[loceng]

Interesting. Would you care to explain how then in Canada - I'm Canadian - with our "free" healthcare system, I've had to spend over $800,000 in under a decade on medical treatments in the US?

You don't seem to understand the pros and cons of both situations, otherwise you wouldn't be simply proposing a blanket "free for all!"

Once you tell me your 100% foolproof solution for countering regulatory capture and industrial complexes, then you'll have my attention.

[xs83]

I am from 2 countries with "Free" healthcare system, I know that in either country if I really required it I would be seen, treated and discharged with no more than a few payments needed for medically necessary prescription medicines if I have a job, If I dont those are also covered.

In both countries - I can CHOOSE to go private for whatever reasons (for example, one of my friends has just had a baby and she chose to go private so she could get the OBGYN that she wanted and have a planned caesarian).

But it is not necessary and for those who cant afford private healthcare (or those who dont want to take it out) that safety net exists.

The foolproof solution (if such a thing could ever exist) - is to not have a healthcare system that is built for-profit. That way the government is the largest bargainer, you dont have companies colluding to drive up prices, everyone know what they are going to get and can't try and sway it that way.

By it coming from taxes the prices are managed better than if you have a bunch of cough self regulating companies running the racket.

I understand the pros and cons very well - and even with my private healthcare I get the benefits of the service I pay for with my taxes so my bill would never even be 10% of that 800k you somehow have paid.

[loceng]

So which countries are those? So I can lookup their health system structures.

In Canada, I can't privately pay a doctor for care - their hands are tied; dentists/dental-jaw aren't included - because dental isn't covered - somehow the teeth and jaw, and related tissues, aren't part of the body.

And you're making lots of assumptions - but no point in addressing those, but I'm curious what some of the pros and cons are? More specifically the cons; usually people haven't thought too deep to extrapolate to the consequences of either the pros or cons.

It's quite clear there's a large disconnect between people who likely had relatively simple health issues needing to be diagnosed and treated vs. others with more complex issues; of course the quality-competence of doctors you encounter is going to be the primary fundamental factors - which in part has to do with their training, their environment of if they are around other competent-knowledgable doctors - which then includes their education, how much they excel at memorization rather than critical thinking and observation skills.

I'm also curious if you ever played any rough sports or been in any serious collisions/accidents, or have you never really had any significant or complex injuries?

[xs83]

UK and Australia.

The pros and cons are the same pros and cons you get with any system that has some form of centralised control.

The main one comes down to triage, if you need / want a procedure that isnt life threatening or helps your quality of life you can expect a long wait or not being able to get it. For example - any kind of cosmetic surgery isnt going to be done for free unless it affects your quality of life (e.g. Rhinoplasty for deviated septum)

If your situation is an emergency you get seen pretty quickly - otherwise it can take a while - as an example my mother needed a knee replacement - it took almost a year from when the doctor recognised the need for her to actually have it done. But it got done and didnt cost a penny.

She could have gone private, had it done the following week and paid 5-6 figures for it - it just wasnt that urgent and she couldnt afford it.

I have played rough sports and been hospitalised from it and I was treated immediately (emergency) - again this was free.

I think this concept is lost on people - not everything medical needs to done immediately and its sometimes fine to wait (even if its not preferred).

[loceng]

Thanks for sharing.

There are blind spots regarding problems that you're unaware of since you haven't experienced them.

Glad your and your mother's situations were simple enough for a relatively quick resolution.

I wonder if your mother could have benefit more from a stem cell treatment, but that perhaps only a knee replacement was covered - even if the knee replacement would have cost the system more money overall.

[_heimdall]

> The foolproof solution (if such a thing could ever exist) - is to not have a healthcare system that is built for-profit.

Well we 100% agree here. The system you describe sounds totally reasonable to me as long as the government is managing things reasonably.

I'd extend this problem to effectively every industry too. Profit is such a corrupting factor in any business and really ruins most things. Free markets, capitalism, whatever I get all of that but creating incentives entirely around winning a zero sum game is terrible for everyone in the long run.

[loceng]

Re: "... as long as the government is managing things reasonably."

Bingo!

The issue is, especially in Canada, which people don't seem to know is a "free" healthcare system structured fundamentally differently than the other more successful systems.

The primary issues I believe are rigid centralization - along with nepotism, and the single point of failure-capture that is then possible in a highly controlled-centralized system, where the people - the voters - get no say; e.g. when the health system doesn't have elected administrators.

In the US, I believe most states and cities, judges and police captains are elected? In Canada, we don't have that even.

There are pros and cons to "both" systems, and there are solutions to better select for the pros in both.

[morkalork]

Can you explain how you've come to spend $800,000 on carr outside of Canada? Certainly if that was the case for everyone there, it would be an untenable situation.

[loceng]

It doesn't appear like you are aware of any of the ranking statistics. You are correct - it's quite untenable, especially with the newly 3 million new immigrants the current government in power has flooded Canada with in the last ~2 years alone; and that doesn't account for the 1.5 million international student visas, nor work visas given - in a relatively small population of now ~40 million.

We spend the most per capita of G7 countries, and rank last of those on quality of care and service metrics.

Try a thought exercise to brainstorm, reverse engineer, why that might be.

[buffington]

Are you saying immigration caused you to spend $800k for US based health care, as a Canadian?

No appeals to thought exercises either. You're the authority on this. Tell HN how this isn't just some convoluted xenophobic rant.

[xs83]

He cant because thats exactly what it is.

The UK NHS system is on its knees because the conservative government has started selling it out from under the people to guess - US companies.

But all the gammons are spouting exactly the same as he is that its the "immigrants" causing it (even though Brexit was going to solve that problem - right?)

[loceng]

Oh hey, you jumped on the "jumping to conclusions" bandwagon too.

Hopefully my question below helps widen your currently racist perspective to understand economics - just copy/pasting my reply to buffington:

Talk about jumping to conclusions.

You jumping to a race lens says more about you than me. Economics and numbers don't care about race. If you have a system with fixed supply and you flood it with demand, what happens genius?

Also, the flood of immigrants started in just the last few years - and I've been dealing with these issues with the Canadian system for 8+ years.

[buffington]

It's fair to say that I introduced the idea of "race" into this conversation. That wasn't a fair assumption for me to make. The only thing it says about me, however, is that I've seen a lot of anti immigration arguments made that were actually just people being racist.

That said, and to be perfectly clear - I'm not trying to find a reason to argue with you. I'm trying to understand what it means to "spend $800k on US health care as a Canadian."

Normally I'd shrug and move on at this point, but frankly, it's seems a bit crazy to suggest that you, a Canadian, spent $800k on US health care because of immigration. You were the one who spent the money. Why not make it crystal clear how and why that happened?

[loceng]

Talk about jumping to conclusions.

You jumping to a race lens says more about you than me. Economics and numbers don't care about race. If you have a system with fixed supply and you flood it with demand, what happens genius?

Also, the flood of immigrants started in just the last few years - and I've been dealing with these issues with the Canadian system for 8+ years.

[itishappy]

Medical tourism? I'm guessing whatever procedure you needed wasn't offered in Canada, and I assume the Canadian government doesn't want to subsidize a different country's medical industry.

[_heimdall]

Another possibility is that procedures are offered but the waitlist for scheduling is unreasonable to people with other financial options.

[loceng]

Waitlists are part of the problem - but arguably not the main ones.

If I had encountered doctors who actually understood what they were taught, who actually understood pain and how the nervous system works, then they would have directed diagnostics like imaging in an efficient manner to actually properly problem solve what was going on; instead over the past 12 years I've had to learn myself everything related to what's been going on - as I've been playing whack-a-mole to knock out the next strongest pain, my pain level being so high that my brain wasn't able to actually feel all of the pain sources at once - and it's arguably been only in the last year that I can feel the last few major remaining sources.

One example of this, the last "top expert" in Canada's largest city - Toronto, didn't even follow the literature for diagnosing what I was certain I had based on the symptoms; and there's no penalty for him - meanwhile I had X months of waiting, where leaving a public review of my experience won't really matter - won't allow the public to review testimonials/experiences for themselves - to then decide to go to - and pay a different doctor, where otherwise free market capitalism forces would instead drive more money through word of mouth referrals (etc) to the doctors who show themselves to be competent; and then their skills and knowledge and organization could expand, rather than whatever incompetent-rotted centralized administration is allowing to exist - so long as they toe the line and comply with whatever rules they put in place.

When I told him towards the end of the appointment that he's not even following the literature - where it's more often a diagnostic through exclusion of other sources, rather than due to an obvious cause from imaging [most laypeople don't understand that diagnostic imaging doesn't catch a lot of things - so just because you don't see it on imaging doesn't mean there isn't a cause]; oh, and he couldn't even pull up the MRI imaging because their health network's servers were down, so he couldn't even review the imaging - but still concluded it wasn't the syndrome I had all the symptoms for.

Not too long after that appointment I went to the US - taking me 1.5 years to even find a doctor/surgeon who was able/willing to diagnose me and do the surgery, trying as quickly as possible in my debilitated state, my pain level still how it interferes a lot with my concentration - and went and did the surgery which 100% resolved that pain and symptoms.

Another observation or insight I had is that when in a system where you don't have enough supply for the demand, the doctors who are really good will get plenty of word of mouth referrals - so their schedule will get filled up quickly. That then means it is either 1) new doctors, or 2) doctors no one refers them to specifically - and so the appointment you'll most likely get, the soonest you'll get, will most likely be a doctor in one of those two scenarios.

If I am to try to get compensated for these procedures I'd have to spend likely $100,000s, where you have to find a lawyer that specializes (very very few of them in Canada) in suing the province's health insurance company (e.g. OHIP in Ontario), and where it would likely take years of legal processes, as they automatically deny something like 86% of claims - as insurance companies seem to do, possibly in hopes the person doesn't have money to fight them even on legitimate claims based on their own rules; and at the moment my concentration is still too fucked and my nervous system too sensitive to stress to be able to start organizing for that, aside from the high cost.