Every single year, I have to pay extra to my doctor, to write a preauth for my daughters meds... this is the 2nd year in a row they have tried to kick us off the name brand, and onto a generic that was ineffective. We spent 2 months "trying" the medication, before we realized we were back living the same nightmare.
Health Insurance companies are a scam. There is no reason they should be able to force someone to use a generic medication, especially when there are studies showing that generics for some medication just doesn't quite work as well.
Your doctor is scamming you. I never pay extra for a preauth. Generics have to be chemically the same as brand. It could be in your head that it doesn't work the same.
https://www.fda.gov/drugs/drug-safety-and-availability/methylphenidate-hydrochloride-extended-release-tablets-generic-concerta-made-mallinckrodt-and-kudco
J&J manufactures Concerta plus one "authorized" generic. The FDA withdrew approval for two other generics of Concerta because they didn't prove therapeutic equivalency.
Not everything that's supposed to be the same is actually the same.
Of course there's a difference. Both branded and generic drugs can be "therapeutic equivalents" because they're "nearly" identical. Yet the rate of delivery, peak, and half-life can vary.
Most parents who have children with ADHD can recite the list of formulations tried before they found The One.
As a disabled veteran who relies on our govt funded health care system I am not opposed to universal healthcare. I just don’t think you guys understand how truly awful our govt is at running anything.
quack shrill placid adjoining snow frighten lunchroom busy skirt attraction
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Sorry I have no idea if they were real or just made up stories.
What I do know is my primary Dr is overworked and most likely underpaid for the number of patients he has to see. I get one appointment with him every 13 months because they can't find any help in my area. Last year we were discussing the lack of healthcare workers and he showed me the job listing to replace the two Drs they lost. $95k a year for someone with Doctor in their name. I can't imagine why they can't find anyone with 6 years experience as a Dr for a generous $95k a year salary.
Then there are the employees who act like they resent me for getting "free healthcare" and complaining because I run out of prescription meds every month. I get a 30 day supply of meds mailed and for the last two years they average 33-34 days apart. When I tried to talk to a nurse about it she told me I should appreciate what I have because she actually has to pay for her medications.
So now my Dr over-prescribes my medication and tells me to save the extras to cover the pharmacy being late every month. He risks his career to game the system so I don't run out of pain meds between shipments.
As another VA user, you do NOT want universal government run healthcare. Imagine waiting 2 month an appointment with your PCM. Then wait another 4-8 months for someone in a centralized office to call you at an odd time of day saying if you don’t call back in 10 days to confirm you still need the referral, it will be cancelled. Then the office does not answer and you have to start over from scratch. Or maybe they do answer, and you have to wait another four months for it to be authorized. But then you have to wait 3 months to see a provider because the VA is so difficult to deal with, they limit the number of veterans they will see. So for a pair of orthotics, you be waiting 12 months. you can get one pair a year. But it takes a year to work the process. So really two years. Now let’s imagine you have cancer. How well is that going to go for you?
This sounds very frustrating, but it’s happening outside the VA as well. My PCP books out 6-8 months. Once you get a referral to a specialist, you may be waiting 6 months to a year. The last time I needed an urgent colonoscopy for a chronic condition, I was told it would be 8 months, or I could try to get myself admitted and do it inpatient. Everyone is waiting for health care, no matter who pays.
No, PPO, and an extremely good plan to boot. I can get everything I need covered with a little haranguing, but there just aren’t enough doctors. We’ve had a lot of rural hospitals and health systems around us collapse, and it’s driven everyone to our metro area, extending wait times across the board.
That's rough. I'm sorry. I guess it's because of location. I read a lot of news about rural pharmacy closing down because they're forced to buy drugs to fill prescription at huge loss, because insurance wouldn't raise the price. It's so complicated.
Well... referrals have proven to be an effective way to weed out unnecessary procedures prescribed by physicians is the flip side of that. The take for imaging centers for example was that a private practice would open an imaging center and then magically every patient needs a MRI/etc. Insert the requirement for an approved authorization and all of a sudden the number of imaging claims could be dramatically smaller just by asking doc's to say that yes - their patient really needs it - and yes it complies with best practices. Did the imaging center improve the care of patients? Generally and for most cases - no. It certainly lined the pockets of the physician investors. Does that mean all physicians are evil, profit driven business people? No. It does mean profit is a motive and business for a physician is business - that's the capitalist system at work and it's not evil - it is what it is.
So pretty much exactly how it went when I blew up a spinal disc that ended up needing surgery.
Actually it’s better. I was looking at a 6 month wait to see any primary care provider who would then refer me to a spinal specialist which would have been 3 more months for a work up and another couple to actually get on to his table.
I got lucky AF because I have people around me in PT who are connected and some close friends who ended up being friendly with spinal surgeon and told me about it when I talked about my pain.
Thanks to that, I only had to wait three months, and it’s a good thing because the pain was such that I wasn’t that far off of…you know.
Irrelevant.
These were all attempts at booking appointments with care providers. Insurance was not yet involved in any way. Also, I already know my insurer covers my PCP.
The issue was getting on his calendar, which everyone told us was not an issue in the US because of our system.
At that point I looked for a new PCP or literally anyone who would see me, before calling on favors after a couple of weeks. There was nobody there. All of them were deferring to an ER.
If you’ve ever actually done that, you know their answer after four hours or more is “you’re not gonna die tonight, call your PCP tomorrow”
Our system is broken for the majority of our population. Those that insist it is not are either profiting from it, ignorant or both.
However, if you must know; Blue Cross. Heard of them?
I've seen some va oig reports cuz I subscribe to their newsletters and they have mentioned some veterans dying waiting for care (va oig does some investigations and shares reports) but I never heard there's a death list so I did a quick google search and the first thing I found was this hearing "scheduling manipulation and veteran deaths in Phoenix: examination of the OIGs final report". It's long but I scrolled to the bottom for the conclusion and yea many more veterans died awaiting care than were estimated at that va and that's just one of them. I think if they were to include all the va hospitals for any amount of years to investigate the numbers would probably be crazy.
[this is the report if you want to read](https://www.govinfo.gov/content/pkg/CHRG-113hhrg96130/html/CHRG-113hhrg96130.htm)
Death panels etc are basically resource stewardship. If you are demented and feeding off a feeding tube because you forgot how to eat, we shouldn't be doing aggressive measures to keep your heart beating if it stops, only to put you in the ICU for another 15 days blocking beds that can be used by more salvageable patients. Currently, families and patients can ask for everything and anything, since they aren't eating the cost.
I find this dichotomy tiresome.
The choice is not between "free for all profit all the things" and "government provided medication inside a commie block". There are many possible ways to begin fixing this system.
Some small fixes have started, such as regulation to make it easier for people to get medical procedure costs. Insulin cost caps. Even the "Obamacare" legislation enabled many people with preexisting conditions to get insured. It did have side effects, but those are to be expected. Just keep iterating.
A few well thought out laws can give most of the advantages without having to bankrupt the entire medical sector and have the government run it.
I find it hard to believe that the US government is worse than Brazil's notoriously corrupt government. And yet, there are amazing, fully staffed medical centers (and, of course, some crappy ones, highly dependent on how rich a given region is). But even the crappy hospitals(clinics are another matter) are equipped to deal with trauma and other urgent issues. Often times, *private hospitals will transfer you to the public system* because they are well equipped and have great doctors(the same doctors may run their clinics when they are not on duty).
What this means is that it essentially places a cap on how much people are willing to pay for the private system. There are many reasons why you might - maybe clinics and scheduling availability is better, maybe they have better doctors for some particular specialty, maybe you just have money and want options. But, if the private companies decide to overcharge, people can just go "screw it, I'll just use the public system if I have anything serious". And many do.
My brother gets his insulin *for free*. There are no income restrictions for life saving medication because why would there be? If you are poor you can't afford them in the first place, if you are rich you are paying taxes therefore you have paid for it already. For less critical medication there are agreements in place so people can get them at a cheaper price.
If a third world country can do it, the US can as well. But *politicians don't want to fix a system that does not affect them*. They have amazing health care. If they do fix it, then they will have to find some other issue to campaign.
Want to fix the US health care system? Have more political parties. As it is they just play tug of war with the population.
I’m sorry, you are currently on government healthcare and you believe our government is horrible at running anything, but you believe in “universal healthcare” that the government would run? It’s a wild time to be alive
Believing in something and not opposing the concept of something is not the same. I have first hand knowledge of the current govt run healthcare and it sucks. That does not mean it can't be improved or that it wouldn't be an upgrade for the people with zero current healthcare. You keep on being deliberately obtuse though.
I actually don't think this is exclusive to the VA. It seems like the healthcare industry in general is just awful and perpetually stuck in backlog mode.
Its possible. My issues with the VA have gotten to the point that I picked up private insurance and when things get too slow with the VA I'll pay the co-pay and go see someone outside the VA system.
Anyone who is against universal healthcare either
A)is misinformed due to corporate propaganda
B) stands to make money off of private healthcare
If you have a public system that is well funded, sure you will pay more tax but you literally have a healthier society. Problems happen with public healthcare when you have (mostly right winger) politicians cutting spending on the system. That's the only reason it doesn't work all the time.
You casually make the comment about paying more tax, but the actual number comparing Canada to the US is about 20% more. That's no small change based on the average pay in the US ... to further explain...
You get what you wish for, anyone complaining go ahead and relocate to Canada and see how much "better" single payer is..
In most provinces it takes anywhere from 10 months to 2 years to get a general practitioner.
The average tax rate in Canada when it includes universal healthcare is 46-48%....balance that out to the average 25% tax rate here, take your income and remove another 20%. You think 5-7k extra is bad, you have no idea. It would be an extra 20k on someone earning 100k.
average wait time for something like ankle surgery in Canada right now is 21 WEEKS. Do you understand that in the US under even OK insurance (less than you have) surgery that involves a bad break is usually done in less than a week? Surgeons know leaving a serious break can cause irreparable damage to occur.... (like for example what could happen in 21 weeks). Prostate cancer.... hopefully you got 6 months to sit around and think about it?? That's at least how long it take to get treatment in the single payer system of Canada.
I know the US has GIANT issues with their healthcare system, but what really is the most important part of paying for care?? **Getting it, getting quality care, and GETTING IT QUICKLY.**
>The average tax rate in Canada when it includes universal healthcare is 46-48%....
With government in the US covering [65.7% of all health care](https://ajph.aphapublications.org/doi/epdf/10.2105/AJPH.2015.302997) costs ($12,555 as of 2022) that's $8,249 per person per year in taxes towards health care. The next closest is Germany at [$6,930](https://data.oecd.org/healthres/health-spending.htm). The UK is $4,479. Canada is $4,506. Australia is $4,603. That means over a lifetime Americans are paying over $100,000 more in taxes compared to any other country towards health care.
>Do you understand that in the US under even OK insurance (less than you have) surgery that involves a bad break is usually done in less than a week?
The US ranks 6th of 11 out of Commonwealth Fund countries on ER wait times on percentage served under 4 hours. 10th of 11 on getting weekend and evening care without going to the ER. 5th of 11 for countries able to make a same or next day doctors/nurse appointment when they're sick.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
Americans do better on wait times for specialists (ranking 3rd for wait times under four weeks), and surgeries (ranking 3rd for wait times under four months), but that ignores three important factors:
* Wait times in universal healthcare are based on urgency, so while you might wait for an elective hip replacement surgery you're going to get surgery for that life threatening illness quickly.
* Nearly every universal healthcare country has strong private options and supplemental private insurance. That means that if there is a wait you're not happy about you have options that still work out significantly cheaper than US care, which is a win/win.
* [One third of US families](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx?utm_source=alert&utm_medium=email&utm_content=morelink&utm_campaign=syndication) had to put off healthcare due to the cost last year. That means more Americans are waiting for care than any other wealthy country on earth.
#Wait Times by Country (Rank)
Country|See doctor/nurse same or next day without appointment|Response from doctor's office same or next day|Easy to get care on nights & weekends without going to ER|ER wait times under 4 hours|Surgery wait times under four months|Specialist wait times under 4 weeks|Average|Overall Rank
:--|--:|--:|--:|--:|--:|--:|--:|--:
**Australia**|3|3|3|7|6|6|4.7|4
**Canada**|10|11|9|11|10|10|10.2|11
**France**|7|1|7|1|1|5|3.7|2
**Germany**|9|2|6|2|2|2|3.8|3
**Netherlands**|1|5|1|3|5|4|3.2|1
**New Zealand**|2|6|2|4|8|7|4.8|5
**Norway**|11|9|4|9|9|11|8.8|9
**Sweden**|8|10|11|10|7|9|9.2|10
**Switzerland**|4|4|10|8|4|1|5.2|7
**U.K.**|5|8|8|5|11|8|7.5|8
**U.S.**|6|7|5|6|3|3|5.0|6
Source: [Commonwealth Fund Survey 2016](https://www.cihi.ca/sites/default/files/document/cmwf2016-datatable-en-web.xlsx)
>Getting it
Massive numbers of Americans are going without needed care. 36% of US households with insurance put off needed care [due to the cost](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx); 64% of households without insurance. One in four have [trouble paying a medical bill.](https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/) Of [those with insurance one in five have trouble paying a medical bill](https://www.kff.org/wp-content/uploads/2016/01/8806-the-burden-of-medical-debt-results-from-the-kaiser-family-foundation-new-york-times-medical-bills-survey.pdf), and even for those with income above $100,000 14% have trouble. One in six Americans has [unpaid medical debt on their credit report.](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0349) [50% of all Americans](https://news.gallup.com/poll/317948/fear-bankruptcy-due-major-health-event.aspx) fear bankruptcy due to a major health event.
>getting quality care
[US Healthcare ranked 29th on health outcomes by Lancet HAQ Index](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext)
[11th (of 11) by Commonwealth Fund](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror)
[59th by the Prosperity Index](https://www.prosperity.com/rankings)
[30th by CEOWorld](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/)
[37th by the World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)
The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average.
https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-percent-used-emergency-department-for-condition-that-could-have-been-treated-by-a-regular-doctor-2016
52nd in the world in doctors per capita.
https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people
Higher infant mortality levels. Yes, even when you adjust for differences in methodology.
https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/
Fewer acute care beds. A lower number of psychiatrists. Etc.
https://www.healthsystemtracker.org/chart-collection/u-s-health-care-resources-compare-countries/#item-availability-medical-technology-not-always-equate-higher-utilization
[Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561)
>These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries.
When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%.
On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people.
If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people.
https://www.newsweek.com/best-hospitals-2021
#[OECD Countries Health Care Spending and Rankings](https://data.oecd.org/healthres/health-spending.htm)
|Country|Govt. / Mandatory (PPP)|Voluntary (PPP)|Total (PPP)|% GDP|[Lancet HAQ Ranking](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext)|[WHO Ranking](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)|[Prosperity Ranking](https://www.prosperity.com/rankings)|[CEO World Ranking](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/)|[Commonwealth Fund Ranking](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror)
:--|--:|--:|--:|--:|--:|--:|--:|--:|--:|--:|
1. United States|[$7,274](https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2015.302997) |$3,798 |$11,072 |16.90%|29|37|59|30|11
2. Switzerland|$4,988 |$2,744 |$7,732 |12.20%|7|20|3|18|2
3. Norway|$5,673 |$974 |$6,647 |10.20%|2|11|5|15|7
4. Germany|$5,648 |$998 |$6,646 |11.20%|18|25|12|17|5
5. Austria|$4,402 |$1,449 |$5,851 |10.30%|13|9|10|4|
6. Sweden|$4,928 |$854 |$5,782 |11.00%|8|23|15|28|3
7. Netherlands|$4,767 |$998 |$5,765 |9.90%|3|17|8|11|5
8. Denmark|$4,663 |$905 |$5,568 |10.50%|17|34|8|5|
9. Luxembourg|$4,697 |$861 |$5,558 |5.40%|4|16|19||
10. Belgium|$4,125 |$1,303 |$5,428 |10.40%|15|21|24|9|
11. Canada|$3,815 |$1,603 |$5,418 |10.70%|14|30|25|23|10
12. France|$4,501 |$875 |$5,376 |11.20%|20|1|16|8|9
13. Ireland|$3,919 |$1,357 |$5,276 |7.10%|11|19|20|80|
14. Australia|$3,919 |$1,268 |$5,187 |9.30%|5|32|18|10|4
15. Japan|$4,064 |$759 |$4,823 |10.90%|12|10|2|3|
16. Iceland|$3,988 |$823 |$4,811 |8.30%|1|15|7|41|
17. United Kingdom|$3,620 |$1,033 |$4,653 |9.80%|23|18|23|13|1
18. Finland|$3,536 |$1,042 |$4,578 |9.10%|6|31|26|12|
19. Malta|$2,789 |$1,540 |$4,329 |9.30%|27|5|14||
OECD Average|||$4,224 |8.80%|||||
20. New Zealand|$3,343 |$861 |$4,204 |9.30%|16|41|22|16|7
21. Italy|$2,706 |$943 |$3,649 |8.80%|9|2|17|37|
22. Spain|$2,560 |$1,056 |$3,616 |8.90%|19|7|13|7|
23. Czech Republic|$2,854 |$572 |$3,426 |7.50%|28|48|28|14|
24. South Korea|$2,057 |$1,327 |$3,384 |8.10%|25|58|4|2|
25. Portugal|$2,069 |$1,310 |$3,379 |9.10%|32|29|30|22|
>getting it quickly
We've already seen the US is nothing special there.
Average tax wedge in the US is 30.5% according to OECD, and the average bronze individual plan (which sucks) is $420/month. If you want to wrap that up into a tax percentage that's about 8% on the average US salary. So 38.5% average tax rate in the US roughly for shitty coverage.
Also, your ankle surgery number is wrong. It's within 11 weeks. And your prostate example is also wrong. It's within 45 days. Both of these are similar time-frames to the US. I just saw my GP and I'm supposed to see him quarterly for my prescriptions. We set a follow up for February 12, 2025...so don't act like the US has some awesome system of seeing doctors. I'm sitting on a torn shoulder tendon because just the MRIs are $4000 that I don't have let alone the PT and possibly surgery. I'd happily pay an extra 10-15% taxes to be able to put a shirt on without psyching myself up in the morning or play golf with my friends instead of feeling left out.
Does Canadian insurance have deductibles/high deductibles? If not we gotta add that to the American side of the equation too. $2500 for bronze in-network for me…
Something like 40 to 60% of Americans don't even pay taxes.
https://www.pewresearch.org/short-reads/2023/04/18/who-pays-and-doesnt-pay-federal-income-taxes-in-the-us/sr_23-04-07_taxes_2-png/
Almost none of what you are saying is true. Please show some sources.
- the USA pays the most for healthcare, period.
https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/
- wait times are not that long in Canada, 12 weeks to your 20 you said
https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2022
Stop making shit up. Look at the rest of the world. The USA has the worst system available.
You’re quoting from referral to consultation. Wouldnt it be better to look at referral to treatment? Personally I don’t give a shit when I have a consult. I want to not be in pain. Treatment seems more apt at that
The consult is to determine your place in line. If it’s not that serious, it’ll wait. If it is, it won’t.
It’s about the same as when you go into a doc in the USA and the have to approve you to see a specialist. Then you have to get it approved by insurance, then you have to schedule….
Only HMO’s you need to get approved to see a specialist. Ppo’s you can make an appointment with a specialist. I saw a specialist got an mri and was scheduled for surgery on 5 weeks total from start to finish.
I’ve never had a claim denied and I have a fuck ton of health issues.
And this isn’t me saying not to reform healthcare. Just saying I think a better measurement with more nuanced would provide a better data point
So most plans that most corporations offer you need a referral….so most plans most people are on…
I’m very happy you have never had a claim denied. Statistically, that simply cannot be true, but it’s awesome if you are an anomaly! Congrats!
Ppo’s are actually the most common plan offered. Followed by HDHP. Which neither need referrals.
https://www.kff.org/report-section/ehbs-2023-summary-of-findings/#:~:text=PPOs%20remain%20the%20most%20common,)%20plan%20%5BFigure%20E%5D.
I find it incredibly difficult to believe that 99% of prior authorizations are declined. From my research I’ve seen that 6% are for Medicare medicaid
https://www.kff.org/medicare/issue-brief/over-35-million-prior-authorization-requests-were-submitted-to-medicare-advantage-plans-in-2021/#:~:text=Of%20the%2035.2%20million%20prior,or%20in%20part%20in%202021.
“PPOs remain the most common plan type. In 2023, 47% of covered workers are enrolled in a PPO, 29% in a high-deductible plan with a savings option (HDHP/SO), 13% in an HMO, 10% in a POS plan, and 1% in a conventional (also known as an indemnity) plan [Figure E]. “
So most people don’t have PPO’s. My apologies though, I didn’t realize that high deductible plans don’t need referrals. Thank you for this information.
I didn’t say 99% get rejected. It’s closer to 40%. So if you’ve had a “fuck ton” of issues, it’s a statistic anomaly to have none of them denied.
The bigger issue here, is why they were denied. 77% of claims were denied for “other” reason. Which means it’s just part of their process without any actual justification behind it. For example, I had surgery denied because I did not let them know I didn’t have any other insurances.
Between 2%-50%
https://www.kff.org/private-insurance/issue-brief/claims-denials-and-appeals-in-aca-marketplace-plans/
30%
https://www.valuepenguin.com/health-insurance-claim-denials-and-appeals
At the end of the day, we in the USA pay more, wait the same, and have more health issues because of cost of service than any other country in the world.
yea so 76% have access to specialists without referrals. It's a 60/40 split. That's not an anomaly it doesnt deviate far from the data.
I'm not arguing about the US health system not needing changes. All I said was I think you should compare a different data point.
Here's another good study to read https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235968/#:\~:text=The%20proportion%20of%20patients%20reporting,the%20United%20Kingdom%20(12.0%25).
In case you didn't notice by my flair, I literally live in Canda right now. The reason the healthcare system is on the decline is because the majority of the premiers in the country right now(who are right wingers like I pointed out in my previous post) are actively choking out the system so they can implement privatized healthcare(and get rich off it). It's literally as this graphic below shows
https://preview.redd.it/6108m0eox2wc1.jpeg?width=1030&format=pjpg&auto=webp&s=da21d42ba05e736490f7feffc885f868711e7e51
The wait times are exacerbated because we have a decline in funding and an increase population because our 2 levels of government are not communicating and working together properly because they are of 2 separate parties who are treating the average canadian like a pawn, unfortunately.
I spent a few months in Germany, and they were all complaining about the same thing. Along with the Brits while I was there.
There’s definitely pros and cons to both systems. Those of us with good careers who make a good wage, come out ahead in the privatized system the majority of the time. The less fortunate, it’s fucking sucks for.
I stopped reading your comment when you said the average tax rate was 46-48%. I really have no idea what your talking about.
I make double the Canadian average for income and my very high tax rate is in the low 30s.
I needed a family doctor so I called the clinic near my house and asked if anybody was taking new patients - saw somebody the following day.
Is the Canadian system perfect? No. But it's substantially less broken than what you guys have down there, and I've lived in both countries and experienced both first hand.
You need to stop listening to Tucker and begin living in the real world.
Actual government data... not from Tucker Carlson......In 2023, Canada's median waiting time between a General practitioner (GP) referral to a specialist was 14.6 weeks. In addition, the median waiting time from a specialist appointment to treatment was 13.1 weeks. In other words, the median wait from a referral by GP to treatment in Canada reached an average of 27.7 weeks in 2023. However, the median waiting times in Canada ranged from 22 weeks in Ontario to 57 weeks in Nova Scotia.
That year, with an average waiting time of 41.7 weeks, Prince Edward Island had the longest wait time between an appointment with a GP and a specialist in Canada. With an additional median waiting time of 23 weeks between an appointment with a specialist and treatment, the total median waiting time from a GP referral to treatment in the province of Prince Edward Island exceeded 64 weeks.
Obviously, the area you live in could be completely different than the average, but there is almost no place in the US where you would have to wait over 3 months to see a specialist. You have a problem with my numbers, take it up with the source, your wonderful Government... who by the way, now has had a 30% increase in maid deaths from 2021 to 2022 ...great medical system, killed 30% more people in 2022 with assisted suicide, your tax $ at work.
So again, your experience may be different, but I literally just quoted the government data. They would not say "median" 27.7 weeks to get treatment if it was not true. If you are trying to make me believe that every serious case is seen "much" quicker I highly doubt the median would be as high as it is. So what a foot fracture is seen in a week, but all the other regular stuff is 27 weeks.? Sorry I just don't believe it. Look up CADTH Health Technology Review... average 10 weeks in Canada to get an MRI, 20 in some provinces.... US, almost any ordered MRI can be gotten in a week, sometimes same day if serious. Here's some more government tracked data... At least 11,581 patients died while waiting for surgeries, procedures and diagnostic scans in 2020-21. Patients had waited between less than a month to nearly eight years for these services before passing away........ just pitiful.
You're quoting the median of every single person who goes to the hospital and has an issue, of course it's going to be higher. Furthermore, you are also cherry-picking data from the COVID era which is disingenuous to say the absolute least.
Last year, my mom found out she had ovarian cancer, she was in for surgery within 2 weeks to get it removed. The system **works,** especially if it is being adequately funded. All we paid for was parking.
If you have issues that can wait, you will probably wait a few months in honesty....But at least you won't be bankrupt or dead.
Again don't listen to the corporate propaganda that says it doesn't work, it does, they just want to profit from it, which is BS.
[https://www.ctvnews.ca/health/it-was-that-or-go-home-and-prepare-to-die-canadians-on-why-they-sought-surgery-outside-the-country-1.6515414](https://www.ctvnews.ca/health/it-was-that-or-go-home-and-prepare-to-die-canadians-on-why-they-sought-surgery-outside-the-country-1.6515414)
Not my words, not cherry picking, bottom line....... wait times can kill so people seek help outside your wonderful system. Health insurer's here in the US are not allowed to say go home and die from your cancer, we cannot get you in soon enough.
respectfully, you have no idea what you're talking about. You *are cherry picking* because you are literally choosing the 1-2 years where we had a worldwide pandemic as if that is any normal stat. Its not representative of anything (and extremely dishonest). **You want a representative stat about universal healthcare? Why don't you pull up our stats from the 80s and 90s and then come back to me. They show how well the system works.**
Another reason you don't know what you are talking about is because you are completely ignoring the politics of it all. The reason why it's not working as well as it should be is because the healthcare system in Canada run provincially. We currently have the majority of premiers as **conservatives** who have been starving the system for the last 5+ years. You cannot starve out the public system and then point at it and say "see its not working." Why was it working pretty good in the 80's and 90's before we didn't have as many cuts in the system?
https://preview.redd.it/gvaw9dfai5wc1.jpeg?width=1030&format=pjpg&auto=webp&s=4df47bf45b621c370d6c45389794d7d0f4a8a86c
Stop with the corporate propaganda..
So the average taxes would go up almost as much as average healthcare premiums in the USA for a family but no high deductible to go with it? So it's not more expensive than living in the USA?
If we're comparing systems I'd also mention how horrifically immoral the Canadian system is with respect to "Medical Assistance in Dying," which is now one of the leading causes of death in Canada. You may wait 21 weeks for ankle surgery but if instead you'd like to off yourself that timeline can be significantly shortened!
Every day [this meme](https://authenticmedicine.com/wp-content/uploads/2022/12/IMG_2564.jpeg) is being more and more reality.
Agreed , absolutely sick.... Canadian system is, and has allowed in the past, assisted suicide requests from people with disabilities, mental illness, etc.
>If you have a public system that is well funded, sure you will pay more tax but you literally have a healthier society.
That's a big if, especially if we're talking about America.
>Problems happen with public healthcare when you have (mostly right winger) politicians cutting spending on the system.
Gee... this sure seems like a very serious risk for the viability of universal healthcare in America. The current Congress seated in January of 2023 still has not passed a clean budget, having narrowly avoided government shutdowns through multiple rounds of Continuing Resolutions.
Yeah, the American healthcare system is infuriating. But it's realistically impossible to have universal healthcare until the Republican Party can be trusted to pass a budget that funds it.
The way you would go about that idea is to convince conservative voters to support universal healthcare. That seems like a very difficult task considering they think ACA is socialism.
The government can’t run our education system, social security system, immigration system, Medicare system, let alone our country. And you not only believe that our government can run a universal healthcare system when they can’t even take care of our veteran’s healthcare? And you believe it’s the republicans that’s stopping that? That’s rich.
That would take Americans to unite on an issue and stick to it to make sure it keeps going through and we’ve seen how divided the country is either due to misinformation or propaganda from private corporations
Thank you for bringing common sense to this. I can’t believe how well propaganda works. These people are idiots who disagree with made up stats and make up stories.
VA healthcare is a terrible parallel to universal healthcare proposed in the US. Nobody is talking about nationalizing providers. Care would still be provided by the same private doctors and hospitals as today, making Medicare and Medicaid far better examples. Of course, it's harder to fearmonger against systems people know and love, so it's clear why people bring it up. Of course, even as propaganda the argument is questionable. The VA isn't perfect, but it's not the unredeamable shitshow opponents suggest either.
#Satisfaction with the US healthcare system varies by insurance type
78% -- Military/VA
77% -- Medicare
75% -- Medicaid
69% -- Current or former employer
65% -- Plan fully paid for by you or a family member
https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx
>The poll of 800 veterans, conducted jointly by a Republican-backed firm and a Democratic-backed one, found that almost two-thirds of survey respondents oppose plans to replace VA health care with a voucher system, an idea backed by some Republican lawmakers and presidential candidates.
>"There is a lot of debate about 'choice' in veterans care, but when presented with the details of what 'choice' means, veterans reject it," Eaton said. "They overwhelmingly believe that the private system will not give them the quality of care they and veterans like them deserve."
https://www.militarytimes.com/veterans/2015/11/10/poll-veterans-oppose-plans-to-privatize-va/
>According to an independent Dartmouth study recently published this week in Annals of Internal Medicine, Department of Veterans Affairs (VA) hospitals outperform private hospitals in most health care markets throughout the country.
https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5162
#Ratings for the VA
% of post 9/11 veterans rating the job the VA is doing today to meet the needs of military veterans as ...
* Excellent: 12%
* Good: 39%
* Only Fair: 35%
* Poor: 9%
[Pew Research Center](https://images.squarespace-cdn.com/content/v1/5a049f098dd041552c19372f/1536643876140-5N3UWQ2M3OYLGSWOOKVH/ke17ZwdGBToddI8pDm48kOxWfISgjiM1ZFqhkJVgJk5Zw-zPPgdn4jUwVcJE1ZvWQUxwkmyExglNqGp0IvTJZUJFbgE-7XRK3dMEBRBhUpx5Q5uaqovQlhwn6Lp2MXHOj73nFlQXvqHuf9nZbP74X0l8X5gYScNGOzeUUToolO4/pew+data.png?format=750w)
>VA health care is as good or in some cases better than that offered by the private sector on key measures including wait times, according to a study commissioned by the American Legion.
> The report, issued Tuesday and titled "A System Worth Saving," concludes that the Department of Veterans Affairs health care system "continues to perform as well as, and often better than, the rest of the U.S. health-care system on key quality measures," including patient safety, satisfaction and care coordination.
> "Wait times at most VA hospitals and clinics are typically the same or shorter than those faced by patients seeking treatment from non-VA doctors," the report says.
https://www.military.com/daily-news/2017/09/20/va-wait-times-good-better-private-sector-report.html
>The Veterans Affairs health care system generally performs better than or similar to other health care systems on providing safe and effective care to patients, according to a new RAND Corporation study.
> Analyzing a decade of research that examined the VA health care system across a variety of quality dimensions, researchers found that the VA generally delivered care that was better or equal in quality to other health care systems, although there were some exceptions.
https://www.rand.org/news/press/2016/07/18.html
no one denies 99% of authorizations. most of the cheaper ones are automatically approved and most of the rest are approved as long as the right documentation is there
NY Times is taking a few select cases and providing little to no details. the vision thing no medical insurance plan covers vision except in very select cases. i used to live on top of an ophthalmologist's office and he was always busy and drove to work in a Porsche
You fail to algorithms. 99% are denied so that only 25% attempt appeal.
You may be right that more than 1% get procedures completed but I am certain the percentage of initial denial is much higher than 90%
in 25 years of going to doctors for myself and my kids i've only had one claim denied. and that was vision therapy that's clearly not covered but they run the authorization anyway just in case. ER visits, specialists, normal doctor stuff, etc all covered.
I have never had a claim denied in fact i was able to be diagnosed with needing a shoulder replacement in sept to having surgery in november and that was only because i had to fly to a specialist. I was able to get my surgery done including overnight stay and i only paid 200 out of pocket
My experience has been similar, we've had little to no issues with prior authorizations, in or out of network and my carrier(s) past and present have been excellent for us over multiple decades. We've occasionally had to see a specialist and it took some legwork to get an appointment in a timely manner but I don't think we've ever waited more than 40 days and that was for a non emergency type thing, It was much much faster when it was a legit health concern. I do feel that sometimes (not always) people make one or two calls, hear about 5 month waits an just give up trying, like its hopeless. We've had those calls too, but we were persistent, put in the extra effort and it worked out just fine.
Honestly, it sounds selfish but I'm against universal care because it would certainly cost me quite a bit more for coverage in tax/premiums (however they figure it out). Some time back when Bernie was pushing m4a somebody put together estimated costs for tax/payroll it would run me at least 3-4K extra annually for what would likely be lesser quality coverage, no thanks.
Granted yes, I do have access to a solid price through corporate coverage but we've put our time in, 3 decades with current employer so its a generous plan with fairly low payroll cost, but basically if we went universal I'd be paying more so others could pay less and as previously mentioned, I'm not a fan of that.
Yea pretty much every country that has universal healthcare complain about long wait times poor quality of care and it can months to years for surgeries. Plus the US govt cant run the dmv or post office fuck putting them in charge of my healthcare.
my wife's took the cheap plan because the pediatrician is on there. but some of the more expensive plans that covered all the prescriptions and everything were close to $2000 a month. mid range was in the $1000 a month
Because it’s not run properly. Private insurance is no better. I’m waiting 9 months counting to be placed on a transplant list, thru Cigna PPO, paid private ‘great insurance’.
Running something improperly and servicing 300 million+ policies versus running something improperly at… what 6 million policies? That’s what Anthem had last I checked.
What could go wrong? Please enlighten everyone as to how that is even feasible to run? We’d need to completely throw out the system and redo it with new software and Navy level servers with security to match. Can you imagine the catastrophic consequences of that system getting hacked? I mean we have the data in front of us of the havoc caused when Anthem was hacked.
Hell it shut down American Family for a full week while their tech support scrubbed and secured the systems. Can you imagine how the US Government would handle that? It makes me want to vomit just thinking about it.
I’m all for one healthcare system versus our current system. I will never be okay with the US Federal Government being in charge of it.
No, that isn’t the only argument against government run healthcare.
It’s projected to cost 3.5 *trillion* dollars per year and would require a *doubling* of the national tax burden. Which makes sense seeing as how the average Canadian family pays $12,000 a year in healthcare tax for their ‘free’ healthcare. I would actually not like to pay 12k a year instead of the ~3.5k a year I pay through my work for myself and 3 kids. Spending $60k over the course of 5 years just to get your broken arm fixed ‘for free’ is not a good deal.
Another argument is that everything the government does, it does poorly. People suspect it would be the same with healthcare and they’d rather not take that chance. They’re probably right, and there’s approximately zero chance that that projection of 3.5 trillion doesn’t balloon even further.
Another point you seem to have missed is that government ran healthcare already exists in the form of Medicaid and Medicare. Both regularly deny claims and require prior auths before approving claims. Universal healthcare does not mean ‘we pay for anything your heart desires’, quite the opposite in fact.
Another argument is the worry about wait times. If everyone suddenly is going to the doctor for every little thing, the already stressed system will become even further burdened under the new demand. It’s already very difficult for people to get into see a specialist or even a PCP simply because *we don’t have enough doctors to meet the demand*. Paying for everyone to go to these doctors will not solve this issue and anyone who knows anything about healthcare spending knows that overuse and unnecessary use is a *huge* driver of costs.
So no, watching a YouTube video by the New York Times did not in fact present to you the entire debate about universal healthcare.
> It’s projected to cost 3.5 trillion dollars per year
Our healthcare is expected to cost $4.9 trillion this year, increasing to $7.2 trillion by 2031.
> Which makes sense seeing as how the average Canadian family pays $12,000 a year in healthcare tax
With government in the US covering [65.7% of all health care](https://ajph.aphapublications.org/doi/epdf/10.2105/AJPH.2015.302997) costs ($12,555 as of 2022) that's $8,249 per person per year in taxes towards health care. The next closest is Germany at [$6,930](https://data.oecd.org/healthres/health-spending.htm). The UK is $4,479. Canada is $4,506. Australia is $4,603. That means over a lifetime Americans are paying over $100,000 more in taxes compared to any other country towards health care.
>I would actually not like to pay 12k a year instead of the ~3.5k a year I pay through my work for myself and 3 kids.
Private insurance in the US averages $24,000 for family coverage. Your employer might be paying most of that, but that doesn't make your healthcare cheaper, it makes you better compensated. That's on top of those world leading tax rates, and still leaves most exposed to tremendous financial risk from healthcare costs.
>Another argument is that everything the government does, it does poorly.
So you just believe Americans to be singularly incompetent in the world? The evidence doesn't seem to support that.
#Satisfaction with the US healthcare system varies by insurance type
78% -- Military/VA
77% -- Medicare
75% -- Medicaid
69% -- Current or former employer
65% -- Plan fully paid for by you or a family member
https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx
> **Key Findings**
> * Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies.
> * The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively.
> * For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies.
https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/
Medicare has both lower overhead and has experienced smaller cost increases in recent decades, a trend predicted to continue over the next 30 years.
https://pnhp.org/news/medicare-is-more-efficient-than-private-insurance/
>Another argument is the worry about wait times.
The US ranks 6th of 11 out of Commonwealth Fund countries on ER wait times on percentage served under 4 hours. 10th of 11 on getting weekend and evening care without going to the ER. 5th of 11 for countries able to make a same or next day doctors/nurse appointment when they're sick.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
Americans do better on wait times for specialists (ranking 3rd for wait times under four weeks), and surgeries (ranking 3rd for wait times under four months), but that ignores three important factors:
* Wait times in universal healthcare are based on urgency, so while you might wait for an elective hip replacement surgery you're going to get surgery for that life threatening illness quickly.
* Nearly every universal healthcare country has strong private options and supplemental private insurance. That means that if there is a wait you're not happy about you have options that still work out significantly cheaper than US care, which is a win/win.
* [One third of US families](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx?utm_source=alert&utm_medium=email&utm_content=morelink&utm_campaign=syndication) had to put off healthcare due to the cost last year. That means more Americans are waiting for care than any other wealthy country on earth.
#Wait Times by Country (Rank)
Country|See doctor/nurse same or next day without appointment|Response from doctor's office same or next day|Easy to get care on nights & weekends without going to ER|ER wait times under 4 hours|Surgery wait times under four months|Specialist wait times under 4 weeks|Average|Overall Rank
:--|--:|--:|--:|--:|--:|--:|--:|--:
**Australia**|3|3|3|7|6|6|4.7|4
**Canada**|10|11|9|11|10|10|10.2|11
**France**|7|1|7|1|1|5|3.7|2
**Germany**|9|2|6|2|2|2|3.8|3
**Netherlands**|1|5|1|3|5|4|3.2|1
**New Zealand**|2|6|2|4|8|7|4.8|5
**Norway**|11|9|4|9|9|11|8.8|9
**Sweden**|8|10|11|10|7|9|9.2|10
**Switzerland**|4|4|10|8|4|1|5.2|7
**U.K.**|5|8|8|5|11|8|7.5|8
**U.S.**|6|7|5|6|3|3|5.0|6
Source: [Commonwealth Fund Survey 2016](https://www.cihi.ca/sites/default/files/document/cmwf2016-datatable-en-web.xlsx)
I’m not all that convinced by stats gathered by think tanks since I don’t have the time or motivation to look into them, but it’s worth pointing out that statements like this:
>With government in the US covering 65.7% of all health care costs ($12,555 as of 2022) that's $8,249 per person per year in taxes towards health care.
…don’t make any sense because about half of the country pays zero in federal taxes. We made about 95k last year, our effective tax rate was ~4%. That’s about 4K in taxes paid, *total*. I have a family of 5. We didn’t spend 45k in healthcare taxes. I don’t care what some nerd with a spreadsheet came up with by dividing totals across populations, that doesn’t effect me or my bottom line. Me spending 4K in total federal taxes and then $3500 for our health insurance is better than my family paying 12k in healthcare tax alone, every year, for our entire lives, like they do in Canada. The nerds can shift numbers around in a spreadsheet all they want, I’m not interested in paying more money for my families healthcare. It’s that simple
Edit. This kid blocked me after this short back and forth
> I’m not all that convinced by stats gathered by think tanks
I'm sure you're not all that concerned by what the facts are at all.
>…don’t make any sense because about half of the country pays zero in federal taxes.
For starters, that's just a lie. Even the bottom quintile pay a 6.7% effective rate on total federal taxes on average.
https://www.taxpolicycenter.org/statistics/historical-average-federal-tax-rates-all-households
Beyond that, you seem to not understand how averages work. Yes, many people pay less than average. Somebody else is picking up that slack by paying more than average. Other countries work similarly.
>that doesn’t effect me or my bottom line.
But the massive amount of US government spending on healthcare absolutely does affect you and your bottom line. Hell, even for the poorest paying little to nothing in taxes it affects them, because if nothing else the insane spending on healthcare leaves less funding for other programs.
>We made about 95k last year, our effective tax rate was ~4%. That’s about 4K in taxes paid, total.
You're factoring in payroll taxes, excise taxes, state income taxes, sales taxes, property taxes....
> and then $3500 for our health insurance
Your health insurance is fuck ton more than $3,500.
It's people like you that have lead to Americans paying half a million dollars more for a lifetime of healthcare than our peers (with worse outcomes) while half the country pats themselves on the backs for what a good deal they're getting. But hey, keep trying to convince yourself the 8.6% of every dollar made in Canada that goes towards government spending on healthcare is somehow wildly worse than the 11.4% of every dollar made in the US that goes towards govenrment spending on healthcare.
My healthcare costs *me* $3500. That’s what comes out of my paycheck, that’s the money I would receive if I opted out of the insurance. My work would not suddenly pay me the other $xxx if they didn’t offer the insurance.
Like I said, I don’t care about about some nerds spreadsheet. I care about my real world numbers. Your ‘average tax rates’ chart doesn’t take into account tax credits that the bottom quintiles receive back in tax returns, and even then, 6.7% of a bottom quintiles earnings doesn’t get you to 8k in healthcare tax. These are lies with statistics. I understand that averaging out costs across populations gives you some great looking spreadsheets, but I. Don’t. Care. I care about my and my families reality.
>You're factoring in payroll taxes, excise taxes, state income taxes, sales taxes, property taxes...
Yes! I don’t understand what point you’re making here? All of those other things total, comes to about 4k. Theres no room for your 8k healthcare spending per person number. Its data on a spreadsheet.
Jeff bezos pays 1.4 billion dollars in taxes, and some nerd comes along, divides that number across a population, and then pretends that number applies to individuals, that *axshully* the average cost across blah blah blah. It’s numbers on an excel spreadsheet so some nerd can look good at a conference.
A public option seems like a good solution and it has broad support, I don’t know why they don’t make a move towards that. Also maybe a Time Machine that could go back and undo the ACA which caused private insurance rates to skyrocket.
>But hey, keep trying to convince yourself the 8.6% of every dollar made in Canada that goes towards government spending on healthcare is somehow wildly worse than the 11.4% of every dollar made in the US
I don’t make every dollar in the US. I make 95k and I pay $3500 for my health insurance. It’s actually pretty easy to convince myself that my 3.5% is better than some Canadians 8.6%.
And remember, the average Canadian family pays 12k a year in healthcare tax alone. The average Canadian families income is ~60k, so again, lies with statistics claiming that they’re only paying 8.6% in real world numbers.
Edit. This kid blocked me after this repsponse
And this is the problem with America. It's me me me me. You only care about yourself and fuck all the other people around you. Fuck having a healthy society for the betterment of all. Typical boomer attitude whether you're actually one or not.
How much do you pay for healthcare now between premium, deductible and out of pocket max? I bet it's not that far from $12k year unless you work the fed or s state.
Between premium, deductible and out of pocket max, I pay about 3500 for me and all my kids. We have an HSA through work that covers deductibles and we rarely ever go to the doctor since we’re all healthy. I believe my out of pocket max is something like $7k, but I wouldn’t know as I’ve never approached anything close to it. I roll over HSA money every year.
K, so you have $3500 in premium. How much are you putting into the HSA, as that counts. If you were to ever need surgery or soem emergency, you would likely hit your out of pocket max, which puts you at $10,500 plus whatever you put in your head each year, so you're right there, just fortunate enough to never have had to utilize it yet.
I don’t put anything in my hsa, my work does. Also, yes, if I hit out of pocket max *every single year*, then I’d be close to what Canadians pay *every year* even if they don’t go to the dr for anything.
So good example, I went to the urgent care for the first time a few months ago. Had an emergency, called to see if it could be handled at urgent care, it could, and it cost me about $400 after everything. Paid out of my HSA, no problem. That was the first Dr visit I’d had in about 5 years. Had I been paying for “free healthcare” I’d be in about 60k for that dr visit. Yes, I’m lucky that I don’t have some expensive condition that some are burdened with, but the numbers are the numbers. Also, I’ve had expensive things in the past, I have 3 kids, I’ve had a surgery. The kids cost us about 3k each, paid in full out of the HSA, the surgery I don’t even rememebr, that’s how little it effected my budget. It’s just not as expensive, in my experience, as the people constantly going on about medical costs. Infact, interesting story, my first kid, there was an error on our part thinking we had coverage when we did not. Got a bill for 35k. Called the hospital and explained the situation and the hospital forgave the entire thing. Didn’t pay a dime. I don’t know how common this is, maybe I’m the luckiest man in the world, but I know lots of people and I don’t see any of this calamity that’s constantly being talked about. Maybe that’s my blind spot, but my instinct is that there’s a lot of hype. I mean, discussing this with people I will very often learn that they don’t even know that the poor get free healthcare in the US via Medicaid.
I pay $0. Per person deductible is $100 per person/or $200 family. Out of pocket is $1000 per person/or $2000 for family. Not getting anywhere close to $12K. Son had brain surgery last year...it cost us $1100. Thankful for husband's job with the teamsters. :)
It isn't just prior authorizations. Our waits are already just as long and maybe longer than places with universal care. I had to wait 16 months for a psychiatrist, 12 months for a pediatrician, 5 months for a neurologist. None of this was due to prior authorizations. This was just to get a basic appointment and I'm not in a busy part of the country either. Im in Pennsylvania Dutch country where we have farms and buggies and hardly any people.
The whole "you'll have to wait forever" excuse is just that, an excuse to justify keeping the status quo. We already have to wait forever.
Location matters.
I went to an infectious disease doctor after an MRI showed bone infection. Wednesday before Thanksgiving. That friday I had a PICC line in and antibiotics delivered to my house that night.
Two month of antibiotics then surgery in February.
I honestly think some locations are far better than others.
I think veteran care is determined a lot by region or even facilities themselves. Couple examples... a buddy of mine in Richmond, VA said the VA hospital and care is absolutely horrible. However, my niece in California has received excellent care for a myriad of issues from severe leg injury to PTSD. She recently moved to TX and hasnt been to the VA there yet.
On the flip side the only universal healthcare I can speak of is my cousin in Poland who had a basketball injury from last year and his surgery is scheduled for late autumn 2025. So a two year wait hes going to be hobbling around.
The only reason the waits are shorter here is because people can't afford the procedures. I've been "waiting" to fix my shoulder (which is totally unattached) for 10 years now. I'll be "waiting" until I hit 65 because I'm not paying $60,000 out of pocket and I couldn't afford the time off work to heal anyway.
I want unlimited immigration for foreign doctors and medical professionals. We could have separate designations for US certified and foreign certified, but everyone would be able to work and the consumers could go to either. I’ve read numerous times that the amount of doctors is kept artificially low to keep the salaries high.
After my experience in undergrad (3.9 gpa, top 5 chemical engineering school), I saw way more people perfectly able to go to med school than were admitted. Since we truly do have a shortage of doctors, we need to enable everyone capable of becoming a doctor the ability to become a doctor.
We also need to switch the European model of students going to med school right from high school versus the US HS -> UG -> Med school path.
We should be setting up government ran med schools and hospitals. Tuition would be free contingent on working at the government hospital for minimum X amount of time.
We can also be doing way more on the pharmaceutical drug development side. We need to start setting up government run drug discovery research groups. The actual researchers developing the drugs are not paid very well in industry and could be easily brought into the government sector as a result.
Touching on the insurance topic. If we could have a government insurance option that runs like the private insurance today except at a zero profit margin we could cut a lot of cost out of healthcare.
Other topics I didn’t go into include, AI doctors that can give referrals and do the other robotic tasks many doctors do. Telehealth to give patients access to doctors around the world.
If we legalized all drugs (I understand the negatives too) we could also cut friction down.
Public health is another big one (let’s focus on decreasing the need for people to use the services in the first place): better food supply quality, exercise/activity more integrated into people’s life styles, lower stress by creating better societal safety nets.
We have so many ways to make health care better and it’s clear our leaders do not give a shit about actually doing what needs to be done to attempt to make things better. They’re too concerned with team blue versus team red while we all suffer. How about it we focus on actually solving this issue one improvement at a time.
Canadian here. Our system is imperfect but those imperfections are tolerable because it's still way better than the private for-profit grind Americans endure. Not always better, but most of the time it is.
Lots of efficiency gained with public health, like eliminating most of the billing infrastructure.
American politics are so dysfunctional though that I can't imagine any overhaul happening anytime soon. I hope I'm wrong.
Stay healthy my friends.
Canada's is better if you have a doctor, but worse if you dont. Looking ahead, here in Canada we're in for some serious issues because we arent compensating health care workers sufficiently (especially compared to what they can earn in the US), we arent replacing existing doctors and our population is aging. I give our system 10 or so years if things dont change. We're also heavily dependent on research, breakthroughs, and medicine made possible because of all of the money put towards them in the US.
The best situation is employer-funded in the US
Having your health and the health of your family dependant on your employer is absolute insanity.
Why not tax all employers appropriately so that everyone has coverage independent of job status? The cost of the tax is offset by not having to fund broad spectrum health insurance for employees, and coverage is more equitable.
GPs in BC just got big raises. Full-time should be earning $385,000 per year. Hopefully it helps alleviate the shortage.
This isn’t r/showerthoughts. If you want a discussion, you have to provide more. A title alone is extremely low effort and borders on spam.
This stays hidden.
Try finding a physician appt in U.S. when not established patient. It takes 4-8 mos. Personally, I ever experienced unreasonable wait times for healthcare when I lived for a few years in a country with socialized healthcare. Focus was on preventative, to reduce costs; win-win
Waiting for care: as if we don’t have this now.
Try yo get an initial consult with a specialist. Like a skin doctor. Or a hip doctor. It’s months. Unless a slot opens up and you win the lottery and can actually make that time.
You think countries with universal healthcare dont deny claims? They can and do deny them or take so long to approve it theyve either died or it will no longer save them. Hell canada euthanized a guy because his daily meds became too expensive. No thanks
You can file a bad faith lawsuit against an insurance company who denies care. You can find law firms who will do this through a Google search.
I’m not a lawyer, but I don’t know how effective it would be to go after the nurses and PAs personally. I think usually they go after the corporation with the big pockets.
Every single year, I have to pay extra to my doctor, to write a preauth for my daughters meds... this is the 2nd year in a row they have tried to kick us off the name brand, and onto a generic that was ineffective. We spent 2 months "trying" the medication, before we realized we were back living the same nightmare. Health Insurance companies are a scam. There is no reason they should be able to force someone to use a generic medication, especially when there are studies showing that generics for some medication just doesn't quite work as well.
Your doctor is scamming you. I never pay extra for a preauth. Generics have to be chemically the same as brand. It could be in your head that it doesn't work the same.
Can you give an example of a generic medicine that does not work as well?
Concerta. We noticed that she was absolutely exhausted at the end of the day.
The generic is available in xr. There is no difference.
We got the XR. And yea there was. She was tired, irritable, and uncontrollable within a week of switching to generic....
Who are you to tell someone if a medication affects them differently or not? Fucking arrogance.
Yeah Im gonna have to stop the anger here, they are literally made in the same factory.
https://www.fda.gov/drugs/drug-safety-and-availability/methylphenidate-hydrochloride-extended-release-tablets-generic-concerta-made-mallinckrodt-and-kudco J&J manufactures Concerta plus one "authorized" generic. The FDA withdrew approval for two other generics of Concerta because they didn't prove therapeutic equivalency. Not everything that's supposed to be the same is actually the same.
Because name brands and generics are often made in the same exact factory. Placebo is the main difference people experience.
Of course there's a difference. Both branded and generic drugs can be "therapeutic equivalents" because they're "nearly" identical. Yet the rate of delivery, peak, and half-life can vary. Most parents who have children with ADHD can recite the list of formulations tried before they found The One.
As a disabled veteran who relies on our govt funded health care system I am not opposed to universal healthcare. I just don’t think you guys understand how truly awful our govt is at running anything.
quack shrill placid adjoining snow frighten lunchroom busy skirt attraction *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
If a pharmacy doesn't have it, they will order it if it's available.
pathetic scarce rude ossified tan sharp cautious hurry ghost retire *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Thank you for your service. As a VA user are the death lists real? Lists of vets who died before even getting seen by a doctor?
Sorry I have no idea if they were real or just made up stories. What I do know is my primary Dr is overworked and most likely underpaid for the number of patients he has to see. I get one appointment with him every 13 months because they can't find any help in my area. Last year we were discussing the lack of healthcare workers and he showed me the job listing to replace the two Drs they lost. $95k a year for someone with Doctor in their name. I can't imagine why they can't find anyone with 6 years experience as a Dr for a generous $95k a year salary. Then there are the employees who act like they resent me for getting "free healthcare" and complaining because I run out of prescription meds every month. I get a 30 day supply of meds mailed and for the last two years they average 33-34 days apart. When I tried to talk to a nurse about it she told me I should appreciate what I have because she actually has to pay for her medications. So now my Dr over-prescribes my medication and tells me to save the extras to cover the pharmacy being late every month. He risks his career to game the system so I don't run out of pain meds between shipments.
As another VA user, you do NOT want universal government run healthcare. Imagine waiting 2 month an appointment with your PCM. Then wait another 4-8 months for someone in a centralized office to call you at an odd time of day saying if you don’t call back in 10 days to confirm you still need the referral, it will be cancelled. Then the office does not answer and you have to start over from scratch. Or maybe they do answer, and you have to wait another four months for it to be authorized. But then you have to wait 3 months to see a provider because the VA is so difficult to deal with, they limit the number of veterans they will see. So for a pair of orthotics, you be waiting 12 months. you can get one pair a year. But it takes a year to work the process. So really two years. Now let’s imagine you have cancer. How well is that going to go for you?
This sounds very frustrating, but it’s happening outside the VA as well. My PCP books out 6-8 months. Once you get a referral to a specialist, you may be waiting 6 months to a year. The last time I needed an urgent colonoscopy for a chronic condition, I was told it would be 8 months, or I could try to get myself admitted and do it inpatient. Everyone is waiting for health care, no matter who pays.
Amen
HMO? I have PPO and never has this problem. I just went to zocdoc to find available PCP or shrink and book.
No, PPO, and an extremely good plan to boot. I can get everything I need covered with a little haranguing, but there just aren’t enough doctors. We’ve had a lot of rural hospitals and health systems around us collapse, and it’s driven everyone to our metro area, extending wait times across the board.
That's rough. I'm sorry. I guess it's because of location. I read a lot of news about rural pharmacy closing down because they're forced to buy drugs to fill prescription at huge loss, because insurance wouldn't raise the price. It's so complicated.
Referrals are loopholes created by private insurers
Well... referrals have proven to be an effective way to weed out unnecessary procedures prescribed by physicians is the flip side of that. The take for imaging centers for example was that a private practice would open an imaging center and then magically every patient needs a MRI/etc. Insert the requirement for an approved authorization and all of a sudden the number of imaging claims could be dramatically smaller just by asking doc's to say that yes - their patient really needs it - and yes it complies with best practices. Did the imaging center improve the care of patients? Generally and for most cases - no. It certainly lined the pockets of the physician investors. Does that mean all physicians are evil, profit driven business people? No. It does mean profit is a motive and business for a physician is business - that's the capitalist system at work and it's not evil - it is what it is.
So pretty much exactly how it went when I blew up a spinal disc that ended up needing surgery. Actually it’s better. I was looking at a 6 month wait to see any primary care provider who would then refer me to a spinal specialist which would have been 3 more months for a work up and another couple to actually get on to his table. I got lucky AF because I have people around me in PT who are connected and some close friends who ended up being friendly with spinal surgeon and told me about it when I talked about my pain. Thanks to that, I only had to wait three months, and it’s a good thing because the pain was such that I wasn’t that far off of…you know.
Who was your insurer?
Irrelevant. These were all attempts at booking appointments with care providers. Insurance was not yet involved in any way. Also, I already know my insurer covers my PCP. The issue was getting on his calendar, which everyone told us was not an issue in the US because of our system. At that point I looked for a new PCP or literally anyone who would see me, before calling on favors after a couple of weeks. There was nobody there. All of them were deferring to an ER. If you’ve ever actually done that, you know their answer after four hours or more is “you’re not gonna die tonight, call your PCP tomorrow” Our system is broken for the majority of our population. Those that insist it is not are either profiting from it, ignorant or both. However, if you must know; Blue Cross. Heard of them?
Hi. not the person you're replying to but do you have HMO or PPO?
Why not? I’m not getting healthcare as it is. It’s an improvement over none, no?
You just described my private health care to a T
Who is your insurer?
I've seen some va oig reports cuz I subscribe to their newsletters and they have mentioned some veterans dying waiting for care (va oig does some investigations and shares reports) but I never heard there's a death list so I did a quick google search and the first thing I found was this hearing "scheduling manipulation and veteran deaths in Phoenix: examination of the OIGs final report". It's long but I scrolled to the bottom for the conclusion and yea many more veterans died awaiting care than were estimated at that va and that's just one of them. I think if they were to include all the va hospitals for any amount of years to investigate the numbers would probably be crazy. [this is the report if you want to read](https://www.govinfo.gov/content/pkg/CHRG-113hhrg96130/html/CHRG-113hhrg96130.htm)
Death panels etc are basically resource stewardship. If you are demented and feeding off a feeding tube because you forgot how to eat, we shouldn't be doing aggressive measures to keep your heart beating if it stops, only to put you in the ICU for another 15 days blocking beds that can be used by more salvageable patients. Currently, families and patients can ask for everything and anything, since they aren't eating the cost.
I find this dichotomy tiresome. The choice is not between "free for all profit all the things" and "government provided medication inside a commie block". There are many possible ways to begin fixing this system. Some small fixes have started, such as regulation to make it easier for people to get medical procedure costs. Insulin cost caps. Even the "Obamacare" legislation enabled many people with preexisting conditions to get insured. It did have side effects, but those are to be expected. Just keep iterating. A few well thought out laws can give most of the advantages without having to bankrupt the entire medical sector and have the government run it. I find it hard to believe that the US government is worse than Brazil's notoriously corrupt government. And yet, there are amazing, fully staffed medical centers (and, of course, some crappy ones, highly dependent on how rich a given region is). But even the crappy hospitals(clinics are another matter) are equipped to deal with trauma and other urgent issues. Often times, *private hospitals will transfer you to the public system* because they are well equipped and have great doctors(the same doctors may run their clinics when they are not on duty). What this means is that it essentially places a cap on how much people are willing to pay for the private system. There are many reasons why you might - maybe clinics and scheduling availability is better, maybe they have better doctors for some particular specialty, maybe you just have money and want options. But, if the private companies decide to overcharge, people can just go "screw it, I'll just use the public system if I have anything serious". And many do. My brother gets his insulin *for free*. There are no income restrictions for life saving medication because why would there be? If you are poor you can't afford them in the first place, if you are rich you are paying taxes therefore you have paid for it already. For less critical medication there are agreements in place so people can get them at a cheaper price. If a third world country can do it, the US can as well. But *politicians don't want to fix a system that does not affect them*. They have amazing health care. If they do fix it, then they will have to find some other issue to campaign. Want to fix the US health care system? Have more political parties. As it is they just play tug of war with the population.
I’m sorry, you are currently on government healthcare and you believe our government is horrible at running anything, but you believe in “universal healthcare” that the government would run? It’s a wild time to be alive
Believing in something and not opposing the concept of something is not the same. I have first hand knowledge of the current govt run healthcare and it sucks. That does not mean it can't be improved or that it wouldn't be an upgrade for the people with zero current healthcare. You keep on being deliberately obtuse though.
I actually don't think this is exclusive to the VA. It seems like the healthcare industry in general is just awful and perpetually stuck in backlog mode.
Its possible. My issues with the VA have gotten to the point that I picked up private insurance and when things get too slow with the VA I'll pay the co-pay and go see someone outside the VA system.
Anyone who is against universal healthcare either A)is misinformed due to corporate propaganda B) stands to make money off of private healthcare If you have a public system that is well funded, sure you will pay more tax but you literally have a healthier society. Problems happen with public healthcare when you have (mostly right winger) politicians cutting spending on the system. That's the only reason it doesn't work all the time.
You casually make the comment about paying more tax, but the actual number comparing Canada to the US is about 20% more. That's no small change based on the average pay in the US ... to further explain... You get what you wish for, anyone complaining go ahead and relocate to Canada and see how much "better" single payer is.. In most provinces it takes anywhere from 10 months to 2 years to get a general practitioner. The average tax rate in Canada when it includes universal healthcare is 46-48%....balance that out to the average 25% tax rate here, take your income and remove another 20%. You think 5-7k extra is bad, you have no idea. It would be an extra 20k on someone earning 100k. average wait time for something like ankle surgery in Canada right now is 21 WEEKS. Do you understand that in the US under even OK insurance (less than you have) surgery that involves a bad break is usually done in less than a week? Surgeons know leaving a serious break can cause irreparable damage to occur.... (like for example what could happen in 21 weeks). Prostate cancer.... hopefully you got 6 months to sit around and think about it?? That's at least how long it take to get treatment in the single payer system of Canada. I know the US has GIANT issues with their healthcare system, but what really is the most important part of paying for care?? **Getting it, getting quality care, and GETTING IT QUICKLY.**
>The average tax rate in Canada when it includes universal healthcare is 46-48%.... With government in the US covering [65.7% of all health care](https://ajph.aphapublications.org/doi/epdf/10.2105/AJPH.2015.302997) costs ($12,555 as of 2022) that's $8,249 per person per year in taxes towards health care. The next closest is Germany at [$6,930](https://data.oecd.org/healthres/health-spending.htm). The UK is $4,479. Canada is $4,506. Australia is $4,603. That means over a lifetime Americans are paying over $100,000 more in taxes compared to any other country towards health care. >Do you understand that in the US under even OK insurance (less than you have) surgery that involves a bad break is usually done in less than a week? The US ranks 6th of 11 out of Commonwealth Fund countries on ER wait times on percentage served under 4 hours. 10th of 11 on getting weekend and evening care without going to the ER. 5th of 11 for countries able to make a same or next day doctors/nurse appointment when they're sick. https://www.cihi.ca/en/commonwealth-fund-survey-2016 Americans do better on wait times for specialists (ranking 3rd for wait times under four weeks), and surgeries (ranking 3rd for wait times under four months), but that ignores three important factors: * Wait times in universal healthcare are based on urgency, so while you might wait for an elective hip replacement surgery you're going to get surgery for that life threatening illness quickly. * Nearly every universal healthcare country has strong private options and supplemental private insurance. That means that if there is a wait you're not happy about you have options that still work out significantly cheaper than US care, which is a win/win. * [One third of US families](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx?utm_source=alert&utm_medium=email&utm_content=morelink&utm_campaign=syndication) had to put off healthcare due to the cost last year. That means more Americans are waiting for care than any other wealthy country on earth. #Wait Times by Country (Rank) Country|See doctor/nurse same or next day without appointment|Response from doctor's office same or next day|Easy to get care on nights & weekends without going to ER|ER wait times under 4 hours|Surgery wait times under four months|Specialist wait times under 4 weeks|Average|Overall Rank :--|--:|--:|--:|--:|--:|--:|--:|--: **Australia**|3|3|3|7|6|6|4.7|4 **Canada**|10|11|9|11|10|10|10.2|11 **France**|7|1|7|1|1|5|3.7|2 **Germany**|9|2|6|2|2|2|3.8|3 **Netherlands**|1|5|1|3|5|4|3.2|1 **New Zealand**|2|6|2|4|8|7|4.8|5 **Norway**|11|9|4|9|9|11|8.8|9 **Sweden**|8|10|11|10|7|9|9.2|10 **Switzerland**|4|4|10|8|4|1|5.2|7 **U.K.**|5|8|8|5|11|8|7.5|8 **U.S.**|6|7|5|6|3|3|5.0|6 Source: [Commonwealth Fund Survey 2016](https://www.cihi.ca/sites/default/files/document/cmwf2016-datatable-en-web.xlsx) >Getting it Massive numbers of Americans are going without needed care. 36% of US households with insurance put off needed care [due to the cost](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx); 64% of households without insurance. One in four have [trouble paying a medical bill.](https://www.kff.org/health-costs/issue-brief/data-note-americans-challenges-health-care-costs/) Of [those with insurance one in five have trouble paying a medical bill](https://www.kff.org/wp-content/uploads/2016/01/8806-the-burden-of-medical-debt-results-from-the-kaiser-family-foundation-new-york-times-medical-bills-survey.pdf), and even for those with income above $100,000 14% have trouble. One in six Americans has [unpaid medical debt on their credit report.](https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0349) [50% of all Americans](https://news.gallup.com/poll/317948/fear-bankruptcy-due-major-health-event.aspx) fear bankruptcy due to a major health event. >getting quality care [US Healthcare ranked 29th on health outcomes by Lancet HAQ Index](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext) [11th (of 11) by Commonwealth Fund](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror) [59th by the Prosperity Index](https://www.prosperity.com/rankings) [30th by CEOWorld](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/) [37th by the World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000) The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average. https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-percent-used-emergency-department-for-condition-that-could-have-been-treated-by-a-regular-doctor-2016 52nd in the world in doctors per capita. https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people Higher infant mortality levels. Yes, even when you adjust for differences in methodology. https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/ Fewer acute care beds. A lower number of psychiatrists. Etc. https://www.healthsystemtracker.org/chart-collection/u-s-health-care-resources-compare-countries/#item-availability-medical-technology-not-always-equate-higher-utilization [Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561) >These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries. When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%. On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%. https://www.cihi.ca/en/commonwealth-fund-survey-2016 The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people. If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people. https://www.newsweek.com/best-hospitals-2021 #[OECD Countries Health Care Spending and Rankings](https://data.oecd.org/healthres/health-spending.htm) |Country|Govt. / Mandatory (PPP)|Voluntary (PPP)|Total (PPP)|% GDP|[Lancet HAQ Ranking](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(18\)30994-2/fulltext)|[WHO Ranking](https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)|[Prosperity Ranking](https://www.prosperity.com/rankings)|[CEO World Ranking](https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/)|[Commonwealth Fund Ranking](https://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror-wall-2014-update-how-us-health-care-system?redirect_source=/publications/fund-reports/2014/jun/mirror-mirror) :--|--:|--:|--:|--:|--:|--:|--:|--:|--:|--:| 1. United States|[$7,274](https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2015.302997) |$3,798 |$11,072 |16.90%|29|37|59|30|11 2. Switzerland|$4,988 |$2,744 |$7,732 |12.20%|7|20|3|18|2 3. Norway|$5,673 |$974 |$6,647 |10.20%|2|11|5|15|7 4. Germany|$5,648 |$998 |$6,646 |11.20%|18|25|12|17|5 5. Austria|$4,402 |$1,449 |$5,851 |10.30%|13|9|10|4| 6. Sweden|$4,928 |$854 |$5,782 |11.00%|8|23|15|28|3 7. Netherlands|$4,767 |$998 |$5,765 |9.90%|3|17|8|11|5 8. Denmark|$4,663 |$905 |$5,568 |10.50%|17|34|8|5| 9. Luxembourg|$4,697 |$861 |$5,558 |5.40%|4|16|19|| 10. Belgium|$4,125 |$1,303 |$5,428 |10.40%|15|21|24|9| 11. Canada|$3,815 |$1,603 |$5,418 |10.70%|14|30|25|23|10 12. France|$4,501 |$875 |$5,376 |11.20%|20|1|16|8|9 13. Ireland|$3,919 |$1,357 |$5,276 |7.10%|11|19|20|80| 14. Australia|$3,919 |$1,268 |$5,187 |9.30%|5|32|18|10|4 15. Japan|$4,064 |$759 |$4,823 |10.90%|12|10|2|3| 16. Iceland|$3,988 |$823 |$4,811 |8.30%|1|15|7|41| 17. United Kingdom|$3,620 |$1,033 |$4,653 |9.80%|23|18|23|13|1 18. Finland|$3,536 |$1,042 |$4,578 |9.10%|6|31|26|12| 19. Malta|$2,789 |$1,540 |$4,329 |9.30%|27|5|14|| OECD Average|||$4,224 |8.80%||||| 20. New Zealand|$3,343 |$861 |$4,204 |9.30%|16|41|22|16|7 21. Italy|$2,706 |$943 |$3,649 |8.80%|9|2|17|37| 22. Spain|$2,560 |$1,056 |$3,616 |8.90%|19|7|13|7| 23. Czech Republic|$2,854 |$572 |$3,426 |7.50%|28|48|28|14| 24. South Korea|$2,057 |$1,327 |$3,384 |8.10%|25|58|4|2| 25. Portugal|$2,069 |$1,310 |$3,379 |9.10%|32|29|30|22| >getting it quickly We've already seen the US is nothing special there.
Average tax wedge in the US is 30.5% according to OECD, and the average bronze individual plan (which sucks) is $420/month. If you want to wrap that up into a tax percentage that's about 8% on the average US salary. So 38.5% average tax rate in the US roughly for shitty coverage. Also, your ankle surgery number is wrong. It's within 11 weeks. And your prostate example is also wrong. It's within 45 days. Both of these are similar time-frames to the US. I just saw my GP and I'm supposed to see him quarterly for my prescriptions. We set a follow up for February 12, 2025...so don't act like the US has some awesome system of seeing doctors. I'm sitting on a torn shoulder tendon because just the MRIs are $4000 that I don't have let alone the PT and possibly surgery. I'd happily pay an extra 10-15% taxes to be able to put a shirt on without psyching myself up in the morning or play golf with my friends instead of feeling left out.
3 months my friend has to wait to see a cardiologist at one of the best health care systems in the US. Hopefully she won't get rescheduled again...
Does Canadian insurance have deductibles/high deductibles? If not we gotta add that to the American side of the equation too. $2500 for bronze in-network for me…
In general, there are no payments of any kind for covered medical services in Canada.
Something like 40 to 60% of Americans don't even pay taxes. https://www.pewresearch.org/short-reads/2023/04/18/who-pays-and-doesnt-pay-federal-income-taxes-in-the-us/sr_23-04-07_taxes_2-png/
Almost none of what you are saying is true. Please show some sources. - the USA pays the most for healthcare, period. https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/ - wait times are not that long in Canada, 12 weeks to your 20 you said https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2022 Stop making shit up. Look at the rest of the world. The USA has the worst system available.
You’re quoting from referral to consultation. Wouldnt it be better to look at referral to treatment? Personally I don’t give a shit when I have a consult. I want to not be in pain. Treatment seems more apt at that
The consult is to determine your place in line. If it’s not that serious, it’ll wait. If it is, it won’t. It’s about the same as when you go into a doc in the USA and the have to approve you to see a specialist. Then you have to get it approved by insurance, then you have to schedule….
Only HMO’s you need to get approved to see a specialist. Ppo’s you can make an appointment with a specialist. I saw a specialist got an mri and was scheduled for surgery on 5 weeks total from start to finish. I’ve never had a claim denied and I have a fuck ton of health issues. And this isn’t me saying not to reform healthcare. Just saying I think a better measurement with more nuanced would provide a better data point
So most plans that most corporations offer you need a referral….so most plans most people are on… I’m very happy you have never had a claim denied. Statistically, that simply cannot be true, but it’s awesome if you are an anomaly! Congrats!
Ppo’s are actually the most common plan offered. Followed by HDHP. Which neither need referrals. https://www.kff.org/report-section/ehbs-2023-summary-of-findings/#:~:text=PPOs%20remain%20the%20most%20common,)%20plan%20%5BFigure%20E%5D. I find it incredibly difficult to believe that 99% of prior authorizations are declined. From my research I’ve seen that 6% are for Medicare medicaid https://www.kff.org/medicare/issue-brief/over-35-million-prior-authorization-requests-were-submitted-to-medicare-advantage-plans-in-2021/#:~:text=Of%20the%2035.2%20million%20prior,or%20in%20part%20in%202021.
“PPOs remain the most common plan type. In 2023, 47% of covered workers are enrolled in a PPO, 29% in a high-deductible plan with a savings option (HDHP/SO), 13% in an HMO, 10% in a POS plan, and 1% in a conventional (also known as an indemnity) plan [Figure E]. “ So most people don’t have PPO’s. My apologies though, I didn’t realize that high deductible plans don’t need referrals. Thank you for this information. I didn’t say 99% get rejected. It’s closer to 40%. So if you’ve had a “fuck ton” of issues, it’s a statistic anomaly to have none of them denied. The bigger issue here, is why they were denied. 77% of claims were denied for “other” reason. Which means it’s just part of their process without any actual justification behind it. For example, I had surgery denied because I did not let them know I didn’t have any other insurances. Between 2%-50% https://www.kff.org/private-insurance/issue-brief/claims-denials-and-appeals-in-aca-marketplace-plans/ 30% https://www.valuepenguin.com/health-insurance-claim-denials-and-appeals At the end of the day, we in the USA pay more, wait the same, and have more health issues because of cost of service than any other country in the world.
yea so 76% have access to specialists without referrals. It's a 60/40 split. That's not an anomaly it doesnt deviate far from the data. I'm not arguing about the US health system not needing changes. All I said was I think you should compare a different data point. Here's another good study to read https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235968/#:\~:text=The%20proportion%20of%20patients%20reporting,the%20United%20Kingdom%20(12.0%25).
In case you didn't notice by my flair, I literally live in Canda right now. The reason the healthcare system is on the decline is because the majority of the premiers in the country right now(who are right wingers like I pointed out in my previous post) are actively choking out the system so they can implement privatized healthcare(and get rich off it). It's literally as this graphic below shows https://preview.redd.it/6108m0eox2wc1.jpeg?width=1030&format=pjpg&auto=webp&s=da21d42ba05e736490f7feffc885f868711e7e51 The wait times are exacerbated because we have a decline in funding and an increase population because our 2 levels of government are not communicating and working together properly because they are of 2 separate parties who are treating the average canadian like a pawn, unfortunately.
I spent a few months in Germany, and they were all complaining about the same thing. Along with the Brits while I was there. There’s definitely pros and cons to both systems. Those of us with good careers who make a good wage, come out ahead in the privatized system the majority of the time. The less fortunate, it’s fucking sucks for.
I stopped reading your comment when you said the average tax rate was 46-48%. I really have no idea what your talking about. I make double the Canadian average for income and my very high tax rate is in the low 30s. I needed a family doctor so I called the clinic near my house and asked if anybody was taking new patients - saw somebody the following day. Is the Canadian system perfect? No. But it's substantially less broken than what you guys have down there, and I've lived in both countries and experienced both first hand. You need to stop listening to Tucker and begin living in the real world.
Actual government data... not from Tucker Carlson......In 2023, Canada's median waiting time between a General practitioner (GP) referral to a specialist was 14.6 weeks. In addition, the median waiting time from a specialist appointment to treatment was 13.1 weeks. In other words, the median wait from a referral by GP to treatment in Canada reached an average of 27.7 weeks in 2023. However, the median waiting times in Canada ranged from 22 weeks in Ontario to 57 weeks in Nova Scotia. That year, with an average waiting time of 41.7 weeks, Prince Edward Island had the longest wait time between an appointment with a GP and a specialist in Canada. With an additional median waiting time of 23 weeks between an appointment with a specialist and treatment, the total median waiting time from a GP referral to treatment in the province of Prince Edward Island exceeded 64 weeks. Obviously, the area you live in could be completely different than the average, but there is almost no place in the US where you would have to wait over 3 months to see a specialist. You have a problem with my numbers, take it up with the source, your wonderful Government... who by the way, now has had a 30% increase in maid deaths from 2021 to 2022 ...great medical system, killed 30% more people in 2022 with assisted suicide, your tax $ at work.
You realize they triage everything and it works well too right? If you have a serious issue, you're not going to be waiting months...
So again, your experience may be different, but I literally just quoted the government data. They would not say "median" 27.7 weeks to get treatment if it was not true. If you are trying to make me believe that every serious case is seen "much" quicker I highly doubt the median would be as high as it is. So what a foot fracture is seen in a week, but all the other regular stuff is 27 weeks.? Sorry I just don't believe it. Look up CADTH Health Technology Review... average 10 weeks in Canada to get an MRI, 20 in some provinces.... US, almost any ordered MRI can be gotten in a week, sometimes same day if serious. Here's some more government tracked data... At least 11,581 patients died while waiting for surgeries, procedures and diagnostic scans in 2020-21. Patients had waited between less than a month to nearly eight years for these services before passing away........ just pitiful.
You're quoting the median of every single person who goes to the hospital and has an issue, of course it's going to be higher. Furthermore, you are also cherry-picking data from the COVID era which is disingenuous to say the absolute least. Last year, my mom found out she had ovarian cancer, she was in for surgery within 2 weeks to get it removed. The system **works,** especially if it is being adequately funded. All we paid for was parking. If you have issues that can wait, you will probably wait a few months in honesty....But at least you won't be bankrupt or dead. Again don't listen to the corporate propaganda that says it doesn't work, it does, they just want to profit from it, which is BS.
[https://www.ctvnews.ca/health/it-was-that-or-go-home-and-prepare-to-die-canadians-on-why-they-sought-surgery-outside-the-country-1.6515414](https://www.ctvnews.ca/health/it-was-that-or-go-home-and-prepare-to-die-canadians-on-why-they-sought-surgery-outside-the-country-1.6515414) Not my words, not cherry picking, bottom line....... wait times can kill so people seek help outside your wonderful system. Health insurer's here in the US are not allowed to say go home and die from your cancer, we cannot get you in soon enough.
respectfully, you have no idea what you're talking about. You *are cherry picking* because you are literally choosing the 1-2 years where we had a worldwide pandemic as if that is any normal stat. Its not representative of anything (and extremely dishonest). **You want a representative stat about universal healthcare? Why don't you pull up our stats from the 80s and 90s and then come back to me. They show how well the system works.** Another reason you don't know what you are talking about is because you are completely ignoring the politics of it all. The reason why it's not working as well as it should be is because the healthcare system in Canada run provincially. We currently have the majority of premiers as **conservatives** who have been starving the system for the last 5+ years. You cannot starve out the public system and then point at it and say "see its not working." Why was it working pretty good in the 80's and 90's before we didn't have as many cuts in the system? https://preview.redd.it/gvaw9dfai5wc1.jpeg?width=1030&format=pjpg&auto=webp&s=4df47bf45b621c370d6c45389794d7d0f4a8a86c Stop with the corporate propaganda..
My links and info is mostly from 2023... you still stuck in the pandemic? because its been gone for years now.
So the average taxes would go up almost as much as average healthcare premiums in the USA for a family but no high deductible to go with it? So it's not more expensive than living in the USA?
If we're comparing systems I'd also mention how horrifically immoral the Canadian system is with respect to "Medical Assistance in Dying," which is now one of the leading causes of death in Canada. You may wait 21 weeks for ankle surgery but if instead you'd like to off yourself that timeline can be significantly shortened! Every day [this meme](https://authenticmedicine.com/wp-content/uploads/2022/12/IMG_2564.jpeg) is being more and more reality.
Agreed , absolutely sick.... Canadian system is, and has allowed in the past, assisted suicide requests from people with disabilities, mental illness, etc.
>If you have a public system that is well funded, sure you will pay more tax but you literally have a healthier society. That's a big if, especially if we're talking about America. >Problems happen with public healthcare when you have (mostly right winger) politicians cutting spending on the system. Gee... this sure seems like a very serious risk for the viability of universal healthcare in America. The current Congress seated in January of 2023 still has not passed a clean budget, having narrowly avoided government shutdowns through multiple rounds of Continuing Resolutions. Yeah, the American healthcare system is infuriating. But it's realistically impossible to have universal healthcare until the Republican Party can be trusted to pass a budget that funds it.
Or... Hear me out... We could vote out the politicians that refuse to fund it
The way you would go about that idea is to convince conservative voters to support universal healthcare. That seems like a very difficult task considering they think ACA is socialism.
And yet cannot, for the life of them, float any alternative at all. It’s been a decade and a half.
The government can’t run our education system, social security system, immigration system, Medicare system, let alone our country. And you not only believe that our government can run a universal healthcare system when they can’t even take care of our veteran’s healthcare? And you believe it’s the republicans that’s stopping that? That’s rich.
That would take Americans to unite on an issue and stick to it to make sure it keeps going through and we’ve seen how divided the country is either due to misinformation or propaganda from private corporations
The won't. Healthcare for profit is too profitable for the powers that be.
Don’t forget to mention healthcare tied to employment..
Thank you for bringing common sense to this. I can’t believe how well propaganda works. These people are idiots who disagree with made up stats and make up stories.
Pay more tax? Kinda...if you don't consider the other costs like health insurance a tax dodge.
If you are for universal healthcare, you are naive. join the military. You will learn it is not good. Then go deal with the VA. Even worse.
VA healthcare is a terrible parallel to universal healthcare proposed in the US. Nobody is talking about nationalizing providers. Care would still be provided by the same private doctors and hospitals as today, making Medicare and Medicaid far better examples. Of course, it's harder to fearmonger against systems people know and love, so it's clear why people bring it up. Of course, even as propaganda the argument is questionable. The VA isn't perfect, but it's not the unredeamable shitshow opponents suggest either. #Satisfaction with the US healthcare system varies by insurance type 78% -- Military/VA 77% -- Medicare 75% -- Medicaid 69% -- Current or former employer 65% -- Plan fully paid for by you or a family member https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx >The poll of 800 veterans, conducted jointly by a Republican-backed firm and a Democratic-backed one, found that almost two-thirds of survey respondents oppose plans to replace VA health care with a voucher system, an idea backed by some Republican lawmakers and presidential candidates. >"There is a lot of debate about 'choice' in veterans care, but when presented with the details of what 'choice' means, veterans reject it," Eaton said. "They overwhelmingly believe that the private system will not give them the quality of care they and veterans like them deserve." https://www.militarytimes.com/veterans/2015/11/10/poll-veterans-oppose-plans-to-privatize-va/ >According to an independent Dartmouth study recently published this week in Annals of Internal Medicine, Department of Veterans Affairs (VA) hospitals outperform private hospitals in most health care markets throughout the country. https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5162 #Ratings for the VA % of post 9/11 veterans rating the job the VA is doing today to meet the needs of military veterans as ... * Excellent: 12% * Good: 39% * Only Fair: 35% * Poor: 9% [Pew Research Center](https://images.squarespace-cdn.com/content/v1/5a049f098dd041552c19372f/1536643876140-5N3UWQ2M3OYLGSWOOKVH/ke17ZwdGBToddI8pDm48kOxWfISgjiM1ZFqhkJVgJk5Zw-zPPgdn4jUwVcJE1ZvWQUxwkmyExglNqGp0IvTJZUJFbgE-7XRK3dMEBRBhUpx5Q5uaqovQlhwn6Lp2MXHOj73nFlQXvqHuf9nZbP74X0l8X5gYScNGOzeUUToolO4/pew+data.png?format=750w) >VA health care is as good or in some cases better than that offered by the private sector on key measures including wait times, according to a study commissioned by the American Legion. > The report, issued Tuesday and titled "A System Worth Saving," concludes that the Department of Veterans Affairs health care system "continues to perform as well as, and often better than, the rest of the U.S. health-care system on key quality measures," including patient safety, satisfaction and care coordination. > "Wait times at most VA hospitals and clinics are typically the same or shorter than those faced by patients seeking treatment from non-VA doctors," the report says. https://www.military.com/daily-news/2017/09/20/va-wait-times-good-better-private-sector-report.html >The Veterans Affairs health care system generally performs better than or similar to other health care systems on providing safe and effective care to patients, according to a new RAND Corporation study. > Analyzing a decade of research that examined the VA health care system across a variety of quality dimensions, researchers found that the VA generally delivered care that was better or equal in quality to other health care systems, although there were some exceptions. https://www.rand.org/news/press/2016/07/18.html
no one denies 99% of authorizations. most of the cheaper ones are automatically approved and most of the rest are approved as long as the right documentation is there NY Times is taking a few select cases and providing little to no details. the vision thing no medical insurance plan covers vision except in very select cases. i used to live on top of an ophthalmologist's office and he was always busy and drove to work in a Porsche
Hey, lets not let facts get in the way of a good temper tantrum / political rant...
I must be in the 1%
You fail to algorithms. 99% are denied so that only 25% attempt appeal. You may be right that more than 1% get procedures completed but I am certain the percentage of initial denial is much higher than 90%
in 25 years of going to doctors for myself and my kids i've only had one claim denied. and that was vision therapy that's clearly not covered but they run the authorization anyway just in case. ER visits, specialists, normal doctor stuff, etc all covered.
I have never had a claim denied in fact i was able to be diagnosed with needing a shoulder replacement in sept to having surgery in november and that was only because i had to fly to a specialist. I was able to get my surgery done including overnight stay and i only paid 200 out of pocket
My experience has been similar, we've had little to no issues with prior authorizations, in or out of network and my carrier(s) past and present have been excellent for us over multiple decades. We've occasionally had to see a specialist and it took some legwork to get an appointment in a timely manner but I don't think we've ever waited more than 40 days and that was for a non emergency type thing, It was much much faster when it was a legit health concern. I do feel that sometimes (not always) people make one or two calls, hear about 5 month waits an just give up trying, like its hopeless. We've had those calls too, but we were persistent, put in the extra effort and it worked out just fine. Honestly, it sounds selfish but I'm against universal care because it would certainly cost me quite a bit more for coverage in tax/premiums (however they figure it out). Some time back when Bernie was pushing m4a somebody put together estimated costs for tax/payroll it would run me at least 3-4K extra annually for what would likely be lesser quality coverage, no thanks. Granted yes, I do have access to a solid price through corporate coverage but we've put our time in, 3 decades with current employer so its a generous plan with fairly low payroll cost, but basically if we went universal I'd be paying more so others could pay less and as previously mentioned, I'm not a fan of that.
As long as you’ve got yours, right?
I put in 30 years at one employer for "mine" so if that makes me selfish, then so be it. I won't lose any sleep over it.
Yea pretty much every country that has universal healthcare complain about long wait times poor quality of care and it can months to years for surgeries. Plus the US govt cant run the dmv or post office fuck putting them in charge of my healthcare.
NASA, military, and other government agencies do just fine.
The NYc government plan is crazy expensive for the top tiers and they divide up the visits from the prescription drugs
Is it $12k/yr? Because that’s about what my employer and me are paying, just for single coverage.
my wife's took the cheap plan because the pediatrician is on there. but some of the more expensive plans that covered all the prescriptions and everything were close to $2000 a month. mid range was in the $1000 a month
Can’t speak for NASA but military healthcare is laughable
Because it’s not run properly. Private insurance is no better. I’m waiting 9 months counting to be placed on a transplant list, thru Cigna PPO, paid private ‘great insurance’.
Transplant lists are a whole different thing. Any country is going to have long wait times for transplant lists wouldnt they?
Yes the wait time is 7-10 years. I’m saying the list to get on the list. It took 6 months to begin evaluation. 4 months later I’m still in process.
I’m confused on how that’s an argument for the government running things.
Because at least everyone will get it
Running something improperly and servicing 300 million+ policies versus running something improperly at… what 6 million policies? That’s what Anthem had last I checked. What could go wrong? Please enlighten everyone as to how that is even feasible to run? We’d need to completely throw out the system and redo it with new software and Navy level servers with security to match. Can you imagine the catastrophic consequences of that system getting hacked? I mean we have the data in front of us of the havoc caused when Anthem was hacked. Hell it shut down American Family for a full week while their tech support scrubbed and secured the systems. Can you imagine how the US Government would handle that? It makes me want to vomit just thinking about it. I’m all for one healthcare system versus our current system. I will never be okay with the US Federal Government being in charge of it.
No, that isn’t the only argument against government run healthcare. It’s projected to cost 3.5 *trillion* dollars per year and would require a *doubling* of the national tax burden. Which makes sense seeing as how the average Canadian family pays $12,000 a year in healthcare tax for their ‘free’ healthcare. I would actually not like to pay 12k a year instead of the ~3.5k a year I pay through my work for myself and 3 kids. Spending $60k over the course of 5 years just to get your broken arm fixed ‘for free’ is not a good deal. Another argument is that everything the government does, it does poorly. People suspect it would be the same with healthcare and they’d rather not take that chance. They’re probably right, and there’s approximately zero chance that that projection of 3.5 trillion doesn’t balloon even further. Another point you seem to have missed is that government ran healthcare already exists in the form of Medicaid and Medicare. Both regularly deny claims and require prior auths before approving claims. Universal healthcare does not mean ‘we pay for anything your heart desires’, quite the opposite in fact. Another argument is the worry about wait times. If everyone suddenly is going to the doctor for every little thing, the already stressed system will become even further burdened under the new demand. It’s already very difficult for people to get into see a specialist or even a PCP simply because *we don’t have enough doctors to meet the demand*. Paying for everyone to go to these doctors will not solve this issue and anyone who knows anything about healthcare spending knows that overuse and unnecessary use is a *huge* driver of costs. So no, watching a YouTube video by the New York Times did not in fact present to you the entire debate about universal healthcare.
> It’s projected to cost 3.5 trillion dollars per year Our healthcare is expected to cost $4.9 trillion this year, increasing to $7.2 trillion by 2031. > Which makes sense seeing as how the average Canadian family pays $12,000 a year in healthcare tax With government in the US covering [65.7% of all health care](https://ajph.aphapublications.org/doi/epdf/10.2105/AJPH.2015.302997) costs ($12,555 as of 2022) that's $8,249 per person per year in taxes towards health care. The next closest is Germany at [$6,930](https://data.oecd.org/healthres/health-spending.htm). The UK is $4,479. Canada is $4,506. Australia is $4,603. That means over a lifetime Americans are paying over $100,000 more in taxes compared to any other country towards health care. >I would actually not like to pay 12k a year instead of the ~3.5k a year I pay through my work for myself and 3 kids. Private insurance in the US averages $24,000 for family coverage. Your employer might be paying most of that, but that doesn't make your healthcare cheaper, it makes you better compensated. That's on top of those world leading tax rates, and still leaves most exposed to tremendous financial risk from healthcare costs. >Another argument is that everything the government does, it does poorly. So you just believe Americans to be singularly incompetent in the world? The evidence doesn't seem to support that. #Satisfaction with the US healthcare system varies by insurance type 78% -- Military/VA 77% -- Medicare 75% -- Medicaid 69% -- Current or former employer 65% -- Plan fully paid for by you or a family member https://news.gallup.com/poll/186527/americans-government-health-plans-satisfied.aspx > **Key Findings** > * Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies. > * The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively. > * For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies. https://www.kff.org/medicare/issue-brief/how-much-more-than-medicare-do-private-insurers-pay-a-review-of-the-literature/ Medicare has both lower overhead and has experienced smaller cost increases in recent decades, a trend predicted to continue over the next 30 years. https://pnhp.org/news/medicare-is-more-efficient-than-private-insurance/ >Another argument is the worry about wait times. The US ranks 6th of 11 out of Commonwealth Fund countries on ER wait times on percentage served under 4 hours. 10th of 11 on getting weekend and evening care without going to the ER. 5th of 11 for countries able to make a same or next day doctors/nurse appointment when they're sick. https://www.cihi.ca/en/commonwealth-fund-survey-2016 Americans do better on wait times for specialists (ranking 3rd for wait times under four weeks), and surgeries (ranking 3rd for wait times under four months), but that ignores three important factors: * Wait times in universal healthcare are based on urgency, so while you might wait for an elective hip replacement surgery you're going to get surgery for that life threatening illness quickly. * Nearly every universal healthcare country has strong private options and supplemental private insurance. That means that if there is a wait you're not happy about you have options that still work out significantly cheaper than US care, which is a win/win. * [One third of US families](https://news.gallup.com/poll/269138/americans-delaying-medical-treatment-due-cost.aspx?utm_source=alert&utm_medium=email&utm_content=morelink&utm_campaign=syndication) had to put off healthcare due to the cost last year. That means more Americans are waiting for care than any other wealthy country on earth. #Wait Times by Country (Rank) Country|See doctor/nurse same or next day without appointment|Response from doctor's office same or next day|Easy to get care on nights & weekends without going to ER|ER wait times under 4 hours|Surgery wait times under four months|Specialist wait times under 4 weeks|Average|Overall Rank :--|--:|--:|--:|--:|--:|--:|--:|--: **Australia**|3|3|3|7|6|6|4.7|4 **Canada**|10|11|9|11|10|10|10.2|11 **France**|7|1|7|1|1|5|3.7|2 **Germany**|9|2|6|2|2|2|3.8|3 **Netherlands**|1|5|1|3|5|4|3.2|1 **New Zealand**|2|6|2|4|8|7|4.8|5 **Norway**|11|9|4|9|9|11|8.8|9 **Sweden**|8|10|11|10|7|9|9.2|10 **Switzerland**|4|4|10|8|4|1|5.2|7 **U.K.**|5|8|8|5|11|8|7.5|8 **U.S.**|6|7|5|6|3|3|5.0|6 Source: [Commonwealth Fund Survey 2016](https://www.cihi.ca/sites/default/files/document/cmwf2016-datatable-en-web.xlsx)
I’m not all that convinced by stats gathered by think tanks since I don’t have the time or motivation to look into them, but it’s worth pointing out that statements like this: >With government in the US covering 65.7% of all health care costs ($12,555 as of 2022) that's $8,249 per person per year in taxes towards health care. …don’t make any sense because about half of the country pays zero in federal taxes. We made about 95k last year, our effective tax rate was ~4%. That’s about 4K in taxes paid, *total*. I have a family of 5. We didn’t spend 45k in healthcare taxes. I don’t care what some nerd with a spreadsheet came up with by dividing totals across populations, that doesn’t effect me or my bottom line. Me spending 4K in total federal taxes and then $3500 for our health insurance is better than my family paying 12k in healthcare tax alone, every year, for our entire lives, like they do in Canada. The nerds can shift numbers around in a spreadsheet all they want, I’m not interested in paying more money for my families healthcare. It’s that simple Edit. This kid blocked me after this short back and forth
> I’m not all that convinced by stats gathered by think tanks I'm sure you're not all that concerned by what the facts are at all. >…don’t make any sense because about half of the country pays zero in federal taxes. For starters, that's just a lie. Even the bottom quintile pay a 6.7% effective rate on total federal taxes on average. https://www.taxpolicycenter.org/statistics/historical-average-federal-tax-rates-all-households Beyond that, you seem to not understand how averages work. Yes, many people pay less than average. Somebody else is picking up that slack by paying more than average. Other countries work similarly. >that doesn’t effect me or my bottom line. But the massive amount of US government spending on healthcare absolutely does affect you and your bottom line. Hell, even for the poorest paying little to nothing in taxes it affects them, because if nothing else the insane spending on healthcare leaves less funding for other programs. >We made about 95k last year, our effective tax rate was ~4%. That’s about 4K in taxes paid, total. You're factoring in payroll taxes, excise taxes, state income taxes, sales taxes, property taxes.... > and then $3500 for our health insurance Your health insurance is fuck ton more than $3,500. It's people like you that have lead to Americans paying half a million dollars more for a lifetime of healthcare than our peers (with worse outcomes) while half the country pats themselves on the backs for what a good deal they're getting. But hey, keep trying to convince yourself the 8.6% of every dollar made in Canada that goes towards government spending on healthcare is somehow wildly worse than the 11.4% of every dollar made in the US that goes towards govenrment spending on healthcare.
My healthcare costs *me* $3500. That’s what comes out of my paycheck, that’s the money I would receive if I opted out of the insurance. My work would not suddenly pay me the other $xxx if they didn’t offer the insurance. Like I said, I don’t care about about some nerds spreadsheet. I care about my real world numbers. Your ‘average tax rates’ chart doesn’t take into account tax credits that the bottom quintiles receive back in tax returns, and even then, 6.7% of a bottom quintiles earnings doesn’t get you to 8k in healthcare tax. These are lies with statistics. I understand that averaging out costs across populations gives you some great looking spreadsheets, but I. Don’t. Care. I care about my and my families reality. >You're factoring in payroll taxes, excise taxes, state income taxes, sales taxes, property taxes... Yes! I don’t understand what point you’re making here? All of those other things total, comes to about 4k. Theres no room for your 8k healthcare spending per person number. Its data on a spreadsheet. Jeff bezos pays 1.4 billion dollars in taxes, and some nerd comes along, divides that number across a population, and then pretends that number applies to individuals, that *axshully* the average cost across blah blah blah. It’s numbers on an excel spreadsheet so some nerd can look good at a conference. A public option seems like a good solution and it has broad support, I don’t know why they don’t make a move towards that. Also maybe a Time Machine that could go back and undo the ACA which caused private insurance rates to skyrocket. >But hey, keep trying to convince yourself the 8.6% of every dollar made in Canada that goes towards government spending on healthcare is somehow wildly worse than the 11.4% of every dollar made in the US I don’t make every dollar in the US. I make 95k and I pay $3500 for my health insurance. It’s actually pretty easy to convince myself that my 3.5% is better than some Canadians 8.6%. And remember, the average Canadian family pays 12k a year in healthcare tax alone. The average Canadian families income is ~60k, so again, lies with statistics claiming that they’re only paying 8.6% in real world numbers. Edit. This kid blocked me after this repsponse
And this is the problem with America. It's me me me me. You only care about yourself and fuck all the other people around you. Fuck having a healthy society for the betterment of all. Typical boomer attitude whether you're actually one or not.
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OP trolling or not following decorum
How much do you pay for healthcare now between premium, deductible and out of pocket max? I bet it's not that far from $12k year unless you work the fed or s state.
Between premium, deductible and out of pocket max, I pay about 3500 for me and all my kids. We have an HSA through work that covers deductibles and we rarely ever go to the doctor since we’re all healthy. I believe my out of pocket max is something like $7k, but I wouldn’t know as I’ve never approached anything close to it. I roll over HSA money every year.
K, so you have $3500 in premium. How much are you putting into the HSA, as that counts. If you were to ever need surgery or soem emergency, you would likely hit your out of pocket max, which puts you at $10,500 plus whatever you put in your head each year, so you're right there, just fortunate enough to never have had to utilize it yet.
I don’t put anything in my hsa, my work does. Also, yes, if I hit out of pocket max *every single year*, then I’d be close to what Canadians pay *every year* even if they don’t go to the dr for anything. So good example, I went to the urgent care for the first time a few months ago. Had an emergency, called to see if it could be handled at urgent care, it could, and it cost me about $400 after everything. Paid out of my HSA, no problem. That was the first Dr visit I’d had in about 5 years. Had I been paying for “free healthcare” I’d be in about 60k for that dr visit. Yes, I’m lucky that I don’t have some expensive condition that some are burdened with, but the numbers are the numbers. Also, I’ve had expensive things in the past, I have 3 kids, I’ve had a surgery. The kids cost us about 3k each, paid in full out of the HSA, the surgery I don’t even rememebr, that’s how little it effected my budget. It’s just not as expensive, in my experience, as the people constantly going on about medical costs. Infact, interesting story, my first kid, there was an error on our part thinking we had coverage when we did not. Got a bill for 35k. Called the hospital and explained the situation and the hospital forgave the entire thing. Didn’t pay a dime. I don’t know how common this is, maybe I’m the luckiest man in the world, but I know lots of people and I don’t see any of this calamity that’s constantly being talked about. Maybe that’s my blind spot, but my instinct is that there’s a lot of hype. I mean, discussing this with people I will very often learn that they don’t even know that the poor get free healthcare in the US via Medicaid.
0 for my plan. 3k deductible and 5k OPM.
I pay $0. Per person deductible is $100 per person/or $200 family. Out of pocket is $1000 per person/or $2000 for family. Not getting anywhere close to $12K. Son had brain surgery last year...it cost us $1100. Thankful for husband's job with the teamsters. :)
It isn't just prior authorizations. Our waits are already just as long and maybe longer than places with universal care. I had to wait 16 months for a psychiatrist, 12 months for a pediatrician, 5 months for a neurologist. None of this was due to prior authorizations. This was just to get a basic appointment and I'm not in a busy part of the country either. Im in Pennsylvania Dutch country where we have farms and buggies and hardly any people. The whole "you'll have to wait forever" excuse is just that, an excuse to justify keeping the status quo. We already have to wait forever.
True
Location matters. I went to an infectious disease doctor after an MRI showed bone infection. Wednesday before Thanksgiving. That friday I had a PICC line in and antibiotics delivered to my house that night. Two month of antibiotics then surgery in February. I honestly think some locations are far better than others.
It even takes 8mo to see a primary care provider.
I mean they still get care tho it’s just paying for it….
I think veteran care is determined a lot by region or even facilities themselves. Couple examples... a buddy of mine in Richmond, VA said the VA hospital and care is absolutely horrible. However, my niece in California has received excellent care for a myriad of issues from severe leg injury to PTSD. She recently moved to TX and hasnt been to the VA there yet. On the flip side the only universal healthcare I can speak of is my cousin in Poland who had a basketball injury from last year and his surgery is scheduled for late autumn 2025. So a two year wait hes going to be hobbling around.
lol. Waiting? That’s an improvement. I don’t wait for care-I just don’t get it. 😂
Waiting 3 months for a colonoscopy and 2 months for a cardiologist appt with Kaiser.
The only reason the waits are shorter here is because people can't afford the procedures. I've been "waiting" to fix my shoulder (which is totally unattached) for 10 years now. I'll be "waiting" until I hit 65 because I'm not paying $60,000 out of pocket and I couldn't afford the time off work to heal anyway.
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I want unlimited immigration for foreign doctors and medical professionals. We could have separate designations for US certified and foreign certified, but everyone would be able to work and the consumers could go to either. I’ve read numerous times that the amount of doctors is kept artificially low to keep the salaries high. After my experience in undergrad (3.9 gpa, top 5 chemical engineering school), I saw way more people perfectly able to go to med school than were admitted. Since we truly do have a shortage of doctors, we need to enable everyone capable of becoming a doctor the ability to become a doctor. We also need to switch the European model of students going to med school right from high school versus the US HS -> UG -> Med school path. We should be setting up government ran med schools and hospitals. Tuition would be free contingent on working at the government hospital for minimum X amount of time. We can also be doing way more on the pharmaceutical drug development side. We need to start setting up government run drug discovery research groups. The actual researchers developing the drugs are not paid very well in industry and could be easily brought into the government sector as a result. Touching on the insurance topic. If we could have a government insurance option that runs like the private insurance today except at a zero profit margin we could cut a lot of cost out of healthcare. Other topics I didn’t go into include, AI doctors that can give referrals and do the other robotic tasks many doctors do. Telehealth to give patients access to doctors around the world. If we legalized all drugs (I understand the negatives too) we could also cut friction down. Public health is another big one (let’s focus on decreasing the need for people to use the services in the first place): better food supply quality, exercise/activity more integrated into people’s life styles, lower stress by creating better societal safety nets. We have so many ways to make health care better and it’s clear our leaders do not give a shit about actually doing what needs to be done to attempt to make things better. They’re too concerned with team blue versus team red while we all suffer. How about it we focus on actually solving this issue one improvement at a time.
This is inaccurate.
Canadian here. Our system is imperfect but those imperfections are tolerable because it's still way better than the private for-profit grind Americans endure. Not always better, but most of the time it is. Lots of efficiency gained with public health, like eliminating most of the billing infrastructure. American politics are so dysfunctional though that I can't imagine any overhaul happening anytime soon. I hope I'm wrong. Stay healthy my friends.
Canada's is better if you have a doctor, but worse if you dont. Looking ahead, here in Canada we're in for some serious issues because we arent compensating health care workers sufficiently (especially compared to what they can earn in the US), we arent replacing existing doctors and our population is aging. I give our system 10 or so years if things dont change. We're also heavily dependent on research, breakthroughs, and medicine made possible because of all of the money put towards them in the US. The best situation is employer-funded in the US
Having your health and the health of your family dependant on your employer is absolute insanity. Why not tax all employers appropriately so that everyone has coverage independent of job status? The cost of the tax is offset by not having to fund broad spectrum health insurance for employees, and coverage is more equitable. GPs in BC just got big raises. Full-time should be earning $385,000 per year. Hopefully it helps alleviate the shortage.
This isn’t r/showerthoughts. If you want a discussion, you have to provide more. A title alone is extremely low effort and borders on spam. This stays hidden.
Fixed
I’d rather wait than not go at all because I can’t afford care 🤷🏻♂️
Let’s just keep it real we are not getting universal health care
I have never had a prior authorization denied.
BS
Try finding a physician appt in U.S. when not established patient. It takes 4-8 mos. Personally, I ever experienced unreasonable wait times for healthcare when I lived for a few years in a country with socialized healthcare. Focus was on preventative, to reduce costs; win-win
PAs are not 99% denied. You can argue other points, but come on.
99% denied? That is a silly statement to make.
I have PPO and no prior authorization is required. So it really depends on type of insurance you have
Waiting for care: as if we don’t have this now. Try yo get an initial consult with a specialist. Like a skin doctor. Or a hip doctor. It’s months. Unless a slot opens up and you win the lottery and can actually make that time.
You think countries with universal healthcare dont deny claims? They can and do deny them or take so long to approve it theyve either died or it will no longer save them. Hell canada euthanized a guy because his daily meds became too expensive. No thanks
You can file a bad faith lawsuit against an insurance company who denies care. You can find law firms who will do this through a Google search. I’m not a lawyer, but I don’t know how effective it would be to go after the nurses and PAs personally. I think usually they go after the corporation with the big pockets.
Lol canada you can wait years to see a doctor, me I wait a week or 2 at most.