[salsadip]

I‘m really not trying to sound snarky, but - is this the supposedly high quality treatment that U.S. citizens get that is so much more expensive as opposed to the „socialized“ insurance we get in Europe that is cheaper for everybody and supposedly therefore not as good/cutting edge?

[amyjess]

From my experience, other countries are even worse.

I'm transgender, and everything the top-level poster said about incompetent doctors, gatekeeping, and having to read literature and teach yourself about your own medical condition absolutely 100% applies to me and nearly every other trans person I've talked to (I remember printing out the Endocrine Society guidelines and taking a highlighter to them in order to convince a doctor that what I'm asking for is standard practice). I also have friends who have other chronic medical conditions, and their experience with doctors is pretty much the same as my experience and the experiences of other trans people.

And everything I've heard from people in Europe is that over there, it's even worse. At least in the US it's possible to doctor-shop and find someone who knows what they're doing—or who at the very least is willing to listen—but in European countries with single-payer healthcare you are entirely at the mercy of whatever doctor gets assigned to your case (yes, this isn't as bad in multi-payer countries such as France as it is in single-payer countries like the Nordics). And in some cases, the barriers aren't even the competencies of your individual doctors but institutional requirements doctors are legally required to follow even if an individual doctor is competent. Mind you, there are some exceptions: in parts of Spain and in much of Southeast Asia, for example, a good amount of medications that are Rx-only in most other countries are available over-the-counter, so at least you can self-med if you've put in the exhausting effort to research your own condition and figure out what you need (and even then, good luck getting blood tests to confirm your dosage is appropriate).

This isn't an endorsement of the US healthcare system, just an acknowledgement that the shit sandwich offered in the US has slightly less fecal content than the shit sandwiches offered in many other countries.

[Auracle]

If you go to the Mayo Clinic in Minnesota you'll see people from all over the world for a reason. It feels like the UN, where everyone has some sort of debilitating disease.

They have a system where you get evaluated by a general practitioner (or someone more relevant), and then they schedule you to see however many specialists you might need to see - all within a day or two.

It's not perfect, and I've found it's still hard to get them to drill deep on anything not life threatening or obviously testable. That said, I very much doubt that system exists anywhere with socialized medicine. You don't need a referral or anything else to go. You just call and make an appointment.

[albrewer]

I recently had to make an emergency visit to a hospital in a major city, with a really weird presentation.

Within 45 minutes of arrival they had figured out what was immediately wrong and had me hooked up to an IV drip of stuff to fix it. An hour later, a specialist for my issue came and talked to me about the problem and had an idea for a root cause. I was held overnight for observation and had several more tests run; by the time I left the next morning I had a root-cause diagnosis and a prescription to fix it.

[AlbertCory]

"IV drip" - that rang a bell. 25 years ago I was admitted to a hospital with severe abdominal pain. They had a surgeon who was preparing me, mentally, for a temporary colostomy. Fortunately, that IV drip fixed me up within half an hour.

Those antibiotics, man. They work.

[blakesterz]

I'll second the Mayo Clinic. I've (unfortunately) spent way too much time there, and it just can't be beat. I wish every hospital/doctor/system worked like this place. I doubt that's even possible, anywhere, but from my experience, it's how medicine should work.

[bcoughlan]

So tired of these "European" comments feigning cluelessness to try to feel above others. There is huge variety in healthcare quality across EU countries (waiting lists are years long in my country) and no one can speak of Europe as a monolith and make much sense. People in my (EU) country who have serious illnesses often seek to go to the US for treatment because they have facilities and doctors that specialise in their illness and don't have a hope of survival otherwise.

I see these comments all the time on Reddit and HN but never see the reverse from US posters. They just come across as insecure and snooty.

[asdff]

I think it depends on the context of the treatment and how specialized it needs to be. For example, I've had relatives from the U.S. who have gotten dental work done in Croatia because its cheap enough to the point where they can buy a transatlantic flight and spend some time visiting family members along with getting the root canal and crown done. A lot of people in southern California also opt to drive to Tijuana for dental work or other procedures. If its not some cutting edge thing or world renown surgeon, there is no point to paying the costs associated with a lot of treatment in the U.S. at least. For some stuff, yeah, the U.S. is best in class; Saudi princes fly out to Cleveland to get their heart work done.

[jjeaff]

Sometimes that can be a good idea. But many times, you are also getting riskier, out of date treatment for less. For example, root canals and crowns are kind of the cheaper and less effective way to treat a bad tooth. The gold standard is usually extraction and a new implant.

And considering that you can find a dentist to do a root canal for $300 without too much trouble, I'm surprised anyone would be able to fly to Croatia and get treated for that little.

[asdff]

I think actually it was implants that were done which my dentist quotes me $1600 for in the US

[jjeaff]

Yes, I have heard of people traveling for implants. But if they travel once and are done, then they are going to cheap route there as well. You can get all in one implants, and they are cheaper, even here in the US. But the kind of implants you really should get are the type that require placing a base first and then wait a few months for them to heal and set before installing the posts and permanents.

[AlbertCory]

I'm reminded of that Simpsons episode (can't find it on YouTube easily) where they temporarily have to take in boarders: backpackers and so forth.

Then the financial problem is fixed, and Homer carries one of them, all the while spouting about the European health system, to the garbage can. He says "Time to take out the Eurotrash."

[albrewer]

In my experience the quality varies wildly, but every doctor has a base level of knowledge that is far deeper than a layperson. The quality of that knowledge is usually very high, and seems to be pretty well retained by most doctors I've met.

The quality of the actual doctor varies on whether the doctor is a lifelong learner, a deep thinker, a good listener, is good at extracting information from people who are bad at introspecting how they feel, and communicating with people whose language skills and mental capacity are far below or above their own. They also leave out their personal biases about "what" the person they're treating might be (drug seeker, hypochondriac, malingerer, etc.).

If you visit a doctor and they don't have the ability or time to execute those non-medical training qualities, then you get a bad doctor.

The main issue is that the good doctors usually go to desirable places to live. This is often not in rural or even suburban areas of the country, and that's typically where the bad stories come from (adjusted for population density anyway - lots of stories from cities too but there are more people in cities).

[ipaddr]

Most have knowledge of what they studied in college and what worked over the years and by worked they mean did not get sued, made the most money on and worked quickly.

They are not paid by outcome they are paid by referrals, tests, drugs sold and consulting

[ironmagma]

Depends on which doctor you are going to. We have some of the world’s best doctors but they might be in hospitals or doing a concierge service. You get what you pay for.

[Afforess]

> You get what you pay for.

But you don't... that's the whole problem with the American Healthcare industry!

[derefr]

No, with the American health system, you do get what you pay for (i.e. more money ⇒ access to better medicine); but you don’t necessarily pay (the right amount) for what you get (i.e. !(worse medicine ⇒ costs less)).

Which is to say: standard-of-care treatments can cost far too much relative to other countries; but also, if you’re willing to throw millions of dollars at private clinics, you can opt your own way into experimental treatments that don’t exist anywhere else in the world.

[csa]

> is this the supposedly high quality treatment that U.S. citizens get that is so much more expensive as opposed to the „socialized“ insurance we get in Europe

I am an American who has lived in several countries and had experience several medical systems.

The US has the best care… if you have access to it. This access can be limited by geography, insurance, money, awareness of the specific doctor, etc.

In a random provincial area with no university medical school nearby, the treatment will often be quite sketchy.

In other countries I’ve lived in, the best medical care was still in the large cities, but the standard in provincial areas was to a much higher standard (imho) than in provincial areas in the US.

[ipaddr]

This is also Canada with even more socialized medicine compared to Europe.

[nick__m]

The Canadian system (well the one in Québec anyway, each province manages it's own system so I cannot tell about the other province. Hell, I cannot even tell about the one in other administrative regions inside Québec) has a big luck component.

If your lucky enough to have an accessible primary care physician who personally knows specialist and lives where there is a University hospital center, the system is awesome. If you don't, the system appears to be a special kind of administrative hell.

[cjbgkagh]

At least with socialist medicine doctors will gaslight you for free.