Comment by didibus | Hacker News Reader

Comment by didibus | Hacker News Reader

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Having similarly done both, I agree. But, its only because I'm privileged in the US. And I think OP was talking about raising the median, so at least they no longer have to worry about affording health care. In that respect, the Canadian system works great.

If you can afford private care, and are lucky enough to have good insurance through your job, you'll get better care in the US. Not in terms of quality, but in terms of wait times, and how nicely people treat you. I think the actual medical interventions are just as good either way.

I don't know if it would be possible to have it both ways. Give universal health care that's decent to all, yet give even better care to those willing to shell out extra.

I know in Canada its always a big debate. Some people think a hybrid public/private system could do it. Others worry it will just marginalize the affordable health care and lower its quality and increase even more its wait times.

> f you can afford private care, and are lucky enough to have good insurance through your job

Isn't that basically saying "lucky to be full-time salaried"? I don't know anyone in such a position who has bad insurance.

>Isn't that basically saying "lucky to be full-time salaried"? I don't know anyone in such a position who has bad insurance.

I do. A friend of mine had a cushy tech job in Chicago. He recently quit to start his own business. I asked him about health care. His employer provided insurance was quite bad (high premiums). He's paying only about a $100/mo more than when he had the job.

And then there's the issue of what you mean by "bad insurance". I work in a top tech company which gives us multiple options for insurance. For most people, it works out alright, but for each option, you won't have much trouble finding some employee who thought he got shafted with a high bill (things like someone in the chain of care ended up being out of network even though he had done due diligence to ask all people involved).

The quality is also better if you have insurance. Firstly, because it's easy to see a specialist. Our friends in Canada don't even know you're supposed to see specialists for a lot of ailments. Second, most facilities have access to diagnostic equipment that even hospitals might not have in Canada (MRI machines, etc).

We see these as positives in the US (yay! more specialists! more MRI machines!) but they don't improve outcomes on a population basis and they drive up the cost of care. An MRI machine at every hospital in a metro just means that every hospital will try to get you to use them -- they've got to recoup their costs.

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