Comment by maxwell

I live with private healthcare. The last few trips to the ER have been 8 hour waits, too. This is an under capacity thing. I live in a place that has boomed, and the mismanaged hospital hasn’t remotely kept up. They fired a bunch of folks during COVID, then shocked pikachu found themselves understaffed.

The point is, the entire thing is broken nearly everywhere you look. I don’t know what a better alternative is, but we sure need one.

Last time I went to the ER with my dad it was about a 3-hour wait, and he really needed to get in. Saw a few people who looked like they definitely ought to get help, given the runaround and told it'd be hours and hours of waiting, until they left to try to find another ER with a shorter wait (in one case, the patient was delirious, sweating, and being guided around by a couple friends—I hope she got help somewhere), I assume because they looked like they couldn't pay and were probably uninsured (there was definitely a pattern to who got this treatment), so the staff were doing everything they could to discourage them. Some people who were there when we arrived, were still waiting when we got out, so they'd been there at least 4 hours.

US, and he's insured, and it's supposedly a pretty-good hospital.

I've been to the same ER within months of that, and it was empty and I was back in a room (well, cubby) within 15 minutes, with something just barely severe enough to merit an ER visit. Quick. Fucking expensive (think it was almost $3k by the time they were done sending bills, for 5 stitches and an x-ray—and that's with insurance), but quick.

It was mostly just timing and luck.

> My father's cancer treatment was not covered so the last year of his life cost him everything.

Sucks that it happens to anyone, but the final year(s) of healthcare finding a way to soak up every cent, before the end, is basically the norm here in the US. Everyone's retirement savings is just money the healthcare industry's lettings us hold temporarily.

I have both, and the wait at the paid clinic is long, as is the wait at the free clinic.

It’s not whether the cost is socialised or not that decides how long the wait will be.

It also doesn’t help that the private system is incentivised to undermine the ‘free’ system at every turn.

I think another component to the equation in wait times is also doctors per capita and GDP per capita.

It's hard to compare apples to oranges but with high doctors per capita, low wait times for speciality services, long lived citizens and a far lower percentage of GDP spent on health, I wonder if there are any serious holes to poke in Italy's system when compared to the U.S. or if they simply just beat us on every metric.

https://www.oecd-ilibrary.org//sites/242e3c8c-en/1/3/2/index...

I just had kidney stones, while extremely painful not very high on the er totem pole. Got in, got a bed, IV all within 10 minutes of walking in. There's at least 30 hospitals in my metro and hundreds of urgent cares.

$1500 on my HSA plan, which btw right now is returning 4.6% in a money market. How awesome is that?

Great deal. Worst pain ever.

Last time I was the ER in the US, I waited four hours with a pretty serious fever. Talked to a doctor for maybe 5 minutes and got sent home. Cost me only $500.

Senior / elderly care can be enormously expensive. Especially towards end of life. I could agree with you if the population was all teen to 45 year olds but that is not realistic.

The same dynamics play out with pension schemes. Declining birth rates play havoc with proposals that rely on a large, young employed base who's work supports a small, retired set of pensioners.

My own perspective is that healthcare is extremely limited on the provider side. Professional organizations have been limiting the supply of doctors / doctor equivalents for decades. Not to minimize the work a family medicine or general practitioner puts in, but many important health services/early interventiona can be safely and reliably provided by a nurse practitioner or physicians assistant (what a horrible name) on a much larger and affordable scale then exists today.

Insuring populations that are too small/niche/finite or over which you have too much information and ability to price discriminate (i.e. charge them exactly the cost of insuring them) isn't insurance either.

It's a perverted cross between escrow and welfare in which the population basically pays their own way in the long run plus supports all the people who make their living by being "administrative overhead" along the way.

If you need anything more serious than your family doctor, expect a long wait in the US too. My colonoscopy is booking 6 months out for what should be a very routine procedure.

> NHS is not known for speedy treatment, for instance.

From what I understand (I am not a UK citizen, but me mum's mum spoke Scouse. My mother, on the other hand, spoke The Queen's English), everyone loves to hate on the NHS, but no politician in their right mind will touch it. It's a "third rail."