this post was submitted on 16 Aug 2025
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[–] chiliedogg@lemmy.world 22 points 4 hours ago

The short wait times are a myth.

I went ot the ER with a heart scare in May. Turned out to probably be a panic attack, but they wanted a follow-up with a PCP just in case. The earliest appointment I could get with anyone within 100 miles on my insurance plan was in mid-July, and that wasn't even with a doctor, but a PA.

I went to the appointment, and they spent 5 minutes with me and ordered labs. I go to the lab on the 30th of this month, and have a follow-up with the PA in October.

We're looking at what's essentially a 5 month wait for a diagnosis for an ER visit, and the total bill is gonna be around 15-20 grand.

Fortunately, I have "great insurance" so it's only gonna cost me about $1500 to be told that the tests are inconclusive because they were 3 months after the incident.

[–] Gammelfisch@lemmy.world 10 points 4 hours ago (1 children)

Shorter wait times? The US healthcare system is a massive fucking dumpster fire. There are cases of people dying in hospital waiting rooms.

[–] boonhet@sopuli.xyz 4 points 2 hours ago

Probably if you're a millionaire you can get shorter wait times.

The rest of y'all are fucked tho. Wish it wasn't so, but oh well.

[–] Tiger666@lemmy.ca 5 points 4 hours ago

There are no shorter wait times in the US. Lol

[–] Jollyllama@lemmy.world 21 points 7 hours ago (4 children)

Where are the shorter waits?! I called for a primary care appointment in July and only appointment was November or January the next year. FOR A 15-30 MINUTE APPOINTMENT. My insurance was billed $300+ for the visit.

[–] boonhet@sopuli.xyz 4 points 2 hours ago

My insurance was billed $300+ for the visit.

Rest assured, they didn't pay $300+. Of course if you'd paid for it out of pocket without negotiating, YOU would've paid $300+.

That's part of why the prices are so goddamn high. EMR and billing software for the US market gets a "billed" and "expected" field on charges and the "expected" value in particular differs by insurance I believe.

[–] VitoRobles@lemmy.today 7 points 4 hours ago (1 children)

Conservatives bitching about how if we had Canada's healthcare, we'd be waiting forever.

I have AMERICAN healthcare and I have to schedule a basic ass mandatory checkup 4-6 months in advance.

If it was an emergency, the next available slot is six weeks.

[–] InternetCitizen2@lemmy.world 3 points 4 hours ago

if we had Canada's healthcare, we'd be waiting forever.

Or another approach, calculate how much time it takes to save the cash for any given procedure and compare that to any socialized care. Say for an MRI, lab work, root canal, etc.

USA system is great if your wealthy. Otherwise you might as well be in a developing country as far as your access to all these high tech treatments we need massive profits on.

[–] Alaik@lemmy.zip 3 points 6 hours ago

Same... to get an appointment at my PCP in a decently sized city it was 7 months.

[–] Soulcreator@programming.dev 5 points 7 hours ago (1 children)

Sounds like it's time to find a new primary doctor, that's insane.

[–] Jollyllama@lemmy.world 4 points 4 hours ago* (last edited 4 hours ago)

This is the new doctor 😭😭.

I called another place and they actually said to call back in a couple months. The healthcare system is so consolidated in my state that there's only a few systems to go to. Maine.

I could schedule something hours away but then I'd need to take time off work to go or I won't go because of the inconvenience

[–] Bronzebeard@lemmy.zip 25 points 9 hours ago (4 children)

The US does not have shorter waits. Try scheduling an appointment with a primary care doctor, their schedule starts like a month and a half out

[–] booly@sh.itjust.works 10 points 6 hours ago (2 children)

There are basically 3 main systems for universal healthcare in the world:

Beveridge model: the government runs the hospitals and employs the doctors, and any resident may use the services. This is known as socialized healthcare, and it's what UK uses.

Bismarck model: the government mandates everyone get insurance from highly regulated competing insurance companies (some of which might be government operated and run, and some of which might be private). Everyone is put into the risk pools so that the insurers will collect enough from the entire population, including the low risk demographics. Those who cannot reasonably afford insurance are given government subsidies so that they can be covered, too. This is what Germany and Switzerland use, and is sometimes referred to as an "all payer" or "Swiss" model.

National Health Insurance Model: This is where the government gives everyone insurance and positions itself as basically the monopoly/monopsony health insurer to cover everyone and negotiate compensation rates for health care services provided by private providers. This is what Canada uses. It's also known as "single payer."

The fourth model of health care economics should be mentioned, as well. It does not promise, or even try to provide, universal health care. It's the fee for service model, where private providers set their own prices and consumers decide whether to purchase those services. Sometimes insurance can be involved, but the providers are free to negotiate their own prices with insurers, but might opt not to take insurance at all and make the patients deal with that paperwork.

Many countries use hybrid models that combine elements of the Beveridge Model and the Bismarck Model, with government providers competing with private providers, and maybe government insurers providing a backstop for what private insurers won't cover.

The U.S. doesn't follow any one model. It follows all 4 models in different settings:

  • It follows the socialized model for the military and veterans affairs, as well as the Indian Health Service for Native American tribes (the government owns the hospitals and employs the staff directly).
  • It follows elements of the all payer model for most employer-provided health insurance (employers of a certain size are required to provide optional health insurance) and there are the ACA exchanges, where private insurance is highly regulated and is generally required to provide coverage to anyone who a>!!<pplies, and pays providers based on negotiated prices (and since 2021 providers can't go after the patient for the difference if they don't like how much the insurer pays).
  • It follows elements of the single payer model for the elderly, through universal Medicare coverage for those over 65. Medicare is the elephant in the room for negotiating prices and procedures, and providers generally don't want to refuse to take Medicare because it's just such a dominant insurer among the elderly population. For example, federal law requires any hospital with an emergency room to provide life saving services to anyone who needs it, regardless of ability to pay. The actual mechanism for making that policy is by tying Medicare eligibility to that policy. In theory hospitals could refuse to provide emergency medicine to those who can't afford it, but then they'd lose millions in Medicare funding.
  • But the fundamental default in the U.S. is the fee for service model. Providers doing patient intake will ask "and how are you going to pay for this," ready to accept either direct payment or an insurance policy.

Turning back to waitlists for medical appointments, the specific type of payment arrangement in the U.S. is a big determinant for the waits. Providers who take the most popular insurance plans might get their calendars filled weeks or months in advance. Especially in lower population areas that are underserved by healthcare providers. (Side note, expect things to get much, much worse for rural healthcare with the DOGE cuts to HHS and USDA.) But in the big cities, those with higher paying insurance can generally get seen pretty quickly.

There is no universal system in the U.S., so there is no standard experience in the U.S. It's fragmented all to hell, and not only does it suck, it sucks for everyone in a different way.

[–] AnUnusualRelic@lemmy.world 2 points 5 hours ago

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.

[–] ghen@sh.itjust.works 1 points 5 hours ago

Which one is France using? I like their system

[–] fishy@lemmy.today 1 points 3 hours ago

I called to see any gp from a major hospital in my area last week. Earliest appointment is in Feb. Guess I'll just go die.

[–] ameancow@lemmy.world 1 points 5 hours ago* (last edited 5 hours ago) (3 children)

Also, this is a dumb talking point that shouldn't even be addressed as a serious critique of any country's medical care. I hate it. It's like people who want to see the post office abolished because they tried to send a package on a Friday afternoon after work and had to wait 10 minutes because everyone else wants to use the highly effective, cheaper solution for shipping.

What "waits" are we talking about here? Waiting in line at a hospital to be seen by staff? There are always going to be so many doctors in a facility for dealing with emergencies, no matter where you go. It can change at times of day or with workload. I've been seen immediately, and I've had to wait hours for ER service.

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.

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. As it has done to me. It's such a simple concept and talks about "wait times" are just deliberate attempts to muddy this basic human right we should all have in the richest country on Earth in the most advanced time on Earth.

[–] boonhet@sopuli.xyz 1 points 2 hours ago

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).

[–] lowside@lemmy.world 2 points 3 hours ago

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.

[–] jon@lemmy.dbzer0.com 1 points 5 hours ago

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.

[–] damnedfurry@lemmy.world -2 points 5 hours ago

Just looked on Zocdoc and there are 2 PCPs who are:

  • less than 1 mile away
  • covered by my insurance
  • have multiple appointments available tomorrow, and many more over the default two-week span you're shown

https://i.imgur.com/xKanonX.png

You're full of crap.

[–] Ugurcan@lemmy.world 13 points 12 hours ago (2 children)
[–] Jankatarch@lemmy.world 1 points 1 hour ago* (last edited 1 hour ago)

This image is just an english Kanji at this point.

[–] HereIAm@lemmy.world 6 points 7 hours ago (1 children)

I feel like the result from this image today would be to cut off the wings and make the fuselage weaker to make it cheaper to produce, because clearly they aren't needed.

[–] Alaik@lemmy.zip 2 points 6 hours ago

You forgot to give yourself a bonus after "contributing value" to the company.

[–] elbiter@lemmy.world 1 points 7 hours ago (1 children)

There is no such thing as US healthcare

[–] ameancow@lemmy.world 0 points 6 hours ago

We have "plans" you can get through your employer which will bring down your cancer operation costs to just $15000 in deductibles, assuming you don't get fired for taking the time off to get the operation.

Otherwise, if you fall on a iron fence you can go to the ER ~~and at least the bill won't impact your credit history.~~ Sorry I'm being told that now medical bills impact your credit history.

[–] RememberTheApollo_@lemmy.world 7 points 12 hours ago

Sorta makes some sense. People wait until it’s critical and then get rushed in with a heart attack, or they go to walk-in clinics which are a growing trend - a major downside is you don’t have a regular doctor that knows you health trends and can keep up a plan for you. Walk-ins start you from scratch every time. Getting to see your PCP, if you have one? Months for an appointment. Tell them it’s important? Couple weeks. Really important? Tomorrow or go to the ER.

[–] chunes@lemmy.world 30 points 17 hours ago (5 children)

U.S. health care is something else. It took me 7 years to be diagnosed with a well-known disease that has a median survival duration of 2.5 years from onset.

I'll leave it to your imagination the obstacles I faced. Frankly, I don't want to think about it.

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[–] njm1314@lemmy.world 62 points 22 hours ago (11 children)

Who told you about shorter wait times? Oftentimes you have to wait in months.

[–] Witchfire@lemmy.world 25 points 16 hours ago (1 children)

US -> Canada here

I hear this often in Canada, but honestly the wait times are similar. In the US it would often take me ~3 months to be able to see my endo. Also, at least you can get healthcare here.

[–] coaxil@lemmy.zip 7 points 8 hours ago

Aussie here, I just booked to see an endo, wait time was about 10 days

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