime dating back to WWII wage controls that’s enforced a system of third-party transactions tied to your employer?
  - bsanr2 6y ago
    The state of insurance undercuts the quality of the services, actually. It raises costs, changes treatment decisions, and has generally warped our system towards one focused on lucrative, worse-outcome behavior on the part of doctors and hospitals. Much of this related to the putting off of preventative or early treatment due to OOP costs; people gamble that their conditions won't worsen so that they won't be forced to go into debt for treatment (if they can even access credit). Many lose that bet and end up having to pay orders of magnitude more for late treatment. Speaking personally, I had surgery for a long-standing condition, which the surgery failed to correct. Under a different system, my issue might not have become chronic, I might have been able to make a better decision regarding the surgeon and surgery (e.g., getting a second opinion, follow-up imaging, etc.), and I would not have missed a follow-up appointment after losing my insurance. Because I'm an American, living under this system, the circumstances of my treatment and subsequent outcomes were drastically shifted towards unsatisfactory.
  - grecy 6y ago
    Actually, compared to OECD countries, the quality is pretty bad. The US is at or very near the worst among OECD countries in: life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use. It would seem health insurance companies charge a lot of money for not such great healthcare.
StavrosK 6y ago
Isn't there private healthcare in Canada? Here in Greece, you can wait a few months for some tests if you want to use insurance and get them for free, or you can pay (or use private insurance, if you have it), to get them faster at a private clinic.
- smnrchrds 6y ago
  Short answer: no. Healthcare providers are not allowed to charge publicly-insured patients for covered services. Insurance companies are not allowed to insure for covered services. So for covered services (e.g. lab tests and doctor visits) the only available options is public. For non-covered services (e.g. ambulance, dental, prescription drugs, etc.) you pay out of pocket or use private insurance. Many healthcare providers themselves are private. For example, doctors are independent contractors, not government employees, and their offices are private businesses. But they get paid for services by the government (why we call if a single-payer system rather than a public system).
  - wahern 6y ago
    Maybe things have a changed in the past few years, but I knew an orthopedic surgeon with a private practice in Vancouver. The workaround was that he charged a flat hourly rate, not a per-service fee. He specialized in knee surgery and also worked at a local hospital, so you could either wait 3 to 6 months for him to fix your knee at the hospital, or you could book him sooner at his private practice. That sounded like a win-win to me.
    - smnrchrds 6y ago
      A. It's not a true win-win. He is not creating and selling extra treatment capacity. The time he spends in his private practice is the time he would have otherwise spent in the hospital. The same number of patients end up receiving the same number of services. But now, instead of need and urgency determining who gets the services first, it's money. B. It is not a loophole. The federal government fines provinces who don't rein in private billing. British Columbia loses millions of dollars in Canada Health Transfer every year because of lax enforcement though. BC lost $15.9 million in 2018 and was on track to lose $32 million in 2019, but they started enforcing the law better. https://lop.parl.ca/sites/PublicWebsite/default/en_CA/ResearchPublications/201954E https://lop.parl.ca/sites/PublicWebsite/default/en_CA/Resear...? https://www.cbc.ca/news/canada/british-columbia/extra-billing-health-day-dix-constitutional-challenge-1.5160400 https://www.cbc.ca/news/canada/british-columbia/extra-billin...
dayjobpork 6y ago
Apart from a terribly selfish attitude, I'd like to see proof of the wait for CT scans. Australia has mostly socialised healthcare and I've always had xrays same day and CT, Pet and MRI within a couple of days at most. Also all those scans have been completely free.
- Spooky23 6y ago
  Key word is "non-urgent". If you have good insurance in the US, you'll get a same-day CT in a hospital setting to bring in some revenue where a quick xray would suffice.
- woggy 6y ago
  This has been my experience as well. The complaints I frequently hear from Americans regarding 'socialized healthcare' never ring true based on my experience in countries like the UK or Australia.
- smnrchrds 6y ago
  For Canada, the data is easy to find, since it is all public. Here is average and 90% (when 90% of the patients have received care) data for non-urgent CT scans in the province of Alberta. Before the pandemic hit, average and 90% were approximately 12 and 20 weeks. Due to the pandemic, now they are double. Ontario is doing much better. You can see their data in the second link. http://waittimes.alberta.ca/WaitTimeTrends.jsp?rcatID=19&rhaID=All_&doSearch=true&urgencyCode=3&facilityID=-9_&checkedRegionNo=0&oldCheckedRegionNo=0&oldCheckedFacilityNo=0&ifDisplayFacility=false&ifDisplayPhysician=false&command=goToAccessGoals&chartType=access_goal&subChartType=90_AVERAGE_&disabledChartType=trend&status=processAjax&ifHavingFPTMeasurement=true#WaitTimeInfo http://waittimes.alberta.ca/WaitTimeTrends.jsp?rcatID=19&rha... https://www.hqontario.ca/System-Performance/Wait-Times-for-Diagnostic-Imaging?ScanType=AdultCT https://www.hqontario.ca/System-Performance/Wait-Times-for-D...
grecy 6y ago
> Admittedly, that's because I am of the 80 percent of people who get decent health coverage via my employer Have you ever thought about what would happen if you want to take 12 months off work so you can spend time with your kids, learn a language or just some personal time? Have you looked into how quickly your insurance would drop you if you developed a serious illness, or suffered a major auto-crash with extremely expensive and life-altering medical conditions? Tying ones health to their employment is barbaric, and as someone that has never suffered such a fate, I consider it the next step up from slavery. i.e. Slaves - work or you don't eat/live. US heath insurance - work or you get bankruptingly-expensive healthcare. (Rest of the developed world) - work or not, healthcare is for everyone.
- Gunax 6y ago
  Of course I have. That's why I wrote that. Respectfully, I think youre reading into what I wrote and concluding what I actually think. I'm not really trying to argue one view or the other. I'm just saying that it isn't as clear cut as this NPR piece makes it out to be.
hristov 6y ago
Ask your employer how they feel about paying for your healthcare. Whatever your opinion of the quality of healthcare you get may be, it is an undeniable fact that the cost is rising and has been rising at rates far above the rates of inflation. This has been happening for a long time, but it really accelerated after Bush signed a law that said Medicare was not allowed to negotiate drug prices. (Although, I am sure there are other reasons). If you are lucky enough to have an employer that loves you so much that he/she is willing to pay ever increasing cost for your medical care, good for you. But I can tell you that you are in a tiny, tiny minority. As things currently, stand medical care costs are scary high and they are getting higher every year at a very scary rate. And most employers are looking at ways they can limit their health care costs, most of the solutions resulting in limiting benefits for employees.
alkonaut 6y ago
> I am absolutely happier having american healthcare than canadian. Admittedly, that's because I am of the 80 percent of people who get decent health coverage via my employer. Do you still have coverage if you get laid off? For how long? For kids too? That’s what freaks me out about the US system, is that it’s tied to employment to a high degree. This pandemic must have led to tons of people being laid off. Many of them got laid off and then they (or a family member) got Covid. How long after being laid off are people normally covered? How long is coverage for family members on the employee’s insurance after they are laid off? I wouldn’t say care is better under my single payer than it is for US white collar employees, but I assign a massive value to the fact that I don’t worry about insurance or money if I get sick, have a child, or have a chronically ill child.
- flubert 6y ago
  >Do you still have coverage if you get laid off? https://www.dol.gov/general/topic/health-plans/cobra https://www.dol.gov/general/topic/health-plans/cobra
  - phoobahr 6y ago
    "right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan." Yeah, no, that's not the same thing at all. As a Canadian I have health coverage I can, y'know, live with regardless of whether I'm employed or not. And buying coverage in the US (with a pre-existing condition) was absolutely not worth it (even considering the wage gap) when I entertained a few offers in the early oughts. Staying here means I have substantially better freedom of movement and negotiating power. In the US the "freedom" to not have healthcare just seems to mean that everyone has the "freedom" to pay more - and often for less.
  - alkonaut 6y ago
    Looks like it might be hard to ensure coverage for very long if the reason for losing your job was the employer going bankrupt. Are there other systems aside from Cobra that pick up where Cobra doesn’t? E.g for bankruptcy , companies smaller than 20 employees?
cultus 6y ago
Cataract surgery is not urgent. In Canada, they ration by need, not the ability to pay. It's also a problem that is not generally characteristic of health care systems. Overall health outcomes are better by the vast majority of metrics. Even if you have good insurance, wait times can be bad. For a point of reference, someone close to me had a potentially fatal condition and wasn't able to get a specialist appointment for 4 months. That sort of thing isn't uncommon.
- alacombe 6y ago
  > they ration by need, not the ability to pay I guess my gf will have to attempt suicide to get help then... maybe if she succeed, she won't be a burden on the system !
elihu 6y ago
A lot of people have pretty good insurance through their employers, but part of the point of a system like Canada's is that if you lose your job you still have the same insurance. Similarly, if you want to change jobs or launch a startup, health insurance isn't the thing that's holding you back from that. With the ACA, things are at least a little better than before: individual people can at least buy insurance, which wasn't the case before if you had a pre-existing condition and didn't live in a state with a subsidized program (like Oregon's OMIP). A criticism I've heard of Canada's system is just that it's under-funded. They could raise their taxes a little and divert more money to health care, and it would improve some of these wait times. I don't know how true that is, though, and how much of a legitimate problem it is. Canada definitely pays far less per capita for health insurance than the U.S.
- Gibbon1 6y ago
  I had a coworker that was employed with health insurance for 25 years, never used it. Got laid off and then right after COBRA ran out had something major go wrong. Had to get a second mortgage on his house to pay his medical bills. Seems 'unfair' to pay in for almost 30 years and have that count for nothing.
ebg13 6y ago
> I am of the 80 percent of people who get decent health coverage via my employer Fact Check: Only 55.4% of all Americans and 58% of Americans under the age of 65 had employer-based health insurance in 2019. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p60-271.pdf https://www.census.gov/content/dam/Census/library/publicatio... https://www.cbo.gov/system/files/2019-05/55085-HealthCoverageSubsidies_0.pdf https://www.cbo.gov/system/files/2019-05/55085-HealthCoverag... > I've tried to say these sorts of views on reddit, but just get called a troll or a liar. I think it would help if you didn't start by saying that 80 percent of people have employer coverage, decent or otherwise. Because it's both false and easy to check.
- Gunax 6y ago
  Okay, you're right. I should have just said majority. I didn't mean it statistically, just that most americans are insured, either by purchasing privately or by their employer. It's an internet comment not a journal article.
  - ebg13 6y ago
    > I didn't mean it... Saying things you don't mean might be why people on reddit accused you of being a troll or a liar. I don't have proof, but it seems like a good place to start. > It's an internet comment not a journal article. "It's the internet so I can say whatever I want regardless of facts" is not a mindset conducive to meaningful conversation. I'm guessing again that it might be why the people on reddit dismissed you. You might not think that this is important, but, speaking to your complaint that outlets "give this impression that dissent arrises only from ignorance, and I must be some evil, Mr Burns-esque robber baron", it seems pertinent that the available interpretations for people encountering what you said are that either you didn't know that the real number was far lower than what you said or you knew and were intentionally misrepresenting things.
toddh 6y ago
Our neighbors drive from California to Mexico for dental work. Often. They have Medicare, additional coverage from a union, and Kaiser.
- wahern 6y ago
  In the U.S. healthcare plans typically do not cover dental. In particular, neither Medicare nor Kaiser provide dental coverage AFAIK. Dentists are quite willing for patients to pay for services directly. They'll typically charge less than what even insurers reimburse as insurance billing is so time consuming and therefore costly. There's not much negotiating as when you pay directly you're pretty much paying market rate, unless you live in a rural area where there's little competition--i.e. no market. Market rate in Mexico is undoubtedly lower than in the U.S., though. Speaking of Mexico, they seem to have a pretty solid public healthcare program. Maybe expectations are lower, maybe people are sufficiently contented by access to relatively unregulated pharmaceuticals and medical practices regardless of poorer outcomes, or maybe griping doesn't make it across the language barrier to American news, but it definitely seems like there's less anxiety about healthcare in Mexico.
  - toddh 6y ago
    Yes, I’m hoping everyone realizes that’s part of the point. We don’t actually even have “health” coverage, even those with what most in the US would consider top notch coverage.
  - cultus 6y ago
    A person I know went to Mexico for a semi-elective jaw surgery. It was a great experience: more personalized attention than the US, high quality, and they paid much less.
- TMWNN 6y ago
  >Our neighbors drive from California to Mexico for dental work. Often. They have Medicare, additional coverage from a union, and Kaiser. As mentioned, dental coverage in the US is typically decoupled from medical coverage. (This is the same in Canada.) Your neighbors go to Mexico purely because most things, not just dental work, is cheaper there, as opposed to said dental work not being available immediately. Very different from why Canadians typically travel to the US for medical care, which is either a) to avoid long lines (and legislative prohibition of private clinics to pay more for quicker access), or b) expertise that isn't available in Canada.
TMWNN 6y ago
>A significant minority of Canadians agree with me, so it's not like this is some radical position. Various Canadian politicians agree including Prime Minister Jean Chretien, who secretly traveled to the Mayo Clinic twice in 1999 (https://web.archive.org/web/20100204202553/http://www.montrealgazette.com/health/ultimate+tier+health+care/2515150/story.html https://web.archive.org/web/20100204202553/http://www.montre...) during "ski trips" (https://web.archive.org/web/20160624132234/http://www.ezralevant.com/danny_williams_flies_to_us_hea/ https://web.archive.org/web/20160624132234/http://www.ezrale...).

by Gunax 6y ago

ganlaw 6y ago

As a Canadian living in the US, I have to disagree. The fact that 27 million people (1) live in the US without health insurance alone is a big enough reason to know that that US system is not working. People should not die or go bankrupt due to not having insurance. The current system might work for the rich and privileged but that is not good enough. 1. https://www.census.gov/library/publications/2019/demo/p60-267.html https://www.census.gov/library/publications/2019/demo/p60-26...

flubert 6y ago
The thing that always makes we wonder in these types of online health care discussions, is why Medicaid and Medicare are ignored. This is a genuine question, since I'm privileged enough to have a job with good health insurance, and I don't have personal experience with those programs.
- dragonwriter 6y ago
  > The thing that always makes we wonder in these types of online health care discussions, is why Medicaid and Medicare are ignored. They aren't; they are expressly included in GPs coverage statistics.
mrmuagi 6y ago
I don't think having everybody insured would be the criteria for it being working either. I came across a lecture about how metabolic syndrome treatment accounts for a large chunk of health care spending (75% [0]), and there's a lot of blame put on added sugars and processed foods. A large push for preventative care would be ideal. [0] https://www.youtube.com/watch?v=ceFyF9px20Y https://www.youtube.com/watch?v=ceFyF9px20Y
Gunax 6y ago
I'm not really disagreeing. I'm just trying to say that there are valid and rational reasons to prefer private healthcare. Listening to NPR and their ilk would lead you to believe anyone else is some ignorant simpleton (the word 'deplorable' comes to mind)
TMWNN 6y ago
>The fact that 27 million people (1) live in the US without health insurance alone is a big enough reason to know that that US system is not working. That's 91-92% coverage of a country of 330 million. 91% of Americans have medical insurance, whether through their employers, or government programs like Medicare/Medicaid. That's compared to 95-97% in other developed countries because there are always some people who fall through cracks, like (say) a Canadian who doesn't get a new provincial health care card after moving, or a German who neglects to buy into a new sickness fund after changing careers. The only such systems with actual 100% (or as close to it as possible) coverage is something like the UK NHS, which does not have a requirement to show a membership card (because, well, there isn't one) to receive treatment. PS - Obamacare did not greatly expand coverage. 85% of Americans had medical insurance pre-Obamacare. There are things I'd certainly improve about the US system—decoupling primary healthcare coverage from employment, for one—but the way people online ~~lie~~ exaggerate it's not surprising that so many non-Americans believe that every American is one hangnail away from bankruptcy. >People should not die or go bankrupt due to not having insurance. Only 4% of US bankruptcies are because of medical bills (https://www.washingtonpost.com/blogs/post-partisan/wp/2018/03/26/the-truth-about-medical-bankruptcies/ https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0...). A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.

apta 6y ago

> I've tried to say these sorts of views on reddit, but just get called a troll or a liar. Just in this thread people are downvoting anyone praising the US system and talking about the shortcomings of the Canadian one. I've had a Canadian doctor tell me first hand that the US healthcare system is far superior provided you have insurance.

woggy 6y ago
I don't think anyone doubts that American healthcare is technically of good quality. Its the insurance system that is broken.
- gnusty_gnurc 6y ago
  Maybe it’s the legal regime dating back to WWII wage controls that’s enforced a system of third-party transactions tied to your employer?
- bsanr2 6y ago
  The state of insurance undercuts the quality of the services, actually. It raises costs, changes treatment decisions, and has generally warped our system towards one focused on lucrative, worse-outcome behavior on the part of doctors and hospitals. Much of this related to the putting off of preventative or early treatment due to OOP costs; people gamble that their conditions won't worsen so that they won't be forced to go into debt for treatment (if they can even access credit). Many lose that bet and end up having to pay orders of magnitude more for late treatment. Speaking personally, I had surgery for a long-standing condition, which the surgery failed to correct. Under a different system, my issue might not have become chronic, I might have been able to make a better decision regarding the surgeon and surgery (e.g., getting a second opinion, follow-up imaging, etc.), and I would not have missed a follow-up appointment after losing my insurance. Because I'm an American, living under this system, the circumstances of my treatment and subsequent outcomes were drastically shifted towards unsatisfactory.
- grecy 6y ago
  Actually, compared to OECD countries, the quality is pretty bad. The US is at or very near the worst among OECD countries in: life expectancy at birth, healthy life expectancy, rate of obesity, disability-adjusted life years, doctors per 1000 people, deaths from treatable conditions, rate of mental health disorders, rate of drug abuse, rate of prescription drug use. It would seem health insurance companies charge a lot of money for not such great healthcare.

StavrosK 6y ago

Isn't there private healthcare in Canada? Here in Greece, you can wait a few months for some tests if you want to use insurance and get them for free, or you can pay (or use private insurance, if you have it), to get them faster at a private clinic.

smnrchrds 6y ago
Short answer: no. Healthcare providers are not allowed to charge publicly-insured patients for covered services. Insurance companies are not allowed to insure for covered services. So for covered services (e.g. lab tests and doctor visits) the only available options is public. For non-covered services (e.g. ambulance, dental, prescription drugs, etc.) you pay out of pocket or use private insurance. Many healthcare providers themselves are private. For example, doctors are independent contractors, not government employees, and their offices are private businesses. But they get paid for services by the government (why we call if a single-payer system rather than a public system).
- wahern 6y ago
  Maybe things have a changed in the past few years, but I knew an orthopedic surgeon with a private practice in Vancouver. The workaround was that he charged a flat hourly rate, not a per-service fee. He specialized in knee surgery and also worked at a local hospital, so you could either wait 3 to 6 months for him to fix your knee at the hospital, or you could book him sooner at his private practice. That sounded like a win-win to me.
  - smnrchrds 6y ago
    A. It's not a true win-win. He is not creating and selling extra treatment capacity. The time he spends in his private practice is the time he would have otherwise spent in the hospital. The same number of patients end up receiving the same number of services. But now, instead of need and urgency determining who gets the services first, it's money. B. It is not a loophole. The federal government fines provinces who don't rein in private billing. British Columbia loses millions of dollars in Canada Health Transfer every year because of lax enforcement though. BC lost $15.9 million in 2018 and was on track to lose $32 million in 2019, but they started enforcing the law better. https://lop.parl.ca/sites/PublicWebsite/default/en_CA/ResearchPublications/201954E https://lop.parl.ca/sites/PublicWebsite/default/en_CA/Resear...? https://www.cbc.ca/news/canada/british-columbia/extra-billing-health-day-dix-constitutional-challenge-1.5160400 https://www.cbc.ca/news/canada/british-columbia/extra-billin...

dayjobpork 6y ago

Apart from a terribly selfish attitude, I'd like to see proof of the wait for CT scans. Australia has mostly socialised healthcare and I've always had xrays same day and CT, Pet and MRI within a couple of days at most. Also all those scans have been completely free.

Spooky23 6y ago
Key word is "non-urgent". If you have good insurance in the US, you'll get a same-day CT in a hospital setting to bring in some revenue where a quick xray would suffice.
woggy 6y ago
This has been my experience as well. The complaints I frequently hear from Americans regarding 'socialized healthcare' never ring true based on my experience in countries like the UK or Australia.
smnrchrds 6y ago
For Canada, the data is easy to find, since it is all public. Here is average and 90% (when 90% of the patients have received care) data for non-urgent CT scans in the province of Alberta. Before the pandemic hit, average and 90% were approximately 12 and 20 weeks. Due to the pandemic, now they are double. Ontario is doing much better. You can see their data in the second link. http://waittimes.alberta.ca/WaitTimeTrends.jsp?rcatID=19&rhaID=All_&doSearch=true&urgencyCode=3&facilityID=-9_&checkedRegionNo=0&oldCheckedRegionNo=0&oldCheckedFacilityNo=0&ifDisplayFacility=false&ifDisplayPhysician=false&command=goToAccessGoals&chartType=access_goal&subChartType=90_AVERAGE_&disabledChartType=trend&status=processAjax&ifHavingFPTMeasurement=true#WaitTimeInfo http://waittimes.alberta.ca/WaitTimeTrends.jsp?rcatID=19&rha... https://www.hqontario.ca/System-Performance/Wait-Times-for-Diagnostic-Imaging?ScanType=AdultCT https://www.hqontario.ca/System-Performance/Wait-Times-for-D...

grecy 6y ago

> Admittedly, that's because I am of the 80 percent of people who get decent health coverage via my employer Have you ever thought about what would happen if you want to take 12 months off work so you can spend time with your kids, learn a language or just some personal time? Have you looked into how quickly your insurance would drop you if you developed a serious illness, or suffered a major auto-crash with extremely expensive and life-altering medical conditions? Tying ones health to their employment is barbaric, and as someone that has never suffered such a fate, I consider it the next step up from slavery. i.e. Slaves - work or you don't eat/live. US heath insurance - work or you get bankruptingly-expensive healthcare. (Rest of the developed world) - work or not, healthcare is for everyone.

Gunax 6y ago
Of course I have. That's why I wrote that. Respectfully, I think youre reading into what I wrote and concluding what I actually think. I'm not really trying to argue one view or the other. I'm just saying that it isn't as clear cut as this NPR piece makes it out to be.

hristov 6y ago

Ask your employer how they feel about paying for your healthcare. Whatever your opinion of the quality of healthcare you get may be, it is an undeniable fact that the cost is rising and has been rising at rates far above the rates of inflation. This has been happening for a long time, but it really accelerated after Bush signed a law that said Medicare was not allowed to negotiate drug prices. (Although, I am sure there are other reasons). If you are lucky enough to have an employer that loves you so much that he/she is willing to pay ever increasing cost for your medical care, good for you. But I can tell you that you are in a tiny, tiny minority. As things currently, stand medical care costs are scary high and they are getting higher every year at a very scary rate. And most employers are looking at ways they can limit their health care costs, most of the solutions resulting in limiting benefits for employees.

alkonaut 6y ago

> I am absolutely happier having american healthcare than canadian. Admittedly, that's because I am of the 80 percent of people who get decent health coverage via my employer. Do you still have coverage if you get laid off? For how long? For kids too? That’s what freaks me out about the US system, is that it’s tied to employment to a high degree. This pandemic must have led to tons of people being laid off. Many of them got laid off and then they (or a family member) got Covid. How long after being laid off are people normally covered? How long is coverage for family members on the employee’s insurance after they are laid off? I wouldn’t say care is better under my single payer than it is for US white collar employees, but I assign a massive value to the fact that I don’t worry about insurance or money if I get sick, have a child, or have a chronically ill child.

flubert 6y ago
>Do you still have coverage if you get laid off? https://www.dol.gov/general/topic/health-plans/cobra https://www.dol.gov/general/topic/health-plans/cobra
- phoobahr 6y ago
  "right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan." Yeah, no, that's not the same thing at all. As a Canadian I have health coverage I can, y'know, live with regardless of whether I'm employed or not. And buying coverage in the US (with a pre-existing condition) was absolutely not worth it (even considering the wage gap) when I entertained a few offers in the early oughts. Staying here means I have substantially better freedom of movement and negotiating power. In the US the "freedom" to not have healthcare just seems to mean that everyone has the "freedom" to pay more - and often for less.
- alkonaut 6y ago
  Looks like it might be hard to ensure coverage for very long if the reason for losing your job was the employer going bankrupt. Are there other systems aside from Cobra that pick up where Cobra doesn’t? E.g for bankruptcy , companies smaller than 20 employees?

cultus 6y ago

Cataract surgery is not urgent. In Canada, they ration by need, not the ability to pay. It's also a problem that is not generally characteristic of health care systems. Overall health outcomes are better by the vast majority of metrics. Even if you have good insurance, wait times can be bad. For a point of reference, someone close to me had a potentially fatal condition and wasn't able to get a specialist appointment for 4 months. That sort of thing isn't uncommon.

alacombe 6y ago
> they ration by need, not the ability to pay I guess my gf will have to attempt suicide to get help then... maybe if she succeed, she won't be a burden on the system !

elihu 6y ago

A lot of people have pretty good insurance through their employers, but part of the point of a system like Canada's is that if you lose your job you still have the same insurance. Similarly, if you want to change jobs or launch a startup, health insurance isn't the thing that's holding you back from that. With the ACA, things are at least a little better than before: individual people can at least buy insurance, which wasn't the case before if you had a pre-existing condition and didn't live in a state with a subsidized program (like Oregon's OMIP). A criticism I've heard of Canada's system is just that it's under-funded. They could raise their taxes a little and divert more money to health care, and it would improve some of these wait times. I don't know how true that is, though, and how much of a legitimate problem it is. Canada definitely pays far less per capita for health insurance than the U.S.

Gibbon1 6y ago
I had a coworker that was employed with health insurance for 25 years, never used it. Got laid off and then right after COBRA ran out had something major go wrong. Had to get a second mortgage on his house to pay his medical bills. Seems 'unfair' to pay in for almost 30 years and have that count for nothing.

ebg13 6y ago

> I am of the 80 percent of people who get decent health coverage via my employer Fact Check: Only 55.4% of all Americans and 58% of Americans under the age of 65 had employer-based health insurance in 2019. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p60-271.pdf https://www.census.gov/content/dam/Census/library/publicatio... https://www.cbo.gov/system/files/2019-05/55085-HealthCoverageSubsidies_0.pdf https://www.cbo.gov/system/files/2019-05/55085-HealthCoverag... > I've tried to say these sorts of views on reddit, but just get called a troll or a liar. I think it would help if you didn't start by saying that 80 percent of people have employer coverage, decent or otherwise. Because it's both false and easy to check.

Gunax 6y ago
Okay, you're right. I should have just said majority. I didn't mean it statistically, just that most americans are insured, either by purchasing privately or by their employer. It's an internet comment not a journal article.
- ebg13 6y ago
  > I didn't mean it... Saying things you don't mean might be why people on reddit accused you of being a troll or a liar. I don't have proof, but it seems like a good place to start. > It's an internet comment not a journal article. "It's the internet so I can say whatever I want regardless of facts" is not a mindset conducive to meaningful conversation. I'm guessing again that it might be why the people on reddit dismissed you. You might not think that this is important, but, speaking to your complaint that outlets "give this impression that dissent arrises only from ignorance, and I must be some evil, Mr Burns-esque robber baron", it seems pertinent that the available interpretations for people encountering what you said are that either you didn't know that the real number was far lower than what you said or you knew and were intentionally misrepresenting things.

toddh 6y ago

Our neighbors drive from California to Mexico for dental work. Often. They have Medicare, additional coverage from a union, and Kaiser.

wahern 6y ago
In the U.S. healthcare plans typically do not cover dental. In particular, neither Medicare nor Kaiser provide dental coverage AFAIK. Dentists are quite willing for patients to pay for services directly. They'll typically charge less than what even insurers reimburse as insurance billing is so time consuming and therefore costly. There's not much negotiating as when you pay directly you're pretty much paying market rate, unless you live in a rural area where there's little competition--i.e. no market. Market rate in Mexico is undoubtedly lower than in the U.S., though. Speaking of Mexico, they seem to have a pretty solid public healthcare program. Maybe expectations are lower, maybe people are sufficiently contented by access to relatively unregulated pharmaceuticals and medical practices regardless of poorer outcomes, or maybe griping doesn't make it across the language barrier to American news, but it definitely seems like there's less anxiety about healthcare in Mexico.
- toddh 6y ago
  Yes, I’m hoping everyone realizes that’s part of the point. We don’t actually even have “health” coverage, even those with what most in the US would consider top notch coverage.
- cultus 6y ago
  A person I know went to Mexico for a semi-elective jaw surgery. It was a great experience: more personalized attention than the US, high quality, and they paid much less.
TMWNN 6y ago
>Our neighbors drive from California to Mexico for dental work. Often. They have Medicare, additional coverage from a union, and Kaiser. As mentioned, dental coverage in the US is typically decoupled from medical coverage. (This is the same in Canada.) Your neighbors go to Mexico purely because most things, not just dental work, is cheaper there, as opposed to said dental work not being available immediately. Very different from why Canadians typically travel to the US for medical care, which is either a) to avoid long lines (and legislative prohibition of private clinics to pay more for quicker access), or b) expertise that isn't available in Canada.

TMWNN 6y ago

>A significant minority of Canadians agree with me, so it's not like this is some radical position. Various Canadian politicians agree including Prime Minister Jean Chretien, who secretly traveled to the Mayo Clinic twice in 1999 (https://web.archive.org/web/20100204202553/http://www.montrealgazette.com/health/ultimate+tier+health+care/2515150/story.html https://web.archive.org/web/20100204202553/http://www.montre...) during "ski trips" (https://web.archive.org/web/20160624132234/http://www.ezralevant.com/danny_williams_flies_to_us_hea/ https://web.archive.org/web/20160624132234/http://www.ezrale...).