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Comment by scarface_74 | Hacker News Reader

The one country whose healthcare I’ve studied in depth aside from the US is Costa Rica. Our Plan B is to establish permanent residence there and starting next year we will be spending a couple of months there every winter and maybe in July.

Costa Rica has an affordable all inclusive public health care system (Caja). But you can also pay for extra for private healthcare. Is it the same in the UK?

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Yes. Like no matter what someone thinks about the NHS, it's always affordable, and it's entirely inclusive. And if you want private healthcare, you can absolutely get it. I've had private health insurance at every post-university job I've had, it's a standard offering in tech.

The main criticism of two tier healthcare systems (public+private) is that it creates an unstable system. The private system steals all the talent, the rich don’t care if the public system is good since they don’t use it, and thus the public system dies a slow death of 1,000 cuts.

In canada we’re in a phase where this is just starting. Private clinics (e.g. telus health) have started to pull doctors out of the public system and put them behind subscription paywalls. We’re still paying the majority of their salary, but they can only be accessed if you pay their private overlords a monthly fee.

We certainly have this issue in the UK right now. In dentistry in particular there is a problem that basically everyone agrees on which is that the NHS dental contract makes little sense for the dentists providing the care. In many cases they would literally lose money by performing routine treatments on NHS patients and then claiming what allowances they can back from the government. So of course many don't do that and in large areas of the country it is now literally impossible for someone moving there to register with a local NHS dentist because 100% of the surgeries within a reasonable distance are only accepting new private patients. Meanwhile I can register with a private dentist based just a few minutes from my home who offers a full range of treatments and excellent service with near instantaneous responsiveness - at a price that many people in normal jobs can't afford to pay.

The issue is the same in the US. A lot of specialist say they aren’t taking new Medicaid patients and a few who don’t accept Medicare.

> But you can also pay for extra for private healthcare. Is it the same in the UK?

Yes

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