[evnix]

The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude.

Most of Asia has same day or next day medical tests. In India you can order something like UberEats where in a technician comes home collects your blood samples and the results are emailed within the next 24 hours or so.

Medicine seems to be commoditzed in the east, easily accessible and cheap. West treats it like voodoo magic or rocket science that only a chosen few are capable of partaking in. There is always a long queue to get to your local voodoo practitioner.

[calgoo]

I had some pain in my lungs and they gave me an xray in about 30 minutes here in Spain to confirm that i had pneumonia. I waited 45 min to see the doctor in the emergency room and then another 10min waiting for the doc to check the xrays.

[evnix]

Yeah you need to know the keywords in EU, "pain in chest", "seizures". After which the emergency treatment is quite good.

But for the majority, it isn't great. You go with pain in stomach and it happens to be cancer, you die waiting. I personally have seen so many of these and it's heartbreaking.

[attendant3446]

That is true, but it also varies from country to country. In Sweden I haven't been able to see a doctor in 1.5 years. In Germany, the waiting time is ridiculous, usually 1-3 months, but if you choose your doctors (Google Maps is the best catalogue for almost everything) - you get the results and 99% of it is covered by statutory insurance.

[CaptainZapp]

> The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude.

In Switzerland I get an MRI within 48 hours if my doctor orders it.

Mind you, healthcare is also very expensive comparatively but the quality is very high and coverage is extensive.

[evnix]

Condition is if "your doctor orders it" and how long does it take to get to that doctor if it isn't an emergency. I don't about Switzerland but it is quite bad in majority of EU countries.

And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price.

The other part no one mentions is the utter cheating that goes on in statistics to show that the health care system is doing good. Things like counting the patients who were admitted but not counting the rest 90% who died just waiting for months.

[jorvi]

> And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price.

Because false negatives are a massive problem. People get biopsies or treatments for things that never needed it, which is ultimately worse for their health (on average) than catching the rare time it is something.

[evnix]

There is no stats to what you are speaking. General People not being able to get to doctor in months is a bigger problem than a rare false negative.

This also reduces burden on doctors. If the only thing your doctor does is prescribe antibiotics and orders scans. Why not do it yourself and get treated early.

[CaptainZapp]

You can absolutely walk in an have an MRI made at any time.

It's just not paid for by your health insurance.

[jorvi]

Apologies, I mixed up my terms, I meant false positive.

And no, you are wrong, overtreatment is a huge problem.

[piva00]

> And Why can't you just walk in to a clinic to get x-rays and tests done like it is in done elsewhere. Have clinics compete for price.

I hope you are aware that these also exist in many EU countries, private clinics aren't banned because of public healthcare, you can purchase private health insurance in many countries, I can't say all because I don't know the intricacies of every country's system since this is a national policy and each member-state is free to run their own systems.

Here in Sweden I have private health insurance through my employer, I cannot go directly to a clinic for imaging, etc. since it needs a referral from a doctor but it's quite simple and when I needed I had many choices of private clinics to do a MRI. If you don't have insurance you can definitely pay out of your own pocket, both for a private doctor as for exams.

[autoexec]

You can, but it's not necessarily a good idea.

https://www.newyorker.com/science/annals-of-medicine/will-a-...

https://doi.org/10.1016/j.jacr.2024.08.024

[short_sells_poo]

I feel the seiss system really nails it. Health insurance is mandatory. If you can't afford even the basic level, the government pays for it. The basic level itself covers basically everything from emergency care, hospital stays and gp. The extras you can pay for are things like single rooms in hospitals or access to private clinics. Compared to the local salaries, the basic package is quite cheap - doubly so compared to the UK where National Insurance extracts a very hefty portion of your paycheck and this gets you the dire waiting times of nhs...

[soco]

Maybe because the Swiss didn't let the magical hand of privatization solve it? The healthcare providers might be private but the laws and regulations and conditions under which they are run are very strict and very detailed. Perfect? Of course not, I could give examples heaps. But better that many? Very yes.

Now, is there here anybody from Spain to comment on their system? I've heard good stuff about it.

[sega_sai]

National insurance contributions have nothing to do with the NHS. NI contributions determine your state pension (but because the money from NI just goes to treasury, NI is really just income tax with different name)

[MediumOwl]

Does it? It's also close to last in most categories in the linked study.

[Bayart]

> The general slowness extends to simple things like x-rays and blood tests too. This is not just US but whole of the west seems to have the exact same attitude.

In France I could have a blood test right now, without an appointment, and an X-ray by tomorrow morning (just checked).

But the ER is generally far too slow and some specialists have much too long waiting times.

[nope1000]

I think the problem in the west is just demographics. More older people leads to high demand on the healthcare system and fewer working age people leads to less supply.

[InDubioProRubio]

China, SKorea, Japan.. all aging

[nope1000]

And they all make their citicens work insanely long hours. So they are not sustainable either.

[InDubioProRubio]

Got to keep that Necropolis warm

[tmaly]

I had to visit the ER in Philippines.

In US we sit there for 5-7 hours and see a nurse practitioner.

In Philippines we were in an out in 2 hours and saw two doctors.

[cafard]

My last trip to the ER was in 2010. Probably because I had good health insurance, they saw me quickly (less than half an hour), cleaned me up, maybe glued a cut, and I was done.

This was in the US, just outside Washington, DC.

[angio]

If you're willing to pay out of pocket (~100 euro or so) that service is available in western europe too.

[evnix]

Can you name a few services that do this for that price.

[benterix]

I live in Europe and if I take a blood test at 7 am I can usually check the results online by 1 pm.

[Yizahi]

Blood test yes, MRI - no. In the Ukraine I can go to the M24 center, and yes, 24 means it is literally working 24/7/365. And I don't need doctor's referral to do it. In EU I had to wait 2 months and have doctors referral, and that was lucky window I caught by chance. Other people report waiting much longer.

To get to the specialist doctors is also hard in EU, compared to the Ukraine. Here I had to wait between 1 to 3 months to a lot of specialists. And if any mistake in the referral is made, then wait need to be repeated.

Example - I got a referral for the retinal diag. But to do it 15 mins before the test eye drops are administered (atropine) to dilate pupils. Apparently I have needed to have two referrals - one for the drops, and another for the diag itself, and I got only the second one (made by an eye doctor in the same clinic, so regular staff). So I have waited months, and was denied the procedure, then a spend a week on a phone and visiting clinics in person to sort this out. Then I got proper referral (haha, actually not even then, they simply caved and allowed me to do it with what I had) and had to wait a month again to do a simple check which would take me a hour at any arbitrary day in Ukraine.

[aguaviva]

And in the middle of a full-scale war, in a country not exactly wealthy, no less.

[A_D_E_P_T]

Same. But in Croatia where things are a little bit... well... different. For instance, I don't need a prescription to buy (almost) any drug in the pharmacy. And I don't need a prescription or referral for any medical exams or blood tests; I can order them myself. Asia is like this, but Europe to the north and west of Croatia really isn't.

I believe that things in the UK and Germany might be a lot slower and much more restrictive.

[jq-r]

Well some relatively common things are easy to get in Croatia (bloodwork and meds - GPs like to prescribe those to get rid of you), more serious like exams, treatments, surgeries are absolutely terrible with waiting lists which are years long. People are dying, and/or their condition worsens before they even see a specialist. This is common knowledge for many years now.

Private clinics are opening left and right with the same(!) doctors working in both public and private clinics. Also corruption is rampant allowing doctor's friends to jump lines and that also happens for money/favors. So if you're not rich enough to go to a private clinic your second best option is bribes/corruption/nepotism. And if you don't have the latter, you're frankly fucked.

[A_D_E_P_T]

I've lived in the US where my health insurance had like a $6000 deductible and a $1400/month price-tag. (And, by the way, I really didn't appreciate how American doctors would gatekeep drugs, restrict their availability, and add significantly to their cost.)

Here, you can walk into any private clinic in Croatia, and arrange for even a fairly complicated surgery, and it'll cost you way less than all that. Your annual medical expense bill won't even come close; a very sick person in Croatia, who does everything in private clinics, pays less (annually) than a perfectly healthy person in the US who never sees the inside of a doctor's office.

My wife just gave birth here at an "expensive" private clinic, with a private room of her own, and the total price was cheaper than a few months of medical insurance would have cost in the US.

Ultimately, private clinics are a damn good thing, because price transparency, price competition, and paying out-of-pocket -- they all serve to keep fees reasonable. If a Croatian clinic tried to charge $100 for an aspirin tablet or a bag of saline, there'd be riots with pitchforks and torches.

[jq-r]

I'm not sure if we're talking here about the same things. You may say: "oh it's easy to get meds and it's cheap to do X, medical system is great" while being a medical tourist and/or having a far above average pay, I would accept that. It's great if you have the means. Just like it's great in USA if you're rich, right? But directly comparing two completely different systems and different orders of magnitude of purchasing power and taxes doesn't really paint a good picture of how it's here.

For an average citizen the system is terrible and getting worse by the day. The examples are too numerous to mention.

I'm also not sure if you think that I'm somehow against private clinics. I'm not. They of course won't compete on medications with public services as that's pointless. What I do find apalling is that doctors are working in both public and private clinics completely legally. Moreover, that practice makes the public services worse by removing the availability of the doctors and makes taxpayers being double charged for the same service.

There would be riots with pitchforks if most needed some non-basic ("take these pills") medical help. When you're young you probably don't need much. But as you get older you actually might need some procedure or a treatment. But by that time you are actually older, sicker, and there aren't too many of you to actually riot. And many jump the lines by having friends (of friends) working in hospitals. It's bleak and grim and I don't see it getting better.

[A_D_E_P_T]

I don't think you appreciate how much worse things are in the USA, even after adjusting for income and taxes. (Effective tax rates are very similar between the two countries, besides.)

Medical care isn't perfect in Croatia -- but it's not perfect anywhere, and at least in Croatia the poor can have many of their needs met by a pharmacist, without even needing to see a doctor; they'll never need to pay >$1000/month out of pocket for garbage "insurance" with a high deductible; they have the option of public care for certain procedures and treatments, and private clinics for others.

Yeah, there may be an element of corruption to it -- perhaps if you "know a guy" you'll get your appointment more quickly -- but this is small-time corruption on a human scale. In the US the corruption takes place on far vaster and more impenetrable scales, with lobbyists, regulatory capture, and I could go on...

And, yeah, some can't afford private care, and need to rely wholly on the public system in their old age. I dare say the public system in Croatia is still a damn sight better than Canada's, or the UK's. Maybe you can tell me which country has an ideal public system? Distant Japan's, perhaps?

As for public system doctors working in private clinics -- it's like that all over the world, as far as I can tell. The medical system in Hong Kong is very highly regarded, and it produces good outcomes, and I know from personal experience that doctors there also work both systems simultaneously. Public hospital in the morning, private office in the evening -- or public hospital on Mondays and private clinics the rest of the week.

In fact, the system in Hong Kong is very much like Croatia's, but Hong Kong's private clinics are roughly 5-10x more expensive, on average, for the same procedures!

All things considered, and in light of the alternatives, Croatia's is really a better system than almost any in the world, for rich and for poor.

[InsideOutSanta]

"This is not just US but whole of the west seems to have the exact same attitude"

The slowness you describe has not been my experience in many European countries. It really depends on how the healthcare system is designed to work.

I was pretty surprised when I went to China and I could just go to a doctor's office without an appointment, stand in a queue, stick out my tongue, get a diagnosis within ten seconds, and be sent out with a handful of random colorful pills wrapped in paper. Yes, this was, in fact, a real doctor's office, and I did take the pills. I have no idea what they were or did, if anything at all.

I also did enjoy the phone-ordered house visits from nurses in Indonesia when I got Bali belly, although that is probably a result of low labor cost more than anything else. And the poop tests I received a few hours later weren't all that helpful. Oh, I have "amoebas," that's very useful, thanks.

All told, I'm happy I usually live in Western Europe. Relatively expensive, but high-quality, fast healthcare without the constant risk of going bankrupt when something unfortunate happens.

[pitkali]

Out of the Western Europe, I lived in Sweden and Germany, and I have not been impressed with the health care so far. I hear it's different when you're having a heart attack, but if you "just" tore some knee ligaments, for example, getting good care in a timely manner is a struggle.