[doctorpangloss]

This isn’t a very good analogy.

In a just world, nobody would go hungry, nor would anyone die prematurely or suffer needlessly due to lack of care. We can obviously afford both, in this country, just like they can everywhere else in Europe or Canada. So this entire argument about insurance is a straw man.

It’s not the doctors who set up this world. It’s people who want to pay less taxes, but blame doctors.

[throwawaytoday5]

Why shouldn't doctors and the medical industry take the blame in the US? They artificially limit the supply of Doctors in the US and have the audacity to claim that building more medical schools will ruin their already lucrative careers.

The whole industry is a shame.

[nine_k]

Regarding Europe, which I happen to have friends all over: it's not exactly as rosy.

European countries do have more doctors per capita, which is good.

They don't have nearly as much resources in the system, though. Come to a doctor with a bad cough, get a prescription for Paracetamol. You got to have a pretty bad infection to get a prescription for an antibiotic. Endure a long discussion with a doctor to renew an antidepressant prescription made in another country.

Lines are pretty long, too. Wait for two weeks to get an appointment about your coughing and sneezing. Have a deteriorating chronic condition and be prescribed painkillers and be told to wait for a year. You're not yet feeling so bad as the people who are currently being treated and who take up the capacity; these people also waited a long time.

All are examples from my friends dealing with the health systems of Netherlands, Sweden, Germany.

The US system has a ton of issues, but I still take it over these European systems. Have I been floored by medical bills? Yes, from my dentist, from my wife's heart surgery. But I somehow managed — and we both received instant, high-quality help.

Even the Russian system is better, or used to be back in the day. You could buy local insurance, and the choice was reasonably wide. You could pay upfront in cash, and the sums were manageable — Moscow definitely not being a cheap city, more expensive than many EU capitals.

Of course, I'm talking from a perspective of a well-earning software engineer who lives in metropolises, not in countryside. Still I think that either system has downsides, and the European systems are not superior, but just suck differently.

[mschuetz]

I'll chime in with my experience in Austria:

* If I have a cold, I go to a doctor without appointment and if I'm unlucky, I have to wait for 2 hours. Usually it's 30-60 minutes.

* If I have a specific thing that requires a specialist, I may or may not have to get a referral from a general practitioner first. Most specialist don't really need it, but for an allergy test I needed to get one. This puts me at 2 x 60 minutes wait time.

* Costs are close to nothing. Drugs will cost a little, up to around 6€ for a pack of meds. I have to pay 2€ for a doctors visit due to the specific insurance provider I have, which is okay. I needed to pay 12€ for an x-ray because it wasn't an emergency.

* My austrian insurance provider payed more than half of a hospital trip I had to take during vacation in Taiwan. Total cost of the trip to the hospital without insurance was 130€, which included check by the doctor, pain medications and some medical equipment. I had travel insurance, but I didn't use it because I was left with a bill of just 60€.

* A few times I was angry because a doctor only took 5 minutes time, prescribed some pain meds and sent me on my way. Told me all I can do right now is wait until it gets better. Turns out, that was the case.

* If it's an emergency, you get treated immediately.

I wouldn't trade our system for anything. It's not perfect, but it's perfectly fine.

[unionpivo]

Can confirm. I am from Slovenia, which just copy pasted this system (mostly), and it works decently.

we are not as ritch as Austria and that shows, so if you don't have emergency wait lists for certain things are longer.

[ddnb]

Exactly the same experience here in Belgium, only the doctor visit costs are way higher. Instead of €2 it's more like €25 per visit or I think €35 for home visits. I don't have experience with costs abroad so can't comment on that.

What is correct is that in Belgium you also don't get antibiotics because you ask for them. Only when the doctor deems it necessary you will get it.

[greggman2]

In the USA, at least in my experience. If I have a cold I still had to make an appointment which would be 2 to 3 days later. I got around this by joining a doctor in a clinic and they'd let me see any doctor if my doctor wasn't avaiable but i'd have to sit in the waiting room for 1 - 2 hrs.

In Japan I have had mixed experiences:

Good:

* It's relatively cheap. Apprently the government sets prices. The government offers medical insurence. It costs based on previous year's income. i've paid as little as $15 a month and as high as $300. I don't know the range. It only covers 70%. My employeers have provided insurance that covered more.

* Fast. There are no appointments or a least I've never made one. Just walk in, usually no more than a 20 minute wait. Did have one long wait 1998.

* Some pretty good tech. Had back problems once. Got an MRI immediately (Japan has/had ?x more MRI machines than USA). Last week had an unusual pain in neck, went in, got immediate endoscope pictures inside neck.

Note that in Japan, unlike the USA, hospitals are a place you can just walk in for a cold. (you can also go to small clinics and private doctors). The advantage of going to a hospital is they have more specialists and equipmnent. The disadvantage is sometimes longer waits and probably not as close. I only bring that up as a contrast to USA where a hospital is someplace you don't go unless it's an emergency or surgery or something else really serious.

Bad:

* Bar to be a doctor much lower. Have had several very quack doctor expeiences in Japan. Have not yet had a quack doctor experience in USA

* Unclean. Have been to several facilities that seemed unclean to me. Machines that looked like people had coughed on them for years and had never been cleaned. Not all places but enough the experience has stuck out. No idea what that's about but just surprised since my experience in the USA was that medical services are or at least appear spotless.

Unknown:

* Nurses require no training (or so I was told by a nurse). You just go apply for job like a fast food job. Is that better (lower cost) or worse (less training).

[Aeolun]

> Unclean. Have been to several facilities that seemed unclean to me.

The thing I like about it is that you can just leave the unclean facilities behind and find a new doctor, and it will cost you exactly the same as the old one.

[deepaksurti]

>> In Japan I have had mixed experiences:

Replace ‘Japan’ with ‘metro cities in India’ and its almost the same. I can’t still fathom why there would be no walk in facilities for ailments like cold.

I still remember my shock when in US I realised from a colleague that for my cold I need to wait because I can’t walk in and need to take an appointment.

[greggman2]

I noticed recently in the USA places like Walgreens you can see a doctor for colds. That seems like a great idea to me. I guess that's similar in Thailand and maybe Malaysia.

[desas]

What does a doctor do for a cold? In the UK and I wouldn't dream of going to the doctor's for a cold. You just wait it out don't you?

[kelnos]

I don't get this either. If I have a cold, I just take acetaminophen a couple times a day to suppress the symptoms until it goes away. Sure, if you're elderly or have an autoimmune deficiency, you may want to see a doc for everything, but that's not that common.

(Amusingly, I was in London a few years ago and came down with a cold. One of my local colleagues told me about this amazing thing called paracetamol that was just magic and would make me feel better. I was astounded that we didn't have it back home in the US... until I looked it up and realized it's just acetaminophen under a different name.)

[jacobush]

YES?! What the hell? Especially considering, the kind of sinus clearing pills which are forbidden (classed as a narcotic) in Sweden, they handed out in jars like candy at the US office.

[beefalo]

Walk in facilities do exist in the US, but wait times can be 2+ hours because the supply is so constrained.

[broknbottle]

There's no reason to visit a doctor for the common cold. Stay home and get some rest.. Do you take your car to the dealer or local mechanic to put air and washer fluid in your car?

[g4omingron]

>There's no reason to visit a doctor for the common cold.

That's such an american thing to say. A flu can be swine flu and fever can be Malaria or Dangue and one day delay can mean losing your life, so people in many parts of the world take fever and flu seriously.

[dagw]

A common cold and a flu are two different things.

[twobat]

I live in Eastern Europe so it's a bit like a third world country compared to Germany or Sweden. But let me tell you, it's not like you describe it at all. First of all, you don't get antibiotics just because you think you need antibiotics. And then, there's the private sector which has normal prices. And they treat you like a VIP.

[noobermin]

>The US system has a ton of issues, but I still take it over these European systems. Have I been floored by medical bills? Yes, from my dentist, from my wife's heart surgery. But I somehow managed — and we both received instant, high-quality help.

You are not the norm.

[tails4e]

I think you are mis- characterizing the European systems. I say systems as each country is different - some better than others for sure, but from what I've seen from both the US and European systems, I prefer the ones where my family going bankrupt does not depend on one of us getting seriously sick or not. The cost of healthcare per capita is way higher in the US, and outcomes generally poorer (see infant mortality rates for example).

The state of insurance for health in the US has far reach ing, society altering negative effects too which are often not considered. My sister in law would like to stay at home for a few years woth her young kids taking a career break - but cannot as she'd loose her insurance, despite her husband's income being enough to support them, it's the insurance holding her back. This absolutely would not be an issue anywhere in Europe I can think of.

[nine_k]

I agree that the "cost disease" is bad enough.

It's strange to hear about not getting an insurance if staying at home. That's exactly what my wife did when our child was small. She had the same insurance as me, because I was able to add her to my employer-sponsored insurance policy.

What really sucks is to be a small-scale entrepreneur, a garage-stage startup founder. You're cash-constrained, and there's no employer to give you a cheaper insurance plan. Obamacare is said to have helped recently.

[tails4e]

In this case she is a teacher in CT with very good benefits, but her husband, while on a decent salary has pretty terrible benefits, so she could not switch to his insurance is she stayed at home. Crazy situation when you think about it

[onion2k]

Wait for two weeks to get an appointment about your coughing and sneezing.

Here in the UK you can get an appointment to see your GP the following day most of the time, and we have walk-in clinics for same day check ups if you don't care which doctor you see. Availability varies a lot around the country but its mostly good.

[nixgeek]

This was not the case in Bristol when my GP took 2+ weeks to see me for the first time, then upon arrival, pawned me off on a nursing assistant rather than a doctor, then happily prescribed antibiotics for an “STI”, and then ignored my asks for a follow-up appointment for 2+ more weeks.

It turned out to be cancer. Original complaint stated when trying to book the appointment was “I have a testicle the size and hardness of a golf ball”.

Through that now, but the NHS is dysfunctional compared with U.S. healthcare. I have several relatives with bad hips or knees in U.K. who got prescribed stronger and stronger painkillers for >6 months because the waiting list for surgical intervention in their cases was so long.

[desas]

> You got to have a pretty bad infection to get a prescription for an antibiotic

That's because of antibiotic resistance. Increased use of antibiotics means they're less effective in the long term.

[ceejayoz]

> Come to a doctor with a bad cough, get a prescription for Paracetamol.

Good. Most coughs are viral, and that's the appropriate treatment.