As someone living in socialized healthcare, and who has lived with socialized healthcare in about a dozen countries, just a reminder:

Socialized Healthcare is a broken and backwards system

inb4: No I am not promoting the american healthcare system. It may fix or address the parts that are broken in socialized healthcare, but it has its own problems… There are solutions (though no one talks about it) that doesnt resemble either of these failed systems.

Problems I have repeatidly faced both here and in other socialized health care countries:

  • Abusive wait times leading to unnecessary suffering and in my case surgery that wouldnt have been needed if I had prompter care.

  • Lack of access to many prescriptions - (I have had at least a dozen medicines I couldnt get because the cost would be too much of a burden to a socialized system).

  • Monopolies making unfair and abusive rules to line their pockets at the expense of patients (A good example of this is melatonin being a prescription in Israel due to a pharmecutical monopoly).

  • Lack of privacy / anonymity - Since everything is registered through centralized systems (usually) there is no way for you to hide or keep private your medical records. In the USA I would pay cash for prescriptions I dont want on record, not really an option in socialized systems.

@freemo I don’t know what you consider “abusive wait times,” but as someone dealing with the American health system, I’ve been trying to get to a couple of different specialists for nearly 6 months and just to see a GP is a 6 week wait. Urgent Care and the ER have become primary care physicians again.

I would welcome a centralized system for medical records, including specialist doctor referrals. It seems that the US healthcare system still depends on faxing, and in my experience, the faxes never are received. Even within our local healthcare system (1 hospital, 1 outpatient location), they fax in-house, and I’ve recently learned that they use a 3rd party fax provider so even staff calls it the black hole. They have no idea if the request was even sent, much less received.

I totally agree that neither system works and the stresses that COVID put on our healthcare providers has made it even worse.

@Dimestorehalo I cant speak to your specific case, But statistically speaking wait times in the USA are less than almost all other socialized systems.

For example in Australia, canada, france, germany, Netherelands, new zealand, and the UK 20% to 42% of patients with chronic conditions needed to wait more than 2 months to get care.. these are people who are already diagnosed and suffering who need routine care to alleviate that suffering (so its particularly heinous).. In the USA half to a quartyer as many people (10%) have similar wait times.

for comparison In those same countries you have on average about 50% of the people who could get seen in less than 4 weeks, compare that to the USA where 75% of people can be seen in less than 4 weeks.

Specialized doctor referals arent really “centralized” because you dont really “need” it.. just get a ppo and you dont need referals at all. And we already have tons of private systems that are opt-in and centralized for finding doctors (do telehealth and go online and youll get seen super fast as you have a huge centralized database of docotrz)

All that said I do agree with you that there is a LOT of room for improvement and in certain states or regions the problem is likely a lot worse than others.

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@freemo Thank you for all the stats and it just may be my state and my semi-rural area but all specialists require a referral from someone and it has to be faxed, even though my private insurance allows me to see anyone within my network. And then there’s the issue with hospital requires a referral, the insurance doesn’t, and won’t pay for the doctor visit to get the referral.

Telehealth is a great idea and I’ve used it, except for the faxing black hole, I have even brought telehealth orders into a facility and they weren’t accepted because they had no way to get them into the system.

Even my GP, thru a telehealth visit last week, says that when the specialists finally receive the referral, it will be sometime in the summer before I’ll be able to see anyone. 4-6 months seems to be the average wait time, even with going down to the largest city in the state (150 miles).

I know this is anecdotal evidence (and I know of others with similar experiences), but I’m an experienced consumer of the healthcare system and I see the US system getting worse and worse.

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@Dimestorehalo That is very odd that all specialists require a referal. That would be true of course if you have an HMO, but the whole point of a PPO is that you dont need referrals. I’d love to talk to a doctor in your area to know the details on that, its the first time I heard that.

I cabnt imagine why your case is so unusual for the american average but im sorry to hear that, it sounds awful!

I dont think you are wrong about the healthcare system in the USA getting worse, I’ve seen the same. I certainly wouldnt praise the american system. Like I said while on average it does fix some problems of socialized healthcare it also introduces just as many of its own problems too. So its hardly a system worthy of praise.

@freemo @Dimestorehalo I have roughly the same experience. And all that at 3 times the cost of a comparable system in any other 1st world nation.

Give me Iceland. Although that weird public/private system in Singapore seems to be generating a lot of fans.

@JonKramer @freemo I'm going to have to investigate the Singapore system!

@Dimestorehalo @freemo , to be very fair, I do not fully comprehend it myself, or why it is effective. I tend to view most systems as most efficient with a profit motive, IE a free market system. Libertarian, if you will. Healthcare and education are two counter examples. To me at least. But, the results seem to speak for themselves in the case of Singapore: en.wikipedia.org/wiki/Healthca

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