Zero mention of wait times in the US compared to other countries. Pretty sure that's the chief complaint in most countries that have free-ish healthcare.
1. At the very least, the data does not seem to be clear that the US has shorter wait times, and the US may even have longer wait times [1] (regardless of whether Americans pay far more and die younger).
2. Even in countries where people are unsatisfied with free-ish wait times (regardless of whether US waits might be longer), that average complainer may still not want a US-like system. I.e. people might complain about waits in their free-ish system but still think a (theoretically) faster US system is worse. I think a lot of people’s thought process is simply “I wish this were faster” which is still quite different from “I wish we had a fast US system.”
You're exactly right but it runs contrary to the narrative being spun.
A quick search reveals the best ER wait times worldwide are in the US, Germany, and Switzerland, with most the rest of western Europe dead last along with Canada and Australia.
The average ER wait time in the US is 24 minutes. In France 2h21m. Italy 2h44m.
Everyone likes to say how great Canadian healthcare is, but talk to actual Canadians and the cracks start to show, you're waiting months for a CT scan, and most need employer-provided health insurance anyway to fill gaps in coverage.
Yeah but could this be because people are more likely to go to ER in countries with free healthcare?
I've been to the ER in my country because of abnormal stomach pain. Obviously I was triaged and had to wait hours because it was not considered life threatening. But in the end a doctor saw me for free. I think if I were in the USA and didn't have health insurance I would have just stayed home and avoided the risk of an expensive bill.
I'm Canadian, and I like our system. If you're in danger, you'll get that CT scan now. It'll take longer if your case doesn't require urgent care. But I've never waited for medical care more than what I would think was unsafe. Coverage isn't perfect, but it's getting better. I would pick this over your system any day of the week.
It also confuses me whenever Americans bring up that point to defend their profit-driven system, because to me it seems like bringing up something that's completely unrelated to money and billing just to make the other systems look worse by any means. How does a publicly-funded system intrinsically cause longer wait times? From what I can see here, it's an issue of doctor supply, caused by some of the most gruelling, limited-capacity and expensive training processes in the country, as well as purposeful underfunding by the provinces, not by how much money I pay on the way out.
Actually, maybe there is one factor in pricing that causes shorter wait times. I know it's not uncommon for people in the US to wait until they're basically dying to get medical care, because they're that averse to financial ruin. That would naturally cause somewhat lower demand, if you're okay with existing in that system with those kinds of externalities.
> with most the rest of western Europe dead last along with Canada and Australia.
Just for completeness: I presume that is referring to government owned hospitals in Australia, which are free. There are also privately owned hospitals. I've not had to wait at a private hospital.
Private hospitals are expensive, but I suspect not as expensive as USA hospitals. The price is held in check by the alternative of "wait a little longer, and it's free".
Wouldn't you expect to see that reflected in outcomes? TFA mentions that the only studied country with more avoidable mortality than the US was Mexico. If you aren't seeing it, maybe its not as big a problem as all the people who cannot afford any access to care at all while the country spends more per-person.
There’s not (typically) a regular measure of how much pain and disability a patient suffers while waiting for a hip replacement. It certainly would only show up in mortality statistics massively attenuated.
Sure there are. Population measures of morbidity, days of lost work, patient satisfaction, etc are all captured and studied.
Do you have indications that those are worse where wait times happen to be higher, or so you just take it for granted that longer waits must mean worse net experience?
Many universal public systems (not all, see: Canada) effectively allow this through private plans and private providers that supplement the government benefits, often notably for speedier diagnostics and treatment.
Oddly, the country with the expensive ineffective healthcare with lower wait times (citation needed) is also the one that doesn’t have guaranteed paid sick leave and other facilities that would make wait times less of a factor.
Anecdotally, I spend a lot more time literally in waiting rooms in Germany than I did in the US, but getting a specialist appointment is much faster here (getting a therapist absolutely excluded, but I was able to get a psychiatrist to write prescriptions for ADHD meds within a month).
I just moved from a medium sized US city and any specialist provider I contacted for myself or my parents was 5 months or more. It's not good everywhere.
My family has moved around quite a bit from small to large cities. I have never been able to make a same or next day appointment. Sick or not. Where I'm at now (NOT a major city) it was over 6 months to get the next appointment. For our child we had to call around to 4 pediatric practices before we found one open to new patients. And even then it was still over 4 months before they had an opening. Urgent care is an option but there is still a wait and from my experience they are kind of a joke as to what they provide.
You can like your current healthcare and understand that the current system is inefficient. I am one of those people.
There's also many, many types of universal healthcare (including the very crude version we currently have in the US), some of which have more support than others.
I would support a system like Japan, Switzerland, or the UK, but not one where private insurance is banned.
I mean, in rural America short of a trip to the ER with whatever wait time they have, getting a primary care doctor is barely possible and only affordable if your employer provides medical care, which many many don't.
I've experienced healthcare outside the US (in the UK) and it's on par with US healthcare in terms of wait times. Seeing a GP was same day with walk ins. When not busy, it was just a 5 minute wait.
Seeing a specialist can take time. I knew people that saw a 3 month wait to see a specialist in the UK. In the US, I just experienced a 3 year wait getting a specialist for my kid with autism. I had to go out of state to get the initial diagnosis, but to get local followup care I had to do that 3 year wait. After that, we were able to get a bunch of referrals to other issues.
What constrains wait time is how many doctors and specialists are working in a field. That has almost zero to do with the underlying payment system of a healthcare system.
Plenty of wait times in the US. Go to any clinic that accepts walk-ins in the afternoon, and you'll see a long line of sick, insured people waiting.
Getting a specialist in a major metro area will easily take 6-9 months. Family doctors? Anything to do with mental health? Good luck.
Oh, and if you think the situation is better in flyover country... It might be. You might have a world-class pediatric hospital in your zip code[1]. Or, more likely, you will have to drive 80 miles to a roach-motel-grade one. Turns out that poor people in real America don't have a lot of money, and it's not economical to provide them with any healthcare beyond leeching and bloodletting and four pills of Tylenol that will cost them $50.
Good luck getting an abortion, too.
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[1] You'll still get fraudulent bills sent to you by vendors who claim to have performed non-existent services on you, while the hospital won't even be able to tell you if those vendors even work for the hospital. Ask me how I know. (After days of digging, it turns out that no, they don't.)
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Look. It's entirely possible to in theory have a privatized system that works. Also, as Homer Simpson famously said, 'In theory, communism works.'
Unfortunately, we live in the real world, not a theoretical one.
This is my favorite thought terminating cliche when the discussion of American healthcare comes up. Wanna see a specialist? You're waiting. Can't afford insurance? You are waiting even longer.
2. Even in countries where people are unsatisfied with free-ish wait times (regardless of whether US waits might be longer), that average complainer may still not want a US-like system. I.e. people might complain about waits in their free-ish system but still think a (theoretically) faster US system is worse. I think a lot of people’s thought process is simply “I wish this were faster” which is still quite different from “I wish we had a fast US system.”
[1] https://www.americanprogress.org/article/truth-wait-times-un...