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Comment by victor106 | Hacker News Reader

From the outside the Canadian healthcare system looks good. But I have friends in Canada who complain that it’s very very hard to get an appointment for a basic check up. They have to wait anywhere from 2 to 6 months. Also, they just end up going to emergency for anything. Your experience might vary. The same with UK also I hear.

I am no big fan of the American healthcare system but I don’t think any country (don’t bring up Switzerland and Singapore as examples, they are too small and don’t have the diversity, size and complexity of the US) has demonstrated an ideal healthcare model.

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The argument about the US being too large for X gets made for all kinds of X, all the time. It tends to not make a lot of sense. As the size of the country goes up, so do the available resources. Maybe there will be a couple of layers of additional organizational overhead, but there's going to also be access to a lot more economies of scale so it should be just a wash.

Why would health care be harder to scale up in terms of the size of a country than, e.g. the military or the fire brigades?

As for diversity... I don't buy it for your specific example. Switzerland has:

- Four official languages.

- A federal system with similar levels of decision-making devolved to the cantons as to the US states

- 11 political parties significant enough win seats in the parliament

- High levels of immigration: 30% of the population are immigrants.

The reason Switzerland shouldn't be brought up is that the health care system isn't particularly good, just different. In particular it's the second most expensive in the world.

In Toronto, my doc is always able to see me within two weeks for something non-urgent. They also have 24/7 number I can call to speak with a doc. And my doc responds to emails within a few hours. If there's something non-urgent but I want an answer right away I can go to a walk in clinic and be seen within an hour. The vast majority of Canadians live in dense areas like I do and have access to the same level of care.

Am in Germany and can get a basic check up figuratively every day of the year completely for free. It might take a day for a specific appointment, but if i just went to the doctor they would see me guranteed and could assess any ailments. So there you have a country that is similar enough to the US that shows how a single payer system can work. I agree, that there is no such thing as an ideal healthcare model :)

I am Canadian. This is not true. Doctors are quickly available for check ups and basic stuff. Some surgery have long waiting list. I imagine 6 months would be typical for knee replacement. The good thing is that the thickness of your wallet doesn't affect your priority, just the severity of your medical needs.

US has the worst of both worlds. It's very expensive and the wait times for specialist visit are not particularly fast. Forbes says it takes 24 days on average to set up an appointment with an specialist in the US - https://www.forbes.com/sites/brucejapsen/2017/03/19/doctor-w...

> US has the worst… it takes 24 days… to set up an appointment with an specialist.

The worst?

HN is one of the few forums that repeatedly leaves me speechless.

My indian friends travel to india to get routine medical procedures. My understanding is that you get priority if you have a pressing concern but long wait times for procedures that can wait.

What is considered as "can wait" can be pretty insane sometimes.

So why is size and complexity an issue? Why is it that in a country of 1.3 million people I pay a reasonable amount of taxes, get free healthcare and even if I do prefer a private provider pay EUR 50.- per visit. But a similarly sized US town can’t do that. So maybe the role of the feds is to make it so that the size and complexity would matter less?

Hi from Australia!

Even during Covid lockdowns that Sydney is going through at the moment, I can get a GP appointment this week with a 5 minute travel time.

We have a health system delivered by the States of our commonwealth, enormous distance to cover and extremely high health outcomes.

Canadian here, that’s just not true, you only have to wait if you want to see a specific specialist and they are fully booked, then you have to decide if you would rather wait or see someone else.

I still do not get why posts like yours get downvoted. What you say about Canada is true. Not always and depends on particular location but still there are examples of everything you just mentioned.

Lot of the anecdotes like yours probably stems from a deliberate propaganda campaign started by US Health Insurance companies. This is quick npr podcast about it- https://www.npr.org/2020/11/06/931990578/why-americans-have-...

> Canadians might wait several weeks or a few months to get a knee replacement

Hard to tell from this what else falls under "knee replacement" category of urgency. I personally know ppl who traveled to india to get a root canal. Weird to dismiss it as " deliberate propaganda campaign " and link to npr article with no actual statistics.

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