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Comment by Thorrez | Hacker News Reader

Two people I know who moved to the US from countries with single payer healthcare said that in their previous countries they would have to wait a long time for certain operations, but in the US can get them almost immediately.

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Depends on criticality. Yes, the US beats Canada for example on wait time in a lot of cases, however, as a Canadian I can walk into a ER and not have a co-pay.

I had my appendix out a few years ago, I walked into the ER at 2PM, had the surgery done by midnight, and was able to be discharged by 9AM the next day. The only cost was my parking, because I drove myself over. Meanwhile, I've also had friends in the US who were clearly quite ill, and made the conscious decision to not go to the ER because it would have cost them hundreds of dollars.

It's all a balance, but I'm happier with my single pay system, because for the most part, health decisions aren't at the whim of my bank balance being too low. I personally wouldn't be as disappointed in the US system, if the reason someone can get a surgery immediately didn't balance out with something like UnitedHealthcare's 32% rejection rate, because someone wanted a $10MM / yr salary or a $40MM yacht.

The US has a law that 80% or 85% of premiums needs to go to healthcare. So if an insurance company is already up against the limit, increasing the rejection rate will actually decrease salaries and yachts (because less money will be spent on healthcare, thus premiums need to be reduced, and the 20% available for employee salary becomes smaller).

https://www.cms.gov/marketplace/private-health-insurance/med...

Although, if increasing the rejection rate allows the insurance company to decrease individual premiums, which causes a lot more people to sign up for coverage due to low cost, that could increase total premium income, total spent on healthcare, and salaries.

From what I understand, wait time can certainly be an issue with single payer healthcare. However, there's people in the US who have effectively infinite wait time because they can't afford treatment at all.

I have an excellent insurance plan and ready access to a large US hospital system. The wait to see a dermatologist as a new patient is ~6 months. Definitely not unique to single-payer systems.

Also, this wait times in many part of the US are in line with the single payer countries. The quality of care in the US is heavily dependent on location.

Some problems in those countries are also caused by for profit healthcare existing in America. The shortage of doctors in Canada is not helped by the appeal of making much more money down south.

Not to mention Canadian expats are generally the ones who would be able to afford the American healthcare costs.

Also sounds like Canada isn't paying their doctors enough, which isn't to say America's healthcare is better, but it is something to take into account.

Canadian doctors are extremely well paid by Canadian and international standards, just not by the standards of American doctors (who have to repay massive medical debt). Increasing their wages is not really feasible, outside of a few underpaid specialties.

Dutch and Swiss healthcare systems are entirely private (more so than in the US since there are no Medicare or Medicaid equivalents) yet they are highly regulated and profits are limited.

Why can’t the US just copy paste them? It’s not like single payer is the only option..

US health insurance is profit limited too:

https://www.cms.gov/marketplace/private-health-insurance/med...

> Dutch and Swiss healthcare systems are entirely private (more so than in the US since there are no Medicare or Medicaid equivalents)

and Swiss doctors are paid very well compared to let say German ones. There is long waiting list of German doctors that would like to practice in Switzerland.

Waiting time increases with accessibility and aging population. Most developed countries with universal healthcare amd the hospitals are full with elderly. The developing countries are often much better due to younger population. Places like Turkey are incredibly accessible and cheap compared to the develped countries.

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