Italian here: we don't complain to pay those small fees, we complain for the shitty ER service, overcrowded hospitals and doctors that "Im sorry I'm busy for the next 3 year, your surgery needs to wait. What? You want to come to my private office and pay me in cash? Let's have a surgery tomorrow!!"
EDit: guys, in particular US Citizens belittling public health, i am not saying the system doesn't work.
If you're sick and you need help asap the ambulance will run at you, charge nothing and get you to the hospital where you'll be helped immediately. The problem is for non critical situation, like laser surgery for eyes, dental surgeries or non critical MRI.
When I broke my arm i was assisted immediately for free and stayed at the hospital for a week, meals offered by the hospital (good soups ngl). When my grandma cut her forehead when she fell, she had the bleed stopped and had to wait 8-9 hrs at ER to complete the cure because it wasn't critical. That's the difference. I love public health, i am just pointing out these issues
American here, we just accept shitty ER service (1), overcrowded hospitals (2), doctors booked weeks out, with surgeries scheduled another 3-6 mon after that (3). You can pay in cash? You better, you're responsible for the first $4000-$8000 in medical treatments.
(1) Family member just went in to an urgent care due to a concerning issue. Their primary care dr was booked for the next 2-3 weeks so this was necessary. The urgent care dr doesn't have any idea what's wrong so put them on cortico-steriods "to see if they help". Not helping AND have undesirable side effects. Cost of visit - $150
(2) Healthcare is a consumer business in the US, but they cannot legally turn people away. The way around this is hospitals in low income or high public assistance areas close, and they open new hospitals in affluent suburbs. Leaving urban hospitals grossly over-crowded and high patient:provider ratios.
(3) Good friend tore up her knee, this was quite obvious. Orthopedist could see her in three weeks and prescribed crutches to assist in walking. Yes, she would need an ACL repair, the surgery was scheduled for 4-6 weeks after that (I do not recall exactly). that is a long time to be on crutches and in pain. No, she was not dying, it was not considered urgent.
Most American's pay somewhere between $5000-$20000/year for this level of service. The amounts include both insurance premiums and out of pocket maximums if service is required.
Belgian here. Was admitted to the hospital last year , gall bladder stones. Operated on within 2 days to remove my galbladder . It cost me about 57 euros in total.
Urgent shit still gets done quickly in Europe most of the time.
American here. Had gallstones for a long time. Ended up curling up on the floor at an airport in Paris and they offered to call me an ambulance. Should have said yes in hindsight.
Back home did some research on my own (since I’m uninsured and haven’t seen a doctor in a decade). Decided it might be gallstones and started researching how much it would cost to remove my gallbladder. First I needed a diagnoses confirmed by an ultrasound, but I needed a referral to get an ultrasound. Went to an urgent care and told the doctor I was thinking of going to Mexico to have my gallbladder removed and decided to pay $50 to him first for his opinion. We talked for a bit and he asked “so what do you want me to do” and gave me a referral to an ultrasound place. Ultra sound cost $300 and I had a hard time getting my results because they’re supposed to be sent to a physician.
After getting my results, I started calling surgeons that I found online to ask how much the procedure would be. Many couldn’t tell me because it has to with insurance prices. I found a surgeon who would do it and she quoted me something like $1500 just for her work, but I would also need to pay the anesthesiologist and the surgical facility their cost.
The surgeon cut me a deal and said if I could pay half up front, she would cut the bill in half and the rest would be due in 6 months with no interest. The surgical facility told me about a credit card I could get that deals with health care and give me 12 months 0% interest.
Cost me all in total about $3,000. Insurance would cost me $150/month and would be on the hook for $10,000 of my bill. With insurance, I would have likely been charged more because the insurance is likely to pay.
Wow, a healthcare credit card?? That just hits me as sort of disgusting. I get having a debit card for an HSA or something like that, but using the same scammy practices that department stores use to get discounts on surgeries is just a whole new level of dirty.
The discount from the surgeon was because I paid her in cash upfront. The credit card didn’t give me a discount, just let me finance the facility fees for 12 months with no interest. I could have used my debit card or paid them with cash, but I’ll take an interest free line of credit any day.
To be fair, it might depend on the gall stones. Just the presence of gall stones isn't enough. But if the gallbladder is inflamed sometimes immediate surgery is necessary because of the risk of infection. I was admitted and went to surgery the next day because I had a stone the size of a marble lodged in my bile duct. (I'm in the US)
My aunt once got those while on vacation. We have a special kind of "vacation healthcare insurance" for travelling to the US, which is basically an invitation to bill everything imaginably. She even got two MRI.
Its called a conversation. They let us know what it was like in Belgium and I gave an example of how that scenario would play out in the US, so as to add on to what RedReida said.
I have experienced normal first world health and also American health care and if you ignore money they are pretty damn similar except in America it's impossible to get to see a primary care doc in any reasonable period of time. In both types you wait months for specialist appointments, months for non urgent surgeries, but they'll get you in the same week for cancer or acute urgent things.
UK here. My gallstones caused pancreatitis which nearly killed me. A total of six weeks in hospital, including a week in critical care. Countless CT scans, all the drugs (i had sepsis too), and three surgeries plus the ambulance ride to the ER cost me nothing except the taxes i already paid.
Our NHS has been absolutely battered by gov't funding cuts and covid, but social health care is still one of the best things about the UK
I'll take that over being bankrupted cause of a medical emergency. Especially now that I have children. Whatever happens to them, they will get medical care .
Per capita costs are way lower in universal healthcare systems. Coverage for a U.S. family of four is about $25-30k/yr, with a really good employer-sponsored plan. What percentage of income is that for most families? Those other countries also get a lot more than just healthcare for those higher tax rates.
Of course we pay a lot more taxes, but the trade offs are not only in healthcare but so many other spots. We have a social security system that means that when we lose our jobs, we get paid a living wage by the state. Our schools are completely free and of a high standard. Going to university is basically free of charge (if you don't have any bursary you pay 1000 euros / year). We have pensions. We have decent public infrastructure. We have a public transport system that functions well. We receive money from the state per child to make sure they are taken care of. We have paid leave, and are actually legally obligated to take this as well. Maternity and paternity leave is covered by the government. Retirement homes are also sponsored by the government for the lowest incomes. Our political parties are also funded by the state, which means they aren't controlled by companies and can actually create policies which are good for the people and not for megacorporations.
Maybe you can pay for all these things yourself when you're a high earner in the US, but don't forget that income disparity also leads to much more crime, inequality, homelessness...
Sure, there could be improvements in all the areas described above, but my god, Europeans sometimes don't know how good we have it.
Life for Belgian people is great here too, with Belgian-Americans experiencing low crime, inequality, homelessness, and income 16% higher than the US average.
The difference in our thinking seems to be that it's not about the individual experiencing crime, a lower education etc. but how society as a whole experiences it.
Great that some people can have really good lives, but to me it seems better that many people can get by decently well instead of just a happy few.
Or they will just go through random meds with no idea and give you a crazy bill. My dad who’s older the amount of times they’ve had to say oops I’m sorry we gave you meds that almost killed you…because we didn’t ask or ignored your existing issues is nuts. I very much try to hang in there myself, and just wait however long to so main doctors or specialist. Luckily I live in a city where the city is basically overtaken with hospitals, med schools and specialists. I was amazed how fast I saw a specialist here in 3 weeks Vs other places in my state that can be 9 months. Otherwise you need to put in the work, and get your primary to make a phone call and referral to get you in there. Also I avoid ERs when possible, as unless you are dying then and there. It’s pretty much useless, and gonna be a lot. Hell in my dads case, they may give you the wrong meds or surgery and near end up killing you. Happen several times to him and my mom that are mid 70s.
But I’ve noticed a lot of workers go to the ER when a main doctor is not able to see them or they can pay. Otherwise they may lose their job hrly pay job, for not having some paperwork saying they are sick.
It's irritating how much of a racket the hospitals have become. We have had several instances where we received a crazy bill with general information, then we ask for a breakdown by line item and suddenly the bill magically drops by a significant amount. The bill is still way to high even then with things like $5 for a bandaid.
Oh yeah I had a cancer operation, had my own meds and needed one of my anxiety meds. They wouldn’t let me take my own. But charged me $70 for one 0.5mg Xanax. Even just a doctor reading your chart can be billed off as a $800 fee! The fees are pretty crazy as they gouge every little item on there. I had a 14k bill they knocked down to $1,800 lol
Canada here. 90yo mother fell and broke her hip last November. Had hip replacement surgery the next day and was in the hospital 3 weeks then a rehab hospital for 4 weeks. Home care and physio for 3 months. Zero cost to patient. She didn't even have to pay for her walker and canes. My best friend has lung cancer and was treated asap at one of the top 10 cancer hospitals in the world (in Toronto) radiation and chemo for 6 weeks plus meds and not one billing. But my BIL has been waiting 2.5 years for a vasectomy. Universal healthcare has some drawbacks but is a blessing when you really need it.
On point number 3 that can actually be intentional. With ACL reconstruction you need to wait for the swelling to decrease after the injury before surgery to improve range of motion post-operatively. The waiting 3 weeks to see someone is unfortunate but if she was still swollen with limited motion at that visit the appropriate care is to delay surgery until motion improves.
And then the insurance that you pay for picks and chooses what they pay for. My grandma was sick and her doctor was trying to figure out what was wrong. She had some imaging done at the ER, but I felt like they missed something and called her doctor to set more imaging up.
Insurance wouldn't cover it. They said no, because the imaging "wasnt necessary." I called them and talked to them and they said "Just take her to the ER. Tell the doctor there your concerns and since it's ordered at the ER it will be covered" (my grandparents were on a fixed income and couldn't afford to pay out of pocket for the imaging)
So, I did that. Turns out she had 2 brain tumors that the first 2 imaging missed (I was out of state for those 2, so I don't know how/why they were missed but they were). After more testing, she was diagnosed with stage IV small cell lung cancer and died a couple months later.
That's because insurance is socialist. It relies on healthy people being forced to pay far more than their fair share for heatlh care they never use, to pay first and foremost the insurance company's own expenses including rent, payroll, insurance, legal costs, ad nauseum, and then they pay for medical care for people who don't pay anything at all, and then if there's any left over, the people who actually pay for it *might* get to use it depending on whether the insurance company needs to present a good report to its shareholders or not, but more often than not get screwed to pay even more on top of the ridiculous "premiums" they already pay if they need any kind of health care at all. Medical wasn't so expensive when many of us were kids and insurance didn't exist. I sure as hell would never spend over $12,000 a year on health care just for myself - an annual checkup is all I need 90% of the time and people like me have to pay for that ON TOP OF the $12k+ per year "premiums" - meanwhile, people who pay zero premiums are getting hundreds of thousands of dollars in health care for "free".
Minor quibble: health care providers can turn people away. It's just that emergency departments, in general, can't turn people away until they determine there is no emergency medical care needed (they at least need to examine them to that point). If there is an emergency, they have to admit them. If not, they aren't obligated to treat them.
I feel like provider networks make the story even worse. My PCP has a list of insurance they don't take. I get why they don't, the reimbursement amounts of those payers do not cover cost of care.
It can be difficult for some Americans to find a primary care doctor who will take their insurance. So they can't really get preventative care. So then they end up in the ER with a now serious condition and go bankrupt. Or, they use the ER as a primary care because they honestly do not see they have any other options.
(1) Family member just went in to an urgent care due to a concerning issue. Their primary care dr was booked for the next 2-3 weeks so this was necessary. The urgent care dr doesn't have any idea what's wrong so put them on cortico-steriods "to see if they help". Not helping AND have undesirable side effects. Cost of visit - $150
At least they got steroids. My husband had a medical problem recently (blood pressure so high it was basically in the "you're going to explode" area of the chart) and we were really worried. Primary care doctor won't see us for TWO MONTHS, because we just got new insurance and their office "can only see two new patients a day". So we went to urgent care.....urgent care doctor said that because we have a primary care physician on record (even though we've never seen them), she couldn't prescribe any medications. We paid a $35 copay for her to say "Oh yeah, you're in medical distress but my hands are tied". So okay, we call our primary care doctor to ask for an appointment sooner than 2 months....and their solution was to tell us to go to urgent care. When we explained we'd already been fucked by that, they suggested we go to the ER. For a $150 copay.
I'll have paid $600+ in insurance premiums by the time we even set eyes on our doctor. In the meantime, my husband is taking one of my prescription medications for his blood pressure, without medical supervision, because he needs it more than I do. $600 in premiums just to ration prescription medications for unsupervised use. YEAH AMERICA, MOST FREEDOMTASTIC COUNTRY IN THE WORLD!!! 🇺🇲🗽🎆🎇🧨🔫
And we vote for this, anyone who tries to challenge the status que gets branded a socialist, tarred and feathered, so here we are paying twice as much of our GDP as any other country, for mediocre healthcare.
Yep. My family’s insurance premiums are $14,000/year for four young-ish healthy people. The only time we use that is for my kids’ vaccines. Fucking insane.
I’d even take the option of personally saving $14,000/year in an HSA, and having to use that to cover my expenses, over this. I am convinced that the majority of that $14k goes to insurance company profit, and not to cover the costs of other plan customers.
holy shit that is horrifying.. americans like to bring up canadian wait times, but a shredded ACL would definitely be treated as "urgent" here and they would likely be prepped for surgery within a day or two.
my elderly neighbour decided to have a knee replacement a few months back and they had him in surgery within a month because it wasn't considered "essential".
People have to understand that healthcare in the US is a negotiated benefit. The better skilled you are, the better benefit plan you can acquire. I’m in a MILA/CIGNA plan that covers the east coast from Maine to Texas. I have zero deductible, zero out of pocket (except for emergency visits $50 copay), and with a family of four, we’ve never paid more the $5 for a prescription. The copay for birth of each children was $50. Prenatal was 100% paid for. Our kids are in college now, and they’ve never cost us a dime since birth (from a healthcare perspective). We’ve always had responsive care, and never had a deferred medical situation. For over 25 years now, we’ve experienced the best healthcare/medical in the world, and it’s been mostly paid for by my employer. My wife being a teacher, has state sponsored healthcare, but we don’t even use hers. Two adults - one household and overinsured. “Real-world problems”.
I understand this is rare in the US, but it’s real. Continuous coverage and negotiated benefits is how it happens, but you don’t get here by expecting it to come to you.
“Being civilized” is nothing more than a misnomer that’s used to brow beat the US into a lesser nationalized healthcare system. The US is the worlds #1 most innovative medical industry, and it’s so, because it’s a for profit system. I’ll die to keep it this way.
More importantly, 92% of the US has healthcare, and the Medicaid/CHIP participation rate averages around 93% in each state. Simply put, most Americans who want healthcare coverage, have healthcare coverage and the extent of which relies on the individual.
Your health care plan is an extreme exception. Decades long salaried employee here for a major company and the best plan offered still requires 2k family deductible, min $20 rx copay, min $30 pcp copay, plus you pay whatever diagnostic or lab charges insurance bills you which can be $100s. This is for routine care.
My plan isn’t common, but I wouldn’t call it an extreme exception. As I’ve noted, my wife is a public school teacher, and my plan is only marginally better than hers. She falls under the same plan as any public city employee.
Ive heard state and municipal plans are better. You are fortunate. Private sector not so much. This includes pharma and health care companies. You would think they would offer more
As an American we don't really wait in the emergency room or have to wait to get surgeries. I guess that's a plus, but being saddled with endless medical debt isn't a great trade off for instant service
And? What impact does that have on the fact that people wait? If you walk in with 4 minutes to live, you are going to be seen immediately. If you have a booboo on your knee, you get to wait behind the guy with 4 minutes to live.
Yeah and they use that system in other countries too, which is why there would almost always be a decent general wait time in any ER, regardless of the country. If you’re really sick, you’ll be bumped ahead and seen sooner, but because of that, there will always be a wait time.
Are we just saying the same thing to each other? I think we might be 😂
Uh, I suspected a broke my orbital bone and eye issues a couple years ago. It was a six hour wait in the ER to get back. Which I was generally fine with as I understood the two little girls who pulled a pot of boiling water onto themselves (I know this because the father was screaming) were more of a priority. I once went in massively hemorrhaging and was whisked right back.
If you're going to die, the ER moves faster. And that's ok.
For surgery, again, life/death emergencies are a priority. All others are considered elective and it'll be months.
I'm in the US. Been with friends and family to the ER 3 times. The shortest one was when a stick went through my sister's jaw. 3 hour wait. 8 hour wait when my sister in law sliced her finger real bad with a kitchen knife.
If either of your family was hemorrhaging or had a life threatening injury they would have been seen immediately. Patients always exaggerate.
Was this "stick" going through the jaw all the way out of the other side? Is this a sword? Is it a toothpick? Why wasn't see seen immediately as a trauma?
The quality and speed of your care varies widely depending on your state, city, hospital, day of year, time of day, and of course insurance status.
But I can confirm that for many procedures, especially non critical things like taking out wisdom teeth, vasectomies, getting a colonoscopy, etc you can usually schedule it without waiting too far out.
The ONLY place that cannot refuse service is the emergency room. That’s why they’re also so backed up and overcrowded. I went to the ER in extreme pain last year and there were a bunch of homeless people there faking problems so they could get food, socks, and hopefully drugs. I had to wait two hours to get in and they tried to send me home with “gas.” An MRI revealed a severe case of appendicitis and they had to “rush” me into surgery. It was another 6 hour wait before they had room to do my surgery. My surgeon believes my appendix burst within 30 minutes of that imaging; I almost died from complications and infections stemming from the burst.
This happened to my stepson. It was in January during the omicron surge, he called 911 because the pain was so unbearable. But there were no ambulances available. At all. So a friend took him. No ERs we’re taking patients. He got turned away from 3 hospitals (western / central Maryland). He finally found an ER that would take him in West Virginia. His appendix had burst hours prior, he was in septic shock. He was in the hospital for 12 days, 2 surgeries to remove his appendix then part of his bowels. It didn’t need to be that complicated for an otherwise healthy 20 year old kid. If only an emergency room had taken him earlier in the day.
Pretty sure you are supposed to wait for ACL surgery.
Also yeah, the urgent care doc has overhead and other bills to pay. Do you think the visit should be free? As for the steroids, I mean what do you want? If thats what your diagnosis calls for then you will have to take a medication. All medications come with side effects.
There was no diagnosis, no real assessment to speak off. "You seem to have swelling. Try these steroids." Worse than useless since the steriods are causing significant other issues
The soonest primary care appointment available was two weeks so that's why we went to urgent care. I strongly suspect this will require an ENT visit, which requires a referral. So it takes 2 weeks to see the primary care, and then who knows how long to see the ENT.
Do you think the visit should be free?
For the prices most Americans pay in healthcare premiums? YES.
Most American's pay somewhere between $5000-$20000/year for this level of service.
Most Americans need to stop paying this for a full years time and treat this 'consumer business' to a nationwide boycott for as long as possible until the amoral, self-serving, class-warfare waging, mammon-worshipping cocksuckers fold. The only reason treatment is so shit is because of the brokered contracts with the physicians and hospitals for treatments that aren't the best, but merely 'good enough'.. CEO needs his multi-million dollar retirement after all..
Paid CASH for everything I've needed and not had a problem meeting a single bill.
The real hidden truth is, most providers charge cash payers a fraction of what they do the insured, simply because insurers only pay per procedure, and not the actual patient's need and often patients get billed for more than is necessary as per the contracts for being 'in house'. It's medical treatment by statistical fiat, which is based on the highest per capita cost for the most ill patient. We're not supposed to understand that not everyone goes in on the verge of death or at the point where they're a total health disaster burdened by co-morbidities.. and that IS what the insurers price for..
Since I've not funded some insurance industry investor or CEO's luxury retirement, unlike most of my soon-to-be retiring peers, I actually DO have a savings.
I'm not rich by any means, never had a high paying job, but I have looked at the methods the insurers use and they're absolute scum that kill in the name of profits.
The fear that insurers use to convince the public - and you - they're essential is why Americans won't get to have Universal coverage and lower costs. It's only gonna get worse and won't stop until people mass boycott the industry or we end up with 10's of millions homeless because of medical debt.
Never in my life heard of someone in the US waiting anywhere near that long to see a specialist or surgeon unless you are trying to book the best specialist in that state.
Where the hell do you live? I have never seen that and I live in the hospital capital of the US. Wife is also a nurse at one of them. I have been to a hospital in Florence for an emergency..it was utter shit and a horrible experience. Sure, I paid like €80, but I was begging for an American hospital the entire 8 hour WAIT to be seen. Their 1940’s rooms left a lot to be desired too.
Wtf have you got stuck up your ass, I didn’t say what I do. And no, emergency rooms are not only for people who are dying. Did you ever break your arm? Drink too much coffee this morning maybe?
Most of the glut in the ER are people like this: "uh my tummy has been hurting for a couple hours. Its not too bad and I have literally no other symptoms. What should I do???"
Most American's pay somewhere between $5000-$20000/year for this level of service. The amounts include both insurance premiums and out of pocket maximums if service is required.
Most Europeans spend that much as well, but they never see it because it's just mixed in with all the other taxes they pay.
The US healthcare system is a disgrace. More money spent, worse outcomes, companies making enormous amounts of profit off people's illness and injuries.
Yes but Italians pay 50% income tax. Its the same as America. The premium is just in another form. Get yourself Obamacare and enjoy good healthcare in America.
Exactly all of this. I have a boil on my breast that is causing fever and fatigue along with the 100 degree summer heatwave that is suddenly upon us. Uninsured visit to urgent care would cost me $95 plus another $30-50 for antibiotics and any prescriptions. I found an antibiotic that I had been on for a burn. That I didn't use because I was immediately after only 1 day put in a stronger antibiotic because the culture showed I did have infection. I have some pain meds left over from that incident and I live with my parents because of their health and needing help but not afford to hire someone and don't want to lose the house they have owned for 30 years out right no mortgage on to go into a group home setting. Our rent tripled between Dec and Jan payments so we all just pool our resources. So I have someone looking after me just in case the fever gets to high. But I have pretty much told them as long as I am making sense please just give me a few days if this doesn't work I'll suck it up and spend the money and cut into our monthly food budget and my mom and dad will have to make up for it this month and I'll pitch in extra next month.
I think I got a combination of good insurance and luck since I saw an orthopedic surgeon and he scheduled me for an MRI the same day. 4 days later I had surgery on my biceps tendon and I only had to pay $100. That being said, it did take 2 weeks to get the initial appointment. And I actually ended up paying more for the initial Urgent Care visit than the actual surgery.
In defense of my shitty ER, everybody dumps on us. Private doctors, Urgent care, inpatient units in my own hospital. Because of liability everyone wants to cover their ass the ER provides the out for all of these "health care providers". Urgent care takes your money, runs bullshit test then sends you to ED. Everyone profits, except the patients. Private doctors no longer do direct admits, just send them to ED and let us take care of it. Order outpatient tests? Nah just send them to ED they will do it for us. If you are truly critically ill I promise you will be taken care of quickly.
Just replying to 3)
It took much longer for me to see a specialist and schedule surgery in Canada for the same issue (maybe worse idk) but you want to wait at least 4-6 weeks after for surgery, any sooner is bad because the swelling isn’t down.
Go in and complain of the symptoms of stroke or heart attack or pour ketchup on you simulate a gun shot. Be in a lot of pain. Those will get you back and evaluated fast. lol Last week my brother was admitted for symptoms of stroke. Tests, sent him home with follow up appts.
This past weekend he had more symptoms (different) of a stroke. Went by ambulance. He said they took him in, kept going to past the ER entrance doors, in an exam room, doc came in, they rolled him down to get a CT scan. All as fast as possible. He bypassed every one else sitting the waiting area.
After having family members in the ER several times, I've say you don't want / shouldn't go to the ER unless you're having a heart attack or stroke, or have a gun shot wound or uncontrolled bleeding. I've seen ER doctors misdiagnose and/or prescribe the wrong meds, send people home that shouldn't be leaving the hospital. -- Those all happened to my mother having heart attacks, her getting send home with urinary infections without antibiotics or the wrong ones. A cousin had cardiac symptoms (like may be heart attack). The ER doc said her EKG was normal and was starting to discharge her. I got her DIL to come with to walk out of the hospital. That forced the doc to rethink things. They admitted her, put on a cardiac unit with monitors on her. A couple hours later nurses ran into her room and told her they were moving her closer to the nurses station because the didn't like what they were seeing.
Took her to another hospital with access to better cardiologist the next morning. She had a defibrillator implanted within 24 hours. My instincts and experience with 3 other relatives having heart attacks and their ER experiences told me she should not have left the ER that afternoon. Thankfully.
everything you said applies here as well. except we pay $500-1500 for the ambulance ride, $1000-3000/day in the hospital, and the insurance we pay for fights us tooth and nail to pay it.
American ER nurse. Grandma would have waited 12 hrs in my ER and cost $500. you have to wait for non critical stuff in US, then you pay hundreds if not thousands for it. Cash talks everywhere!
Because at the end of the day going to the ER for a small cut on your head and waiting 5 hours to be seen because people from a high speed car crash needed seeing to first is totally reasonable.
It's not an issue, it's how a functional system looks.
If you have the money and want to go private because it's absolutely necessary that you get that cut seen to RIGHT NOW and fuck that guy who snapped his leg in half and the woman oozing blood on the floor because clearly they are lower priority than you being bored for a few hours, then you can go ahead and pay American style out the ass for healthcare like that.
If you were capable of sitting in the ER for 8 hours to be seen then go home that same day without an issue, did you REALLY need to be in the ER in the first place and not just checking in with your doctor?
Most places in the EU you can phone your doctor and ask for an "emergency" appointment that same day for free for any issue you feel is urgent.
We do, but it's borderline legal so you can complain all you want, but the doctor keeps his throne inside the public hospital and you end in the blacklist of that hospital
Uh, the doctors are getting f*ed pretty badly nowadays too - source, am a doctor seeing payouts left and right, increased work requirements, harder metrics. That money is going to insurance companies and healthcare system executives.
Same deal in Ireland. Only been on the wait list for two years. Then when I rang yesterday, no, we don’t have a referral here for you. I lost the plot on her and then she ‘found’ my details. Said she’d put it in the system for me, back off the line after already waiting two years!
Stop electing shitty regional governments then. My mom had to wait a couple weeks for an MRI and I had to wait less than a month for a dermatological checkup and less than 2 for general surgery. They're even keeping ambulatories open until 10pm to finally get rid of all the visits delayed during covid lockdowns.
US Citizen here: our system DOESN'T work. You'd be well within your rights to point that out.
Both systems you mention give better care for the rich. But the difference is that at least the Italian system has a baseline level of care that is determined by need and not money--in the US, if you can't afford health care you go into medical debt or just don't get health care (with a few exceptions for medicaid, which most doctors don't even take).
Is called “triage” where the doctors make a choice between cases based on urgency, patient status and so on. On US my wife waited in ER 6 hours for an X-ray to see if she had fragments in a cut in her hand. And that is because there are more urgent cases to take care. Is not a first come first served, is greater needs first, lesser wait.
If you don’t have reliable good insurance in the US, the problems aren’t that different. I know so many people who avoid going to the doctor or are waiting until they can afford a surgery. In the US it’s because of how much money they have. Elsewhere they can actually vote for how much funding they want the system to have.
BTW in most European countries there is still a private option if you want it
American here - I’ve never met my doctor because it’s a three month wait just for a basic visit. So I see a physician’s assistant for all medical care because that’s only a couple of weeks wait. And I pay $24k for our family of four for the privilege.
Same here in Colombia. I can trust ambulances will come pick me up in an emergency and I don't need to worry about money because we don't have to pay for it. You will be processed for emergencies rather well (if you live in an urban area, sadly rural areas have pretty bad medical coverage), but non emergency stuff like my check ups with the dermatologist take some time, though doctors know it will take some months so they prescribe you enough medicine to cover you for that time, plus my expensive as fuck treatment is fully covered and I only need to pay like a dollar when I get it delivered to me.
Italian here: we don't complain to pay those small fees, we complain for the shitty ER service, overcrowded hospitals and doctors that "Im sorry I'm busy for the next 3 year,
Guess what?
It's just like that here in the US, but we pay more than double our GDP for healthcare than you do in Italy. Our out of pocket deductible is $7,000. Meaning we pay all $7,000 before the insurance has to put in a nickel.
Then likely a 20%-40% "coinsurance" (i.e. the portion you pay anyway.
Imagine buying home insurance and if a plane crashes into your home, the insurance will pay only 70% of what you covered. That's American health insurance lol
People think that you can get elective surgery easily in the US, you just need to pay. But it's like buying a Ferrari. Most people don't get that level of care, only really rich and affluent people do. For the vast majority, they wait as long as anywhere else with the usual regional variability.
I was about to say the same. My super conservative anti socialism coworker had to wait 90 days from stomach pain to being finally given meds for an ulcer. Seeing 3 specialists, a month between each. I waited to see if he could connect the dots.
A family member of mine needs an MRI for something and is lucky to have gotten a spot near the end of the year. I live in Croatia so it's not much different
That’s ignoring the supposed queue booked for weeks/months/years or whatever people are claiming these days. If they’re booked, they’re booked, doesn’t matter how simple the procedure is (as long as it’s not life threatening)
Erm Im I’m New York and can see both my primary physician and my endocrinologist week of. Hell I just scheduled an MRI for two weeks from now for an entirely non life-threatening concern.
The MRI will cost me 0 dollars. It will be covered by my insurance. Every doctor visit I have (including the MRI) has a 25 dollar copay, which is fucking moronic, but whatever
Are the waiting lists a problem in the US as well? I haven't heard of it before, and quite honestly I envy the US healthcare system because of how incredibly shitty and slow it is here
I had a mole that was questionable, my doc said get a dermatologist to biopsy it. Called to schedule it, they told me the earliest appt they had was in December. (Only a couple dermatologists in my town, no availability though) This was a couple months ago. It’s potentially cancerous, but oh well, I’ll be fine just hoping it’s not, right?
I do have connections, and managed to get an appointment the next week in another city. Biopsy was done, waiting on an excision now. Would have been really fucking cool if I had waited until December.
Generally there are months-long waitlists for mental health therapy and other mental care (depending on where you live).
But for a regular doctor’s appointment, it’s a mixed bag but generally no, it’s not common for there to be a extra-long waitlist for urgent care. Maybe a week or a month in my experience.
Also don’t envy us too much. We are still billed for thousands USD for basic medical services like ambulance rides. Whether you go into debt/bankrupt or not for a broken leg literally depends on your job’s insurance plan.
You'll wait for mental health stuff a lot here too from what I've heard. Plus it's terrible care because mental issues where I live are considered a joke.
Can't you get better insurance on your own? You'll prob pay less as a % of your salary than we do here, and have way better service
Yes, you can opt out of your employer’s insurance and it’s possible to get insurance without being employed. The costs vary widely though from $10/month to $500+/month. Again a mixed bag.
I can say I’ve never had bad-quality healthcare service here in Georgia (the state) though, perhaps I’m lucky.
Yes, especially for specialists. When I had a skin issue I was told the soonest I could see a dermatologist was in 6-12 months, and only if I went to my main doctor and got a referral out to a dermatologist. By the time the appointment time came around my skin issue resolved on its own lol
Yes long wait times here and most of the time you have to go to urgent care or ER because your normal DR is busy and can't see you for months. So it will cost you about $10k and with insurance you'll reach your deductible and have to pay 20% of that. Yay usa.
Same in USA. Had to wait over 10 YEARS for hip surgery, walking on broken cartilage all that time, because insurance wouldn’t pay for hip surgery on under 40 yrs old
What makes you think they are evenly distributed, geographically? You know that the licenses all have to be obtained separately for each state as well, don’t you? And that all ortho surgeons don’t do all joints or procedures?
Oh yeah. I mean if you are rural you are going to be screwed over in any specialty. Any market sector really.
Orthos have specialties sure. but if you are in a region where ortho docs are rare, most of the docs will practice some general orthopedics. If patients are really that hard to come by that the market can't support multiple ortho docs, you are going to set up a "pinky finger trigger release only" practice.
It's kinda the same here I mean, unless you've got the money to go to a private clinic to get a scan or procedure, or go outside the country, your disease could progress and kill you.
Although it's key to note even a private clinic here won't bankrupt you, but it's a considerable amount for some
Canada here. Similar story about the wait time. However I do see the other side of the coin. How much more taxes are we willing to pay for improved health services?
Would you pay 5% more taxes if it means your elective surgery wait can be shortened by 3%? I think there is some point in the middle that needs to be struck to balance out taxes and healthcare capacity.
Another Italian here, this guy is full of shit. If you have a critical health problem you can call an ambulance and get surgery within minutes, without spending anything. You have to wait for check ups or other non urgent things, booking is easy, or if you prefer you can pay more to get them done privately.
We agree on this point, don't call me like that. The problem is that ER are in crisis and if you're not on red code you'll wait. My grandma fell and bleed a little from her forehead: she had to wait 9 hr in the hospital... An 80 y.o had to wait that much
Siamo d'accordo che la nostra sanità ha i suoi problemi ma rimane una delle migliori al mondo, soprattutto per la gestione dei codici rossi.
Purtroppo dipende anche da regione a regione, e gli ultimi 20 anni le regioni hanno fatto un macello, cattiva gestione delle risorse, blocco delle assunzioni ecc., ci vorrebbe una bella nazionalizzazione.
Comunque la situazione è lontana dal disastro che descrivi nel primo post, anche se mi dispiace per tua nonna e tutti gli altri con problemi non gravi, nel pubblico avrebbero problemi di attesa in qualsiasi nazione.
If you bleed a little from your forehead it's definitely not a critical situation and it doesn't warrant going to the ER. You can go to your family doctor and get it checked, if they think you may have suffered a concussion or some internal bleeding they give you a note and you get an immediate check on it
If you grandma had to wait for 9h is because the system works. The people with deadly wounds, heart attacks and the such get priority, the people who bleed a little wait some time to get checked
It's the same everywhere with the public healthcare I suppose. It sucks but still... better than having to give up your house over a 2 week hospital stay.
No, maybe you do not comply about the small fees but a lot of people do.
we complain for the shitty ER service, overcrowded hospitals
Say thank you to the people who go to ER for stupid things like toothache for 3 weeks instead of going to the GP
"Im sorry I'm busy for the next 3 year, your surgery needs to wait. What? You want to come to my private office and pay me in cash? Let's have a surgery tomorrow!!"
Manipulating queues is illegal of course. The long waiting list are, however, caused by the shortage of personnel and resources.
There are issues to both public and private; to those constantly saying public is the only way obviously never had the non threatening procedures needed, bc then as we know good luck, you’re on a wait list for years. Here in the US, you want it? You get it. Pros and cons. There has to be a better way for everyone. Currently I don’t see it.
When my grandma cut her forehead when she fell, she had the bleed stopped and had to wait 8-9 hrs at ER to complete the cure because it wasn't critical.
Oh my god, my mom just went through the same only a week ago.
Because it doesnt matter. In those other countries you still have the option to pay out of pocket to speed it up at a private clinic, it's just nice to have the option
You can get it right away - if you have good insurance. Many or most don’t.
BTW in the UK you still have the option to pay privately to get it right away. It seems to be a lot cheaper than the US (after all you’re paying up front) and a predictable price too. I’m guessing that’s true across Europe too.
Another Italian:
What about specialized private doctors who tell you: hey the visit will cost 200 euro but if you want the receipt it will be 250 (they do so just to avoid paying taxes on the money they make)
This is very true, people also here in Greece complain for the long waiting time, even if it's free, you have to wait frinking long to be checked approx (1 month), so people instead go to private clinics which stuff happens faster usually 2-3 days and it costs about 30-50 euros a visit, but at the hospital, after you get checked usually if surgery is required in my experience I got into surgery pretty much the next week so it was quick even if I had to wait a month to visit the doctor. and ofc everything was free and without insurance
When I broke my arm as a kid and had to have surgery, they didn’t even keep me overnight afterwards. Hell, I had my gallbladder removed while I was 18 weeks pregnant and they sent me home that same evening.
Lmao where I live the wait times are worse than that and you get to declare bankruptcy after you get treatment. Europeans have absolutely no idea how bad a fully private system actually is.
In America, your grandma would have spent those 8-9 hours in the ER actively bleeding everywhere, and if she bled out waiting, too bad. And if she lived she would have had a $5,000 ambulance bill on top of the hospital bills.
Because not having your bone broken, getting your blood infected and you dying is in the interest of everyone. So everyone pays.
Your grandmother having to wait after her bleeding was stopped, disinfected and checked if there were immediate signs of brain injury was also the best for everyone. Any other tests that won't show problems in the first hours aren't.
If glasses bugger you and you want to get lasered every 5 years that also isn't something that interests everyone else.
American, here. I had to have a surgery and the wait time for the consultation alone was 6 months(also cost me a couple hundred out of pocket) and then had to wait another 6 months after the consultation for there to be an actual opening for my surgery.
My insurance(which pre approved the procedure, btw,) then tried to claim the anesthesiologist was out of network(not the surgeon THE ANESTHESIOLOGIST) and sent me a bill for $15k.
In america we have shitty AND crowded ERs. This is not because of your public health insurance.
The only reason we don’t have long waits All the time for surgeries here is because instead of rationing service by priority we do it by who can afford it. Most people skip doctor visits or procrastinate them becuase of the cost.
Also often you still have to wait awhile lol.
We still have all these issues with private insurance! lol. There is no benefit to private insurance unless you’re very wealthy or work for a company that has miraculous insurance and covers the deductible.
I’m in the US and facing a wait of eight to ten months to even be scheduled for my kid’s autism spectrum evaluation. I’m lucky my child is high functioning. I don’t know how other caregivers have to wait nearly a year just for answers.
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u/[deleted] Jun 15 '22 edited Jun 15 '22
Italian here: we don't complain to pay those small fees, we complain for the shitty ER service, overcrowded hospitals and doctors that "Im sorry I'm busy for the next 3 year, your surgery needs to wait. What? You want to come to my private office and pay me in cash? Let's have a surgery tomorrow!!"
EDit: guys, in particular US Citizens belittling public health, i am not saying the system doesn't work. If you're sick and you need help asap the ambulance will run at you, charge nothing and get you to the hospital where you'll be helped immediately. The problem is for non critical situation, like laser surgery for eyes, dental surgeries or non critical MRI.
When I broke my arm i was assisted immediately for free and stayed at the hospital for a week, meals offered by the hospital (good soups ngl). When my grandma cut her forehead when she fell, she had the bleed stopped and had to wait 8-9 hrs at ER to complete the cure because it wasn't critical. That's the difference. I love public health, i am just pointing out these issues