Political Memes

Conservatives bitching about how if we had Canada's healthcare, we'd be waiting forever.

I have AMERICAN healthcare and I have to schedule a basic ass mandatory checkup 4-6 months in advance.

If it was an emergency, the next available slot is six weeks.

Same... to get an appointment at my PCP in a decently sized city it was 7 months.

Sounds like it's time to find a new primary doctor, that's insane.

I called to see any gp from a major hospital in my area last week. Earliest appointment is in Feb. Guess I'll just go die.

There are basically 3 main systems for universal healthcare in the world:

Beveridge model: the government runs the hospitals and employs the doctors, and any resident may use the services. This is known as socialized healthcare, and it's what UK uses.

Bismarck model: the government mandates everyone get insurance from highly regulated competing insurance companies (some of which might be government operated and run, and some of which might be private). Everyone is put into the risk pools so that the insurers will collect enough from the entire population, including the low risk demographics. Those who cannot reasonably afford insurance are given government subsidies so that they can be covered, too. This is what Germany and Switzerland use, and is sometimes referred to as an "all payer" or "Swiss" model.

National Health Insurance Model: This is where the government gives everyone insurance and positions itself as basically the monopoly/monopsony health insurer to cover everyone and negotiate compensation rates for health care services provided by private providers. This is what Canada uses. It's also known as "single payer."

The fourth model of health care economics should be mentioned, as well. It does not promise, or even try to provide, universal health care. It's the fee for service model, where private providers set their own prices and consumers decide whether to purchase those services. Sometimes insurance can be involved, but the providers are free to negotiate their own prices with insurers, but might opt not to take insurance at all and make the patients deal with that paperwork.

Many countries use hybrid models that combine elements of the Beveridge Model and the Bismarck Model, with government providers competing with private providers, and maybe government insurers providing a backstop for what private insurers won't cover.

The U.S. doesn't follow any one model. It follows all 4 models in different settings:

• It follows the socialized model for the military and veterans affairs, as well as the Indian Health Service for Native American tribes (the government owns the hospitals and employs the staff directly).
• It follows elements of the all payer model for most employer-provided health insurance (employers of a certain size are required to provide optional health insurance) and there are the ACA exchanges, where private insurance is highly regulated and is generally required to provide coverage to anyone who a>!!<pplies, and pays providers based on negotiated prices (and since 2021 providers can't go after the patient for the difference if they don't like how much the insurer pays).
• It follows elements of the single payer model for the elderly, through universal Medicare coverage for those over 65. Medicare is the elephant in the room for negotiating prices and procedures, and providers generally don't want to refuse to take Medicare because it's just such a dominant insurer among the elderly population. For example, federal law requires any hospital with an emergency room to provide life saving services to anyone who needs it, regardless of ability to pay. The actual mechanism for making that policy is by tying Medicare eligibility to that policy. In theory hospitals could refuse to provide emergency medicine to those who can't afford it, but then they'd lose millions in Medicare funding.
• But the fundamental default in the U.S. is the fee for service model. Providers doing patient intake will ask "and how are you going to pay for this," ready to accept either direct payment or an insurance policy.

Turning back to waitlists for medical appointments, the specific type of payment arrangement in the U.S. is a big determinant for the waits. Providers who take the most popular insurance plans might get their calendars filled weeks or months in advance. Especially in lower population areas that are underserved by healthcare providers. (Side note, expect things to get much, much worse for rural healthcare with the DOGE cuts to HHS and USDA.) But in the big cities, those with higher paying insurance can generally get seen pretty quickly.

There is no universal system in the U.S., so there is no standard experience in the U.S. It's fragmented all to hell, and not only does it suck, it sucks for everyone in a different way.

Also, this is a dumb talking point that shouldn't even be addressed as a serious critique of any country's medical care. I hate it. It's like people who want to see the post office abolished because they tried to send a package on a Friday afternoon after work and had to wait 10 minutes because everyone else wants to use the highly effective, cheaper solution for shipping.

What "waits" are we talking about here? Waiting in line at a hospital to be seen by staff? There are always going to be so many doctors in a facility for dealing with emergencies, no matter where you go. It can change at times of day or with workload. I've been seen immediately, and I've had to wait hours for ER service.

Are we talking primary care visits? Who doesn't schedule them? Are there any countries where you can just walk into a doctor office and they magically have your tests and records just ready in-hand? Of course not, you make appointments. Same with operations and other medical procedures.

Let's argue the only point that matters here: affordability - the promise that the amount of money taken off my paycheck guarantees me healthcare that won't put me in devastating debt or ruin my life with additional costs. As it has done to me. It's such a simple concept and talks about "wait times" are just deliberate attempts to muddy this basic human right we should all have in the richest country on Earth in the most advanced time on Earth.

Just looked on Zocdoc and there are 2 PCPs who are:

• less than 1 mile away
• covered by my insurance
• have multiple appointments available tomorrow, and many more over the default two-week span you're shown

https://i.imgur.com/xKanonX.png

You're full of crap.

We have "plans" you can get through your employer which will bring down your cancer operation costs to just $15000 in deductibles, assuming you don't get fired for taking the time off to get the operation.

Otherwise, if you fall on a iron fence you can go to the ER ~~and at least the bill won't impact your credit history.~~ Sorry I'm being told that now medical bills impact your credit history.

I feel like the result from this image today would be to cut off the wings and make the fuselage weaker to make it cheaper to produce, because clearly they aren't needed.

US -> Canada here

I hear this often in Canada, but honestly the wait times are similar. In the US it would often take me ~3 months to be able to see my endo. Also, at least you can get healthcare here.