Isn’t that exactly the point that’s being made against a public health care system? At least that’s how I always understood it. “If everyone had access, I would have longer wait times” is exactly what I heard so often when I talked with Americans about the public health care system.
I think you found a feature, not a bug.
Yeah, with conservatives here in the US the “quiet parts” often include something about it being preferable for other people to suffer or die than for me to lose some convenience. They just keep getting louder and louder about it.
There are no shorter wait times in the US. Lol
The short wait times are a myth.
I went ot the ER with a heart scare in May. Turned out to probably be a panic attack, but they wanted a follow-up with a PCP just in case. The earliest appointment I could get with anyone within 100 miles on my insurance plan was in mid-July, and that wasn’t even with a doctor, but a PA.
I went to the appointment, and they spent 5 minutes with me and ordered labs. I go to the lab on the 30th of this month, and have a follow-up with the PA in October.
We’re looking at what’s essentially a 5 month wait for a diagnosis for an ER visit, and the total bill is gonna be around 15-20 grand.
Fortunately, I have “great insurance” so it’s only gonna cost me about $1500 to be told that the tests are inconclusive because they were 3 months after the incident.
Shorter wait times? The US healthcare system is a massive fucking dumpster fire. There are cases of people dying in hospital waiting rooms.
Probably if you’re a millionaire you can get shorter wait times.
The rest of y’all are fucked tho. Wish it wasn’t so, but oh well.
You can get shorter wait times in any other health care system too by using a private doctor. At least I don’t know a country where private doctors are illegal.
Even private ones can have long wait times in my country sadly
Then you probably don’t pay enough
Where are the shorter waits?! I called for a primary care appointment in July and only appointment was November or January the next year. FOR A 15-30 MINUTE APPOINTMENT. My insurance was billed $300+ for the visit.
My insurance was billed $300+ for the visit.
Rest assured, they didn’t pay $300+. Of course if you’d paid for it out of pocket without negotiating, YOU would’ve paid $300+.
That’s part of why the prices are so goddamn high. EMR and billing software for the US market gets a “billed” and “expected” field on charges and the “expected” value in particular differs by insurance I believe.
Conservatives bitching about how if we had Canada’s healthcare, we’d be waiting forever.
I have AMERICAN healthcare and I have to schedule a basic ass mandatory checkup 4-6 months in advance.
If it was an emergency, the next available slot is six weeks.
As a Canadian the last time that I had to go to the ER I was in and out in 2 hours and it cost me nothing out of pocket.
Now when it comes to procedures themselves oh there’s a bit of a wait. But generally if it’s serious you get bumped ahead cuz we use triage rules for most things.
if we had Canada’s healthcare, we’d be waiting forever.
Or another approach, calculate how much time it takes to save the cash for any given procedure and compare that to any socialized care. Say for an MRI, lab work, root canal, etc.
USA system is great if your wealthy. Otherwise you might as well be in a developing country as far as your access to all these high tech treatments we need massive profits on.
USA system is great if your wealthy. Otherwise you might as well be in a developing country as far as your access to all these high tech treatments we need massive profits on.
That’s pretty much the definition of a developing country. If you are rich you can live like a king in any country that’s not currently an active war zone.
The measure on how good a country is setup is how well the poor in that country live.
That’s pretty much the definition of a developing
I get what you mean, but USA isn’t developing. A developing country couldn’t if it wanted it; USA chose not to.
That’s fair.
Canada still doesn’t cover root canals. Dental is only now starting to come in on the public health care as is HRT.
Meanwhile I learned just how many people are living on ibuprofen (for years) or just saving up to get the tooth pulled rather than a canal.
Same… to get an appointment at my PCP in a decently sized city it was 7 months.
Sounds like it’s time to find a new primary doctor, that’s insane.
This is the new doctor 😭😭.
I called another place and they actually said to call back in a couple months. The healthcare system is so consolidated in my state that there’s only a few systems to go to. Maine.
I could schedule something hours away but then I’d need to take time off work to go or I won’t go because of the inconvenience
There is no such thing as US healthcare
We have “plans” you can get through your employer which will bring down your cancer operation costs to just $15000 in deductibles, assuming you don’t get fired for taking the time off to get the operation.
Otherwise, if you fall on a iron fence you can go to the ER
and at least the bill won’t impact your credit history.Sorry I’m being told that now medical bills impact your credit history.
I’ve been on a waitlist for my GI for more than a year ( I’m in the US)
The US does not have shorter waits. Try scheduling an appointment with a primary care doctor, their schedule starts like a month and a half out
I called to see any gp from a major hospital in my area last week. Earliest appointment is in Feb. Guess I’ll just go die.
Just looked on Zocdoc and there are 2 PCPs who are:
- less than 1 mile away
- covered by my insurance
- have multiple appointments available tomorrow, and many more over the default two-week span you’re shown
https://i.imgur.com/xKanonX.png
You’re full of crap.
Also, this is a dumb talking point that shouldn’t even be addressed as a serious critique of any country’s medical care. I hate it. It’s like people who want to see the post office abolished because they tried to send a package on a Friday afternoon after work and had to wait 10 minutes because everyone else wants to use the highly effective, cheaper solution for shipping.
What “waits” are we talking about here? Waiting in line at a hospital to be seen by staff? There are always going to be so many doctors in a facility for dealing with emergencies, no matter where you go. It can change at times of day or with workload. I’ve been seen immediately, and I’ve had to wait hours for ER service.
Are we talking primary care visits? Who doesn’t schedule them? Are there any countries where you can just walk into a doctor office and they magically have your tests and records just ready in-hand? Of course not, you make appointments. Same with operations and other medical procedures.
Let’s argue the only point that matters here: affordability - the promise that the amount of money taken off my paycheck guarantees me healthcare that won’t put me in devastating debt or ruin my life with additional costs. As it has done to me. It’s such a simple concept and talks about “wait times” are just deliberate attempts to muddy this basic human right we should all have in the richest country on Earth in the most advanced time on Earth.
It’s not a dumb talking point at all. The wait times are massively important as they are your actual access to said healthcare.
You do not have access to any healthcare if the wait times are so long that by the time you see the doctor you are iether recovered or dead.
The issue with wait times are multifaceted and can’t be fixed by switching to a different payment scheme. It has to do with hospital admin that cut costs at every opportunity. It has to do with the ACGMEs stranglehold on the amount of new doctors getting a medical licence comming in. It has to do with how few doctors are going into the lower paying specialties.
Wait times are different depending on the area, the procedure, and necessity but they are also so what based on luck.
Go into an ER because of a heart attack on a slow night and you get immediate treatment. Go in with the same issue on a busy night when they just had 3 GSWs dropped of at the ER doors, a cardiac arrest In progress, a CVA, and 5 psychs all in the ER right now. Not to mention a handful of incoming ambulances, and you will get the same treatment but much slower.
You spend a few hours in triage then finally get a room inside. Another twenty minutes before a nurse sees you. Another hour before a doctor. They run an EKG and labs in the meanwhile. You are having an NSTEMI.
After you get out of the ER. You spend a day in a hospital room for observation. They didn’t really do anything but you are feeling a bit better on your own. They tell you, you need to go to a cardiologist.
The hospital tried to find you one to transfer you there directly, but no cardiologist within 250 miles has any opening so they spend a few days looking and nothing comes up. You get discharged. You still need to see a cardiologist.
You call around and find which ones are covered by your insurence. You call their offices and they say they are booked out for 4 months. But you can be put on a wait list. There are only 20 other people on the wait-list before you. Maybe you will get lucky.
You where not lucky. 4 months later you finally get seen by the cardiologist. They discover that you now have left sided heart failure which could have been avoided if you just saw them sooner and got a stent placed. Now you are diagnosed with CHF which you will struggle with for the rest of your life.
Now you have to get regular checkup with your primary care provider but also with th cardiologist to keep an eye on things. You make sure to call 4 months in advance because that’s how far out they are booking appointments right now.
You have an appointment comming up in only a month, but your realy not feeling well. You are worried that it’s your heart again. You can’t seem to catch your breath and your body feels slow and heavy. You call your primary care doctor and they say, no we can’t see you. You have to go to the ER. You go to the ER. They run an EKG and basic labs. Everything comes back ok. Your ER doc says nothing I can do, go see your cardiologist.
You call your cardiologist and they say appointment in 3 months but if it gets worse, go to the ER. You call your Primary care and ask if they can move your appointment up. They say no. And they canceled your next appointment when you called because you where going to the ER so they figured you didn’t need it. The slot has already been given to someone else. But they will squeeze you in asap. Appintmet set a month from now.
This is the cycle that people live and die in.
Time matters. In an emergency, but also in routine daily care. Sure everyone makes appointment, but the problem is there are no open appointments for months.
If I get the flu and want to see my primary care provider to get diagnosed and get some antivirals it will be at minimum 2 weeks before I can see her. That’s the closest appointment. By then I don’t have the flu anymore and it’s pointless. What if I was old and unhealthy and that flu nearly killed me? Now I go to the ER and tie up emergency resources all because I could not get in to see my normal doctor.
Are we talking primary care visits? Who doesn’t schedule them? Are there any countries where you can just walk into a doctor office and they magically have your tests and records just ready in-hand? Of course not, you make appointments. Same with operations and other medical procedures.
In my province in Canada we have digital records. While there are some hiccups as a couple of systems merge to one I can see a doctor in the emergency room and then go see my GP the next morning and both the emergency room staff and my GP have access to all of my tests and records.
There are still issues with long waits but in my experience if you have a long wait its because your issue is not extremely urgent and while waiting sucks its better than needing the care urgently.
There are basically 3 main systems for universal healthcare in the world:
Beveridge model: the government runs the hospitals and employs the doctors, and any resident may use the services. This is known as socialized healthcare, and it’s what UK uses.
Bismarck model: the government mandates everyone get insurance from highly regulated competing insurance companies (some of which might be government operated and run, and some of which might be private). Everyone is put into the risk pools so that the insurers will collect enough from the entire population, including the low risk demographics. Those who cannot reasonably afford insurance are given government subsidies so that they can be covered, too. This is what Germany and Switzerland use, and is sometimes referred to as an “all payer” or “Swiss” model.
National Health Insurance Model: This is where the government gives everyone insurance and positions itself as basically the monopoly/monopsony health insurer to cover everyone and negotiate compensation rates for health care services provided by private providers. This is what Canada uses. It’s also known as “single payer.”
The fourth model of health care economics should be mentioned, as well. It does not promise, or even try to provide, universal health care. It’s the fee for service model, where private providers set their own prices and consumers decide whether to purchase those services. Sometimes insurance can be involved, but the providers are free to negotiate their own prices with insurers, but might opt not to take insurance at all and make the patients deal with that paperwork.
Many countries use hybrid models that combine elements of the Beveridge Model and the Bismarck Model, with government providers competing with private providers, and maybe government insurers providing a backstop for what private insurers won’t cover.
The U.S. doesn’t follow any one model. It follows all 4 models in different settings:
- It follows the socialized model for the military and veterans affairs, as well as the Indian Health Service for Native American tribes (the government owns the hospitals and employs the staff directly).
- It follows elements of the all payer model for most employer-provided health insurance (employers of a certain size are required to provide optional health insurance) and there are the ACA exchanges, where private insurance is highly regulated and is generally required to provide coverage to anyone who a>!!<pplies, and pays providers based on negotiated prices (and since 2021 providers can’t go after the patient for the difference if they don’t like how much the insurer pays).
- It follows elements of the single payer model for the elderly, through universal Medicare coverage for those over 65. Medicare is the elephant in the room for negotiating prices and procedures, and providers generally don’t want to refuse to take Medicare because it’s just such a dominant insurer among the elderly population. For example, federal law requires any hospital with an emergency room to provide life saving services to anyone who needs it, regardless of ability to pay. The actual mechanism for making that policy is by tying Medicare eligibility to that policy. In theory hospitals could refuse to provide emergency medicine to those who can’t afford it, but then they’d lose millions in Medicare funding.
- But the fundamental default in the U.S. is the fee for service model. Providers doing patient intake will ask “and how are you going to pay for this,” ready to accept either direct payment or an insurance policy.
Turning back to waitlists for medical appointments, the specific type of payment arrangement in the U.S. is a big determinant for the waits. Providers who take the most popular insurance plans might get their calendars filled weeks or months in advance. Especially in lower population areas that are underserved by healthcare providers. (Side note, expect things to get much, much worse for rural healthcare with the DOGE cuts to HHS and USDA.) But in the big cities, those with higher paying insurance can generally get seen pretty quickly.
There is no universal system in the U.S., so there is no standard experience in the U.S. It’s fragmented all to hell, and not only does it suck, it sucks for everyone in a different way.
Which one is France using? I like their system
As in many things, the US never takes the system that works best, but the one where it can extract the more money from its
inhabitantsressource.
Sorta makes some sense. People wait until it’s critical and then get rushed in with a heart attack, or they go to walk-in clinics which are a growing trend - a major downside is you don’t have a regular doctor that knows you health trends and can keep up a plan for you. Walk-ins start you from scratch every time. Getting to see your PCP, if you have one? Months for an appointment. Tell them it’s important? Couple weeks. Really important? Tomorrow or go to the ER.
I feel like the result from this image today would be to cut off the wings and make the fuselage weaker to make it cheaper to produce, because clearly they aren’t needed.
You forgot to give yourself a bonus after “contributing value” to the company.
U.S. health care is something else. It took me 7 years to be diagnosed with a well-known disease that has a median survival duration of 2.5 years from onset.
I’ll leave it to your imagination the obstacles I faced. Frankly, I don’t want to think about it.
How much of what you experienced is due to the medical mindset (doctors are morons)?
I’m not sure exactly what you mean but I would attribute it to four main reasons:
- I’m rural and the quality of physicians here leaves a bit to be desired
- Physicians are overworked and as a result, generally uncaring and unable to provide substantial help.
- It takes months to get the ball rolling on every step of the process
- Insurance is hellbent on denying everything
My situation didn’t improve until I was finally referred to a couple physicians in the right specialty who truly care and were willing to fight my insurance.
I moved to a rural location and your four points are exactly how it is. I have to harass my doctor to get them to put in referrals. My wife had to go and physically walk a referral from the doctor to the hopsital across the parking lot to make sure they actually got it. Then stayed and scheduled it right then b/c getting a callback for scheduling is a crapshoot.
That’s exactly what I meant, the biggest problem in the medical field is the doctors themselves, they’re basically useless at this point. You could replace them with a potato and give you the same first three points of your list, but for cheaper.
I would’ve been right there with you a few months ago, but I must admit diagnosis did unlock a lot of help for me.
The medical system needs to place a lot more emphasis on prompt and accurate diagnosis, though. Without it, you have people suffering and dying indefinitely. It’s like they don’t care about that, though. They’re happy to blame you for your symptoms and refer you to a psychiatrist or physical therapist. (Something that happened to me twice…)
Will the potato prescribe opiates to me? Massive improvement if so.
Shorter wait lmao
I’ve been waiting for almost a year to see a specialist for my depression
I have health insurance and my parents have money to pay for it, just that we aren’t rich enough to skip the line
Who told you about shorter wait times? Oftentimes you have to wait in months.
US -> Canada here
I hear this often in Canada, but honestly the wait times are similar. In the US it would often take me ~3 months to be able to see my endo. Also, at least you can get healthcare here.
Aussie here, I just booked to see an endo, wait time was about 10 days
I can see my primary within hours normally, she can’t do much except refer me to who I really need see and those appointments take weeks to make and months to get to.
I have a chronic pain issue and my primary referred me to a specialist that took sox months to see. They referred me to a different specialist with a six month wait-list. They then referred me to a more specific sub-specialist for another three month wait. I live in a reasonably well-off and well populated area, so I’m not out in flyover country or anything. I’ve heard the same from many people. Short wait-lists in America is a myth.
100%. Took me 3 months to get an ENT appointment. They’ve still done fuck all about the actual issue almost a year and a half later. The profit incentive is for return customers, not to actually fucking cure anything here.
My first six month wait was for an ENT. I’m actually past ten years, well over a dozen referrals, and three useless surgeries, but that’s another story.
Pro-tip, if they want you to see a neurologist, make sure it’s a headache specialist. I waited 6 months to see a neurologist recommended by an ENT, only to have her immediately refer me to a headache specialist because, duh, nasal sinuses are in the head. What really kind of pisses me off is that I asked the ENT if this specific Neurologist he recommended was good with my kind of issue, and he assured me they were. Total bullshit.
We desperately need more doctors, and those doctors need to cost less.
Free college would make a big difference for that.
Sort of. The US medical system has multiple choke points, but an undergraduate degree is the least limiting. The bigger barriers are the limited number of med school spots and the even smaller number of residency spots. Med school is a whole discussion, I don’t even think you should need an undergraduate degree, but whatever. The final filter is residency spots, which are functionally set by the government. They pay hospitals to take residents, and will only pay for a certain number each year. We gotta increase that number if we want to stop throwing away educated doctors before they can even get to helping people.
I’d say you’re right honestly. Especially since the majority of courses are really pointless for doctors. Organic chemistry only serves to weed out those who can’t or won’t study. You’ll use very little of it as a practicing doctor (Biology majors who take things such as immunology, genetics, etc def get more value than other majors)
Med school acceptance is definitely an issue like you said also. Its only getting worse, with the average GPA/MCAT/extracurriculars being waaaay higher than even in the 90s.
Residency, thankfully, is something theyre trying to address by increasing the slots. Of course they also have fucked anyone who needs FinAid for premed/med school so…
Seems like a simple enough case that there can be a fact of the matter. Either U.S. wait time are shorter than single payer systems on average or they’re not; no need to rely on anecdotal stuff.
Is there anyone that can point to some good data on the subject?
Honestly? I can’t do the searching for you this time, but it’s all the top results when you look for average wait times between countries. The data is easy to access. Pretty much all developed nations have similar numbers, with wide variation between specialties.
My other favorite refrain was the “You can keep your doctor!” crap that was a big selling point for that crowd.
In this system I have had 4 doctors move practices while under their care because they’re playing the capitalist system. I was not able to benefit from continuity of care in any form.
But at least I had to pay for it, not get it for “free” from a natl healthcare system. Yay.
Does american healthcare really have shorter wait times? I’ve seen a lot of people waiting and done a lot of waiting myself.
Is there any data?
While it may depend on what country you want to compare it to there is nothing about privatization that inherently reduces wait times. My experience is that after leaving the US my wait times are equivalent or improved.
Private insurance just means you wait, it costs a lot more, and you’re way more likely to delay treatment of your own accord because the profit motive makes the system a financial terror and a psychological torment.
its also propagandized, designed to make people wait, because the insurance would rather you pay for insurance and not use its services at all, because thats costs them money each time. hence thats why they raise rates for OLDER people(55+), to price them out of the system, and you hare the shitty ones like UHC/UHG, or blue shield deny drugs or procedures all the time.
Remember pre-existing condition exclusions? Hahahs good times 🤑
Sounds right to me.
if i had to pay for healthcare i better not be fucking waiting.
I probably don’t need to tell you this, but don’t visit the US.
Why do you think healthcare is tied to employment?
They only want to help if they can get a return on their investment. That’s all we are to them.
That’s all we’ve ever been.
The problem is that there’s a hell of a lot more of us than there are of them.
If we could only use our collective power to change things to favour all workers instead of the owners and elites… If only there was some way to regulate them into compliance to provide better, safer, and fairer, working conditions… To add some layer of oversight, where dozens of people that represent the majority of people across the nation to help bring forward what the people want, instead of the 1% just doing whatever the fuck they want…
That would be amazing. If only it existed…
Both parties are doing everything they can to make sure it doesn’t.
