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Comment by robertlagrant | Hacker News Reader

> institute a national, single-payer plan that covers everyone, like every other modern industrialized country

The two (real, non-politicians are corrupt) downsides to contend with:

- countries do this by limiting what they will spend; in the US you have access to unlimited treatment. E.g. in the UK the NHS will spend £30k for each good year it buys you

- this one isn't fair, but the US is where health innovation happens. Companies sell into it to make money to survive. They then sell into the other countries to make much less margin, and if those countries were all they had as customers, they wouldn't exist. The US is why we have the advancements we have, and all us non-US countries have silly smug citizens who think our countries are better at negotiating deals. If the US didn't do what it did, we'd be a lot worse off.

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I live in Canada and there isn’t a spending limit. The decision of how to treat is made by the doctor. The doctor is then paid. In my experience living on both sides of the border, you get far more care up here since there is no bullshit with finding a facility that accepts your insurance, and cost isn’t a consideration for doctors or patients.

People will occasionally travel to the states for drug/therapy trials not available in Canada, or for treatments that are not proven effective. These people will then loudly bitch about Canadian healthcare.

If you want the proof of it, remember that a huge majority of Canadians live close enough to drive to the US for health care, but don’t.

Canada has spending limits, but they aren't in $, but in procedures.

It varies by province, but Alberta will do n heart surgeries per year, and who gets them is by triage

Yes. They are limited by facilities and labor that is dictated by provincial spending. Right now the government in Alberta is actively and publicly trying to reduce spending on the public system, and trying to use that as an excuse to go private. The number of doctors and facilities available is a direct function of money in other words. If you increased spending on doctors and facilities rather than reducing it like Alberta is doing, you will see a reduction in wait times.

You will find that triage is a fact of medical care in most places. I have waited hours in a private ER in the states multiple times. You have to wait months to see specialists in the states as well.

The US also has a triage system for care. First they filter by ability to pay, then they filter by doctor and facility availability like Canada does.

An American with no ability to pay will wait far longer than an Albertan for heart surgery.

> An American with no ability to pay will wait far longer than an Albertan for heart surgery.

Won't they be covered by Medicaid?

>If you want the proof of it, remember that a huge majority of Canadians live close enough to drive to the US for health care, but don’t.

With Canada rapidly approaching third-world status, this is hardly surprising. Most Canadians cannot even afford to cross the border, much less pay American prices.

Huh, why would they travel to US. Is Canadian government writing blank check to everyone get treated in US?

> If you want the proof of it, remember that a huge majority of Canadians live close enough to drive to the US for health care, but don't

I don't understand this point. Obviously Canada offers healthcare, and what it offers is no doubt good. That doesn't mean that it offers everything that can possibly be done. People just won't be aware of what can be done, and/or don't have US health insurance to pay for what can be done.

My point is that one of the arguments against universal healthcare in the States that gets trotted out is that Canadians have waits so long or that the healthcare is so restricted that they are dying or that they can't get care.

If people were actually having to wait that long that their health was seriously threatened, they would likely be engaging in medical tourism on a much bigger scale. If you needed surgery or you were going to die/be permanently disabled and the Canadian system wasn't able to provide it, people would be driving across the border, flying to Mexico/Thailand/wherever, or doing whatever else they needed to not die or have their life impacted.

But that doesn't happen. What it tells you is that, as much as some Americans paint a false picture to slander single payer healthcare, and as much as some Canadians complain about waiting, the Canadian system is still better than any alternative available to the participants, despite the alternative being a quick drive away for most of us.

I mean, normal Canadians also likely can't afford the cost of American surgery. And I can think of at least 1 time a prominent Canadian went to the USA for medical procedures that weren't available in Canada.

https://www.cbc.ca/news/canada/newfoundland-labrador/william...

https://www.usnews.com/news/best-countries/articles/2016-08-...

Might be worth a quick Google before posting.

> despite the alternative being a quick drive away

What does this mean? It's not free as long as you can drive to it.

> in the US you have access to unlimited treatment

This is a ludicrous claim.

About how many people in the USA do you think are on an insurance plan that doesn't limit what procedures they can get, and/or can afford to pay out pocket for whatever other procedure?

Also, Healthcare companies are wildly profitable. If they were negotiating prices in the USA just like they do everywhere else, they would only be profitable. Woe is me.

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