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Comment by pcmoney | Hacker News Reader

“Full health coverage” according to all my EU and especially British friends I would still be on a waitlist for a surgery I had 2+ years ago.

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Non-essential surgeries tend to have longer wait times (such as hip replacements in elderly people), but conversely, essential care is accessible to everyone at no cost and in a timely manner.

I live in Canada, and recently had appendicitis. My appendix was removed less than 24 hours after symptoms began, and 10-12 hours after I arrived at the hospital. I walked in to the ER (after a very painful car ride), they asked me some questions and gave them my health card, they said how much, I said 7, they did blood tests and I had a CT scan, I waited a few hours, and then I was wheeled up to the operating room, after which I spent the night in the hospital and discharged the following morning. Not once did the question of insurance or payment come up, and I even had a private room after the surgery.

What you describe in your last sentence is one of the reasons I went with Kaiser. Yes, there are still co-pays for most treatments and prescriptions, but they have in my experience never been more than $20. This includes an elective procedure. It seems to share some aspects of the Canadian system you described, such as longer wait times for non-essential care, and a relative lack of choice in which doctor you see. But to me that is an acceptable trade-off for care where no single visit has cost me more than I would have spent on lunch that same day, and has been consistently of high quality.

> Non-essential surgeries tend to have longer wait times (such as hip replacements in elderly people)

Something ridiculous like 70% of lifetime healthcare spending in the US occurs in the last two years of a person's life (half-remembered number from like 10 years ago). The uncomfortable truth is that we spend way too much on hail-mary treatments for people who are almost certainly going to die, and too much on useless shit like knee replacements for the elderly, and far too little on the earlier stages of their life. But nobody wants to tell the elderly "no" because they vote.

Obamacare had the right idea with "death panels". A lot of treatments that happen near the end aren't medically justified by quality-adjusted years-of-life or similar metrics. And that money comes out of the healthcare of younger people, whom the US treats like shit compared to the elderly. Because they don't vote.

But nobody likes the optics of "pulling the plug on grandma".

I’ve waited longer for basic treatment in the US than I did anywhere else in the world and still paid exponentially more.

And all that extra time and money got me was people saying “You should be glad it isn’t socialized health care!” Yeah. If it were, I would’ve gotten treated faster and cheaper.

Both of these things are true. I don’t want to fully derail the larger discussion, but having lived in both EU and US and used healthcare in both, basic care is significantly better in the EU than the US on nearly every facet. The exact reverse is true for specialized care.

I'm waiting 4 months to see my GP for a physical in Wisconsin.

In Europe they don’t even normally have physicals! The NHS has never just checked up on me like that - they just couldn’t afford to do it.

NHS Health Check is the equivalent of the Medicare Annual Wellness Visit. It's recommended every five years, starting at age 40, for people without pre-existing conditions.

For people with pre-existing conditions it begins at a younger age and is recommended more frequently, based on the determination of your GP Surgery.

You should get your first invitation to an NHS Health Check around the time of your 40th birthday.

https://www.nhs.uk/conditions/nhs-health-check/what-is-an-nh...

Physicals are annual in the US and done pretty much every year and covered 100% by every insurance I have ever had.

Vastly different across Europe

They could lobby their elected officials to spend more on staff, and facilities.

But you’re right, you’ve put me off on the whole idea. Good effort. There’s no way around artificial scarcity.

Zombie argument. This has been show to be inaccurate numerous times.

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