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Comment by mhurron | Hacker News Reader

> Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance

For the citizen, none. For the insurance companies, they get forced signups.

> Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?

The US spends the most of any nation on health care. The US is the only western nation with increasing infant and maternal mortality rates.

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The increasing infant and maternal mortality rates are caused more by increasing obesity than any other factor. Improving prenatal care would help a little but doesn't get to the root cause of the problem.

http://www.vox.com/2016/8/8/12001348/more-women-dying-childb...

> For the citizen, none.

Actually, that's false. I can assure you that having lived in Canada and having moved to the US because of health care, having options beyond "deal with it" when not getting any sort of care or service is wonderful. Single-payer is great if you are actually getting the care you need. But when it fails, you are left with little to no alternative.

What's worse is that because of the perception that single-payer is so great, people don't really push for real solutions to solve its many problems. People would rather stick their head in the sand and ignore the very real problems, pretending everything is ok.

Until then, we happily live here in the US where we get more services for less than what it would have cost in Canada.

Somewhat off topic, it seems to be easier for Canadians to permanently move to the US then for Americans to move to Canada. In your experience is that true?

Not sure. I'm American. My wife is Canadian. My children, by virtue of being my children, have dual citizenship.

Edit: Just to be clear, I can't fairly compare. My wife has an easy time because of me and my children, and I had an easy time moving and working in Canada because of my skills.

The US system is great if you have money.

When some asshole sucker punches you and breaks your jaw, I'd rather be in Canada where getting it fixed is affordable.

> The US system is great if you have money.

Which has no role in the care my children receive.

> When some asshole sucker punches you and breaks your jaw, I'd rather be in Canada where getting it fixed is affordable.

Within the context of my comment, the US provided $0 and -2 week while Canada offered $30k+. and a 1.5 year wait.

You must be pretty healthy or never actually had to pay for care in the US. You also probably shouldn't assume you're the only one in the room who moved to the US from another country.

I moved to the US from Canada, thankfully I am pretty healthy and don't need the healthcare system beyond my yearly checkups. The first place I lived had someone who lived down the street who will be paying off a $100k bill until they die because of a heart surgery they had to have. Wonderful system.

On the other hand my father, who still lives in Canada, complained of shortness of breath one Thursday. Called his doctor and was told to go into the emergency room right then. He did, because he didn't have to worry about how much the visit would cost. They found a 90% blockage in his aorta. Was immediately admitted for surgery that occurred Friday. Was free to leave the next week. Total cost, $150.

Ya, US health care system is fucking awesome.

> You must be pretty healthy or never actually had to pay for care in the US.

Wrong. You probably shouldn't assume you know anything about me, or the situation I'm in.

> You also probably shouldn't assume you're the only one in the room who moved to the US from another country.

You probably shouldn't assume that it matters.

> The first place I lived had someone who lived

I was referring to problems with the system as a whole for entire groups of people, not just individual stories. My children being one of those where the Canadian system fails them horribly.

But no, continue believing that Canadian Health Care is perfect for everyone and that there are no benefits the US system for normal citizens.

> I was referring to problems with the system as a whole for entire groups of people, not just individual stories.

This person is not an isolated incident. Major medical care in the US is far more expensive than any other nation on the planet and for a large number of people in the US life saving care means financial ruin.

> My children being one of those where the Canadian system fails them horribly.

You can't be serious. Need your child to see their primary care physician in the US because it has a fever? That appointment is probably a week or more out, in Canada, they will see that child that day. And that visit will not cost money.

Simply posting as an American on HN I can make a good guess you are paid far better than the majority of the nation. Do you not know people that are not? When a child gets sick, it is a question on whether or not to call the doctor or go to urgent care because that visit costs money. If it's not the visit that is too expensive, its a question of if whatever treatment can be afforded.

The US system is entirely around how well you can afford to be. There are no benefits to the US healthcare system unless you are rich, a doctor or an insurance company.

> You can't be serious. Need your child to see their primary care physician in the US because it has a fever?

I'm not referring to a simple thing like a fever. I'm referring to more serious things, like autism.

> That appointment is probably a week or more out,

We got assistance from the US before we moved here.

> in Canada, they will see that child that day.

The wait time was years. Literally.

> The US system is entirely around how well you can afford to be.

The services that specifically benefit my children's autism has nothing to do with how much I can afford, or my level of insurance. In Canada, however, it would have cost me $30k+ a year to get assistance in the shortest amount of time, and that was still after a 1.5 year wait.

You are making assumptions, all wrong, about the situation my family is in. If you want to pretend that Canada offered better care for them, be my guest. I just hope you never have to go through what we had to go through. It was horrible, and your blind assumption that Canadian health care is superior in all cases is because you choose to remain ignorant of it's problems.

> There are no benefits to the US healthcare system unless you are rich, a doctor or an insurance company.

Or, in my case, I love my child and don't want to see him abused by a corrupted system.

Willful ignorance is a bad thing.

So I agree the US health care system is pretty crap - but as a trans person it was still better than my options in my home province (and by options I mean option). I think we can all agree that there are corner cases for each system where they outperform the other.

Apparently we can't agree that there are no benefits. =/ Every time I suggest issues with Canadian healthcare and how in some cases, the US healthcare system is better, people assume it's all a lie. And, well, frankly, that's why it won't get better.

At least the US is having that discussion.

I read the other comments to this comment, and I'll agree that you must either have money or decent health care coverage, probably a combination of the two.

I read differing stories about the Canadian health care system: Some places it works out better than others, no system is perfect. I'm American, I live in Norway. The system isn't perfect here either, but I never want to go back. Here it is mostly single payer, with some blips, but folks can choose a private doctor if they'd like to and can pay for the difference in cost.

Not having money/health care coverage in the states means things like suddenly having to change your children's doctor because they no longer accept the governemnt health care. Not being able to get surgery for cancer or your bum knee because you can't pay upfront. Considering bankruptcy because you had a heart attack and surgery for it. The hospital 'nicely' dropped the payment to 200k, but you were a flooring installer making less than 25k a year - which you are advised by the doctor that you can no longer do. Paying out of pockets for medications might be an issue, especially if your loved one's anti-psychotic costs 2,000 a month or the injection you take for your MS costs between 2,500 and 5,000 per month.

The market is great if you can pay to get the care you need, but when that fails, you are left with little to no alternative.

> I read the other comments to this comment, and I'll agree that you must either have money or decent health care coverage, probably a combination of the two.

That's incorrect. The benefits I receive have nothing to do with my insurance or my salary.

> Here it is mostly single payer, with some blips, but folks can choose a private doctor if they'd like to and can pay for the difference in cost.

Autism support in Canada falls into this "blip." Unfortunately, it's not as easy as going to a private doctor. Just because you need services now doesn't mean you can pay to get it, even if you had the money.

Sorry, but the idea that there are no benefits to the US system over the Canadian system is simply false. In my case, the US was cheaper, faster, and superior in ever way.

What I was lucky to have was the ability to make that decision to move. Canadians generally don't have that choice.

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