Look, universal healthcare is a complicated system which only every single developed country in the world except for America has solved. That's your good old American exceptionalism at work.
Italy here. I have no problem getting care right away. And for complicated things, it's fast. My wife went from "weird headaches", to her primary, to several diagnostics (like an MRI), to a specialist neurologist in Pisa inside of a week.
Oh, and I'm also American. Back in the US, I thought I had ruptured a disk in my back. Went to urgent care. That wasn't so bad. But it was another week or two before I could see a specialist. And find out that it was shingles (yeah, shingles is that bad) and get appropriate medication.
LOTS of stories about waiting months for appointments that here in Italy happen almost right away. And I've yet to see a bill here. Where in the US, I would get surprise bills in the mail for things the insurance decided not to cover. Not to mention that I work for a global leader in our industry and had "great insurance". Well, two different "great" insurance companies as we switched at one point. Both sucked.
Here in Italy, I also have a program with my company that gives me priority access to the public healthcare. But, I've never used it. It's just not necessary.
Americans get confused about elective vs urgent care.
If you’re in the ER and need a life saving surgery you will get it right away (think a heart attack) both in the US and Europe.
If you go because your knee hurt and they tell you “well you’re QOL might get better if we do a knee replacement” then it’s going to be quicker in the US because is not life threatening and they can overcharge 1000x to the insurance while in Europe it can take a couple months while all the paperwork gets sorted.
No one waits 4 years. That’s just propaganda. If someone waited years it’s because it was not necessary
For every other stuff it’s just as bad or even worse in the US. To make and apt with my PCP I need to do it 3 months in advance in the best case and to see a specialist is even worse and usually you need a referral.
Source: Spaniard that has lived in Mexico and currently in the US so I have experience.
To be clear, when it comes to stuff that's important but not absolutely mandatory, like hip replacements, various joint/back etc. surgeries, basically things where you're suffering but will live...
Canadian wait times are numbers of weeks that are similar to American wait times in number of days for the same procedures.
Just like people that can't walk and are in unbearable pain that blows right through the daily opiods are overjoyed to wait months to do anything about it.
Man, it's almost as if there's not a perfect solution and there are legitimately sacrifices we all have to agree to make or something.
While I agree that there's no perfect solution, the American one is one of, if not straight up the worst one in the world. It's outrageously expensive, poor quality (unless you're rich) while still keeping millions of people without any kind of coverage at all.
While I agree that there's no perfect solution, the American one is one of, if not straight up the worst one in the world.
Not even remotely close. Even our own of 20 years ago was substantially worse, an plenty of places are still on similar or even less regulated systems than that.
Also, it was getting substantially better and we were on track to be able to make even more progress until a snake oil salesman decided to tank the party for more $27 donations to buy more copies of his own book with, but I digress...
It's outrageously expensive
Depends, places with big numbers of employees that actually care about them provide pretty great plans for crazy cheap. Costco, for example.
poor quality (unless you're rich)
Nah, the stuff that claims we're actually getting crappy results is mostly long term purely outcomes-based comparison that doesn't account for the fact that our insane obesity rates means we're starting with way, way worse inputs.
When it comes to things like surviving heart attacks, surgical success and mistake rates, all that kind of stuff, we're among the best even compared only to countries with similar wealth.
I do say mostly, though, because our women's health care still absolutely sucks and is getting even worse thanks to the hamfisted anti-abortion bullshit.
while still keeping millions of people without any kind of coverage at all.
And this is the big issue that we've been trying to address, but it's probably not what you think. The poorest have access through medicaid. It's an area which, back when we used to actually be able to talk about the actual policies and not "this plan or bust", was known as the donut hole-- making too much to qualify for assistance, but not enough to actually be able to afford it.
And here's what's happened with that since the ACA was going through congress:
A public option was passed through the house. We needed 60 votes to overcome the filibuster in the senate. The independent Joe Lieberman, who had lost his primary as a democrat and run in the general as an independent, blocked it.
The public option would essentially be the government selling an insurance plan, competing with the others on the market. There would be no more donut hole because the cost would scale with income, making it so there's no point where you can't afford what you have to pay.
Because that failed, we went with an expansion of medicaid. This moved the line for qualification to 138% of the poverty line, meaning if you're not making almost 140% of what's basically required to live but with no luxury whatsoever, you pay zero.
Republican controlled states tried to refuse it, so they were threatened with having other funding that they do like cut. So they literally went to the supreme court and said "They can't force us to take this extra money to help our poorest constituents," and the supreme court said "Yep you're right," so some 10 red/purple states still don't have it, directly resulting in millions of people being without health care purely because the republicans want people not to like the ACA.
Further, the republicans have cut corporate subsidies. Yes, you heard that right. We subsidize insurance companies in order to help cover the most expensive patients. Basically, certain areas have more high-risk patients than others, for various reasons. Part of what the ACA did was make it so that you cannot refuse to cover a patient because of pre-existing conditions, can't set lifetime limits for what you'll cover, etc.
But... you can just choose not to operate in areas that are full of high-risk patients. So basically what republicans did there was to cut those subsidies, driving affordable options out of entire regions, further widening that hole where people are making too much to qualify for assistance, but can't actually afford any of the plans that are available to them.
I know I just wrote a whole lot of crap that probably nobody is going to actually read, but in short, the plan we had in place was solid, not ideal, but solid, but we through it away before it was even fully implemented by handing control back to republicans and letting them sabotage it.
And that's a huge problem we have with the idea of going to a fully government controlled health care plan here, too. Nobody wants to pay for anything here, and they'll give republicans control back when they have to, and the results of them having full control of our health care will not be positive.
But that's not true, I bet if you go privately you will also get preferential treatment but will have to pay out of pocket. Same here in Austria. If I don't want to pay out of pocket, I'll have to wait several weeks, if I pay , I will wait a couple of days and be seen privately.
If it's an emergency, I doesn't really matter, because we always treat people by severity depending on conditions
See? There ya go. Australia hasn't "solved" health care. It has chosen different priorities and trade offs.
And yeah, in the US there are many ways to get around wait times through self-advocacy. I got a surgery in 4 months that friends in Canada and the UK have been waiting 4+ years for. My life is radically better for it. I had the possibility of doing so because I am in America. But if I lose my job, I'm stuck paying exorbitant COBRA fees every month. Different priorities.
Australia has solved health care - their people don't die because they can't afford things which is the main aim of health care. Obviously access is an issue but its in a much better place than anything the US can offer.
Youre coping brother. What advantage exactly do Americans have by being charged way more money for the same medicine as in other countries? Tell me? Only thing it does is creating billionaires at the cost of peoples lives.
I might be wrong since I've never lived in the US but when I look up jobs in indeed or glassdoor for my field even the junior positions come with private healthcare which covers everything including dental and eye care. When I ask friends who work in the US they've never paid a cent for any visit it's all taken care of by their healthcare plan. Isn't that the norm?
This is a total lie, I'm a VP at a large tech company and I still have to pay almost $1000 a month or of pocket for my family's coverage, I have to pay $1500 for any surgery, a few months ago I needed labs and they were done at a PT of network lab (not known to me) and I got a bill for $700, there is basically no one who pays nothing outside of politicians
You do realize that people can pay for procedures in other countries to skip the queue? Private healthcare via insurance is still a thing in the UK and even that costs a fraction of US healthcare. Yes there are wait times for public healthcare (totally free, including prescriptions and follow-up care) but that's a trade off people are willing to make to not die.
The US healthcare system is one of the most corrupt and inefficient systems in the world and focuses purely on profit over healthcare outcomes and access. In these other countries that you're bashing the people have the freedom to choose whether they want to pay for treatment (private hospitals) or get it for free - nobody dies because they can't afford it.
What type of surgery had a wait time over 4 years in the UK? Currently the only type of surgery with waitlists that long is gender reassignment surgery which is still deemed as elective (non-urgent). You guys get absolutely ripped off with everything and have told yourselves you're the greatest for so long that you actually believe it.
Healthcare is a fundamental human right which is why other countries look after their citizens. They give them options and the freedom to choose their care path without being bankrupted or having a faceless insurance agent in a suit decide whether you live or die to make a company's share value increase.
Unfortunately we just had someone come along claiming the only possibly acceptable plan was his plan, and that plan literally banned private care options or even upgraded options on the public plan.
Really poisoned the well by very deliberately lying that his plan was the only possible way and any alternatives that might actually be passable were just evil corporate sellouts.
So no, in the American discourse, having the option to pay more for better care does not get to be a consideration at the moment. It's still stuck at that plan or bust, while reps have spent the last 10 years busting all over the progress we did make.
I lived in the UK for 6 years and the healthcare was terrible. Everyone kept saying "but its free!". No brother, its free for the homeless man living under the bridge, I dish out 250 quid each month for it. I had to wait 18 months for an appointment with a specialist which was a 5 minute conversation to tell me "Yes, the diagnosis is correct you do need surgery" and after 6 months I was given a date. Oh you got a fever and you are hitting 40 degrees C? Best we can do is a phone call and you can visit us after a week. One time I had terrible stomach pains and went to my local GP and by some miracle they let me in the same day only for the GP to ask me what my symptoms are and then right in front of me GOOGLE them and read out loud what I should do.
Things got so bad It was much better for me to FLY to my home country (Bulgaria) and get the treatment I needed. If I decided to go private in the UK the prices were astronomically high. One appointment with a doctor was around 200-250 quid. You want an ultrasound with that as well? I was quoted 500 with a wait time.
The issue being discussed isn't waiting times, it's cost. Saying the US system is better because of shorter wait times doesn't change the fact that if you can't afford the insurance or co-pays in the first place, you'll likely go into debt just to stay alive. Think of it like wait times being a trade off for not having to pay out of pocket for every single thing.
If you're from outside the UK then yes there's a cost incurred for healthcare but that's if you're not a citizen of the country so that tracks. Kinda the same thing if I went to a country in Europe and needed treatment I'd have to pay because I'm not from there.
The point is that the US system is designed to benefit corporations and shareholders, not to keep a populace healthy. Because it's focused on profit the citizens are squeezed for every penny possible - ambulance journeys, giving birth and even holding your baby when it's born incurs a charge under the current US system.
Christ, even if they do have good insurance then the insurance company can just decide they aren't paying for treatment and the individual is saddled with exorbitant costs because the whole system is built around profit. They don't even have the choice of getting free healthcare and potentially waiting or paying to go private (which is still marginally cheaper than US healthcare on average).
The bottom line is people shouldn't have to choose between seeking treatment and going bankrupt.
The US has far worse access issues than most countries with universal healthcare, and the waiting times in universal systems are nowhere near as bad as you guys like to pretend they are. Furthermore, private healthcare also exists in countries with universal healthcare, so people who want to skip the public waiting list can simply pay for private treatment. The existence of a universal public system also makes private health insurance much cheaper than it is in the US.
In fact, it is still much cheaper to have both universal healthcare and private health insurance because citizens in most countries with universal healthcare pay the same or less in taxes toward healthcare than Americans already do. This often comes as a shock to Americans, but you already pay enough in taxes to fund a universal healthcare system. You just don’t get one.
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u/JimboTCB 5h ago
Look, universal healthcare is a complicated system which only every single developed country in the world except for America has solved. That's your good old American exceptionalism at work.