[hintklb]

Hmm sure, but there must similarly be things that are denied right?

I lived in both systems. In a single payer system, the state essentially decide what is allowed and what is not. And with the state as a single payer, they also go back and forth on price with the hospitals.

It still is a better system overall but there is no places where you can just spend as much as you want on healthcare without some type of centralized supervision.

[empressplay]

Yes, in Australia what and how much of it a doctor can prescribe is tightly regulated. Many medications require a specialist referral and approval. Any medical procedure requires a specialist to sign off on it.

That and there is often a 'gap' that needs to be covered for GP and specialist services, although that tends to be balanced out by much cheaper prescription costs. (Prescriptions in Canada for example easily cost 2X as much).

However, Australia has a two-tier system where you can buy private insurance cover that can cover the costs of gaps and allow you access to private hospitals. This insurance is much cheaper than the equivalent US versions.

[int_19h]

It's not a dichotomy between single payer and US-style private insurance. You can have public healthcare that isn't single payer - that describes a good half of Europe, for example.

[ikr678]

There are tests, proceedures etc that are 'denied' coverage by Medicare(universal health coverage) but you can try get your private health insurance to cover it, or just pay out of pocket, unless it's the doctor refusing the request as not medically necessary.

I had a test recommended once that was not covered, but my Dr explained this in advance and the cash price to me was $110. There are no 'surprise' denials after the fact.

[chii]

> There are no 'surprise' denials after the fact.

this is the crucial difference.

It's absolutely fine (and required even) that single payer public healthcare doesn't cover every conceivable thing under the sun. It should cover the most common, easily scaled and mass produced items.

For the remainder, the patient should be told and know what to expect price wise - private or self-paid etc. And this also allows competition between entities offering this thing that's not covered.

Having opaque and unknown pricing (until after you've done it) is basically a form of highway robbery.

[codedokode]

> In a single payer system, the state essentially decide what is allowed and what is not.

Usually if the state decides you are not eligible for something (for example, some examination), you can just pay and get it anyway.

[adastra22]

In sensible countries that decision isn’t made after the fact. You know going in if it is covered or not.

[harvey9]

In Britain the national health service is a single payer and there are some things it won't fund, but you are still free to take out health insurance or be a self pay customer and go to a private doctor or private hospital.

[arethuza]

In my experience, its not so much what the NHS won't fund but getting access to what it does fund in a timely fashion.

Of course there is dentistry, which is a complete nightmare... people trying to do their own extractions with a pair of pliers is the sort of thing you used to associated with the US but I've actually met some people who have tried that due to how poor NHS dental services are and how expensive private treatments are.

[hintklb]

Weirdly enough the US is actually amazing for dentistry.

With any insurance you get 2 cleanings every year fully included and most routine fillings are almost completely covered. Easy to find appointments everywhere

My experience in Europe has been that it is super difficult to schedule anything. Waiting time of multiple months for new patients.

[arethuza]

Yes, my (private) dental insurance in the UK is similar. If you go private then no real problem getting treatment as soon as you need it (I got an appointment in the same day recently when I broke part of a tooth).

[harvey9]

Long queues are what most people will notice but some things are not approved by NICE or are limited to control cost, for example IVF.

You're right about dentistry.