4 ms·
What about quality of care tradeoffs? In Canada, for example, you are forced to use the government system, and if it doesn't deem you important enough, there is
by solaarphunk 2mo ago
What about quality of care tradeoffs? In Canada, for example, you are forced to use the government system, and if it doesn't deem you important enough, there is no private option.
- intuitionist 2mo agoThe private option is medical tourism to Buffalo or whatever.
- t-writescode 2mo agoIs this quality improvements including or ignoring the 30-ish percent rejection rate of the most popular healthcare system, including such gems as insulin and pre-authorizations refusing surgery for necrotic tissue when “maybe they could PT it, have you tried?”
- aidenn0 2mo agoPT? Luxury! My daughter had PT referred by her pediatrician, then the insurance didn't pay all of it and when I asked the insurance company for the EOBs they said they were not allowed to give them to me because it would violate my daughter's privacy.
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- bcrosby95 2mo agoOur insurance paid for the bill from my wife's surgeon but spent 8 months refusing to pay for literally anything else, including the anesthesia. They said it was "medically unnecessary".
- poncho_romero 2mo agoWhat about them? The Canadian healthcare system has better outcomes than the American healthcare system in several areas. Most simply, Canadians live longer.
- nxm 2mo ago6 month median wait time for treatment, as in the case now in Canada, is not something I'd trade the American system for.
- shigawire 2mo agoThe difference is wealthy people get the care immediately in the US while the poor can go to the ED and get a bankruptcy.
- otherme123 2mo agoI also feared this, until I read that some US citizens avoid going to the doctor until it is unbearable. Take this examples: here in Spain you go to the doctor because you think that mole is slightly bigger than past year. They point you to the dermatologist in january 2027, a terrible 6 months waiting. In the US a lot of people thinks "hey, doesn't look that bad, and it could cost me $5,000". Five years pass, and now the mole is five times bigger, it bleeds and... well, it is a full blown melanoma: you get to the dermatologist 1 day after consultation, yet is too late.
- hbn 2mo agoI'm 29 and when I was a kid, getting a family doctor used to be an easy task and if you needed to see your doctor you could get in that day. Now all the doctors are so overworked, they're fleeing to America where they can get paid a reasonable wage for a reasonable amount of work. If you can even get a family doctor, if you want to book an appointment, they'll ask you which day you'd like 4 months from now. My mom's been dealing with an issue with her lungs for the better part of the past year, and trying to get help through any of the intended methods just gets her put on a 2 year wait list. At this point her plan is to pay tens of thousands of dollars out of pocket to see a specialist in America. The current generation of elderly Canadians now having lived a long life spent most of that life in an entirely different Canada. My generation is going to die on a waitlist.
- 0xy 2mo agoCan you reconcile this with skyrocketing Canada to US medical tourism?
- Tepix 2mo agoSo the government provided healthcare covers everything then? If not, you cannot legally get it by paying for it by yourself? Curious.
- jplrssn 2mo agoMy understanding is that a clinic or hospital can’t legally charge you for a procedure that’s universally available through the provincial healthcare system. So you’re free to pay for anything else if you want.
- skuzye 2mo agoSame here in the UK. If you need to see a specialist, you regularly have to wait months, assuming you can even get a referral in the first place.
- otterley 2mo agoThis is frequently true in the USA as well. My provider's dermatology department is pretty backed up and couldn't make me an appointment for an excision until November. Fortunately it's not urgent.
- nxm 2mo agoDo you have any more evidence than this anecdote - pretty much any specialist is available this week in my area. Did you check ZocDoc?
- otterley 2mo agoI'm a Kaiser member, so I have to use their providers. The same restriction would hold for any HMO that has a closed provider list. You should see how long their surgery departments are backed up!
- dpkirchner 2mo agoAre all of those specialists "in-network"? Have you tried contacting them to see if they truly have availability? It's common for providers (or the insurance carrier), at least in my area, to claim they take new patients when in fact they do not. (For those not in the know, out of network means costs to the patient are much higher).
- ElProlactin 2mo agohttps://healthjournalism.org/blog/2024/08/in-the-u-s-wait-times-to-see-a-doctor-can-be-agonizingly-long/ https://healthjournalism.org/blog/2024/08/in-the-u-s-wait-ti... https://www.chiefhealthcareexecutive.com/view/hoping-to-see-a-doctor-expect-to-wait-a-month-or-longer https://www.chiefhealthcareexecutive.com/view/hoping-to-see-... ZocDoc isn't reflective of availability as a whole. It has a lot of depth in certain areas, like dentistry, dermatology, and primary care, and less in other specialties. Many of the providers are not physicians, they're NPs and PAs. Perfectly qualified for certain kinds of issues but not others. ZocDoc is also, obviously, working only with the providers who are willing to pay for new patients, such as newer practices trying to build a patient base. An established practice that is booked out for the next two months obviously isn't going to use such a service. Finally, you're not considering insurance and continuity of care. So yeah, in an urban area, you can probably find someone to see you sooner than later if they're in network or you can afford to pay, and you're okay with seeing someone you might never see again or with whom there might not be continuity of care.
- triceratops 2mo agoDoes American private insurance pay for everything? And if you say "but they can pay out of pocket", well Canadians can come to America and pay out of pocket too.
- t-writescode 2mo agoNo. For a lot of people it very much doesn’t. And the cost is very prohibitive for people getting any care at all when insurance doesn’t cover it, so they end up not getting necessary care and then ending up on disability for life. A healthy population *makes money for taxes and buying things*, too.
- triceratops 2mo ago> For a lot of people it very much doesn’t. It was a rhetorical question. I'm aware it doesn't.
- dbspin 2mo agoInteresting. In every European country I know of, the private option is still available. Just vastly cheaper and more beneficial due to having to compete with a public option which covers basic necessities, surgery etc.
- slibhb 2mo agoCanadians can (and do) just cross the border and use private US health care. The vast majority of them live near the US border.
- dbbk 2mo agoYes, this is what I find a little odd about the US proposals. I've lived in UK and Spain and in both they have great free public healthcare for everyone, and if you (or your employer) want to layer private insurance on top you can. Wouldn't that be a much more appealing proposal to Americans?
- nradov 2mo agoPerhaps, but given the current shortage of healthcare providers we would probably see many doctors drop out of the public healthcare system and only accept private insurance or cash payments.
- dev_daftly 2mo agoThey have also started recommending patients just kill themselves too
- ses1984 2mo agoThere are private options for lots of things in Canada, depending on the province. Without data on what proportion of people are denied and what the consequences are, this isn’t a good faith argument. On the flip side, cases that would get care in Canada are denied in the USA by private insurance. Private options are far outside the means of most people.
- cgh 2mo agoYes, roughly 30% of health care in Canada, from dental care to cosmetic surgery, is privately funded.
- a_square_peg 2mo agoI think the tradeoff is that in the US, on average one gets to spend about $4000 more per year and live about 3 years less when compared to Canada. https://commons.wikimedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://commons.wikimedia.org/wiki/File:Life_expectancy_vs_h...
- jandrewrogers 2mo agoThe differences in life expectancy are due entirely attributable to vehicular accidents, homicide, and life style factors. It has nothing to do with medical care.
- zulban 2mo agoThere's problems with every system, but as a Canadian, it doesn't sound like you know anything about our health care.
- al_borland 2mo agoMy dad, in the US on Medicare (one of the government funded systems), was denied a test. Because we have the option and had the money, he went and got the test himself on his own dime. That kicked off a series of events that led to a quadruple bypass, avoided an impending heart attack, and likely added many years to his life and his ability to remain and functioning member of society. While I love the idea of never having to think about health care costs for a variety of reasons, I do like that some services are available to anyone with a wallet and not locked behind government controlled gates.
- otherme123 2mo agoI don't know about Canada, but here in Spain you have both. You have public health guaranteed, but many people also have different levels of private coverages, usually to get quicker appointments. As I understand Medicaid, it would just be open Medicaid for 100% of the US population regardless of the income, remove Medicare (they are now under Medicaid), leave the private sector as it is. Do you think Medicaid is too slow, too low quality, too terrible in general? Pay for private insurance, but you can still go to Medicare if needed.
- GreenPlastic 2mo agoThis is what is never mentioned. Quality of care, access to cutting edge treatments, timely access to care are never discussed when moving to universal healthcare. There are examples of private and public systems out there, which would be a much better model.
- BarryMilo 2mo agoThe number of ridiculous claims in this thread... First off, all Canadian provinces are different. Here in Quebec, there is a absolutely a private option. Not everyone likes that it exists, but most people seem to like having that option. Canadians live better for longer on average (for cheaper healthcare overall). Any other metric is just a misguided attempt to justify the US status quo, which has nothing going for it unless you're rich.
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- moralestapia 2mo agoI'm in Canada. The only time I ever needed a doctor in my life it was denied. I ended up having an issue that took ~5 years to resolve, which could have been prevented easily by any competent doctor in a 30 minute session. I'm originally from Mexico. With what I have paid in tax here over the years I can afford to set up and operate my own small hospital over there, with new equipment, this is not an exaggeration. "Free" healthcare, as with many other free things, turns out to be the most expensive kind of healthcare. Anyone who thinks otherwise doesn't really know what they're talking about or they're just stupid. What could work, imo, and since we're all giving opinions here, is private healthcare with a ceiling on profits. Let players take 2x-5x, but not 50x which is what they do now, bring and enforce usury laws into healthcare.
- grahar64 2mo agoIn New Zealand we have private insurance and universal health care. Insurance kind of fills the gaps and usually has faster turn around time, like 1-day vs 1-month for an MRI. But like insulin is free for everyone, so nobody is going broke while dying here rationing it.