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Comment by rattray | Hacker News Reader

waiting lists "can be long" – it's time to stop parroting these misleading statements. They can be, if your test/operation isn't urgent. Urgent things are treated right away.

Frankly, as an American, I think we have shit quality of health service, based on the insurance cos' red tape and restrictions and paperwork alone. Getting healthcare in this country is a bureaucratic nightmare. Maybe the docs and meds and tests are good, but the overall service is bad.

(Disclaimer that I insist on Kaiser, an HMO – I would not live in a US area without it – which is pretty good, but helping family through health issues who had "gold standard" normal PPO was... different).

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My friend in Vancouver had lung xray show up something weird and the doctor scheduled her for an MRI. The appointment was in 7 months. Instead she got the MRI in a private clinic for a pretty reasonable cost and came back with the results for her doctor.

If that's not indicative of something broken, then I don't know what to tell you.

What do you think the odds were that it was something that would cause problems in fewer than seven months, or that if she experienced symptoms that they would move her up in line?

Genuinely asking, since I don't know any details about her situation or much about lung ailments.

I don't know the specifics, but there's also the mental cost of the doctor seeing something concerning enough that warrants an MRI and waiting 7 months just for the test; praying nothing gets worse in the meantime.

That's a very good point.

If she was able to get the MRI at a reasonable cost, doesn't that suggest that the system isn't that broken? As far as I can tell almost nothing comes at a reasonable cost in the US.

I think the criticism is probably of the Canadian health care system a la "She had to go to another country to get her scan in a reasonable period of time (and that country has a terrible global reputation for being insanely expensive and broken itself in the health care department)."

She didn't have to go to the US for the MRI; implication was the clinic was in Canada. Private care isn't illegal or anything there.

People from the US go abroad for care all the time.

Sorry, you are correct. Nevermind.

Some forms of getting private care are indeed illegal:

https://www.capitaldaily.ca/news/private-two-tier-healthcare...

From the article

>“In Canada, the absence of a private system is not due to the illegality of private health care per se,” reads a 2001 analysis in the Canadian Medical Association Journal. “Rather, the lack of a flourishing private sector in Canada is most likely attributable to prohibitions on subsidization of private practice from the public plan.”

Seems fair to me.

Things like paying for a non-public health scan are indeed facing legal crackdowns, though:

https://www.kelownanow.com/watercooler/news/news/Provincial/...

So someone in this position now would have fewer options besides waiting their turn in the queue.

> Extra billing is defined as additional fees charged by a physician or a clinic for a publicly-funded health procedure that is medically necessary, or when a patient pays out of their own pocket for such a procedure in a private facility

This is about extra billing, not per se about MRI. So still seems fair to me.

So it's fair that you cannot get an MRI done paying for it?

In any case, that shows that getting private care may not be an option in Canada.

> So it's fair that you cannot get an MRI done paying for it?

Yup, while the system is being subsidized with public money you can't just setup something competing while taking advantage of the public system too.

What were the results? If it was a serious issue that needed treated urgently there is a problem. If it was not then she was prioritised correctly and there's no issue.

By that logic, playing Russian roulette is safe if one doesn't die.

The question isn't whether it was a serious issue, but whether it had a reasonable probability of being one.

I'm in Canada. In 2010 my son was unwell, having issues with lethargy, balance and vomiting. We took him to the local children's hospital and he had a CT scan within 2 hours and an MRI an hour after that.

As part of his ongoing treatment the hospital scheduled an MRI every 3 months for a year, then every 6 months for 5 years, and now it's annual. The scans happen on time every time.

Waiting lists are prioritized based on urgency.

Each province administers it's own health care. So the level of service and time you have to wait varies significantly depending on where you live in Canada. Waiting six months for a specialist appointment is not unusual, for example, in say Quebec.

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