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I don't live in the US so take this with a grain of salt but I get the impression recently that with the insurance regime they have in place, for most people th

I don't live in the US so take this with a grain of salt but I get the impression recently that with the insurance regime they have in place, for most people the US effectively has socialized healthcare, with all of the downside. The advantage I think, is that if you have enough money you can get better care and not have to wait. But if you've got some run of the mill insurance you're relying on, you might as well be in Canada (our healthcare sucks) with massive wait times and very limited access to any kind of specialist. Personally I'm growing to favor a mixed model, where people pay for primary care and government insures treatment for really expensive, catastrophic stuff. That's much more in line with the normal way we insure things (insuring against regular, knows costs is stupid) and also makes sure people don't become bankrupt when they get a serious illness. Lastly, I was in a European country recently and got doctors appointments (without national insurance) for myself and my son basically on demand, for so little money it was not an issue. That's possible in the US too, I think the current "socialized" insurance system is the biggest impediment.

tourmalinetaco 3y ago
> That's possible in the US too Absolutely, as long as you don’t rely on hospitals for your care exclusively. We have many alternative care facilities in place, most of which are at cheaper prices and lesser wait times. Clinics (which can specialize in everything from mental health, dentistry, rehabilitation, general care), colleges/universities (for both students and non-students, universities with medical courses can provide free/discounted medical care), even some smaller hospitals will have days where they waive fees for general checkups/smaller tests. The staff may be “less experienced”, but I don’t need to waste my time and money on a doctor for an infection when they’ll prescribe me the same things a nurse practitioner would. And if I lack dental/eye insurance, then any care is better than none at all. Though it should also be noted that the US doesn’t have many easily available forms of socialized medicine. We have four forms, two of which are highly state-dependent (which means its a PITA to get). First, veterans get free healthcare for life, paid entirely by the taxpayer via the federal government. Similar to colleges, where prices are insane because its basically the government signs blank checks, but that price thankfully never comes to the vet directly, unlike colleges. Then we have Medicare and Medicaid, for those 65 or older and low income individuals respectively. You can get both, in fact the way coverages are split its almost assumed you will, but while Medicare is paid for by your own taxes, and thus almost immediately available to you once you hit 65, Medicaid is paid by everyones state taxes, and is notoriously hard to get. Additionally, since its a state-funded program, its offerings depend on each state. Finally we have “charity care”, also known as “financial assistance”, which federally is defined as “ free or discounted health services provided to persons who meet the organization’s eligibility criteria for financial assistance and are unable to pay for all or a portion of the services.”[0] This leaves the actual services available and eligibility at the discretion of state law, local law, and the hospital themselves. So our long wait times aren’t exclusively due to any socialized programs. Instead, it’s almost exclusively due to a doctor shortage. For one, costs and time are a natural gate that’s basically ever present outside of extreme situations. One of the major blockades is in residency positions, a requirement for doctors that’s held with a firm grip by Congress via Medicare. And that’s not even getting into the limitations for importing doctors permanently via green cards. [0] - IRC Section 501(r)(4) - https://www.irs.gov/charities-non-profits/financial-assistance-policies-faps https://www.irs.gov/charities-non-profits/financial-assistan...

tourmalinetaco 3y ago

> That's possible in the US too Absolutely, as long as you don’t rely on hospitals for your care exclusively. We have many alternative care facilities in place, most of which are at cheaper prices and lesser wait times. Clinics (which can specialize in everything from mental health, dentistry, rehabilitation, general care), colleges/universities (for both students and non-students, universities with medical courses can provide free/discounted medical care), even some smaller hospitals will have days where they waive fees for general checkups/smaller tests. The staff may be “less experienced”, but I don’t need to waste my time and money on a doctor for an infection when they’ll prescribe me the same things a nurse practitioner would. And if I lack dental/eye insurance, then any care is better than none at all. Though it should also be noted that the US doesn’t have many easily available forms of socialized medicine. We have four forms, two of which are highly state-dependent (which means its a PITA to get). First, veterans get free healthcare for life, paid entirely by the taxpayer via the federal government. Similar to colleges, where prices are insane because its basically the government signs blank checks, but that price thankfully never comes to the vet directly, unlike colleges. Then we have Medicare and Medicaid, for those 65 or older and low income individuals respectively. You can get both, in fact the way coverages are split its almost assumed you will, but while Medicare is paid for by your own taxes, and thus almost immediately available to you once you hit 65, Medicaid is paid by everyones state taxes, and is notoriously hard to get. Additionally, since its a state-funded program, its offerings depend on each state. Finally we have “charity care”, also known as “financial assistance”, which federally is defined as “ free or discounted health services provided to persons who meet the organization’s eligibility criteria for financial assistance and are unable to pay for all or a portion of the services.”[0] This leaves the actual services available and eligibility at the discretion of state law, local law, and the hospital themselves. So our long wait times aren’t exclusively due to any socialized programs. Instead, it’s almost exclusively due to a doctor shortage. For one, costs and time are a natural gate that’s basically ever present outside of extreme situations. One of the major blockades is in residency positions, a requirement for doctors that’s held with a firm grip by Congress via Medicare. And that’s not even getting into the limitations for importing doctors permanently via green cards. [0] - IRC Section 501(r)(4) - https://www.irs.gov/charities-non-profits/financial-assistance-policies-faps https://www.irs.gov/charities-non-profits/financial-assistan...