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Comment by m0zg | Hacker News Reader

Before clicking on the link, I guessed Switzerland would be ahead of the US, and I was right. Switzerland has ACA-like mandatory insurance that's even more expensive than ACA.

Notice how for the US the article doesn't even mention the upper bound for specialists. That's because there is none, and they expect that.

GPs are quite affordable, if it was just the GPs I wouldn't mind paying them $200-300 directly for a visit. But the specialists can really get you crying for mercy, especially if there's no insurance company between you and them.

I broke a leg a few years ago, and if I did not have insurance, the cost to me would be $55K (probably more, this doesn't count the follow-up visits). Surgery alone was $30K+ for about 2 hours of work, not including cost of anesthesia ($5K). Insurance got the total down to about $7K, which is still a lot of money for a relatively run-of-the-mill surgery. Cost to me was my deductible: $1K.

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As a Canadian, it just baffles me reading these kinds of posts. Like, I could break my leg on the way home from work today and any surgery I needed would be completely covered other than a $45 ambulance charge and maybe $50 for painkillers or whatever was needed afterward. (And prescription drug coverage is on the radar going into this fall's federal election, see: https://www.ndp.ca/pharmacare, https://www.greenparty.ca/en/our-vision/health-care)

No drama, no discussion, no appeals or scary forms to fill out. Is this really what Americans mean when they talk about "freedom of choice"?

As a US citizen, your tax rates and multi-month waiting lists baffle me as well.

Well, that is the perspective that is preventing the situation from improving. However, if you take the time to look into it, you may find that the situation is not as dire as conservative talk radio pundits would have you believe.

For starters, nobody waits in an emergency. If you need urgent care, you get it— with no second mortgage needed. Waiting times vary a lot across the provinces and depending what kind of care is needed. Cancer treatment, for example, is very fast.

Generally speaking, wait times are a function of overall funding, and funding has been cut repeatedly over the past three decades, as Canadians have consistently voted for tax cuts over investing in health care. See the decline as reported by the Fraser Institute: https://www.fraserinstitute.org/studies/waiting-your-turn-wa... (Although of course, they're a right-wing think tank, so their agenda is further tax cuts and privatization... take from it what you will.)

As far as taxes, again beware of what you hear from US-based commentators about how bad it is. In fact, the income tax we pay is almost identical: https://en.wikipedia.org/wiki/Comparison_of_Canadian_and_Ame...

Getting into a doctor in the US requires long waits, too! The last time I bought insurance, I decided to get a long-overdue checkup, so I went hunting for a doctor in-network. There goes one afternoon, just calling around to GPs to see if they were accepting new patients. Nope.

A few weeks later I tried again and found someone could see me three months from then!

And I'm paying $400 a month to get this with a $6500 deductible??

The "long wait times" critique of Canadian health care makes no sense in the face of actual American health care access. It's the same here, except we pay coming and going for it.

Don't look at doctor salaries. Look at per capita costs. And by that measure, the US is far more expensive than Switzerland, the Netherlands, or any other country.

It's not that there's something uniquely good about those countries' models. It's that there's something uniquely bad about ours.

> Don't look at doctor salaries. Look at per capita costs.

Per capita costs are in large part (though not completely) determined by how much providers charge. Why shouldn't we look at "doctor salaries"?

Because when you look at doctor salaries out of context, you get a misleading answer.

I looked it up. The US health care system costs 25% more than Switzerland (the second most expensive in the world). That's not because of doctor salaries.

The Netherlands expenditure per capita is also quite high. I cant believe how high it is actually in Western European countries. If you compare it to South Korea or Singapore the Netherlands looks just as expensive as the US of A, just on a different scale.

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