Where are the shorter waits?! I called for a primary care appointment in July and only appointment was November or January the next year. FOR A 15-30 MINUTE APPOINTMENT. My insurance was billed $300+ for the visit.
Same… to get an appointment at my PCP in a decently sized city it was 7 months.
Sounds like it’s time to find a new primary doctor, that’s insane.
I’ve been on a waitlist for my GI for more than a year ( I’m in the US)
The US does not have shorter waits. Try scheduling an appointment with a primary care doctor, their schedule starts like a month and a half out
There are basically 3 main systems for universal healthcare in the world:
Beveridge model: the government runs the hospitals and employs the doctors, and any resident may use the services. This is known as socialized healthcare, and it’s what UK uses.
Bismarck model: the government mandates everyone get insurance from highly regulated competing insurance companies (some of which might be government operated and run, and some of which might be private). Everyone is put into the risk pools so that the insurers will collect enough from the entire population, including the low risk demographics. Those who cannot reasonably afford insurance are given government subsidies so that they can be covered, too. This is what Germany and Switzerland use, and is sometimes referred to as an “all payer” or “Swiss” model.
National Health Insurance Model: This is where the government gives everyone insurance and positions itself as basically the monopoly/monopsony health insurer to cover everyone and negotiate compensation rates for health care services provided by private providers. This is what Canada uses. It’s also known as “single payer.”
The fourth model of health care economics should be mentioned, as well. It does not promise, or even try to provide, universal health care. It’s the fee for service model, where private providers set their own prices and consumers decide whether to purchase those services. Sometimes insurance can be involved, but the providers are free to negotiate their own prices with insurers, but might opt not to take insurance at all and make the patients deal with that paperwork.
Many countries use hybrid models that combine elements of the Beveridge Model and the Bismarck Model, with government providers competing with private providers, and maybe government insurers providing a backstop for what private insurers won’t cover.
The U.S. doesn’t follow any one model. It follows all 4 models in different settings:
- It follows the socialized model for the military and veterans affairs, as well as the Indian Health Service for Native American tribes (the government owns the hospitals and employs the staff directly).
- It follows elements of the all payer model for most employer-provided health insurance (employers of a certain size are required to provide optional health insurance) and there are the ACA exchanges, where private insurance is highly regulated and is generally required to provide coverage to anyone who a>!!<pplies, and pays providers based on negotiated prices (and since 2021 providers can’t go after the patient for the difference if they don’t like how much the insurer pays).
- It follows elements of the single payer model for the elderly, through universal Medicare coverage for those over 65. Medicare is the elephant in the room for negotiating prices and procedures, and providers generally don’t want to refuse to take Medicare because it’s just such a dominant insurer among the elderly population. For example, federal law requires any hospital with an emergency room to provide life saving services to anyone who needs it, regardless of ability to pay. The actual mechanism for making that policy is by tying Medicare eligibility to that policy. In theory hospitals could refuse to provide emergency medicine to those who can’t afford it, but then they’d lose millions in Medicare funding.
- But the fundamental default in the U.S. is the fee for service model. Providers doing patient intake will ask “and how are you going to pay for this,” ready to accept either direct payment or an insurance policy.
Turning back to waitlists for medical appointments, the specific type of payment arrangement in the U.S. is a big determinant for the waits. Providers who take the most popular insurance plans might get their calendars filled weeks or months in advance. Especially in lower population areas that are underserved by healthcare providers. (Side note, expect things to get much, much worse for rural healthcare with the DOGE cuts to HHS and USDA.) But in the big cities, those with higher paying insurance can generally get seen pretty quickly.
There is no universal system in the U.S., so there is no standard experience in the U.S. It’s fragmented all to hell, and not only does it suck, it sucks for everyone in a different way.
Which one is France using? I like their system
As in many things, the US never takes the system that works best, but the one where it can extract the more money from its
inhabitantsressource.
Also, this is a dumb talking point that shouldn’t even be addressed as a serious critique of any country’s medical care. I hate it. It’s like people who want to see the post office abolished because they tried to send a package on a Friday afternoon after work and had to wait 10 minutes because everyone else wants to use the highly effective, cheaper solution for shipping.
What “waits” are we talking about here? Waiting in line at a hospital to be seen by staff? There are always going to be so many doctors in a facility for dealing with emergencies, no matter where you go. It can change at times of day or with workload. I’ve been seen immediately, and I’ve had to wait hours for ER service.
Are we talking primary care visits? Who doesn’t schedule them? Are there any countries where you can just walk into a doctor office and they magically have your tests and records just ready in-hand? Of course not, you make appointments. Same with operations and other medical procedures.
Let’s argue the only point that matters here: affordability - the promise that the amount of money taken off my paycheck guarantees me healthcare that won’t put me in devastating debt or ruin my life with additional costs. As it has done to me. It’s such a simple concept and talks about “wait times” are just deliberate attempts to muddy this basic human right we should all have in the richest country on Earth in the most advanced time on Earth.
Are we talking primary care visits? Who doesn’t schedule them? Are there any countries where you can just walk into a doctor office and they magically have your tests and records just ready in-hand? Of course not, you make appointments. Same with operations and other medical procedures.
In my province in Canada we have digital records. While there are some hiccups as a couple of systems merge to one I can see a doctor in the emergency room and then go see my GP the next morning and both the emergency room staff and my GP have access to all of my tests and records.
There are still issues with long waits but in my experience if you have a long wait its because your issue is not extremely urgent and while waiting sucks its better than needing the care urgently.
Just looked on Zocdoc and there are 2 PCPs who are:
- less than 1 mile away
- covered by my insurance
- have multiple appointments available tomorrow, and many more over the default two-week span you’re shown
https://i.imgur.com/xKanonX.png
You’re full of crap.
There is no such thing as US healthcare
We have “plans” you can get through your employer which will bring down your cancer operation costs to just $15000 in deductibles, assuming you don’t get fired for taking the time off to get the operation.
Otherwise, if you fall on a iron fence you can go to the ER
and at least the bill won’t impact your credit history.Sorry I’m being told that now medical bills impact your credit history.
I feel like the result from this image today would be to cut off the wings and make the fuselage weaker to make it cheaper to produce, because clearly they aren’t needed.
You forgot to give yourself a bonus after “contributing value” to the company.
Sorta makes some sense. People wait until it’s critical and then get rushed in with a heart attack, or they go to walk-in clinics which are a growing trend - a major downside is you don’t have a regular doctor that knows you health trends and can keep up a plan for you. Walk-ins start you from scratch every time. Getting to see your PCP, if you have one? Months for an appointment. Tell them it’s important? Couple weeks. Really important? Tomorrow or go to the ER.
U.S. health care is something else. It took me 7 years to be diagnosed with a well-known disease that has a median survival duration of 2.5 years from onset.
I’ll leave it to your imagination the obstacles I faced. Frankly, I don’t want to think about it.
How much of what you experienced is due to the medical mindset (doctors are morons)?
I’m not sure exactly what you mean but I would attribute it to four main reasons:
- I’m rural and the quality of physicians here leaves a bit to be desired
- Physicians are overworked and as a result, generally uncaring and unable to provide substantial help.
- It takes months to get the ball rolling on every step of the process
- Insurance is hellbent on denying everything
My situation didn’t improve until I was finally referred to a couple physicians in the right specialty who truly care and were willing to fight my insurance.
I moved to a rural location and your four points are exactly how it is. I have to harass my doctor to get them to put in referrals. My wife had to go and physically walk a referral from the doctor to the hopsital across the parking lot to make sure they actually got it. Then stayed and scheduled it right then b/c getting a callback for scheduling is a crapshoot.
That’s exactly what I meant, the biggest problem in the medical field is the doctors themselves, they’re basically useless at this point. You could replace them with a potato and give you the same first three points of your list, but for cheaper.
Who told you about shorter wait times? Oftentimes you have to wait in months.
US -> Canada here
I hear this often in Canada, but honestly the wait times are similar. In the US it would often take me ~3 months to be able to see my endo. Also, at least you can get healthcare here.
Aussie here, I just booked to see an endo, wait time was about 10 days
I can see my primary within hours normally, she can’t do much except refer me to who I really need see and those appointments take weeks to make and months to get to.
I have a chronic pain issue and my primary referred me to a specialist that took sox months to see. They referred me to a different specialist with a six month wait-list. They then referred me to a more specific sub-specialist for another three month wait. I live in a reasonably well-off and well populated area, so I’m not out in flyover country or anything. I’ve heard the same from many people. Short wait-lists in America is a myth.
100%. Took me 3 months to get an ENT appointment. They’ve still done fuck all about the actual issue almost a year and a half later. The profit incentive is for return customers, not to actually fucking cure anything here.
My first six month wait was for an ENT. I’m actually past ten years, well over a dozen referrals, and three useless surgeries, but that’s another story.
Pro-tip, if they want you to see a neurologist, make sure it’s a headache specialist. I waited 6 months to see a neurologist recommended by an ENT, only to have her immediately refer me to a headache specialist because, duh, nasal sinuses are in the head. What really kind of pisses me off is that I asked the ENT if this specific Neurologist he recommended was good with my kind of issue, and he assured me they were. Total bullshit.
We desperately need more doctors, and those doctors need to cost less.
Free college would make a big difference for that.
Sort of. The US medical system has multiple choke points, but an undergraduate degree is the least limiting. The bigger barriers are the limited number of med school spots and the even smaller number of residency spots. Med school is a whole discussion, I don’t even think you should need an undergraduate degree, but whatever. The final filter is residency spots, which are functionally set by the government. They pay hospitals to take residents, and will only pay for a certain number each year. We gotta increase that number if we want to stop throwing away educated doctors before they can even get to helping people.
I’d say you’re right honestly. Especially since the majority of courses are really pointless for doctors. Organic chemistry only serves to weed out those who can’t or won’t study. You’ll use very little of it as a practicing doctor (Biology majors who take things such as immunology, genetics, etc def get more value than other majors)
Med school acceptance is definitely an issue like you said also. Its only getting worse, with the average GPA/MCAT/extracurriculars being waaaay higher than even in the 90s.
Residency, thankfully, is something theyre trying to address by increasing the slots. Of course they also have fucked anyone who needs FinAid for premed/med school so…
My other favorite refrain was the “You can keep your doctor!” crap that was a big selling point for that crowd.
In this system I have had 4 doctors move practices while under their care because they’re playing the capitalist system. I was not able to benefit from continuity of care in any form.
But at least I had to pay for it, not get it for “free” from a natl healthcare system. Yay.
Seems like a simple enough case that there can be a fact of the matter. Either U.S. wait time are shorter than single payer systems on average or they’re not; no need to rely on anecdotal stuff.
Is there anyone that can point to some good data on the subject?
Honestly? I can’t do the searching for you this time, but it’s all the top results when you look for average wait times between countries. The data is easy to access. Pretty much all developed nations have similar numbers, with wide variation between specialties.
Shorter wait lmao
I’ve been waiting for almost a year to see a specialist for my depression
I have health insurance and my parents have money to pay for it, just that we aren’t rich enough to skip the line
I accidentally sliced my finger and non stop bleeding in the ER for 5 hours straight.
This was from 2am to 7am. Not exactly peak times.
American healthcare is broken.
I went to the ER in a wealthy part of the Denver metro with abdominal pain and a significant fever. I was in the waiting room for at least 8 hours for them to decide I might have a perforated bowel and I was admitted. It ended up being diverticulitis.
It makes my head explode when people say wait times are longer in countries with public systems because all the hypochondriacs will be abusing it. Motherfucker, wait times are ridiculous now.
I’m glad you’re here to tell the tale. Thanks for sharing.
No no. It cant be. Everyone in America keeps telling me the wait times in Canada are so high because of socialized medicine and you only have to wait 7 seconds to see a doctor in the glorious US of A.
I am also Canadian and having used both healthcare system, I want to tell you that your Canadian conservative friends and conservative political talking points are all lying to you. It’s far faster in Canada than in America.
My point of view was from a suburb in Toronto and Vancouver vs NYC and Seattle.
Oh I know. Ive used both systems too and thank god Im Canadian and live here. The insurance scheme was a nightmare and the wait times were just as long.
Am Canadian. Got stung by a wasp on the foot last Saturday. Got worried yesterday when i noticed the red area around the sting grew. Contacted my gp’s office at the CLSC, got an appointment to see her this morning, got a scrip for antibiotics since she thinks it’s likely an infection, picked it up this pm and starting it tonight. 0$ for the consult, antibiotics are ~60$ (that’s the only place my private insurance kicks in, my out of pocket is 12$).
And this is a very standard experience in Quebec - with 1 caveat: my family’s fortunate enough to have an assigned GP, there’s a shortage and a pretty long (2y I think) waiting list; on the flip side there are a ton of walking/24/48h appointment clinics (also 0$) for those without.
When i say 0$, i want to be clear: it’s not free, it’s part of what’s covered by the RAMQ, which is the provincial health insurance company, but our yearly premium for that insurance is at most 800$.
That’s what happens when the health insurance is designed to hedge and amortize social costs rather than generate profits…
Im Canadian and despite the American conservative talking points, I’ve never had to wait anywhere near that long and definitely not for a critical injury. There are busy hospitals but there are also more of them so you have options many times.
We have however seen an erosion of our socialized healthcare by conservatives in power in that things keep being removed from coverage, and you have to go out of pocket on things that should be covered.
I also like to mention that it was in a very high end city in the Seattle area.
At 7am, I was considering leaving and waiting at home until a small clinic opens, but they finally saw me.
I had something similar happen to me like 5 years ago. I chopped part of my finger tip off with a slightly rusty axe while camping after having a few too many.
I went into the ER the next day, waited about the same amount of time as you to be seen to have it checked out and get a tetanus booster. I got a bills from each doctor that happened to walk by, totalling in the realm of $2,000 after insurance. Literally all each did was say, “Ouch, lucky you didn’t hit the bone!”
Luckily, my fingertip grew back without nerve damage or anything. I’ll probably try to stay up on my shots and get more confident on dressing myself next time, maybe try and make friends with nurses/vet techs. Shit’s broken on every level.
This is why you just cauterize it with a lit cigar. Just like my dad showed me.
Damn I have almost the exact same story. Except mine also comes with a fucked up workers compensation claim and it messed up my credit for years.
U.S. healthcare has shorter waits
Is that even really true to begin with?
My thought exactly. Specialists are booking months out.
I’m not from the US but once I was in Orlando and took a friend to the hospital cause she wasn’t feeling well, she had insurance. We waited 4 hrs to even see a doctor, I have never waited that long even in public hospitals in my country
I waited from 6pm to 8am when my doctor’s office opened, and then talked to them to determine if I needed to be there (yes, I should have been seen/treated, but now they could see me in the office).
Only one patient was taking from the waiting room in that time.
The US health care system is baaaad.
And almost any specialist is months for a first visit, even for issues that that are life threatening.
That’s insane, though I had something similar. I studied there for a year and at one point I dropped a bed on my toe (dont ask), hurt a lot, got all purple and I was pretty sure it broke. I found out in the US I cant just go directly to an orthopedist, even though its obvious I needed one, so I scheduled a general doctor. Long story a bit shorter: by the time I got an xray done, my toe had already calcified lol
That’s because ERs are the only way poor people see doctors in the US. Since we can’t go see a GP without insurance and a copay, we wait for the stomach pain that could have been treated to turn into sepsis from a gaping ulcer and then crowd into the ER.
You guys should have rioted decades ago, I feel sorry for you, animals live better than (non rich) americans
Still too much to lose, plus the cops have surplus military gear.
I’d say nothing is more important than your health and you already lost that. You have people dying and suffering while waiting on healthcare.
For me personally, I have a family that would be on the streets without my income. If I go protesting and get arrested, I lose my job and it’s GG. I’m sure that’s by design. If I was 20 years younger and didn’t have as much riding on me I’d be out there making some noise.
americans have pussified/pacified by anti-healthcare propaganda for decades.
i waited that long in public subsidized healthcare, i think they forgot me one time, when they put me in a room, i dint see anyone for like 4 hours because they forgot.
Can’t even sue them? Isn’t that the national past time in USA?
I called my primary for my annual checkup, they can’t get me in for 2 months. It’s getting bad out there
Yep. God help you if you need a specialist because he’s likely to respond faster.
Compared to European countries, no. Compared to Canada, yes.
Elective surgery means surgery that can improve quality of life, but is not otherwise life saving right?
Canada also has the lowest number of doctors per 10k, and the lowest wait for primary care.
The US has more doctors, but the highest time to primary care.
I don’t know many elective surgeries that can be scheduled without a primary care referring the patient to the surgeon for consult. Not to mention, beside plastic surgery, it’s usually a case where the patient has no idea they could benefit from the elective surgery.
That graph is highly misleading.
Maybe you don’t need an appointment to see a GP in Canada? I’m from Austria and GPs are walk-in for most things here, maybe they’re the same. But yeah, the graph is pretty useless without explaining what kind of appointments and what kind of surgeries.
To your last point: it could be, eg, your orthopedist (who isn’t a surgeon) referring you to an orthopedic surgeon, no GP required in that case. But that just makes it even more complicated, because in some countries, you need a GP referral to any specialist. I think sometimes even every time you see the specialist.
Canada also has the lowest number of doctors per 10k, and the lowest wait for primary care.
That’s assuming you even have primary care. There’s a desperate shortage of family doctors in Ontario.
What is misleading about it, it’s just numbers? It basically says… My knee hurts, let me go get it checked out: wait time column A. Physician says I need a knee replacement, wait time column B.
The chart isn’t claiming anything. It doesn’t say what is better or worse, just the wait times.
Meh, it is from Australia, so unless they have reason to make Canada look bad, it’s just numbers
What stands out to me on that chart is that the US is more than twice as bad as any other country when it comes to wait time for primary care appointments.
right? like what is that… i consider a wait of more than a couple of days to be too long and just go to a random walk-in clinic… in a month most problems are gone already on their own or have gotten way out of control
Not remotely, no. I’ve been on a wait-list for a few weeks for appointments that are a minimum scheduled 3 months in advance.
It is a common talking point people use when justifying their anti-universal healthcare stance.
It is often paired with refusing to acknowledge the current state of US healthcare and thinking they are paying more for quality and access.
It depends. Do you have a lot of money? I’m sure you can find someone that can see you right away.
Yeah I have heard many many first hand anecdotes of people needing to schedule appointments months in advance
certain health care facilities. i know for things like medi-caid/care it can be weeks to months in advance to see a specialist. they usually are quite fast in scheudling though. if anyone had kaiser, you can see a doctor quite quickly.
ALso URGENT care is a thing. i can see that for private practices, or doctors that Are swamped because of short staffing.
Yeah. I had crippling inflammation and it took months to get into a rheumatologist.
True. Even my primary care doctor needs 3 months advance scheduling to find me a slot.
It’s a very general broad topic. Probably depends a lot on what you need. And more importantly, how rich your are.
I highly doubt Bill Gates have to wait 3 months for a specialist appointment.
From my experience it depends on which health care provider you have. I have Kaiser and some things are pretty quick, some things aren’t. I used to be on Covered California aka the ACA and things were a lot slower. Seems like, generally, the more money you pay in premiums the faster service you can get.
I’ve heard Kaiser is pretty good. I had an employer suddenly switch all their plans to Kaiser, and we had to go individual because we had a few specialists we liked that didn’t work for Kaiser. Plus i couldn’t get a straight answer on what would happen if I got hurt outside of their areas.
kaiser is so-so, but not great, they are just all doctors in one building type of deal. i had a pretty bad experience with a Kaiser ENT, deliberately ignored my concerns because he got MAD , apparently i was supposed to do only phone appointments and he felt like i waste my time according to him, and he vented his anger on the poor nurse that was in the area/ or the one that put me in the room. then he started laughing me out of the room because of that(i was having pretty frequent nosebleeds). when i switched ENT they found the cause of it(and i did have deviated septum as well, but that was apparently the source of his anger, because doctors do not like to hear patients mention procedures/surgery).
also KAIser tends to be expensive as well, thats why some employers arnt willing to pay for it.
I’ve oddly had the best experience with United. Avoid individual at all costs. It’s rough out there.
Kaiser
Maybe it could also be related to the difference between an HMO and normal insurance?
Yeah, could be
Does american healthcare really have shorter wait times? I’ve seen a lot of people waiting and done a lot of waiting myself.
Is there any data?
While it may depend on what country you want to compare it to there is nothing about privatization that inherently reduces wait times. My experience is that after leaving the US my wait times are equivalent or improved.
Private insurance just means you wait, it costs a lot more, and you’re way more likely to delay treatment of your own accord because the profit motive makes the system a financial terror and a psychological torment.
its also propagandized, designed to make people wait, because the insurance would rather you pay for insurance and not use its services at all, because thats costs them money each time. hence thats why they raise rates for OLDER people(55+), to price them out of the system, and you hare the shitty ones like UHC/UHG, or blue shield deny drugs or procedures all the time.
Remember pre-existing condition exclusions? Hahahs good times 🤑
Sounds right to me.
it depends on the insurance, and the providers, kaiser has pretty fast appointments, by usually caters to the west coast, and its pretty expensive hmo plan. some i heard can be weeks or months, depending on where too.
if i had to pay for healthcare i better not be fucking waiting.
I probably don’t need to tell you this, but don’t visit the US.
Depends on the procedure. Orthopedic surgery in the USA is pretty fast to get. Getting an MRI approved when compared to, say Japan, takes forever.
When it’s free or super low cost, it’s paid by the government. This means the government has a vested interest in keeping you healthy so they don’t have to pay more. It’s a great set up.
Plus more preventative care. Get something checked out early rather than waiting months and now being treated inpatient.
Tbf, for profit insurance companies also have a vested interest in keeping you healthy. Healthy people require less care which means more profits.
It’s just that insurance companies also have a vested interest to make sure that they don’t pay out for expensive treatments either. You can be healthy and then get cancer which is expensive vs be a sloth whose only form of exercise is walking back and forth from the front door to their bed and has heart issues.
Edit: judging by the down votes, I suppose it wasn’t clear that I’m not trying to defend for profit health insurance. Let’s be clear here: single payer is the best way to do healthcare. I was only trying to point out that the incentive to keep your customers healthy is the same regardless of who is paying. The only difference is the motive. One wants to make sure they have money for shareholders while the other wants to make sure they have money for everyone to get care.
individual health is about more than individual health… air quality, stress (including financial, other employment), quit campaigns, etc are all things that are solved at the national or regional government level. they’re all linked with better health outcomes, and incentives and profit motive are aligned when health care is paid for by government
I am in full agreement. I am realizing that my point wasn’t made clear. Hopefully my edit will clarify things.
Or they could just arbitrarily deny you care
lmao I had a period of like maybe 5 years when I didn’t get a regular checkup when I was a kid because my parents kinda neglected it. I was insured under the family plan too.
Edit: Forgot to add: USA btw
What’s going on in Sweden?
High wealth inequality IIRC.
Which would explain recent pivot to the right. Although that has global factors fueling it that might outweigh anything local.
I’ve never heard the term “fee for service” so I looked it up and I don’t think that’s exactly what we do in Germany? Physicians are allocated a certain budget per patient (it’s not quite as simple but to keep it short) and if they exceed that, it can be somewhat of an issue.
Or maybe I’m just misunderstanding the term. Any experts in German health care around?
The other issue we may find with these numbers is that they were the latest numbers found by them, but many from 2021. Which I am unsure if doctors visits were altered from average do to COVID infections still being high
Not the flex you think this is.
What are you saying is a flex?
Visiting doctors a lot more than another country.
Yes it is. It means we’re able to go when we need to and can be on top of any potential health issues.
Why do you think healthcare is tied to employment?
They only want to help if they can get a return on their investment. That’s all we are to them.
That’s all we’ve ever been.
The problem is that there’s a hell of a lot more of us than there are of them.
If we could only use our collective power to change things to favour all workers instead of the owners and elites… If only there was some way to regulate them into compliance to provide better, safer, and fairer, working conditions… To add some layer of oversight, where dozens of people that represent the majority of people across the nation to help bring forward what the people want, instead of the 1% just doing whatever the fuck they want…
That would be amazing. If only it existed…
Both parties are doing everything they can to make sure it doesn’t.
Exactly my point.
I work for a big healthcare provider and in spite this likely being true, I still hear all the time about trying to “reduce over utilization”. It’s disgusting.
and probably qoutas for DENIALS, over approvals for certain situations. i know one drug, dupixent is often denied by insurance, because its super expensive.
Is “healthcare provider” an actual provider of healthcare (hospital, private practice, etc) or a middleman?
Hospitals clearly want to have as many procedures as they can. Insurers likewise want to pay for none. Hence “overutilization”.
Any way it is, companies gonna chase profit with no eye for people. Remember, they don’t exist for people. They do for money.
Oh it’s definitely a middleman regardless of what they call themselves.
