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Comment by gpm | Hacker News Reader

Because we have functional universal healthcare, safety nets that let people stop working when ill, etc.

I've lived in both, I am very happy I am in Canada instead of the US right now.

Because we have functional universal healthcare

You'll have to define "functional" for me, as someone who frequently hears advertisements on Palm Springs radio stations for hospitals offering to perform medical services on snowbird Canadians that they can't get done at home.

Uh, does "I can get whatever care I need, whenever I need it, for free" work for you?

Apart from purely elective plastic surgery (which isn't free, or needed) I really can't think of any services that could be being advertised. Maybe your hearing advertisements for medical care that doesn't involve returning to Canada instead of medical care not available in Canada?

You may want to stop waving that "Whatever care I need, whenever I need it" flag.

The average wait time from a GP's referral to seeing a specialist in Canada was 8.7 weeks in 2018. Meanwhile, this USA-an doesn't need a referral to see a specialist. I can just pick up the phone and make an appointment.

"Specialist physicians surveyed report a median waiting time of 19.8 weeks between referral from a general practitioner and receipt of treatment"

That goes up to almost a year (45.1 weeks) to wait in New Brunswick for treatment.

Source: https://www.fraserinstitute.org/studies/waiting-your-turn-wa...

I don't know where they are getting their numbers, but the one I can easily fact check for you are flat out wrong, and the other ones all strike me as very suspicious.

> Canadians could expect to wait 4.3 weeks for a computed tomography (CT) scan, 10.6 weeks for a magnetic resonance imaging (MRI) scan, and 3.9 weeks for an ultrasound.

I've had multiple ultrasounds (outside of a hospital, no urgency) the waiting time is literally 0. I walk in to the imaging clinic and hand them the piece of paper the GP gave me 10 minutes ago and get one.

I've had a CT scan (in a hospital, medium urgency), the waiting time was "a few hours".

I've never needed a MRI, the only person I know who did need one (very urgently) got it within hours.

The waiting time for specialists does not strike me as believable, but given that there is variation across the different fields I can't authoritatively say they are wrong. For context, I just needed to see both a dermatologist and a urologist (nothing serious, no medical related urgency), the waiting time was roughly 2 weeks and 3 weeks respectively.

Well they are using the Fraser Institute, it's a right wing think tank that aims to take away things like universal care in favour of private care. So, I wouldn't trust it.

US wait times aren't ideal either. I scheduled a dermatology appointment (suspicious mole, so this is a necessary treatment, not getting my acne treated) and my wait time is three months for the appointment. My dad was telling me his derma usually schedules a year out, they set up next year's appointment while he's in the office.

The Fraser Institute is not a reliable source, it's a right wing think tank.

Thanks for letting me know. I picked it because it was the first result in Duck. The second one was Forbes, but I figured with "Fraser" in the name it would be more Canadian.

For sure, no worries. It's really hard to decipher what is and isn't a reliable source sometimes. I spend a lot of time on this topic so I know a lot of the usual ones to watch out for.

Just one data point: in the US recently (but before COVID-19) I called around and the best I could do was about an eight week wait to see a GI specialist. So that's apparently comparable to the Canadian average, but in Canada it's free.

Uh, does "I can get whatever care I need, whenever I need it, for free" work for you?

As a Canadian, I can agree with the "free" part, but not the other two. There are things that aren't covered and if you're not dying, the wait can be long.

Would rather wait for my surgery than pay six figures for it

Sounds like you've never had any life-threatening medical problems.

Which are not electives are they

This trope is getting old. Wait times are long for things like hip and knee replacements. Barring a global pandemic, you are getting in ASAP if you are in critical condition. There are without a doubt cases that slip through the cracks, and everyone agrees, especially healthcare workers, that more can be done there. People are not dying in waiting rooms because they weren't seen in time after a stroke, that's a myth.

Bennett was referred for surgery on her right hip in November of 2013 and said she’s been told she won’t get in until early in 2016. She said her joint has deteriorated so much she is unable to work or even function without strong narcotic painkillers.

https://www.cbc.ca/news/canada/british-columbia/patients-liv...

Something weird is up in that case

> Across the country, 76 per cent of patients received a hip replacement in 2017 within the recommended six-month wait time, down from 81 per cent in 2015.

https://www.cbc.ca/news/health/hip-knee-replacement-wait-tim...

I think a lot of the waits are very location driven.

I do agree it's an extraordinary case.

This conversation got lost somewhere between "IF you're not dying" and "life-threatening medical problems"

What are examples of medically necessary procedures (i.e. not elective plastic surgery or elective botox) that aren't covered?

I'd argue that "when I need it" is true, for non urgent matters that might not be when I want it. Personally I've had good experiences on the when I want it side too, but I know that does vary a fair bit.

I've heard very different reports from folks in British Columbia who need specialist care. As with anything that affects a large group of people, your mileage may vary! This is important to remember, as I see it.

Dual citizen here. Most of my life I've lived in the US (Massachusetts and California) with excellent medical care though I often got lots of charges, out of network fees, co-pays, etc. Then the last decade I'm in British Columbia. Despite all I heard when I lived down south I've found the Canadian care to be, yes, excellent. My spouse just got a new knee, very fine treatment start to finish, out the door cost was $0. I can see my GP w/in 24hrs. No one asks about money, no one asks what insurance plan, everyone from the CEO to the very poor are all on the same plan. It's so much more civilized in Canada.

Not in Quebec. The healthcare system in Quebec is in ruins with extended wait times and walk in clinics turn off walk ins frequently. Nurses & Doctor shortages are acute in Quebec to the point that retired nurses are being asked if they could come back to work.

I've gotten healthcare in Quebec a few times and never had any issues - what's your source for this as it just sounds like anti-medicare for all FUD.

It is functional alright. Here is an example:

California has tested 8,316 people total so far [0]. My province of Alberta has tested 8,887 people [1]. This is even though the population of my province is 11% of the population of California. In fact, the population of California alone is higher than the population of Canada, let alone my province.

Put it another way, California has tested 210 people per million residents. Alberta has tested an order of magnitude more, 2030.

Edit: Today's numbers for Alberta are in. Alberta has completed 10,598 tests, or 2,425 tests per million population.

[0] From https://covidtracking.com/data/

There is some uncertainty about the number, but not so much that the real number would be an order of magnitude higher.

[1] https://www.alberta.ca/coronavirus-info-for-albertans.aspx

Citing testing after the CDC's failed initial test reagents is not painting a whole picture of care capability. The testing will catch up in the US. What isn't easy to scale is the critical care of patients who are hardest hit. That is a capability which the US excels in:

[1] USA has 34.7 ICU Beds / 100K [2] Canada has 9.5 ICU Beds / 100K

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351597/ [2]: https://www.researchgate.net/publication/275101876_Critical_...

Given the current situation, the relevant question is which country's healthcare system is most likely able to handle the coming influx of demand. The answer is probably unknowable and will vary quite a bit across each country.

The good news is after this is all over we'll see exactly which healthcare systems are "functional" in a pandemic, ones flush with cash or ones starved for cash. We don't know that quite yet.

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