when has California's government recently shown any capability to successfully implement big projects or spend tax payer money efficiently?
How is the high speed train project coming along?
How is the high speed train project coming along?
The net effect is predictable - Canada consistently ranks very poorly in international health system comparisons. We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season.
What states should do is encourage more competition as a way to lower healthcare costs. Y'all actually have one of the best systems in the world, it's just way too expensive.
Germany has more ICU beds than the US.
That would be shocking if true, which it does not appear to be.
Germany has around 32K ICU beds. US has around 96K ICU beds.
Germany has slightly more per-capita than the US. (387 vs 294 per million inhabitants)
https://en.wikipedia.org/wiki/List_of_countries_by_hospital_...
Not sure what the original poster is talking about, but America's healthcare system is fucked. And it's not just fucked because it's expensive.
I would love to see an international ranking that places Canada's system below that US that isn’t just coming out of some right wing think tank.
Funny that despite this 'extreme example', Canadians have almost 3 years longer life expectancy than us in the US, are healthier throughout their lives, and have comparable or better outcomes with treatments. Where the US has better outcomes (e.g. - some forms of cancer, some organ transplants), it's only very marginally better (like 1% higher chance of surviving 5 years after colon cancer diagnosis when compared to Canada). And for that 1%, you're spending MUCH more money on your treatment.
Basically nearly every measured outcome is better in Canada rather than the US, despite US paying twice as much on healthcare costs per capita when compared to Canada.
> We have far fewer ICU beds, doctors, imaging machines, etc. per capita than peer nations, and the entire country is in varying degrees of harsh lockdown because our hospitals were already overwhelmed during a normal flu season.
That may all be true, yet it's still better care than what the average US citizen gets, despite paying twice as much per capita.
> What states should do is encourage more competition as a way to lower healthcare costs.
They've been trying to 'encourage more competition' for decades now with healthcare costs only continuing to climb while affordable access falls (ignoring the gains that came and went with ACA). "Competition" doesn't exist in industries that are nearly impossible to enter due to regulatory capture and the insane entrenchment of giant healthcare organizations. The few that succeed in making any progress at all get rapidly acquired.
Reality is that no-system is perfect, there will be complaints and tradeoffs. But the US system is broken for a huge proportion of residents, and it's not going to change without drastic measures. I'm all for torching the whole thing and trying single payer. There may be complains about single payer systems across the world, but according to most of the publications I've seen (probably all, but my memory is imperfect), the vast majority of those subject to it would never trade it for what the US has.
Basic healthcare access in 'the richest country in the world' should be a fundamental right, not a for-profit industry.
Which is more likely caused by different lifestyle choices (e.g. 27% vs 42% obesity rate). Also if you take out all the southern states the gap get quite a bit smaller (e.g. 82.4 in Ontario vs 81.7 in California and 81.4 in New York).
As for "fundamental right", this is not really how rights work and it's dangerous to define them that way. You have the right to bodily autonomy, freedom of speech, etc., but you don't have the right to someone else's labour. Rights are generally protection against interference from others, not an obligation to receive something.
Broad access to healthcare across socioeconomic status is a worthy policy goal, but saying it's a "fundamental right" begs the question: how much healthcare are you entitled to, exactly?
There's no free market for health insurance for the people who need care. Insurers don't want those people as customers, not from any state. They're money losers.
What pressure is there to lower costs? Why would they charge less?
So your comment only covers less than 10.5% of people at the moment... a little more than the number of people who have no health coverage (a good portion not out of real choice).
And that does not even cover how horribly this sort of market functions: you never know how good or bad your coverage actually is until you go to use it for a particular problem, and then you don't really know that until it is over and you are maybe bankrupt. Health insurance is the worst place to try and use market forces to regulate it... well maybe after military, fire, and police...
You can't, because the health insurance is provided by your employes so you get whatever they give you.
My health insurance (blue shield) is absolutely terrible (right now I need some medicine they refuse to let me have because it cuts into their profit margins) but there's nothing I can do about it.
And that's after paying $2500/month for the privilege.
I guess I should be thankful my insurance is ~$1000/mo, and hasn't left me with the horror stories some seem to experience.
That's not true, is it? You could decline coverage and then go purchase a policy of your own elsewhere. Yes, that might be expensive but the original claim was "Y'all actually have one of the best systems in the world, it's just way too expensive." and that still tracks.
Even better, you could purchase a policy through the Obamacare exchanges.
If the government offers you bad medical care, you turn to the black market or you fly to the US to get the procedure done because the government has banned alternative care. This is a very normal Conservative talking point and the inherent competition in US healthcare is arguably the biggest benefit of its current system.
What other choices exist, there's only a few giant insurers anyway.
> Even better, you could purchase a policy through the Obamacare exchanges.
I have no direct experience, would love to be wrong, but what I've heard is that even the top-tier plans are extremely limited in what they cover and where they are accepted so it's even worse than company-provided plans.
Basically, get in contact with them, try and get an override, or get them to explain why you are not covered. If it isn't in the formulary your employer opted into, you're hosed; but there is usually one way or another to get them to give in, they will just make you go through maximum hoops.
Ask for their clinical people if you can't get any traction. They will likely be the ones with hand on the knob for whether a drug is "worthy of coverage" or not.
Magic words: Override,coverage decision appeal, utilization management/formulary question.
They will tell you to check a website. Look up your thing in their formulary, if not there, abort. If in there, but high-tier, prepare for the prior-auth gauntlet.
I gave up on BCBS and have resigned to paying out of pocket, but you might get luckier than me. They will generally fight tooth and nail to be difficult, but just keep a cool head and keep escalating. It's been a while since my last butting of heads but I'm gearing up for round 2.
Also remember: You can pay out of pocket, but you'll be at the whims of that pharmacy. They'll generally help you work through coupons.
> Also remember: You can pay out of pocket, but you'll be at the whims of that pharmacy. They'll generally help you work through coupons.
I did ask, but it was nearly $1K/week so can't afford that.
You have now reached beyond my "letters/phone calls to Congress" threshold. Generally doesn't get an instant response, a d may take months, but surprisingly does occasionally get some traction. More out of spite than anything else. However, there is increasing regulatory attention being directed at the space, and even some states have insurance regulators you might be able to hit up.
It's unfortunate, but there are some drugs that insurers are simply not willing to be on the hook for, and if you're the unlucky person suffering from a rare, expensive to treat condition; the only way around it is to make a lot of noise and waves, and be open to trying alternative regimens.
No one should have to go through that though. Good luck.