[busterarm]

No that's the thing, you can't get the treatment if it doesn't exist.

For the years that i was living in Ontario there were only 3 MRI machines across the entire province. The waiting period for that diagnostic MRI ranged from anywhere between 10 and 24 months. If doctors were even convinced you were worth getting it.

You could die from something before you could even end up getting properly diagnosed with it.

You might not have competent enough doctors in some countries for specialist treatment if you need it. A popular Canadian Youtuber who lives in Japan (which generally has great medical care) decided to relocate to the United States during the time they were undergoing their particular cancer treatment a couple of years ago. Japanese yakuza bosses pretty famously obtained their illegal organ transplants at UCLA Medical instead of in Japan...

The US's system is certainly flawed but it guarantees that you can obtain the best care possible if you can afford it. That's much better than not being able to get the care even if you can afford it.

[itishappy]

> For the years that i was living in Ontario there were only 3 MRI machines across the entire province.

Jesus. I've got more MRI machines than that within walking distance of my house.

It does seem to have improved significantly, as in 2020 Ontario had 124 (which made it the best provisioned province at the time). When were you there?

https://www.statista.com/statistics/821422/number-of-mri-uni...

[busterarm]

Early 2000s. When I left in 2003 there were 5 and then they had a few years where they added 20-25 per year.

CT scans were bad too. Everyone I knew just drove to New York to get diagnostic scan and dental work done at the time.

But even then: Ontario has 15 million people and 124 machines? NYC has 8 million residents and 470 machines.

[carbine]

Do those machines operate 24/7? I'm Canadian and get regular (publicly funded) MRIs as part of my healthcare needs and they always happen on time, and close to home. Zero issues. Sometimes you get appointments at weird hours but that's because they run them constantly.

We could definitely use more and our healthcare system could definitely use serious improvements, but the way it's talked about amongst Americans often seems a little divorced from reality.

[contagiousflow]

Is that not two different tradeoffs? One is first come first serve and the other is purely if you have the resources at the time? The only people I see that praise the "guarantee if you can afford it", are indeed, the ones that can afford it.

[busterarm]

Soviet bread lines were first come first serve too and I don't know any former Soviet state residents gushing about how great those times were. Those 3 MRI machines that I mentioned had to service 1/3 of the population of Canada at the time -- about 10 million people.

Saying "oh that's just first come first serve" is totally missing the fact that the service level can be woefully inadequate.

What's really crazy is that I live in a small city of about 100k people and there are about a dozen hospitals that I can choose from, first-class trauma centers, multiple renowned research centers (affiliated with three different universities). None of that is counting all of the urgent care and other facilities in the area. I have an order of magnitude more options for treatment than I did when living in New York City...

The only way I could open myself up to more/better care options would be to move to Texas.

[oezi]

Well the US spends 17% of GDP on health care and Canada only spends 12% while life expectancy in the US is at least 2 years less.

You get superb care for the rich and mediocre care for the average guy and very little for the rest.

[tptacek]

Life expectancy is, perhaps counterintuitively, not highly connected to health care. The major factors contributing to the gap between US and Canadian life expectancy are car accidents, homicides, and cardiovascular disease, and CVD differs wildly depending where you are in the country; there are states that lead the G7 in CVD outcomes, and others (like Mississippi and Alabama) that look like developing-world countries.

None of this is to defend the US system in particular, which wildly overspends on the outcomes it achieves. But generally, when it comes to managing chronic and acute health conditions, those outcomes are very good.

[tensor]

Except that comprehensive studies, in contrast to anecdotes, show that people in countries with public health care in fact DO get good treatment generally. So while maybe in rare circumstances you could have to wait too long, the vast majority of the time your life is not put at risk by a little wait.

[contagiousflow]

If only there was a way to change and influence the use of public funds...