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Comment by Etrnl_President | Hacker News Reader

Now imagine doing this on Canadian healthcare, having to wait months or years for each appointment, and nowadays they try to talk you into MAID to save resources…

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I live in the US. I am a software engineer making more than a half a million annually. I have access to tremendous resources and can advocate for myself and my family. I live in a college town because of my wife's career. It is not a big city, but is also not rural middle of nowhere.

Getting a routine gynecological appointment for my wife any time in the next six months is impossible. I gave up on trying to get an appointment with an allergist for myself, even after getting a referral. What you describe is common in the US too, even for those with means. I cannot imagine what it is like for somebody who doesn't have money and insurance.

Preach.

I wanted to get a sleep study done to get to the bottom of my occasional insomnia. My PCP at the time put in the pulmonologist referral (because this hospital network required a referral to get a sleep study done, which is insane in its own right, but that's neither here nor there).

This was in January. His next available appointment? March! For a friggin sleep study! And I have a HDHP + HSA and was going to pay full boat!

(He also prescribed me with an antipsychotic that can double as a sleep aid at low dosages, which I didn't take because five minutes of research into it made it obvious that taking that for extended periods of time is bad news bears. I stopped seeing him after that.)

(For those looking for answers like I was, I eventually stumbled upon Cognitive Behavioral Therapy for Insomnia, or CBT-I. It's essentially a rigid sliding window-style sleep schedule plus challenge therapy to make you rethink how you approach sleep. I've been doing this for six months now and it has been transformational. Best part? No meds!)

FYI: I'm not a doctor and this isn't medical advice, but you can buy an APAP machine over the counter with money in your HSA, then hack around in it to figure out if you have sleep apnea and how bad it is if so

My wife got a sleep study done within 2 weeks of booking one, after she asked to be put on a cancellation list. Her actual appointment time was for end of October, scheduled about a month ago. You may need to be proactive and ask to be put on one, for some reason no one mentioned to her that there is one.

Well, no need to imagine any longer my friend. I have neither money nor insurance. My experience is identical to yours...other than that whole allergist thing. That's not something I would seek out answers on, as it is simple to figure out at home, and when you do get to an allergist, you will likely hear something very useless like "yeah you're allergic to at least some degree to these 17-25 different things; please try to limit exposure". :-D

I know HN is a privileged place but people should recognize that the “worst case” of Canadian/European healthcare wait times is already the reality for many if not most Americans.. You shouldn’t base your understanding of American health care on personal experience if you work for a big company that provides a nice health insurance plan.

I have jank government insurance and this is not true. When I got out of prison and had no insurance I went to the city's clinics. Wait times have never been an issue (at most was two weeks for specialist). The doctors in the clinic were also friggin amazing doctors/people. I had a ton of shame around getting out of prison, some much shame about needing to get tests ran for HIV/Hep from being in prison but they were so good about it all (all came out negative so woohoo).

Now dentists...when we had money we went to a family friend. He still totally f'd us and did unnecessary work. It's only now that I have a cash only country dentist that I trust my dentist again. Crazy part is the cash only dentist ends up being cheaper than my previous copay/premiums insurance dentists.

I'm always surprised when people leave comments like these, based on nothing but N=1 anecdata. You don't have any authority to say something like "this is not true" with regards to the whole of the American healthcare experience. Compared to my own personal experience, yours was uncommonly-good. Wait times for specialists for my SO's heart condition are routinely several months out.

What this demonstrates is that wait times are widely variable by specialty and region. Arguments like "for most Americans" are wrong on their face, because most Americans don't live in the same area or have the same issues.

My wife and I have both had to see various specialists. Some had very long wait times, many didn't, and of those that did, we were (fortunately) able to call around to different clinics to find one that wasn't too bad.

"Most" comes from the actual data

The exceptions are part of that data set

Really...

To be fair, their statement of n=1 is more evidence than the other person posted (comment without any evidence). Although both are weak.

I mean, n=1 of a guy that had a good experience -- n=roughly 28,000,000 with no health insurance at all. These don't seem like two sides of the same coin in my view.

I'd the original comment actually mentioned that and laid out a theory behind it, that would be different (is that health insurance or dental insurance?). Even your comment about uninsured people doesn't fully connect the dots or explain what their experiences are, as some people in these comments are stating that cash dentists are cheaper/easier to deal with than with insurance. I have had experiences that also back this up.

This is not true.

I mean, the wait times sometimes are, but they vary by province. More conservative provinces have worse wait times. That is not surprising given that the provincial conservative government are all actively attempting to sabotage public healthcare so we can move to an American style system. A system where we will all pay more, and still see similar wait times anyway.

MAID is not actively proposed as a way to save resources.

> More conservative provinces have worse wait times.

This feels like a pretty glaring generalization. If we look at the actual data, the story becomes a little more nuanced [1]. "Conservative" provinces have wait times that are a couple of days to a couple of weeks higher than national average (assuming we call BC, AB, SK and MB "conservative" [2]), but then again almost all of the maritimes provinces (which are considered strongly liberal-leaning) have abysmally bad wait times relative to the average (10-20 weeks worse).

Overall, the average is ~half a year anyways, which is pretty rough regardless.

[1] - https://www.fraserinstitute.org/file/waiting-your-turn-2021-... [2] - https://en.wikipedia.org/wiki/2021_Canadian_federal_election, "Results by province and territory

AB, SK and MB are conservative with high rates of Trump flags.

And nice lies dude. They all have over double the national average!

Don’t use Fraser institute for sources. They are a far right “think” tank. If they posted it, it’s a lie or misrepresentation.

Absolutely true, and that is if you even have a family doctor to refer you to a specialist. For those who had the luck to lose their family doctor (mine through retirement), it is impossible to find one that takes new patients. Many retired during covid, many more only work part time. The Canadian health care is a disaster at this point, and those who have a family doctor have no clue how awful this is.

In the US it's not easy to find a primary care provider also. When we moved couple of years ago and called a local medical center to establish a primary care provider, we were given answers like "we have the nearest appointments in 6-8 months". If you have something urgent, there's telemedicine line where you can talk to advice nurse or if there's something really urgent, get an appointment with an urgent care doctor. But all primary care providers seem to be booked solid for months. And given how many patients they'd have and how often they see each one, establishing any kind of personal care relationship is out of the question. How personal can it be if you can see you doctor twice a year for 20 minutes? I think the only solution is go get rich enough so you can afford personal concierge doctors or however it is called (no idea since I'm not rich enough).

rich enough so you can afford personal concierge

A few minutes research suggests it's not that expensive. (As little as ~2000/year).

For most people, that's expensive.

No, it isn't. Most people pay about that much for their cable. For the bottom 20 percent, yes, it is a budget-buster.

However, that is beside the point. Believe me, I hate explaining simple, simple things--but the person I was responding to is probably comfortably middle or upper-middle class and could afford a miserable 2000/year on a doctor. He doesn't have to become "rich enough", and almost 100 percent of the people in this thread don't have to either.

Average canadian income is 60k

2 k is a lot for even those at the 50th percentile and extremely significant for those below it.

Min wage earners make about 30k, so that 2k is 6.6% of thier income....

What I can find around me with a quick look sounds like about ~$400/m, or $4800/yr - which I could handle if I had to, but it would sting (especially as I still would have to pay my regular health insurance, of course). And there doesn't seem to be all that much choice - at least in places where I know to look.

Yeah that's a hyperbolic exaggeration.

If you think waiting for months is a Canada-only problem, you clearly haven't tried to get a specialist appointment[1] in much of the US. And that's with good insurance.

[1] Or shit, even a PCP that accepts new patients.

Favorably comparing the US health system to the Canadian one is an interesting take indeed…

I know people in Canada who come to the US for healthcare (better care for specialties, shorter wait times).

I'm not aware of the reverse (admittedly, that would require more than just $$).

And Americans go to Mexico for healthcare, I'm not aware of the reverse, I guess that means Mexico has the best healthcare in the world.

I actually drove someone across the border from Mexico to the U.S. for healthcare (voluntourism injury).

The reason to go to Mexico is price. The reason to go to the U.S. is quality.

How about for Canada vs the U.S.?

If you're a Canadian citizen, Canadian healthcare is cheaper, but generally has much longer wait times.

U.S. healthcare is much more expensive, but much more quickly available, and specialty care (e.g., rare disease treatment) is much better.

Then there's this - When a woman went to the hospital for help with suicidal ideation, a clinician told her the waits to see a psychiatrist are long, "the system is broken", and "have you considered [assisted suicide?]...MAID would be a more “comfortable” process during which she would be given sedating benzodiazepines among other drugs."

She will be able to see a psychiatrist "when one is available in the fall."

https://web.archive.org/web/20230809170345/https://www.thegl...

MAID == Medical assistance in dying (assisted suicide)

Went from nothing/reluctance to popular for some segments of the population

No one is talking anyone into going the MAID route, that's just some far right conservative party bs.

Really, you just engaged in deception and promulgation of propaganda intended to push people toward neofascist ideology.

Shame on you.

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