[alexasmyths]

The US health-care system is not a 'disaster'.

This is a bit of Canadian propaganda and mythology.

I lived in the US (and Canada) and the US has the best healthcare in the world bar none - for those who are covered.

The 'flaws' which are deep - is that it doesn't cover everyone, if you don't have coverage, you are totally screwed, and it's obscenely expensive.

For a 20-30 something 'STEM' it's actually much better. Doctors will actually listen to you, you don't wait for stuff, it all just seems magically better than Canada.

Again - I'm not ignoring the deep systematic problems with the US system - rather taking a more nuanced view.

I think the US system could be more socialized (and cheaper) than it is, but for 'those with good jobs' ... it doesn't matter.

And when I say 'propaganda' - I'm serious. I believed all this CBC-promoted stuff until I lived abroad for many years, then one looks back on one's youth and thinks about all the things we were told that were 'given as truth' but really are not :).

Anyhow, it's complicated obviously.

[specialist]

"...rather taking a more nuanced view."

Aka concern trolling.

[alexasmyths]

No, not trolling, providing some perspective to someone who has, it seems, not lived within the American system and has some views that have been promoted by certain Canadian elements which are borderline bigoted.

The 'Canadian view on the street' of the 'American system' is misinformed, and it's largely due to a certain consensus promoted within the Canadian elite. It's a very highly politicized issue.

As another Canadian ex-pat pointed out below (and as so many Canadians living in the US can attest to) - the 'Canadian consensus view' on the American system is not correct.

FYI - Canada is the only country in the world wherein it's legal to pay a mechanic to fix your tire, but it's illegal to pay someone to fix your broken arm.

I personally had to live through this conundrum. The 'official position' in Ontario is to move people away from doctors - and to push them into clinics where they can't get 'long term' type of care.

I was sick - and there were no doctors in my region taking patients. I was forced to go to a clinic where they couldn't properly diagnose me. They didn't care at all, as the are 99% dealing with 'kids with colds and the flu'. Every time I went I saw a new doctor. I was ill, with weird symptoms, the doctors 'didn't give a s*' - and there was nothing I could do about it within the system.

I finally went to the 'Cleveland Clinic' - an American not-for-profit entity operating in a 'grey legal area' in Toronto, and they helped out. Thankfully, nothing serious - but it could have been.

I have family members in Canada who waited years for hip and knee replacements - and they think this is 'normal'.

Most Canadians who have no exposure to 'other' systems have a limited view of their own system vis-a-vis others.

I wouldn't want 'the American system' for Canada, and it's far from perfect, but it has some merits which are often overlooked by the CBC-centric types.

[cpncrunch]

I prefer looking at the evidence rather than getting my facts from CBC or other news titbits. And the evidence clearly shows that overall the Canadian system is better. It's not perfect, and sometimes you have to wait for non-critical procedures, but overall we receive good care. Whereas in the USA there is still a large percentage of people who have no healthcare at all, or who go broke paying for it.

[specialist]

I'm glad you got the care you needed.

Cleveland Clinic (in Ohio) is a superior organization. World class. They were one of our early adopter customers (when I was doing electronic medical records exchanges).

Your story of having a rare (hard, difficult to diagnose) disease and not getting the care you need is the norm. This has happened to me many times.

I suspect (Atul Gawanda style) the root cause is care providers are basically organic expert systems doing triage. They are taught to do their best and then move on. Do the maximum good with limited resources.

Your fix was to find the care you needed. Do not accept No for an answer. Someone somewhere has the answers you need. You did the right thing.

--

One of my besties got a terminal diagnosis, second opinion, third opinion. Decided he was too young to die, so he started looking at available clinical trials. Luckily, he exactly matched a trial for immunotherapy for his specific disease. He then found a superior doctor willing to support, manage his treatment goals, plans.

Another one of my besties has advanced Lyme Disease. It's terrible. He moved across country to be near the 2nd best specialist, to better manage his care. He regularly goes to NYC to see the #1 specialist. Further, he is now something like an angel funder for early stage research. He has actually benefitted from these early results.

My own story is similar. I had aplastic anemia. I've had numerous experimental treatments, first for the anemia and then for the subsequent side effects (GVHD). I'm a living miracle of modern technology. I have so many war stories (both good and bad), it's boring.

--

Here's the thing. You, me, my two friends are not the norm. We're the outliers. Changing the payment system, insurance, whatever does not fix this problem.

Perhaps teaching doctors to escalate is the solution. Perhaps connecting similar patients, by matching symptoms. Perhaps data mining. Apple's healthcare initiatives will certainly help (eg matching patients with trials). I keep asking everyone I meet for their ideas.

Lastly, back to the point, Canadians spend less on healthcare, are healthier, and live longer than USA people. The Canadian system is superior. Simple statement of fact.

[hacking_again]

Canadians eat less, smoke less, and are exposed to less sunlight. Lifestyle is important for health and longevity.