Actually, the median American has access to exceptional care.

What is actually the case is that care available to the bottom quartile of Americans is below the care received on average in a top-tier universal care nation, and the US spends an absolute fortune delivering this quartile with substandard care.

We also spend a bit more than average providing exceptional care to everyone else, except that we also spend a truly ludicrous amount (compared with every place on earth except possibly Japan, which is still less than us but not quite as much less) on care for roughly everybody above the median during the last year of life, because we have baked some very expensive decisions in as the default (basically, if you don't specifically ask otherwise, you will get absolute treatment maximalism basically until 30 days from death)

Why do Americans always have to play a zero sum game with human lives.

If a quarter of our country has the worst healthcare in the developed world that is unacceptable.

Answers like this are just begging us to give up our humanity.

I have made no statements about how things should be. I have lots of opinions about how things should be, which I don't share on HN.

I was making statements about how things actually are, since no discussion about how to make the world we want is likely to be meaningful or useful if there is not a shared view of what is first.

And what you focus on brings about thoughts of a zero sum game which I called out. You can safely assume I don’t agree with what you find most pertinent.

I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.

I'm not seeing that out of his comment. I see him saying we spend a ton of money, and there's the implication that we could be spending that money better/differently. That doesn't imply a zero-sum game. It does imply that the money available for health care is not unlimited. That's pretty much a fact, though.

How do you incentivize smart people to go into cancer treatment instead of other careers? If they can't get rich treating cancer, talent will choose other fields where they can get rich. The market allocates funding to that which people find important. Health care is extremely important, so it gets a lot money thrown at it.

Countries other than the US exist. Doctors, health care workers etc are significantly less paid in Japan and yet they still exist.

The idea of 'market forces dictating absolutely everything' is proven objectively wrong by countries that still have a large amount of doctors despite being paid less. The market theory would posit that all of those doctors and what not would move to a country that pays them more but there are many, many other factors other than just pay.

You are assuming that I believe many things which I do not.

You should just assume I'm a misanthrope who enjoys watching people suffer. I mean, it's not true, but lots of idiots assume it.

> I think a country which lets some get rich off of other’s cancer is an abhorrent, indefensible, system.

lol

> Actually, the median American has access to exceptional care.

Is there a source for this? I'd guess that there's a percentile where American health care has better outcomes than other countries, but 50th seems pretty low.

1) It's not clear it will be worse, many countries with single insurer/single payer have just as high quality care (Canada)

2) Leaving these people uninsured is not cheaper, you're paying for it already with significant healthcare costs. The same people complaining about the cost of healthcare turn around and deny preventative coverage to people who end up in the ER and you pay for it regardless.

3) It's the right thing to do, ethically, morally and financially (long term)

What an incredibly ignorant take, no wonder we don't have any healthcare solutions.

My wife, a practicing surgeon, refuses to work as a wage slave.

She already performs a significant amount of her practice as "charity care" where she gets no reimbursement whatsoever.

Given that for a fellowship-trained (3) board-certified (2) surgeon the train-up period is measured in ~2+ decades, not 4 years for regular professions.

> What an incredibly ignorant take, no wonder we don't have any healthcare solutions

Please don't assign false morality to the compensation people expect when their working career is effectively halved due to their extensive training requirements, and their educational bills dwarf by comparison every other profession.

The US already subsidizes medical research and bigpharma profits for the entire planet. We're not the freeloaders you're making us out to be.

You ever been to a Canadian hospital?

> You ever been to a Canadian hospital?

As a Canadian: yes.

And the bill was $0 at the end of my father's heart bypass and valve replacement surgery. My friend's sister cancer treatment also had a bill of $0.

Finished filing my taxes last month, and my average rate (provincial+federal) for last year was 21%. Happy to pay.

"... and then I found out that this other country - which I thought had the best healthcare system in the world - allowed for-profit insurance companies to dictate what treatment would be paid for, and allowed millions of people without insurance to likely go without any sort of test for cancer at all."

I'm not sure I'd feel better with the explanation "No, we won't pay to cure your cancer, but hey, if you were in the US there is a chance they won't pay for it either!"

Pretty sure I'd prefer even a 5% chance versus a guaranteed 0%.

Folding doesn't help someone with a US$7000 deductible but no means to pay it.

Legit every major drug company would give you the drug in question for free, not to mention Medicaid, which if you can't afford 7k, you would easily qualify for.

I have Canadian friends and it sounds better than when my older brother had to call their insurance company every months to get their anxiety meds covered because, for some reason, the insurance company lost the paper work for approving them every month. For a year.

Funny because it’s just the sort of thing to cause more anxiety in an anxious person.

I’d also love hear how many Canadian cancer survivors have to put up gofundmes or go bankrupt for care.

Who here is saying Canadians are perfect? I’m sure it’s easy to find individuals who had a better experience in the US.

I have, as have members of my family, and have received excellent care for some fairly serious conditions. I think the Canadian system is under funded, and I'm sure there are plenty of true horror stories, but they always get highlighted by people who want to tear down/prevent a public healcare system so I feel I have to bring up that my family have received good and timely care. When I really needed healthcare I was unemployed and it was stressful enough seeking care without having to worry about insurance. Now that I'm employed I'm happy to pay back into the system.

I value having public health care. I hope the US can come up with a good public system so that Canada can stop resting on "at least we're not like the US!"

It really seems to be one of those things where depending on who you are, you are better off under one system or the other. I have an aunt who was handicap from birth. Her care in Canada from birth to her death in her 70s was far better than what she would have received in the US under Medicaid, which is what her disability likely would have restricted her to as her ability to work and access quality health insurance would have been limited. On the other hand, there's no shortage of Canadians who end up coming over to the US to get timely care that the Canadian system treats as low priority even though it has a large quality of life impact and even in some cases, a life expectancy impact. There was a case recently of a Canadian YouTuber living in Japan who ended up in Florida for treatment because both the Japanese and Canadian systems failed her. The comparisons between systems aren't anywhere near as clear as many would have us believe.

Those stories aren’t irreconcilable. The US is huge and has a lot of specialists and I don’t doubt there are some cases where you can get better treatment in the US, especially if you’re rich.

The issue is we fail most people and those we don’t fail we often bankrupt. That isn’t acceptable.

I've been to multiple Canadian ERs (2 times total) and multiple US ERs (2 times total).

The only difference has been that 1 time the Canadian ER was busier and I waited my turn (based on an initial triage).

I feel, during my visit, I was appropriately handled in all 4 locations. After leaving the hospital in Canada I was done. However in the US, both times a few weeks later I got a bill for roughly $1000, and it actively makes me think twice about going to the ER (even though I can afford the $1000). In the US, I may have skipped the ER the second time if I hadn't felt strongly I was having an appendicitis. Truly scary to think I considered not going based on a bit of money.

If it wasn't clear, even being well off in the US, I prefer the overall experience in Canada.

The quality of Canadian healthcare depends greatly on who is in the room having the discussion about it. If it's just my Canadian relatives discussing it, it's the worst healthcare system on Earth and too much of their taxes goes to funding something to provides garbage care. Once someone from the US enters the conversation, the quality of the Canadian healthcare system skyrockets. Things get really interesting when my cousins from Ontario who have lived in Florida for most of their adult lives get in the conversation since they're willing to call out both sides on their BS.

Yeah, I've also had friends and family go. No complaints.

Why do you ask?

Have you? Do tell.