this post was submitted on 18 Sep 2023
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Hello, Canadians of Lemmy! Down in the USA there is a lot of conflicting information regarding the efficacy of y'alls healthcare systems. Without revealing my personal bias, I was hoping for some anecdotes or summaries from those whom actually live there.

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[–] Chobbes@lemmy.world 86 points 1 year ago (4 children)

As a Canadian living in the USA… the efficiency of the US healthcare system in comparison to Canada’s is INCREDIBLY overstated. From my experience it has been no more efficient, but a HELL of a lot more expensive and insanely depressing.

[–] owenfromcanada@lemmy.world 23 points 1 year ago (3 children)

Same. The paperwork alone is enormous, and there's always a lingering dread of "What if my insurance doesn't cover this somehow?"

[–] Chobbes@lemmy.world 12 points 1 year ago (1 children)

It consumes so much time and is so stressful. This healthcare system is an embarrassment and I cannot believe there are people who advocate for this.

[–] Vex_Detrause@lemmy.ca 2 points 1 year ago

Have we mentioned we have 12 month maternity leave?

[–] SeaJ@lemm.ee 2 points 1 year ago (1 children)

What if they use the wrong billing code? What if part of their automation to increase efficiency means being charged for work that was never done? What if they send testing out to a place that is our is network? What is the hospital is in network but the fucking emergency room is not?

Before the ACA you could add: what if I hit my lifetime maximum coverage and what if they consider my condition to be pre-existing?

[–] NABDad@lemmy.world 1 points 1 year ago

What if the insurance just aggressively "makes errors" to delay payment?

[–] teawrecks@sopuli.xyz 3 points 1 year ago (1 children)

I've literally never heard anyone state that the US healthcare system is more efficient than Canada's, let alone overstate it.

[–] SeaJ@lemm.ee 1 points 1 year ago (3 children)

Generally people in the US fear monger about wait times in Canada as if they are awesome here in the US. They might be better here in the US for a lot of things but we also pay 50% more.

[–] NABDad@lemmy.world 2 points 1 year ago

In any case where the wait times aren't extreme in the U.S., you also have to consider the large number of people who don't even have the opportunity to wait.

Wait times are reduced when people can't afford to get on the waiting list.

If they want to fairly compare wait times, they need to include in average the infinite wait times for the people who are left out of the system entirely.

[–] Honytawk@lemmy.zip 1 points 1 year ago (1 children)

The difference is about 50$ to 50 000$, so more like 100 000% more.

[–] SeaJ@lemm.ee 1 points 1 year ago

I was more talking about how what percentage of each country's GDP goes towards healthcare. The US, despite having fewer regulations and supposedly being a more efficient private solution, spends 19% of its GDP on healthcare compared to 12% in Canada. Somehow Republicans are under the delusion that less regulation and more privatization will make it cheaper in the US despite healthcare companies fully admitting that the opposite is true.

[–] MajorHavoc@lemmy.world 1 points 1 year ago (1 children)

Based on the responses in this thread we pay infinity percent more. There's a lot of $0.00 stories here.

Almost like the capital owners are the ones paying...

[–] SeaJ@lemm.ee 1 points 1 year ago (1 children)

I mean the total cost. Yes you do not pay at the time of service but you still pay for it in the form of taxes. Canada spends about 12% of its GDP on healthcare. The US spends about 19%.

[–] MajorHavoc@lemmy.world 2 points 1 year ago (3 children)

I don't particularly pay for it in taxes.

I personally, make substantially less than our highest tax bracket of $578.126.00 per year, and I make plenty.

https://www.nerdwallet.com/article/taxes/federal-income-tax-brackets

I'm not personally worried about the taxes I'm paying for healthcare.

I'm worried about being financially ruined (myself and my children) by a health event.

1 in 4 of U.S. adults carries medical debt. One in four. Those are lousy roulette odds with a loaded barrel to the head. It makes some of us think harder about doing risky activities like driving a car to work. https://www.census.gov/library/stories/2021/04/who-had-medical-debt-in-united-states.html

Personally, I have no sympathy for those making over $578.126.00 per year. Let them pay a lot more, if that's really necessary (it's not, but if it is, let them). Hell, I'll gladly pay more to eliminate the risk of being ruined, if it's really necessary (it's not).

And no, as a relatively well off knowledge worker my private insurance does not eliminate the risks. One head injury could:

  • give me permanent ongoing medical expenses
  • take away both my ability to work (where I get my health insurance that pays my medical expenses
  • drastically lower my chances of winning a lawsuit (or even choosing the right representation) against a ln insurance company that doesn't feel my health merits their expense column.

This isn't a terrible system for rich people with steady jobs. But none of us are rich people with steady jobs 100% of the time.

[–] teawrecks@sopuli.xyz 2 points 1 year ago (1 children)

Their point was addressing the "$0.00" you quoted. If you're in Canada, and you pay taxes, some of your taxes go toward the healthcare that everyone benefits from, even if you didn't have to pay anything out of pocket when receiving services. So even if you indirectly pay $0.01 in healthcare taxes, then it would not come out to "infinity percent more".

[–] MajorHavoc@lemmy.world 1 points 1 year ago

Lol. Fair enough.

[–] SeaJ@lemm.ee 2 points 1 year ago

Preaching to the choir, my friend. I think anyone who prefers the American system is either fucking nuts or they are profiting off of it. The US pays 50% more overall to come out worse in most metrics. And you are correct that the additional costs fall on the working class. My healthcare costs were about 19% of my income when my wife and I were in the top 10% of households incomes. Lower income households spend more than that 19% here in the US. The ones in the top 5% he up spend only a small percentage of their incomes on healthcare costs. That is extremely fucked.

[–] Chobbes@lemmy.world 2 points 1 year ago* (last edited 1 year ago)

This is a huge difference. Plus, even if you do end up paying a similar amount in Canada because you're very well off (boo-hoo), you also don't have to deal with the US insurance companies that cannot even accurately tell you which facilities are in network or whatever. It's just so much simpler and the mental burden of dealing with health care is much less in Canada. You don't have to worry about massive surprise bills or insurance not covering treatment you receive... It's just not an issue.

[–] SeaOtter@lemmy.ca 2 points 1 year ago (1 children)

Also a Canadian living in the US, and I would tend to disagree. In major US cities, with good health insurance, there are plenty of PCPs, and availability of specialists.

For instance, I had a ganglion cyst that I went to see my PCP for. We decided to give it a couple weeks to see if it would go away by itself. It didn’t, so I messaged him, and was scheduled to see an orthopedic surgeon (probably overkill) within 3 days to have it looked at and drained. Total cost: $0 for PCP; $40 co-pay for the specialist.

Meanwhile, my father in Nova Scotia waited close to a year for a knee replacement surgeon consult and is now waiting for surgery slot, which is expected to be another 6-9 months, despite being in significant pain. That just would not happen in the US.

There are many problems for sure, and I don’t have a universal measure for efficiency, but anecdotally, in my experience, there is just way less waiting in many parts of the US. I also acknowledge how privileged I am to have good insurance, resources to not worry about large out of pocket maxes in an emergency, and to live in a city with some of the best hospital networks in the country.

[–] Chobbes@lemmy.world 2 points 1 year ago (1 children)

In my experience the wait times issue has been similar between Canada and the US to see specialists, though admittedly I haven't had to schedule a major surgery in either place. I will admit that there's some really nice facilities in the US and stuff too (and some REALLY not so nice facilities... Canadian facilities were consistently good across the board in my experience), but it's hard to really appreciate them in my experience because it's really shitty to be worrying about the cost of treatment / dealing with insurance and it also sucks to think about how weirdly exclusive it can be and how many people cannot afford it here. Frankly the insurance and cost issues are huge in my opinion and it makes it kind of weird to talk about because it means almost everybody has different experiences with the US health care system, especially when many Americans think it's fine that they spend a fortune on insurance because they've never really known anything different.

[–] SeaOtter@lemmy.ca 3 points 1 year ago

I agree. I think both system have significant flaws, and that is coming from someone for whom the US healthcare system benefits the most (great health insurance, mid-30s, healthy, well-off, very capable of navigating complicated paperwork, and access to some of the best hospitals). I can't imagine being a lower income, lower educated, aging person with chronic health problems, in a rural flyover state with limited community hospitals. Night and day difference.

On the other hand, some 20% of the total population of Nova Scotia is currently active on the waiting list to get a PCP. You don't like your PCP? Too bad. You want to get a second opinion? Too bad. Your PCP retires/moves/closes their practice? Too bad. They have tried to plug the gap with allowing pharmacists to prescribe certain meds, and expanding PA/NPs. This is probably better than the alternative of no doctors, but its probably a net negative on the system as a whole compared to properly staffing with physicians.

Overall, it seems like chronic underfunding, and underpay for doctors has led to situation in Nova Scotia in which preventative care, or really, care for anything non-life threatening, has deteriorated quite meaningfully.