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Comment by delichon | Hacker News Reader

In the US before Obamacare I could make an appointment with a specialist on the same week. Now it takes more than six months. Three different specialties that I know of and the only three I tried. Apparently we're catching up with Europe.

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This is literally not true if you live close to any urban center. Plenty of specialists available in any city. The US healthcare system is broken in many, many ways but "obamacare made me wait 6 months" is not one of them.

This is Albuquerque, which is a three hour drive. There used to be a couple of these specialists in a closer, smaller city, just two hours away. They have all gone. Along with more than half of the rural general practitioners in the surrounding 100 miles. One closed his practice entirely after completely failing to find a replacement. I recently went to an appointment with a specialist in Albuquerque that took me six months to get ... and spoke only with a nurse. No doctors are available even after that long. This was after six months of waiting while in pain and bleeding out of my ass daily.

Shortly before Obamacare I went to the same variety of specialist in that closer city. I called on a Monday and was in to see him on Thursday morning. Now, the three closest clinics to me have no doctors at all between them, just nurse practitioners and physician assistants. If your condition isn't on their short script you get an appointment in six months with a different nurse, or directions to the emergency room. I'm not claiming this is the general experience, but my experience has vastly enshittified.

The specialist nurse that took me six months to see? He ordered a test and scheduled me to come back and discuss it with him in another six months. Maybe I'll get another five minutes of his time then.

It sounds like you live in a rural area. In those places, the providers are drying up as the doctors get old and retire, and there's no one to replace them. This has nothing to do with Obamacare; it's like this in many places, including here in Japan. They actually offer more money here for people to work in the medical field in rural areas, but people would rather get paid less to live in Tokyo, because no one with an education wants to live in rural areas these days if they don't have to.

Basically, if you want really good healthcare, you need to live in or near a very large city. (Albuquerque is not a very large city.)

Another thing that's probably changed in the US is larger healthcare companies taking over doctors' practices and enshittifying them to increase profits. Doctors are happy to sell because they're getting close to retirement, and/or tired of dealing with all the administrative hassle on top of actually being a doctor and caring for patients. I've read about this type of thing greatly affecting veterinary care in the US too.

While that does absolutely suck, and I’ sorry you find yourself in that situation, it’s not a consequence of Obamacare. It’s just that the time you remember when things were better happens to be before Obamacare.

As another commenter said, there’s been an exodus of specialists from rural areas. This is a global phenomenon, not limited to the US.

Americans are discovering that giving universal healthcare access to everyone means those who already had access, now have to wait longer to make room for everyone else. That's how it works.

No they aren't. Americans are finding out that when you abuse medical workers by calling them "essential workers" who have to continue working during a pandemic while hundreds of thousands of patients berate you for saying things like "you should get vaccinated" or "don't eat an anti-parasite medication for horses" and overwork them and pay them shit, they quit in droves.

They are then finding out that for profit businesses have no interest in re-hiring all the workers they had before the pandemic, because they didn't lose as much business as they saved money in salary, so everyone is just running a skeleton crew that they overwork.

Meanwhile the data I find for emergency room visits are that there's barely been any increase in percentage of the population that visited an emergency room since 1997.

Companies are spending less on services and letting us just suffer because we don't have better options and YET AGAIN dumb Americans for some reason blame the government for completely independent companies making self serving choices?!

Also in the US before Obamacare many people couldn't afford to see a specialist at all. Trade-offs.

I do not have this problem where I live in the US. Perhaps the issue is that specialists don't want to live where you are?

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