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Comment by criddell | Hacker News Reader

I’m a Canadian living and working in the US and I’d take the Canadian system any day of the week.

I think it’s crazy that your access to healthcare is dependent on your employment.

But it's also crazy that your access to healthcare is based on how the government prioritizes your need of it.

I agree with the idea of public healthcare, but not as a legislated monopoly. And that's true for government services generally. Monopolies don't benefit anyone except the monopolist, and competition makes everyone stronger. If the government wants to use it's buying and borrowing power (and maybe even taxation to the extent voters tolerate it) to provide a universal healthcare option, that's a big win. But if they want to push out other market participants in the name of some kind of fairness - well instead of having two-tier healthcare, everyone is on the bottom tier

> But it's also crazy that your access to healthcare is based on how the government prioritizes your need of it.

Triage is a pretty universal concept.

Healthcare has difficulty with competitive market effects because the amount anyone is willing to pay to live is essentially infinite.

>"... the amount anyone will pay to live is essentially infinite."

This has actually been studied, and is not true.

I suspect that there are people who would rather die than burden their families with crushing debt but that's a slightly different issue.

> But it's also crazy that your access to healthcare is based on how the government prioritizes your need of it.

So does every private insurer under the sun. You've never had insurance deny access to care? No insurer can afford to give an MRI to everyone a doctor wants.

> But it's also crazy that your access to healthcare is based on how the government prioritizes your need of it.

Doctor's prioritize need. More sicker, more quicker 'service' / treatment.

> I agree with the idea of public healthcare, but not as a legislated monopoly.

There is no monopoly on health care in Canada: if you want to cut a cheque you can get private care. What is legislated is that if you take provincial funding you cannot also take private funds. It's either-or.

At least in Vancouver there are private clinics[0] where you can get MRIs, CT scans, endoscopies, etc within the week if you are willing to pay.

[0] e.g. https://www.timelymedical.ca/

> Monopolies don't benefit anyone except the monopolist

For healthcare in Canada, the monopolist is the Canadian people.

It's not though. We have have ACA plans you get independent of employment and Medicaid for the unemployed.

Costs $20k for a family.

Just interestingly - the average per capita cost of Canada’s system is $4,000.

Of course in the US, there are costs beyond just insurance, but if you had to pay for coverage out of pocket it would be $16,000/yr for a family of 4.

Well the point is that you don’t have to worry about coming up with 20k if you leave your job in Canada.

Of course, but it puts the cost in perspective a bit if you did have to pay it out of pocket.

My "ACA plan" (Individual, bronze) through my state's exchange costs $2770 in premiums, which seems relatively good until you add the $8250 deductible. Now we're up to $11,020 for one person. Plus we're not counting whatever portion of my taxes also goes to healthcare expenses for myself or others already.

Are you making that decision because the quality of care you've received is better in the Canadian system than the American system, or because you disagree with how the American system is structured?

> Are you making that decision because the quality of care you've received is better in the Canadian system than the American system

That would depend completely on their job in the US. If they're a line cook, care was better in Canada. If they're a software engineer, it's better in the US.

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