Political Memes

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 ~~inhabitants~~ ressource.

Which one is France using? I like their system

What “waits” are we talking about here

It differs a lot by specialty and country, but there are genuine waitlist issues, and there are non-issues.

Think the wait for a dermatologist appointment is approx 2 years in my country by now. Psychiatry? Called the hospital, they said they don't have any openings for the foreseeable future (but luckily you can get private psychiatrists, only problem is that mine went to another clinic and doubled his already high price). ENT? A few weeks, very manageable. PCP? They're limited by how many patients they can have (you're assigned one at birth, but you can change later, you can't just schedule an appt with a random PCP usually), it might vary by PCP, but mine schedules me for the next day quite often, no problem at all there.

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.

I'll agree that healthcare access without devastating debt or costs is a basic human right. But it's not the ONLY point that matters. In my country you might suspect a mole of being cancerous and die of said cancer before you get to see the dermatologist. Wouldn't want to switch over to the American model, but there's clearly something wrong with our system too. Parliament has decided to raise payroll taxes and enact a profit tax (a completely new tax) to develop our military since we share a border with Russia. There's a brand new car tax including a pretty damn hefty registration tax (includes old cars changing owners if they haven't been paid for yet, so pretty much all used cars) that's being used to balance our budget... Oh and of course there was a second VAT increase in 1.5 years.

I don't see the healthcare system getting any better, despite my annual tax load across the board increasing by several thousand euros and the ER and specialty doctor visit charge being quadrupled (which, surprise surprise, has NOT lessened the burden on ERs because it's already a literal meme how unlikely Estonians are to go to the ER, or to a doctor in general - we only do it when our family members tell us to, not when we're simply bleeding to death).

It's not a dumb talking point at all. The wait times are massively important as they are your actual access to said healthcare.

You do not have access to any healthcare if the wait times are so long that by the time you see the doctor you are iether recovered or dead.

The issue with wait times are multifaceted and can't be fixed by switching to a different payment scheme. It has to do with hospital admin that cut costs at every opportunity. It has to do with the ACGMEs stranglehold on the amount of new doctors getting a medical licence comming in. It has to do with how few doctors are going into the lower paying specialties.

Wait times are different depending on the area, the procedure, and necessity but they are also so what based on luck.

Go into an ER because of a heart attack on a slow night and you get immediate treatment. Go in with the same issue on a busy night when they just had 3 GSWs dropped of at the ER doors, a cardiac arrest In progress, a CVA, and 5 psychs all in the ER right now. Not to mention a handful of incoming ambulances, and you will get the same treatment but much slower.

You spend a few hours in triage then finally get a room inside. Another twenty minutes before a nurse sees you. Another hour before a doctor. They run an EKG and labs in the meanwhile. You are having an NSTEMI.

After you get out of the ER. You spend a day in a hospital room for observation. They didn't really do anything but you are feeling a bit better on your own. They tell you, you need to go to a cardiologist.

The hospital tried to find you one to transfer you there directly, but no cardiologist within 250 miles has any opening so they spend a few days looking and nothing comes up. You get discharged. You still need to see a cardiologist.

You call around and find which ones are covered by your insurence. You call their offices and they say they are booked out for 4 months. But you can be put on a wait list. There are only 20 other people on the wait-list before you. Maybe you will get lucky.

You where not lucky. 4 months later you finally get seen by the cardiologist. They discover that you now have left sided heart failure which could have been avoided if you just saw them sooner and got a stent placed. Now you are diagnosed with CHF which you will struggle with for the rest of your life.

Now you have to get regular checkup with your primary care provider but also with th cardiologist to keep an eye on things. You make sure to call 4 months in advance because that's how far out they are booking appointments right now.

You have an appointment comming up in only a month, but your realy not feeling well. You are worried that it's your heart again. You can't seem to catch your breath and your body feels slow and heavy. You call your primary care doctor and they say, no we can't see you. You have to go to the ER. You go to the ER. They run an EKG and basic labs. Everything comes back ok. Your ER doc says nothing I can do, go see your cardiologist.

You call your cardiologist and they say appointment in 3 months but if it gets worse, go to the ER. You call your Primary care and ask if they can move your appointment up. They say no. And they canceled your next appointment when you called because you where going to the ER so they figured you didn't need it. The slot has already been given to someone else. But they will squeeze you in asap. Appintmet set a month from now.

This is the cycle that people live and die in.

Time matters. In an emergency, but also in routine daily care. Sure everyone makes appointment, but the problem is there are no open appointments for months.

If I get the flu and want to see my primary care provider to get diagnosed and get some antivirals it will be at minimum 2 weeks before I can see her. That's the closest appointment. By then I don't have the flu anymore and it's pointless. What if I was old and unhealthy and that flu nearly killed me? Now I go to the ER and tie up emergency resources all because I could not get in to see my normal doctor.

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.