State of our health care system

[Patrick NC]

A few years ago I was diagnosed with Diverticulitis.  Most of the time I don't have any symptoms,  but yesterday I had a pretty bad flare-up. So I called my doctors office and was told they couldn't get me in until June 15th. Went to an urgent care and they were all booked up and don't take walk ins. Got up early this morning to make an appointment online with urgent care and the earliest I can get in is 5:30 this evening.  It's almost like they are trying to force me to go to the emergency room. Last time I had to visit the emergency room I spent 10 hours in the waiting room and it cost $500 with my insurance.  So I guess I'll do my waiting at home and spend $75 at urgent care.  

[Old saw fixer]

It is a sad state of affairs for sure, just be glad we are better off than our neighbors to the North and their socialized health care.  A lot of us are old enough to remember when the family doctor would do house calls if needed.

[Andries]

My Dad, a family doctor, would ask me to keep him company in the car as he did several house calls per evening. He never raised an objection when our health system went National.
The Press would have you believe a lot of nonsense, and lead you to believe it’s all about politics, which it’s not. 
The thorniest issue is triage. For example, is it heartburn or an imminent heart attack? Tricky.
This Canadian is very glad that his younger brother didn’t have to declare bankruptcy when he was diagnosed with cancer eighteen years ago. 

[Hilltop366]

Well it isn't perfect for sure up here, as far as delays it sounds similar. My daughter ended up at the ER for a bladder infection because she has no family doctor and appeared to time it right and was out in 3 hours, 6-8 hours would be more normal but the pandemic has really shown the weak spots and it seems that there is real progress on improving services going on and in the future.

As far as the "socialized" part it is not much different than there in that everybody pays here too. It is through a portion of your taxes (Sales, property and income) but because it is tied to taxes it is automatically tied to your income (and credit too I suppose if you borrow to buy) so everyone is covered and no need to go broke for health care. Medication (outside of the hospital)  is not covered yet but there is also private insurance and some provinces also offer some insurance that will pay most of cost of most medications. A real up side is that our cost per capita for health care is about ½ the cost compared to the USA.

Hope you are feeling better soon Patrick.

[Iwawoodwork]

A lot of U.S. folk's  are severely misinformed about the Canadian healthcare system unfortunately believing the misinformation provided mostly by the current U.S. private health care system whose CEOs are afraid of losing their cushy multimillion $$$$$ positions/business.
My administrative assistant was from Toronto Canada area and when her parents got cancer, they were well taken care of. She stated that if that had been here in the states they would have been bankrupt.

[Ianab]

A lot of U.S. folk's  are severely misinformed about the Canadian healthcare system unfortunately believing the misinformation provided mostly by the current U.S. private health care system whose CEOs are afraid of losing their cushy multimillion $$$$$ positions/business.

It would seem so. Universal health care is basically health insurance that covers everyone, no matter what job or income they have. The problems are still similar, sometimes having to wait for non-urgent appointments or walk-in care, just that you don't have to worry about a $500 bill (or more) for what should be a $75 consult. 

[Tom K]

A lot of people also don't understand how most heath care works in the US either. My heath care insurance has always had a maximum out of pocket amount, which it typically around $5k. Anything over that and the insurance company pays it all.

My nephew spend about a month in the hospital back when he was in his late teens. He had no insurance and he did not get a bill, the hospital write it all off. My other nephew has a daughter that spent a couple weeks in the hospital before she was 2 months old. He had insurance and even at 20 years old it sure didn't bankrupt him. I know quite a few people that have had some major medical issues and not one of them has had to file for bankruptcy because of them. I'm sure it might happen, but its rare.

The biggest factors in our rising heath care cost are lawsuits and government regulations. The "Affordable Care Act" is costing all Americans more for heath care. 

Take a look at you local hospital and see if they are a for-profit, or not for profit hospital. Most of the smaller ones in my area are Not for profit, while the bigger chains are for profit. For profit organizations can be driven by investors to maximize profit. Not for profit hospitals invest any "extra" back into the community either by funding community projects or writing down patient bills.

In Patrick's case I'm willing to bet his delay boils down to a staffing shortage. COVID has burnt out a lot of people in heath care, and pushed more away with the mandated vaccination requirements. We are just starting to see the whiplash affect taking place. On top of that, a lot of hospitals are bleeding money right now and are operating with massive losses. Neither of those usually lead to quick, quality care. There's a fine line between having enough employees to handle the expected patient load vs being overstaffed and underutilized.

I should probably use a disclaimer. My wife is upper management at a hospital, so I may have a little more background on how our system works.

[doctorb]

“The biggest factors in our rising heath care cost are lawsuits and government regulations. The "Affordable Care Act" is costing all Americans more for heath care.”


While it is a common opinion that malpractice litigation “significantly” increases to cost of US healthcare, it is a difficult figure to ascertain.  Litigation costs are more than just the mega-judgements you read about in malpractice cases.  It’s also what docs do to try and prevent malpractice.  The cost of borderline indicated tests and studies is very hard to measure.  Does a doc order everything under the sun to “go all out” to make or confirm a diagnosis (as insurance pays most of those costs), or do docs order just the basic tests, risking missing something and being sued?  And the costs of exactly the same tests are variable when comparing different areas of the US, as well as comparing the US to other countries.  Profit, profit, profit!  Most studies place the medicolegal portion of increased medical costs around 10%.  Here’s a recent one:

https://pubmed.ncbi.nlm.nih.gov/15500024/

Advancing technology is expensive, as is its marketing.  Administrative costs have skyrocketed in medicine.  There are tons of factors weighing on our health care costs.  Obamacare has increased medical costs in the sense that millions of people now have health care who didn’t before. In the US, we have a system where patients can request all the healthcare that they desire, and doctors can order all the healthcare they wish to provide.  Is it any wonder our healthcare costs are ridiculous?  While the Canada system is held up by some as an example of how NOT to provide healthcare, their system is an attempt at curtailing these two out of control factors.

While some patients have no healthcare coverage and still receive care, many are saddled with bills, bankruptcy, or legal judgements that are oppressive for decades.  We all agree we could do better.  I’m sure we are all tired of seeing drugs advertised on TV!  It’s a complex issue, which makes it quite hard to quantify….and solve.

[RetiredTech]

  I don't know the solution, but I do know there's a problem. I live in a small community where I can still walk into the doctor's clinic and be seen even without an appointment. However, the closest hospital to us no longer has a doctor in the emergency room. They use a telemed type service to connect you to a doctor over hundred miles away. When I have to see a specialist in a larger city there's almost always a long wait usually accompanied by inconsiderate staff and doctors in such a rush you feel more like a side of beef in a coral than a person. Finding a specialist that takes time to help you understand what's going on is like finding a diamond laying in the street. I know my friendly little clinic is on it's way out, but I hate to see it go. It's just another example of the state of our nation (USA) as a whole. I don't see it getting any better any time soon. We've lost sight of our roots.:'(

[nativewolf]

As someone that knows something about legal discovery and lawsuits I think you'd be surprised to find out how little that really matters.   The USA spends more on healthcare as a percent of our economy than any nation on earth and we have a very low lifespan expectancy compared to most developed countries.  Take Canada, the average newborn should live 4 years longer than an American and it is getting worse.   So we pay much more for healthcare and we live a shorter amount of time and it is getting worse in both directions...our costs have skyrocketed over the last 4 decades and our lifespans haven't.  That's happened against ALL other developed countries having universal healthcare.  In the USA we have a bastardized system where govt pays for 50% of all healthcare spending but gets none of the credit..and it shows in our nations health and our costs.  

It is mirrored in the state of our citizens.  Look at a picture of a football game tailgate in 1950s.  People are fit and trim pretty much.  Today if you look at the same picture obesity reigns.  Gross obesity which used to be very rare is quite frequent today.  The costs to keep such a person alive today is huge and the govt is paying directly for 50% of the healthcare spending in the USA but by DESIGN is prevented by congress from using that spending power to negotiate.  Congress keeps our government from being efficient buyers.  It's quite horrible and transcends any  liberal/conservative or left/right label.   Republican and Democratic congresses have allowed this.  This is our congress and we elected them and every year it gets worse.  

What to do?  First, America needs to lose billions of pounds of fat and stop eating so much.  Just this one simple thing would do wonders.  Secondly we need to let the free market lose on the healthcare system and actually allow buyers to negotiate just as any company would.   The second recommendation would be hotly resisted because the logical buying decision in many healthcare situations would be to buy the pharmaceutical from Germany or Japan or Canada instead of the USA, to demand discounts...deep discounts on services, etc etc.