We wouldn't have this problem if we have universal healthcare in America, no?
The US system is so dumb not to mention inefficient.
The US system is so dumb not to mention inefficient.
The fact that you immediately jumped to 'you might not have as good insurance as you think' tells me either you are fundamentally out of touch with how disastrous the system is or have had no need to engage with medical care outside of visiting a doctor once per year.
Other countries with "universal healthcare" also have times consuming referral processes and wait lists for stuff. But they have it worse because there are more people seeking service, and less providing it (because profits are capped). I've heard plenty of stories of people in those countries dying on the wait lists for things that sound urgent or mundane, like appendectomy surgery. I even heard a few where people with ordinary problems like trouble walking were offered euthanasia. You should do a bit of research before you whine too much.
So, what would solve the problem of having to wait? Ultimately more supply of service providers, less demand, or an unlimited budget to pay for the scarce ones that exist.
Emergency procedures like this wouldn't be put on a waitlist, you can just go to ER and settle administrative stuff later.
First of all, a problem should not have to take you to within an inch of your life to be treated.
Secondly, good luck with getting treatment in the ER! https://www.cbc.ca/news/canada/toronto/ont-teen-death-1.7616... Emergency rooms offer advanced first aid. They are not equipped to do specialist surgery. They have to call doctors in and stall you or even send you away until the proper care can be arranged.
That isn't even the case I was referring to. I've seen many stories and verbal accounts of people waiting for months for essential treatment in "universal healthcare" countries. Anyone with a rudimentary understanding of how supply and demand works would expect long waits.
If you complain then you may be offered euthanasia lol https://nypost.com/2022/12/03/canada-offered-to-help-euthani...
The profit motive just seeps in to everything and screws everything up even if you have great insurance.
Insurance companies are already required to spend at least 80% (or 85%) of the premiums they collect on paying out claims. If they spend less, they are required to give rebates / premium refunds to policy holders.
It wouldn't be crazy to increase that percentage even more, since it's effectively a cap on the profit margin insurers are allowed to earn on premiums.
Ration on price. Or availability. Or quality.
Eventually, every system ends up with one of the three. Sometimes 2.
a year is just crazy.
I'm from Australia. If I want to "skip the line" I can just pay to do so. Private practice exists. People don't, because it's expensive and they can't afford it.
This is exactly like the US, except in the US you just don't get healthcare at all and die instead.
The "backlog" in any public healthcare system is a triage line. If you actually need care, you get it immediately. If you can live with it but keep it monitored, you might not for longer then is optimally comfortable if you can't afford private consults.
In the US, again, you just don't get anything.
Now, the US sucks really bad if you don't have good insurance / any insurance....
"We have the best!". But like, so do dictators of 3rd world countries. Do you actually have access to the best care? Are you sure? Because about 1 in 10 Americans are uninsured[1] and a substantially larger percentage are underinsured[2].
Meanwhile Australian life expectancy is higher then America[3] (I mean let's be fair: most of the western world's life expectancy is higher then America...I wonder what common trait most of those places have...)
[1] https://www.kff.org/uninsured/key-facts-about-the-uninsured-...
[2] https://www.forbes.com/sites/joshuacohen/2024/01/01/us-healt...
[3] https://www.psu.edu/news/research/story/australia-offers-les...
you two are talking past each other, and talking about two different cohorts of people.
Just "the best care ever", no qualifiers, examples and no indication of costs.
Just what does "good healthcare" in America get you, that you imagine people in other countries do not get?
In the U.S. i’d consider good health insurance to be:
- low monthly premiums (majority of cost is covered by a generous employer). Say $30-50 per paycheck for a single adult.
- A PPO plan, not an HMO (HMO limits your options when picking doctors).
- A plan that does NOT require pre-authorizations for most procedures and tests. They are a pain in the butt. And many crappy insurance companies like United Healthcare tend to auto-deny many things as “not medically necessary”.
- A medical plan that covers almost every non-experimental drug prescription, at low cost ($30 or less). Including antibiotics, EpiPen, GLP-1 (Ozempic), inhalers, etc.
- A reasonably low annual out-of-pocket max, say $2,500 or less? ALL costs after that max are fully covered by insurance. So you have peace of mind if something really bad happens.
- $0 or very low deductible for seeing your doctor. Also a very low coinsurance rate, say 20% or less. Coinsurance is the % of the bill you pay before your insurance covers the remainder.
All the above basically means, “low stress” when you get sick or into an accident, or get pregnant.
What does good “care” look like? I think we all know. In the U.S. this is _very_ region dependent. Most people don’t consider this when buying a home for some reason lol.
There are many cities with excellent hospitals and medical centers and also some top notch hospitals GLOBALLY. And then there are many “medical deserts”, typically cheaper areas to live, where care is harder to come by.
Examples of good care:
- QUICK access to your primary doctor/PCP (within 1-2 weeks)
- ability to get care urgently, within a days notice, from another doctor. urgent care, etc.
- ability to see a specialist within 3 months, ideally less than 1 month. Yes this is possible in some parts of the U.S. believe it or not.
- Living near (45 min or less) a major, well-rated hospital, in case you have a heart attack, get into a nasty car accident, etc.
The unfortunate truth is a LOT of americans are in a “healthcare desert”, or they are poor and can’t afford care, or their employers are not generous and offer them crappy plans. For example where the out of pocket max is $15k lol. Or where monthly premiums for a single person are $400.
The US is not a fun place to live if you’re lower class or lower-middle class. And our healthcare system is a confusing mess. :)
Maybe look at the rankings of best treatment facilities globally. Here is the list for oncology. Choose any dropdown you like. You are going to see a lot of "US" at the top.
https://rankings.newsweek.com/worlds-best-specialized-hospit...
You seem to not understand what "good" is. You do at least seem to agree with my second point....
This magical "good insurance" doesn't exist, because it's not up to the insurance company.
Scheduling is controlled by the hospital. Right now american hospitals are insanely booked out, and have been for many years. There's no magical insurance that bumps someone else out of the line.
If you aren't experiencing 3 month delays for non-emergency medicine, it's not that you have "good insurance", it's that you live in a place where the local medical infrastructure is seriously underutilized. This might mean you just live in a rich enough place where more hospitals than needed were built, or it could mean that a lot of your neighbors just aren't getting the healthcare the local hospitals were expecting to serve.
Or maybe what you are hinting at is that in your state, the affordable health insurance for most people doesn't actually get them any real treatment options, so only very wealthy people can afford to actually get treated, so hospitals around you don't do much healing.
And that's fucking ghastly and should be seen as the abhorrent thing it is. You have hospitals around you that are not treating people even though there are plenty of people needing healthcare. A lot of resources were already spent building that hospital and training doctors and we are not utilizing those resources because of some abhorrent "but then I might have to wait a month for a completely non-threatening medical concern" ideology. Yes, that's called efficient use of resources. Triage is a core part of healthcare. Sometimes that means someone else gets treated before you, and that's because they need it more than you do.
I didn't say "affordable". I said good.
No. Try living in Quebec.
To structurally reduce the fraction of GDP devoted to healthcare, we need to make far bigger changes. A lot of the setup right now is to subsidize those on Medicare by those on private insurance programs. The cross-subsidization goes very deep, and anything that might reduce costs also has the risk of undoing cross-subsidization. With half the country refusing to reform health care for the past 30 years, and the other half having their hands tied behind their back on trying to improve health care, we have built a gigantic overly complex system that's very hard to unwind.
There are a lot of similar mysteries in America. For example, why does it cost a billion dollars a mile to do subways which is 20x almost everywhere else.
It can, at least to some degree. Every doctor's office has people who run through the insurance maze, trying to get services paid for. And every insurance company has people on the other side, trying to find ways to not pay for stuff. Having only one organization to deal with would simplify that; having one organization with clear, transparent rules would simplify it more.
I get the sense I'm probably preaching to the choir here. But, the U.S. spends almost 2x what comparable countries (with universal healthcare) spend on healthcare. And we get worse than average results on virtually every measure.
This, of course, makes sense. When you're running healthcare as a for-profit business, part of our expenses are... profit to pay out shareholders. And advertisement budgets. And middlemen (insurance). And employees to do things like decline coverage. Medical employees to deal with insurance companies declining coverage. Etc. etc. There's a whole industry that only exists to support our private healthcare system that would cease to exist in a universal healthcare system.
There's room, either private or public, to backstop catastrophes, but not the rest.
Something like 15% of US healthcare spending goes towards administrative fees just around insurance. That's order of $800 billion annually, roughly $1,500 per American, that does not contribute in any way to improving health. This is roughly the size of the US defense budget that we spend on gating healthcare.
There are knock-on effects of our system that increase some costs, such as people skipping preventative care or medications due to high costs or lack of insurance and then ending up in higher-cost emergency care. Or see the recent trend of physicians documenting how much of their time spent arguing with insurance companies on behalf of patients, time not spent providing medical care (and thereby increasing costs).
True parasites.