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Comment by piyush_soni | Hacker News Reader

In USA it's still much better. In many countries including India for example, people pay taxes for their whole life but if they lack money in the end, there's no health/food/shelter security - you are basically on your own. Legislative Bills are there, but they are just that - dormant bills. Nothing exists in reality.

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The fact that you have to compare the USA to a developing country to be able to say that "it's still much better" speaks volumes.

I am also from a developing country (Uruguay) but if any of my family ever has cancer all our concern will be in the emotional issues, the economic issue are already resolve: basically the health system coveres all diseases that you could get.

I do not understand the countries that don´t have this, it is just logical that if you pay when you are healthy you must be 100% covered when you are sick (without excuses or having to justify anything). The most strange thing is that what I pay for my health insurance is less of what I heard it is pay in USA (I pay 70 USD per month) but the difference is big: I live assured that whatever happens I'll be covered, no disease will make me lose my house.

The problem is not about beeing a developing country or not, it is about political decisions that obligate insurances to do what they must do.

Uruguay isn't really a developing country. Not like India, that's for certain. Anyway, the health care system in the US isn't something that was willed into existence. It came from a series of accidents and circumstances.

What about Canada? Is that acceptable? Left canada to come here to the US where we pay less and get more for the care my children need.

No system is without its problems. I'm just glad in the US it's not about quality or quantity of care, just funding.

There are some situations where the US healthcare system is superior to the Canadian one, but this is definitely not one of them.

There are medications I need that cost an entire order of magnitude more in the US than in Canada. I'm not exaggerating. They're about $80 full price from Canada and $800 here in the US.

That's the pharma industry's 'America pays' system. Canada receives subsidized costs on medications like much of the world, and America picks up the tab.

Not sure what point you're trying to make here. The pricing on the medication was exceedingly high, about $200/dose, but as far as I can tell, that is the same price as in the USA:

http://breastcancer.answers.com/medications/the-cost-of-neup...

The cost of the drugs was just picked up by the medical system instead of my pocketbook.

I have seen this argument before; American health care is expensive because everybody else is a slacker who can't pay. It's obviously false. US pharma companies aren't subsidizing Canadian drugs, the Canadian government is. That Canadian drug prices are lower is more a function of the broken US medical system than anything else.

Are you honestly saying that only the US does [significant] pharma research?

I am a Canadian who occasionally complained about long (several hour) emergency waits for broken limbs from mountain bike downhill racing. The triage system prioritizes people who are dying, not adrenaline addicts.

... However ...

I got diagnosed with Cancer (lymphoma) in 2008. I was xrayed, CT scanned, blood tested and ultrasound guidance biopsied so fast that my head spun. From initial lump discovery to the onset of chemo was only a couple of weeks. Quality of care was first rate, and it's been 5 years. My experience with Canadian health care for a life threatening condition was extremely good.

I should also note that the cost of my medication was a significant $100k+ figure, not including chemo drugs, and this was all covered to an out of pocket of under $1k.

I was a working as a contractor, and didn't have any private medical insurance of any kind.

Needless to say, looking at the cost of treatment, and the ruinous effect it would have had on my (and my wife's) finances, I am very glad I live in Canada.

I'm not talking about waiting times in the emergency room.

Imagine not getting treated for cancer for 3 years after being diagnosed.

Sorry if I wasn't clear. I went from "Hmm, that's a weird lump" to chemo in just over two weeks. The quality of care was stunning, and the success rate is one of the highest in the world.

That sucks in regards to India, but not an excuse for our politicians not to get their shit together.

Here in Fiji we've always had universal healthcare. When people need surgery/treatment they can't get here, the government sends them to India (Used to be Australia/New Zealand, but not any more).

Yeah. Thanks to India's affordable health care, we don't have to be dependent on this national scam called health insurance. We just go to doctors, they give us treatment, we pay money, that's it. I remember how here in US I had to go to a doctor to be told "You don't have any disease, that happens to everybody" (no diagnosis) and charged $400. Insurance paid $300, I paid $100.

Right.. That "national scam" is working great all over Europe. It's cool when you can pay your treatments, but cancer treatments are in the 6 figure range - enjoy paying that from you bank account.

The funny thing is, at least here in the US, even if you have medical insurance you are totally ripped off your pockets if you have something like cancer. Mostly, you just don't pay the price which was anyway artificially inflated by this scam I'm talking about. There was an article only a few days back about this guy who had his appendix treated: http://imgur.com/a/WIfeN

He had to pay $11k out of the total $55k bill, rest was paid by insurance. ($7000 for a CT scan? $4500 worth of Anesthesia? I'd be surprised if one still doesn't think these are artificially inflated prices)

I'm not sure how much would he be charged if this whole insurance thing was not there - may be ~$11k?

(Just for the curious: In India, that operation in the best of hospitals would have cost him may be around $1600 without insurance. With insurance, he'd save most of even that. )

On the other hand, if you adjust the costs for purchasing power, the unfortunate result is that most of the people are pretty much fucked.

In fact the US would look cheaper for the majority of the population. Which is comparing against a low bar.

I don't think you could classify that as a working system.

>On the other hand, if you adjust the costs for purchasing power, the unfortunate result is that most of the people are pretty much fucked.

They are not. As I said, this was the cost in the best of hospitals. In government hospitals, poor people get medical care for a fraction of it. Of course, the health care system is still not good, but I'm convinced that a US like system of insurance is not a solution either. Canada and some other countries have it much better.

>In fact the US would look cheaper for the majority of the population.

No, it's not. Had this system been working, millions of Americans wouldn't go outside USA to get basic treatment (many of them go to India). Something is fundamentally wrong here ([1], [2], [3], [4]).

[1] 7.5 Million US residents travel abroad for care each year: http://www.cdc.gov/features/medicaltourism/

[2] Medical Bills Are the Biggest Cause of US Bankruptcies: Study : http://www.cnbc.com/id/100840148

[3] Why U.S. Health Care Is Obscenely Expensive, In 12 Charts : http://www.huffingtonpost.com/2013/10/03/health-care-costs-_...

[4] 'Medical tourism' draws Americans to India : http://communities.washingtontimes.com/neighborhood/traveler...

I agree with some of your points here, but this has to be noted.

It's not 7.5 million US residents per year, it's 750,000.

And this:

"The nonpartisan Fraser Institute reported that 46,159 Canadians sought medical treatment outside of Canada in 2011, as wait times increased 104 percent — more than double — compared with statistics from 1993."

Calculated upwards, that would be 404,000 or so on a population equal basis with the US. A lot of Canadians are seeking treatment abroad too.

Humm ... That's a mistake on my part. But this is because I'd seen another article from 2009 [5] which clearly said it was 6 million. And this article was from 2014 so I quickly read that as 7.5 million.

[5] http://news.health.com/2009/04/08/traveling-treatment/

That image is insane. $7,500 for a couple of hours in a recovery room. Not sure how that can be justified, they're clearly just getting as much money out of people as possible. As the services are not exactly optional.

See my reply to markdown for context on his/her comment (if you're not aware).

You should clarify your comment by mentioning what state and city you live in, how much you earn a year, and how many multiples that is of the average income in India, and in your state.

Healthcare in India is operated by the states; there is no national program. Care is not consistent. [0]

In India, can doctors provide food? I'm serious. 42% of Indian children are malnourished [1] - a frighteningly higher rate than the average malnourishment rate of sub-Saharan African countries.

This is but one figure representing India's overall healthcare system (or lack thereof), and unhealthy populace.

[0]: https://en.wikipedia.org/wiki/Health_in_India

[1]: https://en.wikipedia.org/wiki/Healthcare_in_India#Health_iss...

Health care in India has a lot of issues, but it's affordable for most part. And if you read my reply to plaguuuuuu below, I wrote that it's still not good - but going the US way of insurance lobbying is not a solution either (because certainly, it's not working). Unfortunately, there are a lot of people who don't even have money to pay food, understandably they won't have money to pay for medicines. They get free government treatment in many cases (though no free food). There is a new Food Security bill passed late last year which is made to tackle those 42% undernourished children and other poor people. Implementation of that, in a populous country like India will take time. Poverty is a complex problem to solve.

Context: Australian and NZ relations with Fiji have seriously deteriorated (expelled diplomats, aid cuts, trade sanctions) since the military coup in 2006, and the resulting dictatorship there. [0]

Despite the diplomatic meltdown between Fiji and the western world, Australia and NZ continued to offer healthcare to Fijians. It was a decision by the Fijian government to start sending people to India instead. [1]

Also, Fiji has very large ethnic ties with India. [2] The country has a history of deep social and religious divisions as a result. [3]

I don't think there's any suggestion or indication that it's actually preferable to have surgery or treatment in India rather than Australia or NZ.

As an Australian, I'm sorry that Fijians can't come here anymore under their healthcare program.

[0]: https://en.wikipedia.org/wiki/2006_Fijian_coup_d%27%C3%A9tat...

[1]: http://www.fiji.gov.fj/Media-Center/Press-Releases/FIJI-LOOK...

[2]: https://en.wikipedia.org/wiki/Indians_in_Fiji

[3]: https://en.wikipedia.org/wiki/Indians_in_Fiji#Religious_and_...

The choice to send patients to India is purely based on financial, rather than political reasons. Even with the higher airfares, it often turns up significantly cheaper to send patients there. Of course in outlier cases where its thought that there is a higher chance of survival in Aus/NZ, patients are sent there instead.

Australia and New Zealand only deny medical visas for people in the Fiji government and military (and their family).

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