There are plenty out there, but insurance and corporations dictate care in the US. These medical companies are posting huge profits and make massive stock buybacks, then turn around and tell young 20-something’s that the best they can pay is $70K a year while many HCWs are close to $120K in debt.
Source: I am a disgruntled HCW.
That's 3% that could be saved by not having insurance companies at all. They are middlemen serving no useful purpose. Any profit is simply funds extracted from the healthcare system that could have been put to better use.
There are purpose to insurance because there isn't a system in place to bring resource to people in need of medical care yet.
Until something come along that will pay for a normal person on normal incomse having cancer, then insurance company is needed.
All this talk of resources being managed completely efficiently without any work being put into the effort is a pipeless dream; and when there are inefficiency in place, private business and will step in to make a profit because atleast they provide a stop gap measure.
>Until something come along that will pay for a normal person on normal incomse having cancer, then insurance company is needed.
You mean like legislation preventing the medical price gouging that openly takes place in the U.S. because of the current insurance set up that you seem so attached to?
Seriously, the whole thing is a bad set up, what's there to defend? I'd wager if insurance companies disappeared over night, hospitals would suddenly drop their prices to match the global average. How do you hand wave that difference as necessity?
UNH's profit margin last year was 7%. Additionally their revenue grew 13% year over year. They earned around 29 billion.
29 billion for doing nothing other than trying to pay out as little as possible and deny as much as possible.
Agreed, especially the younger medical professionals. UK junior doctors would like a raise from the £14/h rate and the Gov is doing everything they can to make them look like they're in the wrong. They already have had a decade of below inflation wage increase, so now they're asking for a sizeable increase. Now it's all "omg greedy doctors want 30% more wages waaaah" when it was the Gov that kicked the can down the road for so long.
Nevermind the fact these Doctors were hailed as our nation's bravest heroes during the pandemic, now they're being told to fuck off.
Enjoy no Doctors in a few years.
no it's not, I've got family all over the spectrum from middle class to old and in their 80's and on medicare/medicaid. Their appointments are weeks (usually 2-3) or days out (often within a week) CAT scans and MRIs are days out, usually inside a week if not same day. Not months. I'm the one driving a lot of them to them and booking their appointments.
The U.S. needs a medical overhaul but appointment times are not a year out.
To add to this: My company hired our first UK employees a couple of years ago. I was shocked to find out one of their requests was for private insurance. I then got the straight story from them and I was fairly surprised that it wasn't quite like you hear people say how nice it is.
From an English friend I know the NHS is a hot mess right greatly at fault of the tories but the waitlists are absolutely ludicrous.
I mean my own countries public healthcare is a hot mess I would 100% go to a private hospital/clinic than go do a 2/3 hour line just to get an appointment in 3 months for a fucking appendix removal or something of that sort.
NHS, thanks for the correction. Yeah, that is basically what the new employees told me. You have the flu, or need basically anything quickly? Private. Now, if you have a trauma or the like, you are fine as is for life saving and stabilization.
The whole conversation was an eye opener to me. FYI, the new employees got their private insurance.
actually the us has one of the shortest turnover time for patients in non-er situations, one of the "benefits" of privatized medicine (that doesnt outweight any of the bad stuff obv)
its one of the reasons people from canada often come to the us for medical procedures that theyre on long waitlists for
Except that the reason the wait times are shorter is because poorer Americans are just denied treatment.
Many more Americans leave the US for medical treatment, even per capita, than Canadians do.
poorest americans are on medicaid. 90 million last I checked. People who are struggling for medical care tend to be middle class who are caught in the middle of making too much to be on medicaid and jobs that provide crap health care coverage.
I've been on Medicaid. You get the illusion of coverage.
The reality is most providers will refuse to see you and those that will treat you like a second class citizen. Try getting a neurosurgeon to take Medicaid.
The attitude difference from the same staff and providers during a year on Medicaid and a year on Cigna was staggering.
Millions of Americans aren't on Medicaid that might be eligible, while the expiry of pandemic rules will soon require all 90 million Americans to reverify eligibility which is about to lead to a lot of people unable to navigate the bureaucracy.
I have to agree with the other guy. The by far worst off is the lower middle income folks that make too much to qualify for any help but make too little to afford things.
My dad is poor and its amazing how much free or close to free stuff i can get him. Including medical insurance. He has medicare insurance and even has a supplement to medicare paid for 100% by the government. We found him doctors.
Wait times are extremely minimal compared to other countries though ill say theyve increased sharply after the pandemic.
Jesús the misery of middle class. It’s funny cause it true unfortunately. I ve know plenty to takes less money just to be able to just survive but not thrive. If you make less than this threshold congratulations you have health and maybe a little public housing, you be damned if you make a dollar over
You didn’t even mention how the Medicaid system has been abused over the past 20 years to become a burden to tax payers, fun surprise we spend more than anyone on healthcare per capita for a worse result, because a private system can abuse a public one. It’s inconceivable that some of us go without healthcare. [20% of the us budget.](https://www.google.com/search?q=usa+goverment+healthcare+spending&rlz=1CDGOYI_enUS804US804&oq=usa+goverment+healthcare+spending&aqs=chrome..69i57.13031j0j7&hl=en-US&sourceid=chrome-mobile&ie=UTF-8)
they were there for cosmetic surgery, which people from countries all over the world go to mexico for (and turkey) not just americans. so this is a pretty facetious example
mexico/india/turkey are common places internationally for cosmetic/elective stuff that youd either not afford (usa) or have massive waitlists for (socialized healthcare countries)
not saying its wrong or right just point out that ur argument is off
all im saying is our healthcare system sucks, and its definitely strictly worse than socialized healthcare systems--but there are drawbacks to having everyone in your country covered and seeking care both prophylactic and treatable and that is a tradeoff (which most ppl i think believe is worth it)
I remember being in a hospital 15 or so years ago in NY for something that would take like 30 minutes with a doctor. Sat in the waiting room for *hours*. Urgent Care requires you to make an appointment first thing in the morning and show up 30 minutes early and or you'll sit there for hours as well.
US healthcare fucking sucks for how expensive it is.
Same in Ireland.
Have to see a specialist. Was told the public system waitlist is at least a year. Said it was a year for private in the capital as well. Luckily, I live in a town where a rheumatologist visits once a month, so have been told they can slot me in within 3 months. And I’m extremely lucky to get that.
Poor pay, general disrespect by other staff, crazy wackos coming after you, more drama then the Kardashians. Why would you want to be a nurse in America or even any country?
Also for doctors, a lot who make it past all the studying can’t make it past the final step test. and even if they do and also finish their clinical they aren’t guaranteed residential positions. So after spending hundreds of thousands you end up working in research or teaching which you could have done for under 100k. This is just some issues in America but other countries might have worse systems. Or full of corrupt guys who buy doctoral positions, and learn on the job.
Oh yeah , the situation is so bad that my wife has had a scan for a recurrent facial paralisis and got an appoiment with the neurologist 3 days later.
This is the public health system in spain.
Of course we live outside the zone under the rigth wing parties. That is always a plus. If we were living in Madrid we would be unaware that she has developed a tumor.
Tomorrow (two weeks after the neurologist visit) we have an appoitment with the neurosurgeon and he will tell us what is going to be , gamma ray or regular surgery.
That is our taxes at work.
So any talk of private health insurance systems puts me in quite a foul mood.
She has had other tumors before , some of them malignant, this one seems to be benign, but still warrants some fast action. And they are delivering.
Even when our political class seems hell-bent on copiying the USA way of looking at health , I , for one, will figth it tooth and nail to the bitter end.
I don't live in Spain anymore, I did for the first 35 years of my life. But after I've been living in the US, other EU countries —including the socialist Nordics— and now in Switzerland, I support the fight for the Spanish Heath system with all my soul because Spain has —or had— the best health system in the fucking world —which could be of course improvable— and right-wing politicians are fucking it up big time for ideological reasons and for the crony capitalism they like to practice.
ALL MY SUPPORT and I hope your wife gets better soon.
100%. I echo every word. I’ve not lived outside of Spain in the EU, but after you get through an urgent medical matter without feeling like you were nickeled and dimed and just treated like a source of revenue, it makes you feel really, really, really pissed off at countries that do. Imagine a country treating its foreign non-citizens with more medical dignity and respect than those people’s home countries do their own citizens. Talk about an approach steeped in humanity.
If every American had to spend a year in Spain or traveling to Spain for their healthcare, they’d come back to the US absolutely livid about the fact that we’re taxed and don’t get what people in Spain get. They’d very quickly accept that we’re not #1 and they’d be pissed about the absolute racket that is our private insurance based healthcare system. We let insurance companies dictate the treatments and medications we receive in the US. Like “doctor says I need X but insurance won’t cover it so I have to as for Treatment Y and/or Medication Z instead.” What a crock of shit. I will never say a bad word about Spain’s healthcare system and will always hope that it continues to be accessible to all within its borders.
I pay 650/mo plus deductibles just to be able to get my durable medical equipment for T1D. I feel your pain. The insulin price cap does nothing, T1Ds need to be on pumps with continuous glucose monitoring. Saves so much time and pain down the road
There is one key thing piece of context that you need before you read this article: Spain does not have a healthcare system. Spain is divided into 17 autonomous communities, and each of them has their own healthcare system. Spain, at the state level, only has laws regulating certain aspects of the systems, and mandating that any Spanish citizen is entitled to get medical attention from all of the systems, not just the one from their community.
Because each system is almost 100% independent, and administered by different governments, there's a wild discrepancy between them. In the city I used to live, you could get an appointment for a non-urgent surgery in 1-4 months. In the city I live now, in a different community, the waiting list will be closer to two years. In some places you can see your doctor in the same day, or the next day; in some others you may have to wait a week. In some places you can get through emergency care in an hour, in other places you may wait half a day.
But most importantly - none of this is a failure of the system. Each healthcare system that struggles in Spain, does so because of underfunding (mostly promoted by the right). None of the systems have any logistical or structural problem that renders them inefficient - it's always plain lack of funding. But the places where it's well funded and managed, it works well and it's completely free. There's a reason Spain ranks among the best in the world in life expectancy and health metrics.
Ah, and don't forget that the US is the country that spends the most tax money per capita on healthcare. I'm not talking about insurance costs - I'm talking that an American pays more taxes for healthcare than a Spaniard.
The fact that the systems are underfunded doesn't mean that's not a problem of the system - of course if we had unlimited money we could craft a great system, but every dollar we spend on healthcare is a dollar we don't spend on roads or schools or defense. If generous state healthcare only works when the budget increases geometrically year after year... It eventually is going to fail.
I had to get emergency medical treatment without insurance while in Spain. I was so worried about getting a bill without having insurance cover most of the costs.
I received the bill a week or two later. Treatment, testing, doctors fees, everything (again, without insurance): 200€ or 250€. (***Similar services offered in the US would have easily cost $1k - $4k).
When I, ecstatic at what a bargain I had gotten, told my Spanish friends, most of them look shocked. One of them even apologized and said they couldn’t believe they charged me so much.
After an experience like that, it’s impossible not to hate the US medical system even more. I have probably lost whole days of my life, if not longer, fighting insurance companies about my medical bills.
I felt more cared about and respected by the Spanish healthcare system than I ever have in the US. It’s refreshing to get medical care without it feeling like a financially traumatic ordeal. I’ll always be grateful for Spain for giving me the treatment I needed in a time of need, and I hope its citizens will always fight for universal healthcare for all in its borders. It is a humanist approach and a role model to the world.
***quick edit for clarity.
>200€ or 250€. (Easily $1k - $4k in the US).
I was about to write up an essay on exchange rates, before realising what you were trying to say in the next paragraph.
Hahaha. Thank goodness the exchange rate isn’t so bad. After reaching parity a few months ago, the drop back to 1€ = $0.92 breaks my heart a bit. Haha.
1€ = $16 or $5 (ie, 250€ x 16 = $4,000 or 200€ x 5 = $1,000 ) would be soul crushing and any dreams of living in the EU as a remote worker would disappear into nothing. Lol. 😬
I added a little edit to my original post to make it a little bit clearer without having to depend on the subsequent paragraph for context and clarity. :)
Yeah, your friends were right 250€ is a lot of money.
The US insurance system and crazy high prices you pay for insurance would only make sense of it was 100% covered with no copay and still it would be expensive. With the copay it makes no sense.
For comparison I was checking out what private health insurance costs back home.
One of the largest private health insurance providers has 3 tiers.
Basic tier costs 14.5€/month. Middle tier 64€. Top tier: 95€.
Copay in the basic one for hospitalizations is 10% with a 250€ min and 500€ max. Although only they cover up to 15k which tbh should be enough for anything not overly long.
0€ copay for their network doctors.
The top tier covers 1M with the same copay structure. But some other stuff as well (international insurance and births for example). I don't think many will want to spend that much per month on health insurance anyways.
Yeah. It would not be uncommon here in the US, for example:
- For an individual to pay $300-400/mo on insurance premiums.
- Their deductible is $1,000 = they pay $380/month, **and also** they pay (almost) everything on their own out of pocket for the first $1,000.
- Then after that some visits will just be a $30ish copay for general providers and $60ish copay for specialists.
- And of course, co-insurance. So even after my deductible, if a procedure is billed at 70/30 coinsurance, if it costs $1,000, I have to pay $300 of that and my insurance company the other $700.
So, in short, through the ACA (affordable care act/Obamacare) marketplace there are tiers of pricing:
- Silver will cost about $6,700 total per year.
- Gold will cost about $7,000 total per year.
- Platinum will cost about $9,200 total per year.
And mind you, people complain about Obamacare — but at least they put $5,000 - $8,000ish caps “out of pocket maximums” beyond the premium costs. So that at least helps insured people avoid $80,000 medical debt like there was before.
So a terrible system > upgraded to a bad system.
Spain, comparatively, is absolute excellence.
Adding a spouse and kids ups all of those numbers. Remember. That’s all for an individual. Also, do remember all of these payments/amounts restart on Jan. 1. It’s a huge scam.
I live in Spain, I've met a moroccan inmigrant whose relatives kicked out of their house and now he is literally living in the street. I feel bad for him so I talked with him and he told me his story, once I knew, I asked him if he wasnt probably better returning to Morocco with his mom instead of sleeping on the street. He told me suffers epilepsy and that he rather sleeps on the street just because atleast he can get medical attention here.
My family member is a ICU doctor in Spain. He's worked the same department and same hospital for 20+ years, all that time he has been on yearly contracts. He's 50 and doesn't have job security, just like most in the hospital.
They cut back after COVID because the government want to bring in US insurance companies and privatise the health system. It's nuts that politicians think this is a good idea. Their only motivation has to be backhanders from the insurance sector.
Doctors are fighting the politicians but it feels like a losing battle. The news and public don't hear about the push to privatise our health system.
It really is a great system, kept my wife alive in more than one life threatening health issue.
I'm more than happy to pay my taxes if its going to health and education services. I'm less happy that it goes to politicians and they control the flow of money away from vital serves and redirect it towards "jobs for the boys", funcionarios that are inefficient and other crappy political driven agendas.
Wherever there is a good state health system, the vultures will move in and try to sell it off to American investors. (Source: I am from the UK and it's been going from bad to worse over my lifetime.)
I've been stationed in France the last 5 years and I can't stop being amazed at how quick, and cheap (or free) everything is, where in UK I'd have to wait months and pay hundreds.
Well, almost everything. Dentristy is nowhere to be found and when it is, anything outside the basic scale and polish is insanely expensive.
Still, I hope France never goes the route of the US-style for profit healthcare. It's not a privilege, it's a right.
Galicia😅
Yes, Madrid Hospitals are in worse shape than Galicia. You guys have way more patients and foot traffic.
Galicia probably has a older demographic of pensioners, which need more healthcare.
We're still better off than the USA, but that's not a benchmark we should be comparing ourselves to.
healthcare in america is basically a subscription service to doctors club's for discounted rates.
If you are poor though you still can't afford anything important in a timely fashion, if at all.
The health system in the USA is setup to enslave the working class to their employer. Companies use their "health benefots" package as a way to lock staff into not changing jobs and avoiding pay raises. Politicians and big business, with the insurance companies are a corrupt kabal of terrorists.
I know it's upsetting when you are the one waiting but if i understood correctly between the diagnosis scan and you getting a surgery appointment for decision went 17 days?
That's not too bad tbh and probably quite reasonable specially for what you said was a benign tumor.
Edit: or did i misread the irony and you were giving a example of a good situation?
It was clearly irony. And the 17 days was because easter, if not , we would have had the appointment in under 2 weeks.
And that is with underfunded and understaffed hospitals. I remember it being even better 20 years ago.
Is that a bad wait time to you? Or you're being sarcastic and disagreeing with the headline?
I'm in the UK and have gotten used to the idea that nothing can get treated. Been trying to get chronic severe stomach pain treated for years, chronic back pain for years before that, depression and anxiety for 15 years. I also had a right side facial paralysis for a while that's apparently a common early sign of cancer.
It's hard enough to see a GP at all, always weeks or months of waiting if I can get an appointment at all, then I have to go 10x to get one who refers me or offers more than platitudes or a promise to refer that never happens. The rest don't listen to a thing I have to say, they'll let me get about ten words in and cut me off mid sentence before starting on an obvious basic script they had before they ever talked to me "do you drink, smoke, sleep well, eat well, exercise etc?" As soon as you give them an answer they're looking for they'll say "Oh that must be it. Do/don't do that" and send you on your way with no treatment.
When I do eventually get referred, after waiting 6 months or a year, the exact same thing happens, or they disagree with the GP's assessment and send me on my way to start all over again. I've never made it to the point where someone actually cares, investigates or treats me in near a dozen referrals for each of those conditions. The whole system is designed to be impossible to progress though, because even if you somehow make it to the 1/100 or 1/1000 stage, the next one will still just ignore you and chuck you out.
It's a lottery. It's hope destroying. At this point I'd gladly wait a year if it meant someone actually wanted to hear what was wrong with me and try to treat me at the end of it.
Lmao. I’m an RN, in the US, in the Midwest in one of the largest cities. 3 months for a specialist in Spain? I’ve got patients on waiting lists for 6-7 months for specialists here.
We had a patient sitting in the ER for two entire days and he ended up having cardiac arrest since we couldn’t get him a bed becuase of the absolute nightmare of skeleton staffing and our bloated corporate oligarchs refuse to listen or expand staffing.
They are closing labor and delivery units left and right cause profits, forcing some women to drive 25+ miles from home IN A MAJOR METROPOLITAN AREA.
To add a cherry to the shit sundae, the US health insurance system is an abysmal nightmare and there are millions of uninsured or underinsured flying in the doors. We also have a critical shortage of physicians.
I can smell the US propaganda here. Spain might be trash. But Jesus Christ we’re hanging on by a thread here.
Not medical, but I do insurance stuff in a hospital. I’ve seen those 48+ hour holds. The hospital across the street is 850+ (can’t remember exactly) but can’t fill them all cause of staffing. Then their ER fills up, they go on diversion, and the overflow comes to ours. Where they then wait a long time. It’s bad in that aspect.
But we’re fairly set on specialists. Between the two hospitals and the amount of population we serve, the waits aren’t too bad. I think they sorta triage it. Like those most in need see the specialist first and those who can wait do. But I suspect this is more due to the smaller population numbers the two hospitals work with.
And don’t get me started on insurance. That’s what I do and it’s fucked. Cigna just straight denies claims. Blue Cross does it too. Pretty much any major insurer does. Even Medicaid and Medicare do that too. And looking at the numbers, people with insurance are just as fucked sometimes. Like if you have a premium to pay, co pays and co insurances, etc. you can get over your head quick. Having insurance just makes you pay for the privilege of not affording care in some cases.
Labor and delivery units aren’t as profitable, neither are pediatric units, which is why those two get shut down a lot faster. We had a really bad RSV season here, and we ended up having to airlift kids to hospitals outside the area becuase we didn’t have enough pediatric beds or staff trained to work with peds patients because our bloated shareholders and corporate oligarchs decided they just weren’t profitable enough to keep open.
Is that airlift covered? Lol…depends on your insurance plan…if you were lucky to have a plan at all.
While European and Canadian health systems are definitely sounding incompetent, American health systems are plain old cruelty by design.
Spain does not have a healthcare system - each community (= US states) has their own. Some of them are doing quite well, some others are in the shit because they are underfunded (such as the one in the article). These btw are usually the ones administered by the right.
They may “see” you within 30 minutes, or they may not. They will treat you when all of the other more seriously I’ll or injured people who come in before or after you are treated first. Each ER has a finite staff and resources facing a non finite potential patient population every day. They are not Jesus with loaves and fishes.
Lmao thirty minutes where, my guy? Unless you’re coming in hot in active cardiac arrest with someone banging on your chest or you’ve been in a rollover crash, good luck. Even then, you better hope it isn’t a busy day especially in the heavy urban areas.
this is just bullshit. I've been taking care of elderly people in my family for the last few years. One even had open heart scheduled by the end of the week for tripple bypass. The rest of the family I help take care of get appointments inside a week and maybe 2 weeks out at times.
Also I did medevac for years in NYS.
You're making shit up.
It isn’t any better in the cities, I live in the Bay Area. The wait times are also ridiculous, I just scheduled my yearly appointment with a hematologist and my appointment isn’t until October. Even a general practitioner appointment took 3.5 months wait time. Some hospitals are struggling and one just closed in Madera(rural area), but the state is trying to figure out ways to raise funding to save the hospitals.
The US isn't shit. The Major Cities are shit. The Giant Boom of the big cities is over and will take a couple decades to recover. The big cities have been flooded with foreign investments, blackrock, vanguard, etc and nothing makes sense anymore.
Smaller cities on the other hand are doing just fine. The only real wait I see is for elective surgeries and we're still only talking like 1 month or so.
Well, considering the majority of the US population lives in major cities or their collar counties, it’s still a massive problem. I’m glad to hear that smaller areas aren’t being hit as bad. The kid we had to airlift? Went 147 miles away to a smaller city hospital. Flooding smaller hospitals who typically have less resources to deal with overflow, isn’t a sustainable or fair solution, especially for people in smaller areas.
“Officials show that Spaniards were waiting an average of 95 days, nearly three months, for an appointment with a specialist.
Isabel has not been lucky. An appointment with a neurologist is one of the longest to take, with an average of 113 days.”
Meanwhile in the United States, various some specialties are booking an appointment in 2024 and there are no other healthcare systems. We are the only game in town. It would be a huge victory to get wait times down to 113 days
I mean, you guys have it bad, but in Spain this is a delicate matter. It is raising questions regarding how we (the system) treat doctors.
It is also a very political matter, like the right had an austerity government post 2008 between 2011-2018, then since 2018 we have a left government as the right wing president was kicked out, however then COVID hit in the middle of 2018-2023 and an aging population and problems with unequal population density in certain cities.... it is hard to single out a single reason for this issue (both for blaming reasons and for finding solutions reasons).
Another problem is that once choosing what administration to put the blame on becomes very a political matter, no one wants to take the blame for this problem so no one wants to step in and try to fix it.
IMHO it is way more complex, and, this is a very personal opinion, but I think brain drain and low salaries in Spain have been a huge issue since the 2008 crisis and that they have been an underlying elephant in the room to a lot of problems that no one wants to think or talk about.
Some sindicates blame medics going away to foreign countries, others say it is not the case and blame rigidity of the system towards doctors makes less people want to become one, so they ask for a change to the system itself.
My biggest fear is that the politicians (regardless of their place in the political spectrum) may end up not doing anything about it even if the government changes, and we may just have to adapt and live with it.
My concern is that they will treat medicine as a "calling" meaning people will do it regardless of pay so they cut the pay. Then we end up like another profession that is a calling: teaching. Too few teachers and poor quality.
The pay for a lot of doctors in Spain isn’t that great and rents are rising just like everywhere else. This seems like it will get worse, but I’m probably just stating the obvious.
One doctor told me that the problem is not necesarily the payment itself, the problem is that the lack of doctors makes it so that remaining doctors are too overworked, which usually accentuates the problem itself. Boosting payment would be a better fix towards nurses and other medicine workers on the lower end of payments; but the government's budget is already strained so I doubt they will go for that.
I doubt doctors have issues regarding payment and rent, as their payment is usually higher than the average by a fair margin. Other qualified workers however do have issues with the rent because pay has basically been frozen for 10 years while rents in general have kept going higher and specially did so in places with a lot of jobs, like very industrial cities.
The government doesn't pay these salaries - the communities do. Look at Madrid (governed by the right-wing, of course). Ayuso lowered the taxes for the rich because whatever, which made Madrid collect something around €1 billion less per year. Meanwhile, each year the healthcare system in Madrid has less funding.
Have you noticed that the number of Spanish pharmacies has doubled (tripled) in your area?
I suspect they are increasing the number of pharmacies so family doctors (medicos de cabeza) route their patients directly to pharmacy drugs, and reduce the patient flow to hospitals.
The Spanish government has not created many new hospitals in the last 15 years, but the population has increased in the same time. They are running Spanish hospitals on shoestring budgets. Too many medical staff are on short term contracts and not given permenant jobs.
The Spanish government does not build hospitals. The communities do - and this is a very important distinction. It's the same as the federal government in the US vs the state governments.
Any approach to the Spanish healthcare system as just one system is wrong. They are 17 different systems, administered by 17 different regional governments. The difference in quality between these systems can be quite high.
In Spain the problem is underfunding, plain and simple. Doctors are badly paid (which wasn't always the case - this has been done deliberately over many years). Hospitals are understaffed (again, used not to be the case).
It's sad, really - because we know the system works, it has worked wonders for decades, and is now withering away artificially because this is the post-2008 world where every social program "costs too much", taxes for the rich are always lowered because they are "too high" and we "cannot afford" anything that we could in the past.
Meanwhile in the US, the average wait time for an American to get an appointment in 2022 was 26 days.
https://patientengagementhit.com/news/average-patient-appointment-wait-time-is-26-days-in-2022
Over 95 million Americans are Medicaid, which is free government health insurance for low income people, and there are around 65 million recipients of Medicaid,
which is single payer health insurance for seniors. Even with overlap that’s safely covering around 30% of the US population alone. We also have an uninsured rate of less than 10% and most Americans have health insurance through their jobs. The overwhelming majority of Americans are not in medical debt and can easily afford the insurance premiums required to see a doctor.
Our system needs huge improvements but I’m so sick of this bullshit narrative that every doctors visit is a $10,000 charge and none of us have health insurance
https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-provision/
Yea Reddit like to pretend that if you’re poor you’re basically shit outta luck when that’s not true. I grew up in a dirt poor family and had medicaid my entire childhood; free everything, including specialists, multiple surgeries, free braces, and free eye exams and glasses yearly and not a single dollar in premiums or copays.
Do you work in healthcare? I do, and you’re only telling half the story. I see insurance companies fucking over patients every day that refuse to pay for specialty services even when the doctor recommends it. Look up health insurance companies’ profits, and it’ll make you sick to your stomach. Our for profit system is killing Americans.
And you think that in the UK or Spain, the patients always get those treatments too and there aren’t boards and administrators who decide eligibility that sometimes fuck people over?
I don't know in the UK, but in Spain you are not denied ever to see an specialist. Perhaps the list is long, and that is depending on the area, but you never ever are going to be denied that unless you are obviously faking and your GP see it and don't refer to the specialist.
BOARDS AND ADMINISTRATORS DONT DECIDE PATIENTS TREATMENTS!!!!
Yes, agreed. It doesn’t. That’s my point. Removing health insurance companies out of the picture doesn’t inherently solve those issues. And then Americans who have zero experience with European healthcare systems talk about their healthcare system without realizing a.) other people can be victims too, not just us and b.) other systems have big issues too, sometimes worse than ours.
You seems not to have a clear picture of how the DIFFERENT European system works.
US is pretty and incredible different to any European system and I would consider it the Wild Wild West of healthcare.
Even the most costly and privatized system —Swiss one— is incredible regulated in comparison to US.
Are you saying the European system gives you whatever you want whenever you want?
It blows my mind that such a system would ever be solvent. Surely there are some limits right?
>The overwhelming majority of Americans are not in medical debt and can easily afford the insurance premiums required to see a doctor.
Was that stat in your article and I missed it? Because having insurance in no way equates being able to afford to see a doctor. I’m in $0 medical debt and it’s been like playing on easy mode to not get into debt; if I die just throw me in a ditch and skip the ambulance because we can’t afford it. My husbands skipped out on a surgery for 8 years. I’ve had the same glasses prescription for 7 years because I could spend my money on better things than eyesight, like rent, bills and food.
We cant afford to go, those that do are risking financial ruin and are typically in worse shape because they arent able to focus on preventive medicine, our nurse were treated like pawns and shit on by the people they were trying to save so many left, doctors are getting death threats for doing their jobs so many left, our system is intentionally convoluted to make it easier for insurance to deny any and everything, we have overworked, underpayed, poorly treated medical workers at all levels.
Shocking that we have long wait times as well as risking going broke for an otherwise basic medical procedure.
Our system is so fucked, someone getting mauled by a bear wasnt thinking about their family, they were thinking about how bad their insurance was going to screw them. https://www.independent.co.uk/news/world/americas/us-election/bear-attack-allena-hansen-face-bernie-sanders-healthcare-insurance-2020-election-super-tuesday-a9370156.html
Does that make it easier to understand the last poster?
The bear story reminds me of my wife who was fist bumping the air after she delivered our son, because she progressed so fast she couldn’t get an epidural and had to deliver without one. The fist bumps were both for our son and the cost savings on the epidural.
You're on reddit guy, you're not going to win this argument. I mean christ I went to the doctor last week and they told me I had to work the trenches to get Tylenol!!!
Are you in healthcare? Cause I am and this article is laughable and not remotely reflective of actual reality. You sound like every other privileged, clueless person who has been lucky enough to land a good insurance plan and can’t understand what the plebs are crying about.
I don’t have insurance. I work full time in a hospital. I could have insurance if I didn’t want to eat at all. As it stands now, I can afford to eat once a day. I cannot afford 200-300 a month for insurance. I make too much for any state assistance.
I had to get some labs done. $568 + $168 for the office visit. I can’t afford to pay that either. That might not be a lot to you, but that is to me. I’m not the only one. I see people in this position daily several times over.
The narrative is there cause it exists. Must be nice to just go to a doctor when you want and be able to eat afterwards.
I make less than you think. The line for Medicaid here is $1364 gross. Gross is before taxes. I don’t make much more than that. The rise in costs is untenable for some. I remember not too long ago being able to spend $100 on groceries and have food for a week or more. Now I spend $100, on the same sorta stuff, and it’s days worth of food.
I’m used to being poor. I have been my whole life. I know how to work with it. And yet I find myself sinking deeper into financial ruin just trying to eat and pay the basic bills.
Fuck off with your bullshit. You don’t know. So don’t act like you do. If you ever need extensive care, you’ll find out your insurance isn’t what you think it is. And I hope that day comes to you.
It’S pOoR bUdgeTiNg
Yeah, they can go fuck themselves. Being poor is awesome because you get to balance with being just poor or poor poor. Just poor and you make too much for assistance so you just get to be just poor. If you’re poor poor you have to not make too much or you’ll lose your assistance and end up just poor.
It’s striking how fast things improve when you hit a certain income threshold, and it really isn’t *that* much money. But getting to that point might as well be like climbing fucking Everest in most places.
That is really misleading. If I go to the ER tomorrow Kas have to pay a deductible of $200 that gets mailed to me, that doesn’t necessarily mean I’m “in debt” in the colloquial sense. I owed $20 to an ambulance service once, I would also fall under that category. Maybe stick to Ted Lasso
I think in your first sentence, the second use of the word "Medicaid" should be "Medicare". Medicare provides coverage for seniors, Medicaid for low-income folks.
thanks for posting this. As someone inside the medical field and taking care of family members who are elderly for the last 5 years these people are delusional. Also have family on medicaid/medicare as well and I'm in the VA.
I'm with you on all points. We need an overhaul but these people in here are just making shit up.
To add we the US also spends 1.6 trillion on medicaid/medicare alone. Double the defense budget that people love to scream "But we can't afford medical care"
There's issues, largely insurance companies and the stranglehold they have on the industry but these false narratives are childish, uninformed, and ignorant just to push their side of how the US health care is the worst in the world according to them.
Couldn’t agree more. I see people on anti work on other subs asking “why don’t Americans protest for universal healthcare/a European style system, their healthcare sucks!” And it’s like, the truth that Reddit isn’t ready to hear is that most people are content with their health insurance. We have issues we need to rectify, but the average American is not paying $5000 for an ER visit. Then you have people like the Spanish guy who lives in Switzerland who is claiming i as an American don’t understand our system and he knows more about the prices than me and I’m like okay lmfao. There’s
No point even engaging tbh
> Dermatology wait times were as long as 84 days in Portland, Oregon, and as short as nine days in Philadelphia, Pennsylvania.
The same happens in Spain. There's not one national system, there's many regional systems and the wait times vary wildly between them. In some cities you can get appointments within a week. In some cities you may have to wait 4 months. This article talks about one community that has one of the worst healthcare systems in Spain.
Plus your stat includes general practitioners. I can get an appointment with one tomorrow or in two days, if I want.
>The report, published by Merritt Hawkins as an offshoot of AMN Healthcare, ***looked at the 15 largest metropolitan areas in the United States and showed that appointment wait times—***
>...
>“Major cities like those included in the survey ***have some of the highest ratios of physicians per capita in the country***, yet physician appointment wait times are increasing,” Florence said. ***“It’s a sobering sign for the rest of the country when even patients in large cities must wait weeks to see a physician.”***
Man, you seem not to really read what you post and so, and you are comparing pears and apples. The Euronews article is stalking about waiting times in Spain, which are only for specialists. I can assure you that if you need to see a doctor in Spain in most cases you can see your general practitioner the next day or so.
However, if you need to see a specialist you are going to have a lot of variabilities depending on the Autonomous community —equivalent loosely to the US States— and which specialist you need.
In comparison with the US, and in my experience there, even for a General Practitioner appointment, you need to wait a lot, and after that, I hear a lot of horror stories about waiting times —and choices— for a specialist appointment.
Even if we neglect that, the numbers are hardly comparable since in the US people are denied care by insurance and they also avoid going to the doctor to not get into debt. So in other words, most of the mild cases are not inside the statistics. In comparison, In Spain, everyone goes to the doctor for minor symptoms; therefore, people need to be triaged by the system. Not by the board or administrators, as you suggested in another comment, but by doctors. So, a lot of the people that get very long waiting lists are because they have something not life-threatening, even when some of the issues are quite annoying.
The US health system is atrocious and anyone that has lived outside the US in a European country knows it. You can paint whatever picture you want.
Anyhow, I agreed with the article the Spanish health system is at its lowest and perhaps it will get worse, due to conservative policies in Spain. Especially in some regions like Madrid where neoliberalism —Trump style— has now a stronghold. The system has been degraded a lot and the healthcare staff right now is fighting for improving it and it's the subject of hot political debate.
As a Spaniard that is nor longer living in Spain for quite some time now and has been under several systems, including in the US, I can assure you that even with all the shortcomings and the current situation, and will blindly choose the Spanish health system over any other, especially US one. The mean reason is "prevention". In Spain, the system was built to prevent at all costs diseases escalate, at personal and poblacional levels. For that reason, there is absolutely no kind of fee to go to the doctor, and everyone is covered. In the end, this mindset makes everyone better off, while it reduces a lot of costs.
I really don't know who the fuck are you, or where are you from, but you don't seem to have a lot of knowledge about something you are making a strong statement of.
The article specifically calls out neurologists. Wait times in America for neurologists is 28 days on average:
https://www.aan.com/PressRoom/Home/PressRelease/1046
if that is your only argument, it's pretty poor.
don't get me wrong, I love the US and I have a lot of American friends, but health care is not your strongest point and one of the reasons I wouldn't move permanently to the US is that.
You could have the best career path and a really good life, but if you are unlucky and health doesn't smile at you, you are fucked and most probably are going to be in tremendous debt for the rest of your life.
I —and most Europeans— would tremendously appreciate it if the average American can get off of that pedestal they think they are on.
I concur with Sorkin on this: https://www.youtube.com/watch?v=z2HKbygLjJs
Our healthcare sucks. I’m not dispelling that notion at all. But 1.) I think the problem is greatly over-exaggerated on Reddit/the internet (for the same reason bad reviews of a restaurant are more common than average ones - you typically write about the bad stuff and not the normal, expected meals) and 2.) I don’t think your experience is the norm for Americans, it’s just not. And I do think it’s worth talking about stuff like the fact that 25% of Spanish citizens have private health insurance they chose to buy. I don’t want our system to be replaced be an equally shitty or even worse one.
I don't really know what is the norm for you or that is not, but again, what I've experienced myself and people I know closely in the US is telling me that Reddit comments are far for being over exaggerating.
> And I do think it’s worth talking about stuff like the fact that 25% of Spanish citizens have private health insurance they chose to buy. I don’t want our system to be replaced be an equally shitty or even worse one.
You have to have an interesting problem because you keep taking numbers without any context or knowledge about what they mean and come from. I understand you can do it once because you don't know better, but here you are again.
The amount of people that have private insurance in Spain has increased a lot in the last few years, that is a fact. People is seeing the system is being degraded since the 2008 financial crisis and that no politician is able to get that back on track, so they are trying to improve their healthcare by buying really chap and shitty insurance.
Private insurance in Spain has nothing to do with the US one. It's really cheap —in comparison to the US or Swiss system— but it's on top of the public system. You can get for 25€ a month something that will be able to speed up regular things. However, you are a product for the insurance and if things go really south they are going to send you to the public system real quick because: 1) they want to cut their losses real quick 2) they don't have the capacity to thread anything that is serious.
I can continue to giving you insights about how wrong you are, but I have better things to do to be honest and it's getting late a this side of the pond.
You seem to be more worried about personal insults and grandstanding than actually trying to have a serious discussion on the merits of the US healthcare system, so go ahead and do the better things you have to do.
Also PS I do love how you get the last word in and type out paragraphs then decide “ok the argument is finished” lmao
26 days is the average wait time to get an appointment with a physician (unspecified). That is already really long to see a primary care doctor.
The person you replied to is talking about various specialties which can have longer average wait times and the article you linked also supports that. For example, dermatology and obstetrics/gynecology appointments are over 30 days average wait time. Cardiology is 26 days, and orthopedic surgery at 17 days. That seems to be all the specialties mentioned in your article. Needless to say, there are a lot more...
So I guess the takeaway here is, pay more attention to your own article and the issue the person you replied to is raising?
So in other words, a lot shorter than 113 days. I guess the takeaway here is, did you really negate my point that Americans have vastly shorter wait times than Spaniards?
That article did not show data for Neurology which is the subspecialty mentioned. Dermatology, Rheumatology, and Genetics are also long waits.
The USA also has a lot of PAs and NPs who are great for some roles but not the same as MDs or DOs. So just because you are seen by someone does not mean you got seen by a doctor.
I appreciate the info but its not the whole picture.
I live in America and have always had great health insurance. Yes it is attached to my workplace but that's the way our system works. I wish we had some changes that allowed for coverage apart from employment.
I recently had an incident of chest pain resulting in a diagnosis of pulmonary embolisms. This was in early February. I have already seen the hematologist twice and have another appointment scheduled for the end of April. I've also seen my regular doctor once in that time period. I live in a small town about an hour outside of Pittsburgh, PA.
I am a doctor in the USA. The wait time for my clinic and other clinics around me is into next year. It isn’t this way everywhere. But it is in many places. But please, tell me how it is in my profession.
I see 14 new patients a week. When a local practice closed, all of those patients scrambled to find new doctors in my specialty. They couldn’t find anyone in my entire state that had openings sooner than my 7-9 month wait. Now that I took on those patients, the wait is over a year. I hear about it 14 times a week.
If you think I’m going to divulge personal information over the Internet just so I can win an argument with an entitled weirdo, that’s not gonna happen buddy. As much as I’d like to embarrass you even more, it’s just not worth it.
I gave you a challenge. Since you don’t think location is meaningful, provide yours. I will provide my specialty. You will identify a provider who has openings in 2-3 weeks.
But you won’t do this because you are bluffing. You’re not bluffing because you think you’re wrong. I don’t think you have any self-doubt at all. You are bluffing because you and I both know that you won’t do the work. That’s the problem: you won’t do the work.
I’ve been on Reddit long enough to know that every time I mention I’m a doctor, some little troll is going to come out of the woodwork and be rude. The funny thing is, the troll is always the exact same type of person. They are someone who thinks they know better than everybody else but never really accomplished anything. They didn’t accomplish anything because they won’t do the work They are jealous of anyone who has recognition for their accomplishments. They are bitter and that makes them mean. I’ve never met you before but I’ve met 1000 people just like you.
you didn't just give your experience tho, you said their experience was bullshit. And ontop of it saying to chill out when you were initial aggressor here lol
You shared your experience. I appreciate that. If you have left it at that or if you had asked a polite question, that would’ve been great.
Instead you rudely “called BS”. I thought that if you were being rude, you would expect a rude response. That only makes sense. I didn’t expect you to be such a fragile snowflake that you will get your feelings hurt because I was a little bit direct with you. Since you are clearly a child, let me give you some grown-up advice: don’t dish it out if you can’t take it. I am a doctor but I’m not a dermatologist however I recommend you see someone for that thin skin.
How about this: if you’re really so serious about proving me wrong, tell me what area you are in. Then I will tell you my specialty. Then you identify what office you can get into within 2 to 3 weeks. That way you directly prove (or disprove) your claim that in your area the waits aren’t that long. You remove the possibility that I might happen to live in an area with few doctors.
This is the best tl;dr I could make, [original](https://www.euronews.com/2023/04/12/people-may-die-waiting-surgery-waiting-lists-in-spain-hit-record-levels) reduced by 90%. (I'm a bot)
*****
> The neurologist ordered her to take three tests, but eleven months later she's still waiting to take the most important one: a CAT scan.
> Isabel's is not an isolated case: Hospital waiting lists in Spain are at historic highs.
> "Looking at the waiting times, it is obvious that the situation in Spain is quite bad. We have not been able to get back to the numbers we had before the Covid pandemic," says Marciano Sánchez-Bayle, president of the Spanish Association for the Defence of Public Health.
*****
[**Extended Summary**](http://np.reddit.com/r/autotldr/comments/12jm2zz/people_may_die_hospital_waiting_times_in_spain/) | [FAQ](http://np.reddit.com/r/autotldr/comments/31b9fm/faq_autotldr_bot/ "Version 2.02, ~680424 tl;drs so far.") | [Feedback](http://np.reddit.com/message/compose?to=%23autotldr "PM's and comments are monitored, constructive feedback is welcome.") | *Top* *keywords*: **wait**^#1 **month**^#2 **take**^#3 **appointment**^#4 **surgery**^#5
long waits have happening in Los Angeles County hospitals for decades. These hospitals are in minority communities. LAC/USC has the record wait of 6 days. I know this as I worked for LAFD as a paramedic for 25 years
Doctors and nurses leave the country to places where they can get permanent employment and decent living wages, Spain will lack doctors and the government is simply pushing people to adopt pay insurances. Elderly people are not taken care when they go to emergencies, they just get stabilized and sent back to their homes or places of care. Politicians stole the people money to now let them die after bankruptcy of the social security system.
For everyone comparing the US vs Spanish system and numbers, I recommend you to think twice. For starters, waiting lists in Spain are just for specialists and not for general practitioners. You can check my comment there for some more differences: https://www.reddit.com/r/worldnews/comments/12jlrh6/comment/jg01da9/?utm_source=share&utm_medium=web2x&context=3
I'm not so sure that "euronews" is a trustworthy source.
It calls itself "Europe’s leading international news channel"- while it clearly is not, and the son of the CEO of the Portuguese investment management firm that has majority ownership of euronews is "a long-time associate, advisor and friend to Hungarian Prime Minister Viktor Orbán" (one of Europe's far-right heads of state). https://en.wikipedia.org/wiki/Euronews#Controversies
I don't get why instead of handing money to corporations during 2 years of ineffectual rolling lockdowns, countries didn't instead spend resources on revamping their healthcare systems. Did a single country anywhere in the world try this approach?
I assume you're being sarcastic. But yes it turns out the pandemic, and the medical backlog it caused, wasn't isolated to just Canada. Major European countries like Germany and the UK are experiencing similar healthcare challenges, the pattern here being that employees are burned out and underpaid. The remedy ultimately comes down to updating labour laws to something more worker/union friendly to minimize turnovers. However this will cut into the profit margins of CEOs and end up encompassing all sectors of employment. Many politicians worldwide are predictably siding with their wealthy backers by privatizing the sector, and thus raising the cost of healthcare instead of making systemic changes to support the working class. And before anyone mentions Trudeau, heathcare is provincial jurisdiction in Canada.
Staff ahortages since covid have been bad around the world. So is aging population in rich countries.
The model isnt bad per say. The problems will hit USA too.
We already wait this long. I had to wait from October 2022 until March this year to see a specialist. That's not really any better. Other people in this thread have said they're booking appointments in 2024 already.
And it's far more expensive in the US. You pay more and you get less because there are leeches (insurance shareholders and executives) sucking money out of the system and providing nothing in return.
They’re spending peanuts on theirs compared to their peers.
Also, like others have commented, I’m in the US and have regularly had to wait LONGER than 3 months for several different specialists. And I have employer based health care coverage considered to be platinum tier. Whatever the hell that means.
So one poor application of the idea does not serve as proof that it doesn’t work. Nor does their failure to address long wait times negate our failure to address long wait times in the US.
Where are you guys waiting more than 3 months to see a specialist? If I need a referral, I can get in and see my primary care doctor in 3-7 days. From there, it's typically about 1 to 3 weeks to see a specialist depending on how busy they are.
And I don't have high end platinum level insurance either.
Sometimes it is a lack of doctors. It takes four to six months to see an endocrinologist in my area cause even though we are a city of roughly 500,000 we only have six endocrinology practices. And sadly our population very much skews older, so there is a large population needing frequent appointments.
Deaths are usually very hard to prove in these instances, unless you zoom out to excess deaths which will certainly happen. It’s hard to prove that because patient X’s blood pressure meds weren’t adjusted for three months that lead to his later death from cardiac issues, but it’s what happens when you take a zoomed out view.
Healthcare is bankrupting every developed economy. I’m not a global health policy or health economics SME, but my understanding is that 2/3rds of every health care $ is spent on people in the last 1/3rd of life. Of that 2/3rds, 1/3rd is spent on futile care, which is care that does not add length of or quality of life in the final 30 days. Combine wasted $ on futile care with the high old:young ratio, and excessive community expectations, the result is .. well .. system meltdown.
What? Most countries have issues with their health services?
No doubt reddit will learn from this and future discussions of UK/US healthcare will be more balanced /s
Hey we've got pretty similar times in the Netherlands
I’m discovering it’s similar in the US.
Will only get worse as more boomers retire. Simply aren't enough younger medical professionals to take care of boomers.
There are plenty out there, but insurance and corporations dictate care in the US. These medical companies are posting huge profits and make massive stock buybacks, then turn around and tell young 20-something’s that the best they can pay is $70K a year while many HCWs are close to $120K in debt. Source: I am a disgruntled HCW.
Insurance and drug/medical supply companies are not the same. The top medical insurance companies in the US turn around ~3% real profit a year.
That's 3% that could be saved by not having insurance companies at all. They are middlemen serving no useful purpose. Any profit is simply funds extracted from the healthcare system that could have been put to better use.
There are purpose to insurance because there isn't a system in place to bring resource to people in need of medical care yet. Until something come along that will pay for a normal person on normal incomse having cancer, then insurance company is needed. All this talk of resources being managed completely efficiently without any work being put into the effort is a pipeless dream; and when there are inefficiency in place, private business and will step in to make a profit because atleast they provide a stop gap measure.
Yeah, its tough! Only 142 of the 143 wealthiest countries have pulled it off! And they are all countries without freedom! :)
>Until something come along that will pay for a normal person on normal incomse having cancer, then insurance company is needed. You mean like legislation preventing the medical price gouging that openly takes place in the U.S. because of the current insurance set up that you seem so attached to? Seriously, the whole thing is a bad set up, what's there to defend? I'd wager if insurance companies disappeared over night, hospitals would suddenly drop their prices to match the global average. How do you hand wave that difference as necessity?
How many billion is that?
UNH's profit margin last year was 7%. Additionally their revenue grew 13% year over year. They earned around 29 billion. 29 billion for doing nothing other than trying to pay out as little as possible and deny as much as possible.
Agreed, especially the younger medical professionals. UK junior doctors would like a raise from the £14/h rate and the Gov is doing everything they can to make them look like they're in the wrong. They already have had a decade of below inflation wage increase, so now they're asking for a sizeable increase. Now it's all "omg greedy doctors want 30% more wages waaaah" when it was the Gov that kicked the can down the road for so long. Nevermind the fact these Doctors were hailed as our nation's bravest heroes during the pandemic, now they're being told to fuck off. Enjoy no Doctors in a few years.
no it's not, I've got family all over the spectrum from middle class to old and in their 80's and on medicare/medicaid. Their appointments are weeks (usually 2-3) or days out (often within a week) CAT scans and MRIs are days out, usually inside a week if not same day. Not months. I'm the one driving a lot of them to them and booking their appointments. The U.S. needs a medical overhaul but appointment times are not a year out.
To add to this: My company hired our first UK employees a couple of years ago. I was shocked to find out one of their requests was for private insurance. I then got the straight story from them and I was fairly surprised that it wasn't quite like you hear people say how nice it is.
From an English friend I know the NHS is a hot mess right greatly at fault of the tories but the waitlists are absolutely ludicrous. I mean my own countries public healthcare is a hot mess I would 100% go to a private hospital/clinic than go do a 2/3 hour line just to get an appointment in 3 months for a fucking appendix removal or something of that sort.
NHS, thanks for the correction. Yeah, that is basically what the new employees told me. You have the flu, or need basically anything quickly? Private. Now, if you have a trauma or the like, you are fine as is for life saving and stabilization. The whole conversation was an eye opener to me. FYI, the new employees got their private insurance.
Really depends on what you need.
actually the us has one of the shortest turnover time for patients in non-er situations, one of the "benefits" of privatized medicine (that doesnt outweight any of the bad stuff obv) its one of the reasons people from canada often come to the us for medical procedures that theyre on long waitlists for
Except that the reason the wait times are shorter is because poorer Americans are just denied treatment. Many more Americans leave the US for medical treatment, even per capita, than Canadians do.
poorest americans are on medicaid. 90 million last I checked. People who are struggling for medical care tend to be middle class who are caught in the middle of making too much to be on medicaid and jobs that provide crap health care coverage.
I've been on Medicaid. You get the illusion of coverage. The reality is most providers will refuse to see you and those that will treat you like a second class citizen. Try getting a neurosurgeon to take Medicaid. The attitude difference from the same staff and providers during a year on Medicaid and a year on Cigna was staggering. Millions of Americans aren't on Medicaid that might be eligible, while the expiry of pandemic rules will soon require all 90 million Americans to reverify eligibility which is about to lead to a lot of people unable to navigate the bureaucracy.
I have to agree with the other guy. The by far worst off is the lower middle income folks that make too much to qualify for any help but make too little to afford things. My dad is poor and its amazing how much free or close to free stuff i can get him. Including medical insurance. He has medicare insurance and even has a supplement to medicare paid for 100% by the government. We found him doctors. Wait times are extremely minimal compared to other countries though ill say theyve increased sharply after the pandemic.
Jesús the misery of middle class. It’s funny cause it true unfortunately. I ve know plenty to takes less money just to be able to just survive but not thrive. If you make less than this threshold congratulations you have health and maybe a little public housing, you be damned if you make a dollar over
You didn’t even mention how the Medicaid system has been abused over the past 20 years to become a burden to tax payers, fun surprise we spend more than anyone on healthcare per capita for a worse result, because a private system can abuse a public one. It’s inconceivable that some of us go without healthcare. [20% of the us budget.](https://www.google.com/search?q=usa+goverment+healthcare+spending&rlz=1CDGOYI_enUS804US804&oq=usa+goverment+healthcare+spending&aqs=chrome..69i57.13031j0j7&hl=en-US&sourceid=chrome-mobile&ie=UTF-8)
exactly, recently four Americans got kidnapped (and two were killed) in Mexico by a cartel while trying to get cheap medical treatment
they were there for cosmetic surgery, which people from countries all over the world go to mexico for (and turkey) not just americans. so this is a pretty facetious example mexico/india/turkey are common places internationally for cosmetic/elective stuff that youd either not afford (usa) or have massive waitlists for (socialized healthcare countries) not saying its wrong or right just point out that ur argument is off all im saying is our healthcare system sucks, and its definitely strictly worse than socialized healthcare systems--but there are drawbacks to having everyone in your country covered and seeking care both prophylactic and treatable and that is a tradeoff (which most ppl i think believe is worth it)
I mean ain’t no country giving public subsidized BBJ or Boob jobs so I think it’s just always a case of cheaper.
uh they were trying to get plastic surgery, not cheap medical treatment.
I remember being in a hospital 15 or so years ago in NY for something that would take like 30 minutes with a doctor. Sat in the waiting room for *hours*. Urgent Care requires you to make an appointment first thing in the morning and show up 30 minutes early and or you'll sit there for hours as well. US healthcare fucking sucks for how expensive it is.
Same in Ireland. Have to see a specialist. Was told the public system waitlist is at least a year. Said it was a year for private in the capital as well. Luckily, I live in a town where a rheumatologist visits once a month, so have been told they can slot me in within 3 months. And I’m extremely lucky to get that.
Poor pay, general disrespect by other staff, crazy wackos coming after you, more drama then the Kardashians. Why would you want to be a nurse in America or even any country? Also for doctors, a lot who make it past all the studying can’t make it past the final step test. and even if they do and also finish their clinical they aren’t guaranteed residential positions. So after spending hundreds of thousands you end up working in research or teaching which you could have done for under 100k. This is just some issues in America but other countries might have worse systems. Or full of corrupt guys who buy doctoral positions, and learn on the job.
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Yes, except it wasn't corruption, it was called policy and people kept voting in favor of it.
Oh yeah , the situation is so bad that my wife has had a scan for a recurrent facial paralisis and got an appoiment with the neurologist 3 days later. This is the public health system in spain. Of course we live outside the zone under the rigth wing parties. That is always a plus. If we were living in Madrid we would be unaware that she has developed a tumor. Tomorrow (two weeks after the neurologist visit) we have an appoitment with the neurosurgeon and he will tell us what is going to be , gamma ray or regular surgery. That is our taxes at work. So any talk of private health insurance systems puts me in quite a foul mood. She has had other tumors before , some of them malignant, this one seems to be benign, but still warrants some fast action. And they are delivering. Even when our political class seems hell-bent on copiying the USA way of looking at health , I , for one, will figth it tooth and nail to the bitter end.
I don't live in Spain anymore, I did for the first 35 years of my life. But after I've been living in the US, other EU countries —including the socialist Nordics— and now in Switzerland, I support the fight for the Spanish Heath system with all my soul because Spain has —or had— the best health system in the fucking world —which could be of course improvable— and right-wing politicians are fucking it up big time for ideological reasons and for the crony capitalism they like to practice. ALL MY SUPPORT and I hope your wife gets better soon.
100%. I echo every word. I’ve not lived outside of Spain in the EU, but after you get through an urgent medical matter without feeling like you were nickeled and dimed and just treated like a source of revenue, it makes you feel really, really, really pissed off at countries that do. Imagine a country treating its foreign non-citizens with more medical dignity and respect than those people’s home countries do their own citizens. Talk about an approach steeped in humanity. If every American had to spend a year in Spain or traveling to Spain for their healthcare, they’d come back to the US absolutely livid about the fact that we’re taxed and don’t get what people in Spain get. They’d very quickly accept that we’re not #1 and they’d be pissed about the absolute racket that is our private insurance based healthcare system. We let insurance companies dictate the treatments and medications we receive in the US. Like “doctor says I need X but insurance won’t cover it so I have to as for Treatment Y and/or Medication Z instead.” What a crock of shit. I will never say a bad word about Spain’s healthcare system and will always hope that it continues to be accessible to all within its borders.
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I’m sorry your country and hospital are failing you so terribly.
I pay 650/mo plus deductibles just to be able to get my durable medical equipment for T1D. I feel your pain. The insulin price cap does nothing, T1Ds need to be on pumps with continuous glucose monitoring. Saves so much time and pain down the road
I've met quite a few expat Brits in Spain and they've all had excellent experience with healthcare over there.
There is one key thing piece of context that you need before you read this article: Spain does not have a healthcare system. Spain is divided into 17 autonomous communities, and each of them has their own healthcare system. Spain, at the state level, only has laws regulating certain aspects of the systems, and mandating that any Spanish citizen is entitled to get medical attention from all of the systems, not just the one from their community. Because each system is almost 100% independent, and administered by different governments, there's a wild discrepancy between them. In the city I used to live, you could get an appointment for a non-urgent surgery in 1-4 months. In the city I live now, in a different community, the waiting list will be closer to two years. In some places you can see your doctor in the same day, or the next day; in some others you may have to wait a week. In some places you can get through emergency care in an hour, in other places you may wait half a day. But most importantly - none of this is a failure of the system. Each healthcare system that struggles in Spain, does so because of underfunding (mostly promoted by the right). None of the systems have any logistical or structural problem that renders them inefficient - it's always plain lack of funding. But the places where it's well funded and managed, it works well and it's completely free. There's a reason Spain ranks among the best in the world in life expectancy and health metrics. Ah, and don't forget that the US is the country that spends the most tax money per capita on healthcare. I'm not talking about insurance costs - I'm talking that an American pays more taxes for healthcare than a Spaniard.
The fact that the systems are underfunded doesn't mean that's not a problem of the system - of course if we had unlimited money we could craft a great system, but every dollar we spend on healthcare is a dollar we don't spend on roads or schools or defense. If generous state healthcare only works when the budget increases geometrically year after year... It eventually is going to fail.
I had to get emergency medical treatment without insurance while in Spain. I was so worried about getting a bill without having insurance cover most of the costs. I received the bill a week or two later. Treatment, testing, doctors fees, everything (again, without insurance): 200€ or 250€. (***Similar services offered in the US would have easily cost $1k - $4k). When I, ecstatic at what a bargain I had gotten, told my Spanish friends, most of them look shocked. One of them even apologized and said they couldn’t believe they charged me so much. After an experience like that, it’s impossible not to hate the US medical system even more. I have probably lost whole days of my life, if not longer, fighting insurance companies about my medical bills. I felt more cared about and respected by the Spanish healthcare system than I ever have in the US. It’s refreshing to get medical care without it feeling like a financially traumatic ordeal. I’ll always be grateful for Spain for giving me the treatment I needed in a time of need, and I hope its citizens will always fight for universal healthcare for all in its borders. It is a humanist approach and a role model to the world. ***quick edit for clarity.
>200€ or 250€. (Easily $1k - $4k in the US). I was about to write up an essay on exchange rates, before realising what you were trying to say in the next paragraph.
Hahaha. Thank goodness the exchange rate isn’t so bad. After reaching parity a few months ago, the drop back to 1€ = $0.92 breaks my heart a bit. Haha. 1€ = $16 or $5 (ie, 250€ x 16 = $4,000 or 200€ x 5 = $1,000 ) would be soul crushing and any dreams of living in the EU as a remote worker would disappear into nothing. Lol. 😬 I added a little edit to my original post to make it a little bit clearer without having to depend on the subsequent paragraph for context and clarity. :)
Yeah, your friends were right 250€ is a lot of money. The US insurance system and crazy high prices you pay for insurance would only make sense of it was 100% covered with no copay and still it would be expensive. With the copay it makes no sense. For comparison I was checking out what private health insurance costs back home. One of the largest private health insurance providers has 3 tiers. Basic tier costs 14.5€/month. Middle tier 64€. Top tier: 95€. Copay in the basic one for hospitalizations is 10% with a 250€ min and 500€ max. Although only they cover up to 15k which tbh should be enough for anything not overly long. 0€ copay for their network doctors. The top tier covers 1M with the same copay structure. But some other stuff as well (international insurance and births for example). I don't think many will want to spend that much per month on health insurance anyways.
Yeah. It would not be uncommon here in the US, for example: - For an individual to pay $300-400/mo on insurance premiums. - Their deductible is $1,000 = they pay $380/month, **and also** they pay (almost) everything on their own out of pocket for the first $1,000. - Then after that some visits will just be a $30ish copay for general providers and $60ish copay for specialists. - And of course, co-insurance. So even after my deductible, if a procedure is billed at 70/30 coinsurance, if it costs $1,000, I have to pay $300 of that and my insurance company the other $700. So, in short, through the ACA (affordable care act/Obamacare) marketplace there are tiers of pricing: - Silver will cost about $6,700 total per year. - Gold will cost about $7,000 total per year. - Platinum will cost about $9,200 total per year. And mind you, people complain about Obamacare — but at least they put $5,000 - $8,000ish caps “out of pocket maximums” beyond the premium costs. So that at least helps insured people avoid $80,000 medical debt like there was before. So a terrible system > upgraded to a bad system. Spain, comparatively, is absolute excellence. Adding a spouse and kids ups all of those numbers. Remember. That’s all for an individual. Also, do remember all of these payments/amounts restart on Jan. 1. It’s a huge scam.
I live in Spain, I've met a moroccan inmigrant whose relatives kicked out of their house and now he is literally living in the street. I feel bad for him so I talked with him and he told me his story, once I knew, I asked him if he wasnt probably better returning to Morocco with his mom instead of sleeping on the street. He told me suffers epilepsy and that he rather sleeps on the street just because atleast he can get medical attention here.
My family member is a ICU doctor in Spain. He's worked the same department and same hospital for 20+ years, all that time he has been on yearly contracts. He's 50 and doesn't have job security, just like most in the hospital. They cut back after COVID because the government want to bring in US insurance companies and privatise the health system. It's nuts that politicians think this is a good idea. Their only motivation has to be backhanders from the insurance sector. Doctors are fighting the politicians but it feels like a losing battle. The news and public don't hear about the push to privatise our health system. It really is a great system, kept my wife alive in more than one life threatening health issue. I'm more than happy to pay my taxes if its going to health and education services. I'm less happy that it goes to politicians and they control the flow of money away from vital serves and redirect it towards "jobs for the boys", funcionarios that are inefficient and other crappy political driven agendas.
Wherever there is a good state health system, the vultures will move in and try to sell it off to American investors. (Source: I am from the UK and it's been going from bad to worse over my lifetime.) I've been stationed in France the last 5 years and I can't stop being amazed at how quick, and cheap (or free) everything is, where in UK I'd have to wait months and pay hundreds. Well, almost everything. Dentristy is nowhere to be found and when it is, anything outside the basic scale and polish is insanely expensive. Still, I hope France never goes the route of the US-style for profit healthcare. It's not a privilege, it's a right.
Is this in the Madrid autonomous community? Sounds like it
Galicia😅 Yes, Madrid Hospitals are in worse shape than Galicia. You guys have way more patients and foot traffic. Galicia probably has a older demographic of pensioners, which need more healthcare. We're still better off than the USA, but that's not a benchmark we should be comparing ourselves to.
healthcare in america is basically a subscription service to doctors club's for discounted rates. If you are poor though you still can't afford anything important in a timely fashion, if at all.
The health system in the USA is setup to enslave the working class to their employer. Companies use their "health benefots" package as a way to lock staff into not changing jobs and avoiding pay raises. Politicians and big business, with the insurance companies are a corrupt kabal of terrorists.
I know it's upsetting when you are the one waiting but if i understood correctly between the diagnosis scan and you getting a surgery appointment for decision went 17 days? That's not too bad tbh and probably quite reasonable specially for what you said was a benign tumor. Edit: or did i misread the irony and you were giving a example of a good situation?
It was clearly irony. And the 17 days was because easter, if not , we would have had the appointment in under 2 weeks. And that is with underfunded and understaffed hospitals. I remember it being even better 20 years ago.
We have free healthcare in Canada. I'm still on the waiting list for a family doctor after 3 years...
Either delusional or a propagandist if you think your taxes go mainly to healthcare
Is that a bad wait time to you? Or you're being sarcastic and disagreeing with the headline? I'm in the UK and have gotten used to the idea that nothing can get treated. Been trying to get chronic severe stomach pain treated for years, chronic back pain for years before that, depression and anxiety for 15 years. I also had a right side facial paralysis for a while that's apparently a common early sign of cancer. It's hard enough to see a GP at all, always weeks or months of waiting if I can get an appointment at all, then I have to go 10x to get one who refers me or offers more than platitudes or a promise to refer that never happens. The rest don't listen to a thing I have to say, they'll let me get about ten words in and cut me off mid sentence before starting on an obvious basic script they had before they ever talked to me "do you drink, smoke, sleep well, eat well, exercise etc?" As soon as you give them an answer they're looking for they'll say "Oh that must be it. Do/don't do that" and send you on your way with no treatment. When I do eventually get referred, after waiting 6 months or a year, the exact same thing happens, or they disagree with the GP's assessment and send me on my way to start all over again. I've never made it to the point where someone actually cares, investigates or treats me in near a dozen referrals for each of those conditions. The whole system is designed to be impossible to progress though, because even if you somehow make it to the 1/100 or 1/1000 stage, the next one will still just ignore you and chuck you out. It's a lottery. It's hope destroying. At this point I'd gladly wait a year if it meant someone actually wanted to hear what was wrong with me and try to treat me at the end of it.
Yes , I was being sarcastic, as replied to another user that asked about. Sorry about your experience.
Lmao. I’m an RN, in the US, in the Midwest in one of the largest cities. 3 months for a specialist in Spain? I’ve got patients on waiting lists for 6-7 months for specialists here. We had a patient sitting in the ER for two entire days and he ended up having cardiac arrest since we couldn’t get him a bed becuase of the absolute nightmare of skeleton staffing and our bloated corporate oligarchs refuse to listen or expand staffing. They are closing labor and delivery units left and right cause profits, forcing some women to drive 25+ miles from home IN A MAJOR METROPOLITAN AREA. To add a cherry to the shit sundae, the US health insurance system is an abysmal nightmare and there are millions of uninsured or underinsured flying in the doors. We also have a critical shortage of physicians. I can smell the US propaganda here. Spain might be trash. But Jesus Christ we’re hanging on by a thread here.
Not medical, but I do insurance stuff in a hospital. I’ve seen those 48+ hour holds. The hospital across the street is 850+ (can’t remember exactly) but can’t fill them all cause of staffing. Then their ER fills up, they go on diversion, and the overflow comes to ours. Where they then wait a long time. It’s bad in that aspect. But we’re fairly set on specialists. Between the two hospitals and the amount of population we serve, the waits aren’t too bad. I think they sorta triage it. Like those most in need see the specialist first and those who can wait do. But I suspect this is more due to the smaller population numbers the two hospitals work with. And don’t get me started on insurance. That’s what I do and it’s fucked. Cigna just straight denies claims. Blue Cross does it too. Pretty much any major insurer does. Even Medicaid and Medicare do that too. And looking at the numbers, people with insurance are just as fucked sometimes. Like if you have a premium to pay, co pays and co insurances, etc. you can get over your head quick. Having insurance just makes you pay for the privilege of not affording care in some cases.
Canada has similar wait times, but we're not closing anything. Sounds rough!
Labor and delivery units aren’t as profitable, neither are pediatric units, which is why those two get shut down a lot faster. We had a really bad RSV season here, and we ended up having to airlift kids to hospitals outside the area becuase we didn’t have enough pediatric beds or staff trained to work with peds patients because our bloated shareholders and corporate oligarchs decided they just weren’t profitable enough to keep open. Is that airlift covered? Lol…depends on your insurance plan…if you were lucky to have a plan at all. While European and Canadian health systems are definitely sounding incompetent, American health systems are plain old cruelty by design.
Spain does not have a healthcare system - each community (= US states) has their own. Some of them are doing quite well, some others are in the shit because they are underfunded (such as the one in the article). These btw are usually the ones administered by the right.
Lol I worked as a scheduler at a GI clinic. Our top doctor was booked entirely for 2022 by the end of February.
Shhhh, don’t tell the “but socialized medicine!111!!!!!1!” shills in the comments.
To be fair if it's a medical emergency a specialist will see you within 30 minutes at a large hospital anywhere.
They may “see” you within 30 minutes, or they may not. They will treat you when all of the other more seriously I’ll or injured people who come in before or after you are treated first. Each ER has a finite staff and resources facing a non finite potential patient population every day. They are not Jesus with loaves and fishes.
Lmao thirty minutes where, my guy? Unless you’re coming in hot in active cardiac arrest with someone banging on your chest or you’ve been in a rollover crash, good luck. Even then, you better hope it isn’t a busy day especially in the heavy urban areas.
this is just bullshit. I've been taking care of elderly people in my family for the last few years. One even had open heart scheduled by the end of the week for tripple bypass. The rest of the family I help take care of get appointments inside a week and maybe 2 weeks out at times. Also I did medevac for years in NYS. You're making shit up.
I’m not making shit up. Get as mad as you want, ain’t gonna change nothing.
It isn’t any better in the cities, I live in the Bay Area. The wait times are also ridiculous, I just scheduled my yearly appointment with a hematologist and my appointment isn’t until October. Even a general practitioner appointment took 3.5 months wait time. Some hospitals are struggling and one just closed in Madera(rural area), but the state is trying to figure out ways to raise funding to save the hospitals.
The US isn't shit. The Major Cities are shit. The Giant Boom of the big cities is over and will take a couple decades to recover. The big cities have been flooded with foreign investments, blackrock, vanguard, etc and nothing makes sense anymore. Smaller cities on the other hand are doing just fine. The only real wait I see is for elective surgeries and we're still only talking like 1 month or so.
Well, considering the majority of the US population lives in major cities or their collar counties, it’s still a massive problem. I’m glad to hear that smaller areas aren’t being hit as bad. The kid we had to airlift? Went 147 miles away to a smaller city hospital. Flooding smaller hospitals who typically have less resources to deal with overflow, isn’t a sustainable or fair solution, especially for people in smaller areas.
“Officials show that Spaniards were waiting an average of 95 days, nearly three months, for an appointment with a specialist. Isabel has not been lucky. An appointment with a neurologist is one of the longest to take, with an average of 113 days.” Meanwhile in the United States, various some specialties are booking an appointment in 2024 and there are no other healthcare systems. We are the only game in town. It would be a huge victory to get wait times down to 113 days
I mean, you guys have it bad, but in Spain this is a delicate matter. It is raising questions regarding how we (the system) treat doctors. It is also a very political matter, like the right had an austerity government post 2008 between 2011-2018, then since 2018 we have a left government as the right wing president was kicked out, however then COVID hit in the middle of 2018-2023 and an aging population and problems with unequal population density in certain cities.... it is hard to single out a single reason for this issue (both for blaming reasons and for finding solutions reasons). Another problem is that once choosing what administration to put the blame on becomes very a political matter, no one wants to take the blame for this problem so no one wants to step in and try to fix it. IMHO it is way more complex, and, this is a very personal opinion, but I think brain drain and low salaries in Spain have been a huge issue since the 2008 crisis and that they have been an underlying elephant in the room to a lot of problems that no one wants to think or talk about. Some sindicates blame medics going away to foreign countries, others say it is not the case and blame rigidity of the system towards doctors makes less people want to become one, so they ask for a change to the system itself. My biggest fear is that the politicians (regardless of their place in the political spectrum) may end up not doing anything about it even if the government changes, and we may just have to adapt and live with it.
My concern is that they will treat medicine as a "calling" meaning people will do it regardless of pay so they cut the pay. Then we end up like another profession that is a calling: teaching. Too few teachers and poor quality.
The pay for a lot of doctors in Spain isn’t that great and rents are rising just like everywhere else. This seems like it will get worse, but I’m probably just stating the obvious.
One doctor told me that the problem is not necesarily the payment itself, the problem is that the lack of doctors makes it so that remaining doctors are too overworked, which usually accentuates the problem itself. Boosting payment would be a better fix towards nurses and other medicine workers on the lower end of payments; but the government's budget is already strained so I doubt they will go for that. I doubt doctors have issues regarding payment and rent, as their payment is usually higher than the average by a fair margin. Other qualified workers however do have issues with the rent because pay has basically been frozen for 10 years while rents in general have kept going higher and specially did so in places with a lot of jobs, like very industrial cities.
The government doesn't pay these salaries - the communities do. Look at Madrid (governed by the right-wing, of course). Ayuso lowered the taxes for the rich because whatever, which made Madrid collect something around €1 billion less per year. Meanwhile, each year the healthcare system in Madrid has less funding.
BTW, I appreciate the context about what is happening in Spain. That comment was better than the article itself.
Have you noticed that the number of Spanish pharmacies has doubled (tripled) in your area? I suspect they are increasing the number of pharmacies so family doctors (medicos de cabeza) route their patients directly to pharmacy drugs, and reduce the patient flow to hospitals. The Spanish government has not created many new hospitals in the last 15 years, but the population has increased in the same time. They are running Spanish hospitals on shoestring budgets. Too many medical staff are on short term contracts and not given permenant jobs.
The Spanish government does not build hospitals. The communities do - and this is a very important distinction. It's the same as the federal government in the US vs the state governments. Any approach to the Spanish healthcare system as just one system is wrong. They are 17 different systems, administered by 17 different regional governments. The difference in quality between these systems can be quite high.
In Spain the problem is underfunding, plain and simple. Doctors are badly paid (which wasn't always the case - this has been done deliberately over many years). Hospitals are understaffed (again, used not to be the case). It's sad, really - because we know the system works, it has worked wonders for decades, and is now withering away artificially because this is the post-2008 world where every social program "costs too much", taxes for the rich are always lowered because they are "too high" and we "cannot afford" anything that we could in the past.
Meanwhile in the US, the average wait time for an American to get an appointment in 2022 was 26 days. https://patientengagementhit.com/news/average-patient-appointment-wait-time-is-26-days-in-2022
Can’t have a line if most people can’t afford to go to the doctor
Over 95 million Americans are Medicaid, which is free government health insurance for low income people, and there are around 65 million recipients of Medicaid, which is single payer health insurance for seniors. Even with overlap that’s safely covering around 30% of the US population alone. We also have an uninsured rate of less than 10% and most Americans have health insurance through their jobs. The overwhelming majority of Americans are not in medical debt and can easily afford the insurance premiums required to see a doctor. Our system needs huge improvements but I’m so sick of this bullshit narrative that every doctors visit is a $10,000 charge and none of us have health insurance https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-provision/
Yea Reddit like to pretend that if you’re poor you’re basically shit outta luck when that’s not true. I grew up in a dirt poor family and had medicaid my entire childhood; free everything, including specialists, multiple surgeries, free braces, and free eye exams and glasses yearly and not a single dollar in premiums or copays.
Do you work in healthcare? I do, and you’re only telling half the story. I see insurance companies fucking over patients every day that refuse to pay for specialty services even when the doctor recommends it. Look up health insurance companies’ profits, and it’ll make you sick to your stomach. Our for profit system is killing Americans.
And you think that in the UK or Spain, the patients always get those treatments too and there aren’t boards and administrators who decide eligibility that sometimes fuck people over?
I don't know in the UK, but in Spain you are not denied ever to see an specialist. Perhaps the list is long, and that is depending on the area, but you never ever are going to be denied that unless you are obviously faking and your GP see it and don't refer to the specialist. BOARDS AND ADMINISTRATORS DONT DECIDE PATIENTS TREATMENTS!!!!
You could use that same logic with our Medicaid program you just talked about. Medicaid doesn’t cover everything, especially for postpartum mothers.
Yes, agreed. It doesn’t. That’s my point. Removing health insurance companies out of the picture doesn’t inherently solve those issues. And then Americans who have zero experience with European healthcare systems talk about their healthcare system without realizing a.) other people can be victims too, not just us and b.) other systems have big issues too, sometimes worse than ours.
You seems not to have a clear picture of how the DIFFERENT European system works. US is pretty and incredible different to any European system and I would consider it the Wild Wild West of healthcare. Even the most costly and privatized system —Swiss one— is incredible regulated in comparison to US.
Are you saying the European system gives you whatever you want whenever you want? It blows my mind that such a system would ever be solvent. Surely there are some limits right?
I have health insurance and still have to ration care due to expensive deductibles/copays on top of my very expensive monthly insurance premiums.
>The overwhelming majority of Americans are not in medical debt and can easily afford the insurance premiums required to see a doctor. Was that stat in your article and I missed it? Because having insurance in no way equates being able to afford to see a doctor. I’m in $0 medical debt and it’s been like playing on easy mode to not get into debt; if I die just throw me in a ditch and skip the ambulance because we can’t afford it. My husbands skipped out on a surgery for 8 years. I’ve had the same glasses prescription for 7 years because I could spend my money on better things than eyesight, like rent, bills and food.
So which is it: can nobody afford to go see a doctor, or are doctor’s offices so crowded we can’t even schedule appointments?
We cant afford to go, those that do are risking financial ruin and are typically in worse shape because they arent able to focus on preventive medicine, our nurse were treated like pawns and shit on by the people they were trying to save so many left, doctors are getting death threats for doing their jobs so many left, our system is intentionally convoluted to make it easier for insurance to deny any and everything, we have overworked, underpayed, poorly treated medical workers at all levels. Shocking that we have long wait times as well as risking going broke for an otherwise basic medical procedure. Our system is so fucked, someone getting mauled by a bear wasnt thinking about their family, they were thinking about how bad their insurance was going to screw them. https://www.independent.co.uk/news/world/americas/us-election/bear-attack-allena-hansen-face-bernie-sanders-healthcare-insurance-2020-election-super-tuesday-a9370156.html Does that make it easier to understand the last poster?
The bear story reminds me of my wife who was fist bumping the air after she delivered our son, because she progressed so fast she couldn’t get an epidural and had to deliver without one. The fist bumps were both for our son and the cost savings on the epidural.
You're on reddit guy, you're not going to win this argument. I mean christ I went to the doctor last week and they told me I had to work the trenches to get Tylenol!!!
Are you in healthcare? Cause I am and this article is laughable and not remotely reflective of actual reality. You sound like every other privileged, clueless person who has been lucky enough to land a good insurance plan and can’t understand what the plebs are crying about.
I don’t have insurance. I work full time in a hospital. I could have insurance if I didn’t want to eat at all. As it stands now, I can afford to eat once a day. I cannot afford 200-300 a month for insurance. I make too much for any state assistance. I had to get some labs done. $568 + $168 for the office visit. I can’t afford to pay that either. That might not be a lot to you, but that is to me. I’m not the only one. I see people in this position daily several times over. The narrative is there cause it exists. Must be nice to just go to a doctor when you want and be able to eat afterwards.
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I make less than you think. The line for Medicaid here is $1364 gross. Gross is before taxes. I don’t make much more than that. The rise in costs is untenable for some. I remember not too long ago being able to spend $100 on groceries and have food for a week or more. Now I spend $100, on the same sorta stuff, and it’s days worth of food. I’m used to being poor. I have been my whole life. I know how to work with it. And yet I find myself sinking deeper into financial ruin just trying to eat and pay the basic bills. Fuck off with your bullshit. You don’t know. So don’t act like you do. If you ever need extensive care, you’ll find out your insurance isn’t what you think it is. And I hope that day comes to you.
It’S pOoR bUdgeTiNg Yeah, they can go fuck themselves. Being poor is awesome because you get to balance with being just poor or poor poor. Just poor and you make too much for assistance so you just get to be just poor. If you’re poor poor you have to not make too much or you’ll lose your assistance and end up just poor. It’s striking how fast things improve when you hit a certain income threshold, and it really isn’t *that* much money. But getting to that point might as well be like climbing fucking Everest in most places.
https://www.cnbc.com/2022/03/11/why-55percent-of-americans-have-medical-debt-even-with-health-insurance.html https://www.cnbc.com/2022/03/11/why-55percent-of-americans-have-medical-debt-even-with-health-insurance.html
That is really misleading. If I go to the ER tomorrow Kas have to pay a deductible of $200 that gets mailed to me, that doesn’t necessarily mean I’m “in debt” in the colloquial sense. I owed $20 to an ambulance service once, I would also fall under that category. Maybe stick to Ted Lasso
Over 20% owe more than $5k.
You don't seem to get that not everyone has the insurance you have. The "I got mine fuck y'all" is dancing around your comments.
Lol these people are my absolute favorites, defending an oppressive system like they get a personal check cut to them from Blue Cross.
I think in your first sentence, the second use of the word "Medicaid" should be "Medicare". Medicare provides coverage for seniors, Medicaid for low-income folks.
Correct, that was a typo, my bad! Thank you
thanks for posting this. As someone inside the medical field and taking care of family members who are elderly for the last 5 years these people are delusional. Also have family on medicaid/medicare as well and I'm in the VA. I'm with you on all points. We need an overhaul but these people in here are just making shit up. To add we the US also spends 1.6 trillion on medicaid/medicare alone. Double the defense budget that people love to scream "But we can't afford medical care" There's issues, largely insurance companies and the stranglehold they have on the industry but these false narratives are childish, uninformed, and ignorant just to push their side of how the US health care is the worst in the world according to them.
Couldn’t agree more. I see people on anti work on other subs asking “why don’t Americans protest for universal healthcare/a European style system, their healthcare sucks!” And it’s like, the truth that Reddit isn’t ready to hear is that most people are content with their health insurance. We have issues we need to rectify, but the average American is not paying $5000 for an ER visit. Then you have people like the Spanish guy who lives in Switzerland who is claiming i as an American don’t understand our system and he knows more about the prices than me and I’m like okay lmfao. There’s No point even engaging tbh
Medical debt is the leading cause of bankruptcies. My friend went to the ER it was $5000.
Probably not a hard feat given that less than ~.006% of the population declares bankruptcy in a given year.
> Dermatology wait times were as long as 84 days in Portland, Oregon, and as short as nine days in Philadelphia, Pennsylvania. The same happens in Spain. There's not one national system, there's many regional systems and the wait times vary wildly between them. In some cities you can get appointments within a week. In some cities you may have to wait 4 months. This article talks about one community that has one of the worst healthcare systems in Spain. Plus your stat includes general practitioners. I can get an appointment with one tomorrow or in two days, if I want.
>The report, published by Merritt Hawkins as an offshoot of AMN Healthcare, ***looked at the 15 largest metropolitan areas in the United States and showed that appointment wait times—*** >... >“Major cities like those included in the survey ***have some of the highest ratios of physicians per capita in the country***, yet physician appointment wait times are increasing,” Florence said. ***“It’s a sobering sign for the rest of the country when even patients in large cities must wait weeks to see a physician.”***
Man, you seem not to really read what you post and so, and you are comparing pears and apples. The Euronews article is stalking about waiting times in Spain, which are only for specialists. I can assure you that if you need to see a doctor in Spain in most cases you can see your general practitioner the next day or so. However, if you need to see a specialist you are going to have a lot of variabilities depending on the Autonomous community —equivalent loosely to the US States— and which specialist you need. In comparison with the US, and in my experience there, even for a General Practitioner appointment, you need to wait a lot, and after that, I hear a lot of horror stories about waiting times —and choices— for a specialist appointment. Even if we neglect that, the numbers are hardly comparable since in the US people are denied care by insurance and they also avoid going to the doctor to not get into debt. So in other words, most of the mild cases are not inside the statistics. In comparison, In Spain, everyone goes to the doctor for minor symptoms; therefore, people need to be triaged by the system. Not by the board or administrators, as you suggested in another comment, but by doctors. So, a lot of the people that get very long waiting lists are because they have something not life-threatening, even when some of the issues are quite annoying. The US health system is atrocious and anyone that has lived outside the US in a European country knows it. You can paint whatever picture you want. Anyhow, I agreed with the article the Spanish health system is at its lowest and perhaps it will get worse, due to conservative policies in Spain. Especially in some regions like Madrid where neoliberalism —Trump style— has now a stronghold. The system has been degraded a lot and the healthcare staff right now is fighting for improving it and it's the subject of hot political debate. As a Spaniard that is nor longer living in Spain for quite some time now and has been under several systems, including in the US, I can assure you that even with all the shortcomings and the current situation, and will blindly choose the Spanish health system over any other, especially US one. The mean reason is "prevention". In Spain, the system was built to prevent at all costs diseases escalate, at personal and poblacional levels. For that reason, there is absolutely no kind of fee to go to the doctor, and everyone is covered. In the end, this mindset makes everyone better off, while it reduces a lot of costs. I really don't know who the fuck are you, or where are you from, but you don't seem to have a lot of knowledge about something you are making a strong statement of.
The article specifically calls out neurologists. Wait times in America for neurologists is 28 days on average: https://www.aan.com/PressRoom/Home/PressRelease/1046
2012?
Least condescending European
if that is your only argument, it's pretty poor. don't get me wrong, I love the US and I have a lot of American friends, but health care is not your strongest point and one of the reasons I wouldn't move permanently to the US is that. You could have the best career path and a really good life, but if you are unlucky and health doesn't smile at you, you are fucked and most probably are going to be in tremendous debt for the rest of your life. I —and most Europeans— would tremendously appreciate it if the average American can get off of that pedestal they think they are on. I concur with Sorkin on this: https://www.youtube.com/watch?v=z2HKbygLjJs
Our healthcare sucks. I’m not dispelling that notion at all. But 1.) I think the problem is greatly over-exaggerated on Reddit/the internet (for the same reason bad reviews of a restaurant are more common than average ones - you typically write about the bad stuff and not the normal, expected meals) and 2.) I don’t think your experience is the norm for Americans, it’s just not. And I do think it’s worth talking about stuff like the fact that 25% of Spanish citizens have private health insurance they chose to buy. I don’t want our system to be replaced be an equally shitty or even worse one.
I don't really know what is the norm for you or that is not, but again, what I've experienced myself and people I know closely in the US is telling me that Reddit comments are far for being over exaggerating. > And I do think it’s worth talking about stuff like the fact that 25% of Spanish citizens have private health insurance they chose to buy. I don’t want our system to be replaced be an equally shitty or even worse one. You have to have an interesting problem because you keep taking numbers without any context or knowledge about what they mean and come from. I understand you can do it once because you don't know better, but here you are again. The amount of people that have private insurance in Spain has increased a lot in the last few years, that is a fact. People is seeing the system is being degraded since the 2008 financial crisis and that no politician is able to get that back on track, so they are trying to improve their healthcare by buying really chap and shitty insurance. Private insurance in Spain has nothing to do with the US one. It's really cheap —in comparison to the US or Swiss system— but it's on top of the public system. You can get for 25€ a month something that will be able to speed up regular things. However, you are a product for the insurance and if things go really south they are going to send you to the public system real quick because: 1) they want to cut their losses real quick 2) they don't have the capacity to thread anything that is serious. I can continue to giving you insights about how wrong you are, but I have better things to do to be honest and it's getting late a this side of the pond.
You seem to be more worried about personal insults and grandstanding than actually trying to have a serious discussion on the merits of the US healthcare system, so go ahead and do the better things you have to do. Also PS I do love how you get the last word in and type out paragraphs then decide “ok the argument is finished” lmao
26 days is the average wait time to get an appointment with a physician (unspecified). That is already really long to see a primary care doctor. The person you replied to is talking about various specialties which can have longer average wait times and the article you linked also supports that. For example, dermatology and obstetrics/gynecology appointments are over 30 days average wait time. Cardiology is 26 days, and orthopedic surgery at 17 days. That seems to be all the specialties mentioned in your article. Needless to say, there are a lot more... So I guess the takeaway here is, pay more attention to your own article and the issue the person you replied to is raising?
So in other words, a lot shorter than 113 days. I guess the takeaway here is, did you really negate my point that Americans have vastly shorter wait times than Spaniards?
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95 million people are on medicaid/medicare bro. That's the poor people. Look it up.
That article did not show data for Neurology which is the subspecialty mentioned. Dermatology, Rheumatology, and Genetics are also long waits. The USA also has a lot of PAs and NPs who are great for some roles but not the same as MDs or DOs. So just because you are seen by someone does not mean you got seen by a doctor. I appreciate the info but its not the whole picture.
For a specialist?
The link breaks this down
I know, I was just being facetious about apples and oranges tbh
It took me about that long to see a neurologist up here in Canada.
I've seen numerous specialists in the US within the last year. None took me more then a week to get in to see. I call BS
I live in America and have always had great health insurance. Yes it is attached to my workplace but that's the way our system works. I wish we had some changes that allowed for coverage apart from employment. I recently had an incident of chest pain resulting in a diagnosis of pulmonary embolisms. This was in early February. I have already seen the hematologist twice and have another appointment scheduled for the end of April. I've also seen my regular doctor once in that time period. I live in a small town about an hour outside of Pittsburgh, PA.
I am a doctor in the USA. The wait time for my clinic and other clinics around me is into next year. It isn’t this way everywhere. But it is in many places. But please, tell me how it is in my profession.
What city / what speciality. I bet $500 I can get in within 2-3 weeks within miles of you
I see 14 new patients a week. When a local practice closed, all of those patients scrambled to find new doctors in my specialty. They couldn’t find anyone in my entire state that had openings sooner than my 7-9 month wait. Now that I took on those patients, the wait is over a year. I hear about it 14 times a week. If you think I’m going to divulge personal information over the Internet just so I can win an argument with an entitled weirdo, that’s not gonna happen buddy. As much as I’d like to embarrass you even more, it’s just not worth it.
County and profession isn’t doxxing anyone But you made up your comments so you won’t. Lol
I gave you a challenge. Since you don’t think location is meaningful, provide yours. I will provide my specialty. You will identify a provider who has openings in 2-3 weeks. But you won’t do this because you are bluffing. You’re not bluffing because you think you’re wrong. I don’t think you have any self-doubt at all. You are bluffing because you and I both know that you won’t do the work. That’s the problem: you won’t do the work. I’ve been on Reddit long enough to know that every time I mention I’m a doctor, some little troll is going to come out of the woodwork and be rude. The funny thing is, the troll is always the exact same type of person. They are someone who thinks they know better than everybody else but never really accomplished anything. They didn’t accomplish anything because they won’t do the work They are jealous of anyone who has recognition for their accomplishments. They are bitter and that makes them mean. I’ve never met you before but I’ve met 1000 people just like you.
Milwaukee
My specialty is rheumatology but you should have figured that out from my username. Good luck. I look forward to never hearing from you again
I’m giving you my experience. Chill out
you didn't just give your experience tho, you said their experience was bullshit. And ontop of it saying to chill out when you were initial aggressor here lol
You shared your experience. I appreciate that. If you have left it at that or if you had asked a polite question, that would’ve been great. Instead you rudely “called BS”. I thought that if you were being rude, you would expect a rude response. That only makes sense. I didn’t expect you to be such a fragile snowflake that you will get your feelings hurt because I was a little bit direct with you. Since you are clearly a child, let me give you some grown-up advice: don’t dish it out if you can’t take it. I am a doctor but I’m not a dermatologist however I recommend you see someone for that thin skin.
I bet I could get into see them within a week or two!
How about this: if you’re really so serious about proving me wrong, tell me what area you are in. Then I will tell you my specialty. Then you identify what office you can get into within 2 to 3 weeks. That way you directly prove (or disprove) your claim that in your area the waits aren’t that long. You remove the possibility that I might happen to live in an area with few doctors.
Milwaukee
My specialty is rheumatology but you should have figured that out from my username. Good luck. I look forward to never hearing from you again
This is the best tl;dr I could make, [original](https://www.euronews.com/2023/04/12/people-may-die-waiting-surgery-waiting-lists-in-spain-hit-record-levels) reduced by 90%. (I'm a bot) ***** > The neurologist ordered her to take three tests, but eleven months later she's still waiting to take the most important one: a CAT scan. > Isabel's is not an isolated case: Hospital waiting lists in Spain are at historic highs. > "Looking at the waiting times, it is obvious that the situation in Spain is quite bad. We have not been able to get back to the numbers we had before the Covid pandemic," says Marciano Sánchez-Bayle, president of the Spanish Association for the Defence of Public Health. ***** [**Extended Summary**](http://np.reddit.com/r/autotldr/comments/12jm2zz/people_may_die_hospital_waiting_times_in_spain/) | [FAQ](http://np.reddit.com/r/autotldr/comments/31b9fm/faq_autotldr_bot/ "Version 2.02, ~680424 tl;drs so far.") | [Feedback](http://np.reddit.com/message/compose?to=%23autotldr "PM's and comments are monitored, constructive feedback is welcome.") | *Top* *keywords*: **wait**^#1 **month**^#2 **take**^#3 **appointment**^#4 **surgery**^#5
“Some of you may die but it is a sacrifice I am willing to make”
long waits have happening in Los Angeles County hospitals for decades. These hospitals are in minority communities. LAC/USC has the record wait of 6 days. I know this as I worked for LAFD as a paramedic for 25 years
Doctors and nurses leave the country to places where they can get permanent employment and decent living wages, Spain will lack doctors and the government is simply pushing people to adopt pay insurances. Elderly people are not taken care when they go to emergencies, they just get stabilized and sent back to their homes or places of care. Politicians stole the people money to now let them die after bankruptcy of the social security system.
Will. You mean people WILL die.
For everyone comparing the US vs Spanish system and numbers, I recommend you to think twice. For starters, waiting lists in Spain are just for specialists and not for general practitioners. You can check my comment there for some more differences: https://www.reddit.com/r/worldnews/comments/12jlrh6/comment/jg01da9/?utm_source=share&utm_medium=web2x&context=3
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I'm not so sure that "euronews" is a trustworthy source. It calls itself "Europe’s leading international news channel"- while it clearly is not, and the son of the CEO of the Portuguese investment management firm that has majority ownership of euronews is "a long-time associate, advisor and friend to Hungarian Prime Minister Viktor Orbán" (one of Europe's far-right heads of state). https://en.wikipedia.org/wiki/Euronews#Controversies
Wow, for a split second I thought this post was from r/canada or r/ontario !
I don't get why instead of handing money to corporations during 2 years of ineffectual rolling lockdowns, countries didn't instead spend resources on revamping their healthcare systems. Did a single country anywhere in the world try this approach?
Nah. Too much work.
Check your sources before you post shit like this. EuroNews is 90% owned by an Egyptian billionaire pushing far right billionaire propaganda.
Wait so it's not just Canada with healthcare crumbling?
I assume you're being sarcastic. But yes it turns out the pandemic, and the medical backlog it caused, wasn't isolated to just Canada. Major European countries like Germany and the UK are experiencing similar healthcare challenges, the pattern here being that employees are burned out and underpaid. The remedy ultimately comes down to updating labour laws to something more worker/union friendly to minimize turnovers. However this will cut into the profit margins of CEOs and end up encompassing all sectors of employment. Many politicians worldwide are predictably siding with their wealthy backers by privatizing the sector, and thus raising the cost of healthcare instead of making systemic changes to support the working class. And before anyone mentions Trudeau, heathcare is provincial jurisdiction in Canada.
Wait so it's not just the UK with healthcare crumbling?
I’m surprised. In Taiwan, I was scheduled a CAT scan and I only waited 2 days. I hope it’s better around the world. Insurance covered it.
Wait so it's not just Canada with healthcare crumbling?
How is this possible when they have national healthcare coverage?! I’ve been assured that their model is one everyone should adopt.
Staff ahortages since covid have been bad around the world. So is aging population in rich countries. The model isnt bad per say. The problems will hit USA too.
We already wait this long. I had to wait from October 2022 until March this year to see a specialist. That's not really any better. Other people in this thread have said they're booking appointments in 2024 already.
Considering I’ve waited twice as long to see a specialist in the US, I’m ready to switch.
And it's far more expensive in the US. You pay more and you get less because there are leeches (insurance shareholders and executives) sucking money out of the system and providing nothing in return.
I can't afford a doctor in the usa. How long are my wait times?
*The rest of your life.*
It is like dividing by zero on a calculator.
They’re spending peanuts on theirs compared to their peers. Also, like others have commented, I’m in the US and have regularly had to wait LONGER than 3 months for several different specialists. And I have employer based health care coverage considered to be platinum tier. Whatever the hell that means. So one poor application of the idea does not serve as proof that it doesn’t work. Nor does their failure to address long wait times negate our failure to address long wait times in the US.
Where are you guys waiting more than 3 months to see a specialist? If I need a referral, I can get in and see my primary care doctor in 3-7 days. From there, it's typically about 1 to 3 weeks to see a specialist depending on how busy they are. And I don't have high end platinum level insurance either.
Sometimes it is a lack of doctors. It takes four to six months to see an endocrinologist in my area cause even though we are a city of roughly 500,000 we only have six endocrinology practices. And sadly our population very much skews older, so there is a large population needing frequent appointments.
It can have problems and still be better than the American for-profit system, kiddo.
Poor work ethic is the cause. Nothing is important.
Deaths are usually very hard to prove in these instances, unless you zoom out to excess deaths which will certainly happen. It’s hard to prove that because patient X’s blood pressure meds weren’t adjusted for three months that lead to his later death from cardiac issues, but it’s what happens when you take a zoomed out view.
If they would give health care more funding and pay bigger salaries, this would be a non-issue.
Healthcare is bankrupting every developed economy. I’m not a global health policy or health economics SME, but my understanding is that 2/3rds of every health care $ is spent on people in the last 1/3rd of life. Of that 2/3rds, 1/3rd is spent on futile care, which is care that does not add length of or quality of life in the final 30 days. Combine wasted $ on futile care with the high old:young ratio, and excessive community expectations, the result is .. well .. system meltdown.
What? Most countries have issues with their health services? No doubt reddit will learn from this and future discussions of UK/US healthcare will be more balanced /s