Last year my best friend got diagnosed with cancer, and his VA docs let him sit 3 months between appointments. By the time they offered a treatment plan, he had become terminal, almost a year in. He died last June. It's really quietly horrifying to see it play out in real-time.
But on the bright side, the insurance company probably saved a lot of money. And as you know, line going up is more important than quality of life going up or even staying alive. /s
I’m sorry about your friend, nobody deserves that.
Are these doctors just seeing patients all day, every day? If not, I can't imagine how they could possibly justify making someone wait 10 months for a virtual visit.
A rheumatologist? Basically. Any ‘old person’ specialty is hard to get an appointment in because they’re booked out for ages, unless you’re lucky and live near a bunch of them or have insurance with a really big network of providers.
Honestly? A lot of them are. They also might have a few hours during the day where they review lab results or imaging for their various patients.
A lot of the specialists don't work for a hospital or anything, so they're basically a doctor and also a small business owner in a business with a very long ramp up time and uncertain demand on the timeframe that you can make the decision to work in the field. So you end up with "how many people do you think will have arthritis in five years, and how many people do you think will have decided to become rheumatologists by then?" And if you're wrong you're still a rheumatologist and you basically just need to move someplace that needs one and hope you can run a business.
You might luck out if you're near a big medical facility that's involved in teaching, because then you might end up with several doing teaching and research.
E.g. in the UK, someone I know had to wait 18 months for an (online) assessment for ADHD. I was along as a character reference, since I have ADHD myself, so could point out the bits they forgot (due to ADHD).
At the end, they apologised again for the delay. Apparently, since COVID, they have been receiving almost as many referrals in a week than they used to in a year. It takes a long time to train new doctors, particularly in specialist positions. They were swamped.
Many specialists are in the same boat, even before insurance companies get involved.
The American healthcare system killed my grandpa by waiting so long to care for his severe foot infection that his heart (which was already damaged from a heart attack 15ish years prior) couldn't handle the strain anymore and he passed away. I will never forgive that hospital or the insurance companies involved, and I never even got to say goodbye to him. That kind of shit doesn't happen as frequently here in Canada and I am thankful for the system we do have, flaws and all.
They send you away for everything except imminent death. You then have to book an appointment with a specialist instead, and it’s at least a month from now.l if you’re lucky.
To be fair I had to have an organ removed due to exploding or something. It took less than 24 hours. Then insurance denied it-no way to tell if said exploding organ was an elective surgery or required by the doctor who required us to do it.
Apparently all the cool kids are doing elective organ removal these days.
I had a 14ga puncture wound last year in Canada, about 1" from my femoral artery. Rapidly flowing blood, tourniquet applied on-scene just below the groin.
Ambulance was on scene quickly, I was immediately put into the trauma center in the ER, stapled, full body CT with contrast, tetanus booster and some more stuff I don't remember. Time in ER waiting room: zero. Time in hospital: ~1.5 hr total, mostly spent waiting for a follow up outside the ER.
I paid $250 for the ambulance and nothing else. Canada's healthcare system is GREAT at keeping you alive (if you're not indigenous, which is a true national shame).
Canada's healthcare system is not amazing at keeping you healthy. Something minor and chronic? Get fucked, it's a 2 year wait for a specialist referral. Minorly hurt but not at risk of death? Yeah enjoy the 4-10 hour wait in the ER room. When will you be seen? Idk when we can get to it. Want to see a doctor? Walkin will see you for free in about 45 minutes. Want to see your doctor? Yea they're out this month working at the hospital, how's 3 months from now?
All of this is vastly better than my time growing up in the US where the hospital missed diagnosing me with pneumonia and gave me permanent lung scarring. Or missed my fractured ankle on the xray and said I was fine. And then billed my parents 10's of thousands of dollars.
I will say, in my city, our family doctor is in office at least 4 days a week.
If you dont have a scheduled slot, you can see another in the same clinic tho, but usually you wanna schedule if possible.
If you give them a few hours heads up before leaving, you can usually be in and out in lile an hour total which is fine imo for non-energency.
For emergencies you are not spending any time in the waiting room yeah, they are pretty good at fixing you up fast.
If you just go to a hospital 15 minutes out of town at a smaller city, non emergency wait times plummet tremendously.
We have like 3 hospital options where I live, to go to, that are an extra 15min drive but 1/10th the wait times for non-emergency.
Politicians love to pick the one hospital dead center of the city that is the busiest one and cherry pick its busiest time of year as average wait times.
In reality its the exception and most other hospitals are faster, and 1 city out from the major one and hospital wait times are negligible.
American here. Reluctantly went to the ER because I had been vomiting for a couple of days. Turned out that my gallbladder just stopped working. Was immediately placed into a room, given IV antibiotics, and had surgery the next morning.
Had to stay for 4 days to make sure I was in good shape. The surgery wasn’t super expensive, but the room itself cost me way too much.
Total cost was just over $24k. No insurance (contractor). Even on payments, it’s insane.
My plan is to just never get sick for the rest of my life so I don’t go into another debt hole.
The ambulance ride was something like $1200, which I've come to learn was "cheap" comparatively speaking, as they're typically thousands of dollars each. My insurance didn't cover the cost of that ambulance because the particular service that picked me up was out-of-network. Insurance also didn't cover the ibuprofen I was given for pain citing the fact that they require prior authorization for it. Two ibuprofen alone cost me $40.
You can haggle with them. Save up a few k and then call them offering to pay a lump sum to settle the debt. A few years ago I broke my wrist and ended up with a 16k bill. I got 3k together, called them, told them I'm poor AF, that they could take the 3k or nothing. They took the 3k.
Similar story back when I didn't have insurance for a bit. In my case the hospital billing actively offered a settlement when I called and asked about options.
The worse part is that this is totally dependent on who your insurance is, and you don't know prices on anything until the bill shows up 3 months later. You or your doctor also might have to fight your insurance to prove a procedure is necessary, or that a medication needs to be covered. Most times you can expect your procedure to not be covered, so you have to tell the insurance company that yes, this is covered, here's why it was necessary (usually this first round of rejection is done via having an algorithm or ML setup "review" the case).
In some sense the US system is more reflective of the "true" cost of healthcare, just in the least humane way possible.
Take a country with "bad" socialized healthcare: Patient pays some percentage of visit cost, government pays the rest.
You break your leg: ambulance with two EMTs is $100/hr, 2 x-rays at $10/per, $30 in assorted bandages and plaster, and $150/hr for a doctor. Total patient cost: some percentage of $300.
The US system charges all those, but also reflects the cost of those things existing and being available as reflected in patient usage. The socialized system sees the ambulance ride as distinct from when the community needs a new ambulance, or the cost of having EMTs available 24/7/365.
Likewise, you get charged not just for the bandaging, but the cost of the person who brought the bandage to the nurse applying them, the cost of the person tracking the inventory, and the cost of the nurse isn't included in the medical care. Your room isn't charged as a room but as the room plus the services of everyone who keeps a hospital room ready to go.
A socialized system just happily says "of course a hospital needs skilled janitors and maintenance people, but only an idiot would call what they do patient care"
No one notices the cost of every hospital janitor and HVAC specialist in an entire country being divided amongst the entire tax base. You do when your share of the salary of all of them at your local hospital gets added to a bill addressed to you.
Our system is the way it is because otherwise no one pays for the pharmacist, and insurance caps things weirdly. Also, you have to multiply everything by 3 because the insurance company will refuse to pay anything above 1/3 of "list" price.
It may be outstandingly cruel, but it isgood also terrible at providing cost transparency. Which is worthless to everyone except accountants at work paying for healthcare.
So yeah. That's cheap, and the WTF goes deeper than most people can imagine.
Don't all of those costs have a profit counted into them? I've always thought that a socialized system is incentivized to be as cheap as possible, to have as few "customers" as possible, which means that the whole system, from education to taxation, should make policies that improve people's health, to make sure they need to use the hospital as rarely as possible.
That depends a lot on the medical system. Some systems target profit, but some are non-profits, affiliated with universities or other arrangements that make sense for a medical system.
The city I live in has two main hospitals. One is run by a for profit corporation. The other was a non-profit that got government funding to cover the difference because they were the main "ER as only healthcare" hospital in the area, since the other was built on the rural side of the suburbs and this one was in the middle of the population center. Then they got bought by, of all things, another non-profit operated by a public university. The first non-profit also owned a for-profit insurance company and a fitness center. I think the disposition of those is an ongoing legal question, since the university also owns an insurance company and there's some weird conflict of interest interplay.
It's a clusterfuck but the redeeming side is that the hospitals are actually extremely good.
Having at some point or another used all three systems I can say that the prices were basically the same. The staff all like that they can transfer patients to the university easier, but dislike the new parking system.
Yeah it's actually a serious problem how many hospitals in the US are non profits run by religious organizations. Like, your local ER has a decent chance of being owned by the catholic church and you won't know until you need medical care they don't approve of.
Yup, it's preposterously cruddy. I like my random bits of research so I happen to know the ownership details of my local institutions, but that's far from common. And even if it was, it's not like you even get a choice if you're in need, if you even had options to choose from.
The previous non-profit, the one that got purchased by the university, started as a charitable outreach from a local women's group in the 1890s. Then a business man donated some land and money and they made a proper hospital.
The Catholic "hospital" was a ghoulish dive that was basically a small ER with a few other beds and offices. Eventually they got bought out by the womens group hospital and turned into a sleep medicine and medical imaging annex.
I'm just realizing we have three hospitals which feels like a lot for a city this size.
Yes and, insurance companies spread out their costs among all their enrollees, whether or not they have to use those hospital services and equipment, in the form of premiums. (And of course they add on the cost of their CEO's yacht, etc. because evil.) So that's how they "save you" a portion of the billed amount.
But having so many uninsured people, whether healthy or sick, that aren't even part of the system hurts everyone.
Which is why we need to eliminate the insurance racket, make healthcare universal and pay for it through taxes, perhaps a sliding scale based on net worth as long as I'm fantasizing.
Medical debt aside, (not that it's not important) you are an example of something that's true about both systems: If you are at death's door you'll get treatment immediately, even if it's just to stop you actively dying and stabilize you enough to wait for admission to the ICU. If you are waiting 12 hours in the ER before being seen by anyone but Triage, you're probably the least sick/wounded person there.
Maybe instead of cursing the nurses and doctors, muster up the most powerful curse you can conjure, and send it to the germs and cancer cells in the Children's Ward. Can't hurt, might help. I like to start with "Fuck you, you filthy neuroblastomas! With your disgusting corrupted DNA and misshapen tumors oozing and squooging into places you don't belong! Just fucking shrivel up and die! Don't you know nobody wants you here? You're fucking waste, so waste yourself and go out the shithole!"
Then see if you can call some good vibes for a quick resolution to the people who look miserable enough to be ahead of you. You're on your own there, I'm not so good at prayers or that kind of thing.
Also a summertime reminder: a lot of people in the ER these months will be getting an IV because they're severely dehydrated. And others will be getting an IV because their ability to withstand whatever else they have will be improved by getting better hydrated. You can help keep yourself and your friends out of there by pre-emptively drinking more water and non-alcoholic no-caffeine drinks, and being a ...did "hydro homie" get ruined when I wasn't paying attention?
Based on the price and it affecting your credit, it must have been something that you asked for, rather than needed. Like a couple of Tylenol for pain.
I'm beginning to think if I need to call 911 for myself, I should grab a couple Tylenol to take with me, even if I'm not sure it's a good idea to actually take them. In my experience it's possible to get permission from a doctor to take one's usual home meds and the nurse will chart that you did so. In my husband's case it was Evrysdi, which they were very glad we could provide, and his insurance (Platinum Plan because he needs it) did cover Tylenol, but I bet mine doesn't.
I recently wound up with a ~$300 ER bill while unemployed for an extended period. I tried to negotiate a payment plan, and they insisted the minimum payment was $100/month. So, they got zero.
That instant room you got is nothing special, but just how triage works. I came to the emergency room some years ago, shitting and vomiting my guts out, and they placed me in quarantine faster than I could hand over my insurance card. Come with a sore ankle and wait until the other patients are stabilized.
That's a great plan until it's not. If you're able to, I'd highly recommend looking into getting Obamacare if you can't get insurance through an employer due to being a contractor. I don't know your personal situation, but Obamacare plans are often more reasonable than people imagine.
Obamacare is getting gutted bit by bit. You might have noticed the enrollment has dropped. This is because the premiums are way up, it’s now harder to get a subsidy to offset this, there are less insurance companies available, and the plans that are there now cover less. If Dems don’t win in the midterms, it’s toast.
Never let Republicans forget that the best socialized healthcare system in the country was copied from a Republican system created and approved by voters in one of the most leftist states in the nation. It makes them so mad that they can't blame a black guy for it when you do.
My gf had a mini stroke a few weeks ago. We were traveling so didn't go to the hospital right away, mostly because she hates them and is terrified of the bill. On the way home and got way worse. We went immediately. They tried to tell us it was nothing more then a headache, and charged us 18k. I'm also a contractor so even if I could get insurance, because I'm not married to her I would have to pay double. Fuck this system.
When I went to Econ class, the professor explained that we call it "Free Market Economics" because of four freedoms:
Freedom of entry and exit - participants (buyers, sellers, and prospective such) can enter or exit the market at their leisure, and the market will not change
Freedom of participation - every participant is in the market of their free will and can leave the market without repercussion
Freedom of substitution - every product on a particular market is essentially the same
Freedom of information - every participant has the same information about availability and prices at the same time
The reward is that free markets are efficient: they lead to the lowest prices and greatest exchange of goods. That is the reason we have them.
When the four freedoms are not mandated, the market fails in different ways, and that's absolutely expected. When information is available to some before it is to others, we get price distortions - that's where insider trading laws come from.
Health care, the prof explained, suffers from the fact there is no freedom of participation. You either buy care or you suffer the potentially deadly consequences. That's why free markets and health care are fundamentally incompatible: they are expected to be.
Healthcare is the literal example of inelastic demand my prof used to teach us the concept. If you die without it, then there is no price where a reasonable actor can choose to stop participating in the market.
Non-fatal health conditions that lots of people put up with. Someone I knew went to ER for first kidney stone, then just endured the pain the second time until they could get a non-emergency appointment, since it's non-fatal but agonizing, and a non-emergency visit is like 80% cheaper.
Lots of people just accept chronic problems, for example joint pain without seeking medical examination.
Of course, in many cases, hard to make an informed decision on whether it is or is not one of those life or death scenarios in many cases.
Yeah, but that holds as much water as my argument in macro 100 about gas being elastic because of how many people scoff at the shell price and look for a sunoco. I did it when I drove every day (in a city with a high density of gas stations), and I will now take other forms of transportation if gas is too expensive, but that’s not common behavior, nor is it normally logical (saving five cents per gallon, driving an extra five miles, and wasting twenty minutes is not a true savings for most people).
It’s technically true, but in an academically idealized market, it wouldn’t be.
I feel like #3 no longer exists for anything in the US economy. You get one product in each niche either owned by 3 companies whose executives all have lunch together (egg farms, meat, ram manufacturers, etc) or where its just absolutely so black boxed its unclear what the product actually is (windows, google, ai etc)
There's no freedom of information either. Good luck getting your healthcare provider (your doctor, the hospital) to tell you how much any given procedure will cost in advance.
Even upper middle class Americans have shitty healthcare. But many or most of them are proud of learning the system so they refuse to consider that they could have been getting fucked their whole lives.
That's a good point. If I had a dollar for every time someone smugly explained a horrific aspect of American healthcare like I'm an idiot for not knowing it, well, I still wouldn't have enough dollars to go see a doctor, but it has happened a lot.
Currently, emergency rooms are bound by law to provide care to all patients, regardless of insurance status. Busy emergency rooms will triage patients, ensuring those who need care the most get it first. Unfortunately for uninsured patients, the hospital will hand them a bill as they leave; something simple as wound cleaning and a few stitches will run upwards of several thousand dollars. That total can exceed tens, if not hundreds of thousands of dollars depending on level care and length of stay.
A family member of mine recently had a medical episode while we were at a restaurant. Spontaneous syncope followed by prolonged lightheartedness and loss of balance. The ambulance ride to the hospital alone cost over $7000. They arrived at the ER around 4pm and was released shortly before midnight. Within a couple hours of arriving my family member felt and that they had fully recovered, but the ER would not release them until a doctor was available to discuss test results. Around 10pm the doctor finally called them back; they found nothing out of the ordinary in the blood work, heart seemed to be working fine. We waited two more hours before they gave the okay for release.
The bill for the ambulance, ER care, and about a baker's dozen of various fees and incidentals, was over $23000. Thankfully they had insurance, which covered most of it, but they still had to pay several thousand out of pocket for going to an "out of network" hospital. That alone is infuriating because not only is the entire concept of in-or-out of network medical providers a predatory practice, the choice of which ER to go to was up to the paramedics, it was never up to us. Even if it was up to us, we had no way of quickly knowing which local hospitals, if any, were "in network."
It depends on the situation. Emergency rooms are required by law to stabilize emergency medical issues, regardless of the patient’s potential ability to pay. This is because there used to be a big issue with ERs dumping non-paying patients. If the hospital didn’t think a patient could pay, security would literally wheel them across the street, then just leave them there to figure their own shit out.
ERs run on triage, (and lots of people go to the ER for things which could be handled by an urgent care or family doctor instead), which means wait times entirely depend on your specific situation. Mildly upset stomach? You’ll probably be waiting at least a few hours, especially if it’s a busy night with lots of more urgent patients. Chest pains with a history of heart disease? You’ll have EKG leads stuck to you before you’re even finished telling the intake nurse what your issue is.
And the big key thing is that ERs are required to stabilize an emergency medical issue. They aren’t required to provide follow-up care, long-term support, etc… If you show up with a cut that needs stitches, they’ll stitch you up. But they’ll tell you to follow up with your regular doctor to make sure it’s healing properly, and to remove the stitches in a few weeks. Don’t have a regular doctor because you’re uninsured? Good luck, hope it doesn’t get infected, then maybe chew some Tylenol and remove the stitches in your bathroom.
ERs run on triage, (and lots of people go to the ER for things which could be handled by an urgent care or family doctor instead), which means wait times entirely depend on your specific situation. Mildly upset stomach? You’ll probably be waiting at least a few hours,
Canada is the same, I went in bleeding badly and was seen right away. But another time I went in just needing my finger sewn and it took around 3 hours to be seen.
Personally, I've never had particularly long waits in the ER, but I only ever went to the ER when something was seriously wrong.
But it can really depend on where you are, time of year, holiday weekend, etc etc. Hospitals do triage, So chest pains and broken legs tend to be seen before someone there with a runny nose, and the runny nose person will probably have a significantly longer wait time than someone coming in with the left side of their body sagging and uncontrollable. .
No, just like anywhere else, wait times are based on urgency. A severed limb will be taken instantly, a bloody nose will wait until there’s an empty bed. Doesn’t matter if you’re insured or not.
Uninsured will just get billed a full amount after the fact (payable in installments to the hospital), vs insured who might have to pay a copay, and then a few month later will get billed a reduced amount, after the insurance company chooses what they’ll cover.
I speak from experience. I was uninsured for a short time, and of course my appendix chose that time to rupture. I was admitted and in the ER instantly. Spent three days recovering in the hospital. Before I left the hospital had a bill for me. It was very high. I set up a payment plan. Eventually I stopped making payments, because I was broke. Hospital sent my bill to a collector. I blew them off.
Was unable to get a loan for a house for 10 years.
It’s largely because the “tens of thousands” is usually a result of being uninsured. And if you’re uninsured, it’s usually because you’re unemployed. And lenders tend to get squirmy at the idea of giving a loan to anyone who hasn’t been fully employed since the day they were born.
There was actually a rule implemented by the Consumer Finance Protection Bureau shortly after the pandemic, to prevent medical debt from impacting your credit history. Because lots of Americans were suddenly finding themselves in an awful job market with tons of medical debt from being sick. But last year, the fifth circuit court of appeals (the one that presides over Texas and Louisiana, and which is stacked with conservative judges as part of the Southern Strategy) voided the rule and allowed medical debt to appear on credit reports again. The ruling from the conservative court also prohibited the CFPB from implementing similar rules in the future.
There was actually a rule implemented by the Consumer Finance Protection Bureau shortly after the pandemic, to prevent medical debt from impacting your credit history. Because lots of Americans were suddenly finding themselves in an awful job market with tons of medical debt from being sick. But last year, the fifth circuit court of appeals (the one that presides over Texas and Louisiana, and which is stacked with conservative judges as part of the Southern Strategy) voided the rule and allowed medical debt to appear on credit reports again. The ruling from the conservative court also prohibited the CFPB from implementing similar rules in the future.
you have to wonder what kind of soulless, hateful, worthless pile of shit roughly packed into a humanoid shaped bag would look at medical debt not ruining peoples lives and go "You know what, thats not right. people need to be more fucking miserable" and sue to get it overturned.
I imagine it was something like "but the lenders deserve to know if you were in medical debt ever!! They didn't save millions in case anything went wrong ever!!"
In America they shut down hospitals because the publicly traded corporation which bought the hospital realized it was more profitable to run 1 hospital per 5 counties.
Trip to ER deemed emergency: free.
Night doctor determined likely gall stone, kept overnight in ER to be confirmed by morning ER doc: free.
Morning doctor determined non-critical issue, added to wait list and scheduled checkin with specialist in 2 months All free.
Same pain next night. Same song and dance, ambulance, same ER night doctor, this time he stays overtime to ensure that it gets an ultrasound booked.
Ultrasound later that morning determines it needs to come out. Admitted same day for surgery. Bumped two days because literal life and death surgeries(c-sections and a motorcycle v car accident victim) and some time to let the surgeon have some sleep. He shows up and gets it done first thing.
Two weeks later, end up getting minor surgery for drain removal because her parent's cat purred on her nonstop and overhealed the drain scar.
All free.
Tldr: the Canadian system works on priority and is hobbled by conservatives.
Every conservative government cuts funding for every provincial healthcare system and then acts like the idea is flawed after they kneecapped it by limiting nursing hiring, freezing/reducing funding, and doing the 400th reorg to "find efficiencies". They shuttered 3 ERs in my city against the pleas of the College of Physicians and our ER wait times went up a couple hours overnight.
Who could have guessed?
I will vote Liberal, I will vote NDP, I will vote Green, I will never vote conservative.
This is common and a literal conservative tactic called "starving the beast". You strangle off funding to a thing you wanna cut, wait a couple months for the service to go to shit because they have to realign to compensate for having no money, and then go "wow look this sucks, better just kill it".
Yeah the reason I haven't waited that long in the ER isn't because I'm American. Ok actually it is, as an American I'm not going to the ER unless I'm certain I have to. Head trauma, blood loss, issues breathing, anaphalaxis… I think a bone might be broken? I can go to the urgent care in the morning
Today i crushed my finger in a metal door and it started bleeding a LOT because the metal cut my skin.
In the beginning i did not want to go to the ER, but then my SO persuaded me "what if you get sepsis and it needs to be amputated???"
I went there and i waited 1 hour only for triage (i can understand it, everyone was dying on a hospital bed while i had this little cut on the finger)
after triage the doctor says we need to xray. Xray?? Don't need it's just a cut, not broken, i don't feel painful. She persuades me to wait another hour for the xray and i am a bit pissed because now i have to waste time for xraying a finger that's definitely not broken, just cut and bleeding.
Result: i broke my index finger. WHAT?? I did not expect this conclusion.
Accurate. I had an afib issue recently, went to the hospital at 9pm and sat there in the emergency room bed all night because they told me the cardiologist needed to see me before they could treat me. The cardiologist got in at 9am, and I continued to wait until 12:30pm without seeing them. It finally went back to normal rhythm at that point and I was discharged a few hours later. Luckily I have health insurance, so I didn’t have to pay much, but I don’t live in bumblefuck; I live in a pretty populated area of New York and was sitting there waiting for treatment for over 15 hours. It’s a dumb argument that we don’t have to wait for treatment as long as countries with socialized healthcare.
It’s a dumb argument that we don’t have to wait for treatment as long as countries with socialized healthcare.
Yeah it's super disingenuous. They like to pretend like we don't have wait times for specialists too. It's ridiculous that people still try to use those arguments.
Oh that’s another thing; it’s two months to see a cardiologist by me… so they wanted me to follow up with a cardiologist after I got out of the emergency room and it’s a two month wait.
It's weird, I had a-fib recently and the hospital didn't let me see a cardiologist. I asked several times in the 3 days I was there, and the answer was always no. Until they discharged me, and then it was "you should see a cardiologist ASAP."
That’s ridiculous. They didn’t shock you out of it? They’re not supposed to let it go more than 48 hours because your blood starts clotting in your heart around that time and can lead to a stroke. I guess they probably gave you blood thinners to prevent that though.
No shock, and they did give me a blood thinner after the first night. If I had known what I know now, I might have tried to advocate for myself more, but unfortunately that doesn't always help.
I think the main risk with it is stroke from the clotting, so the blood thinners alleviate that risk. It’s odd that they didn’t try to shock you out of it tho, I’ve gone to the hospital about five times for it and converted back on my own, but twice they were going to shock me. Usually it’s that threat that scares me back to normal.
The thing about Canadian care is that it usually works well for urgent and life saving care. If you don't like the wait for non urgent items, you have to option to pay - you just need to travel somewhere to get it done. The media likes to go on about the cases when people die while waiting but some of them were so sick they weren't going to make it anyway. Having quick access to ER isn't a guarantee that you will survive the heart attack symptoms you've been ignoring for the last month.
Lol if you got a real problem in Canada, you're in and out. No fucking around. Trauma, injury, blood everywhere, yah you get stabilized and attention right away. Hell, I've gotten into a car accident. Bad one, no injuries though, got home started to feel rough after the adrenalin kicked out went to hospital said what's up, in 40 min I had xray, CT scan, and an all clear, see ya.
You come with a flu? Go sit your ass down maybe they will see you tommorow.
I had heart arrythmia. Was in within 5 minutes and hooked up to monitors. If Im in for something less serious, I'll wait. No big deal.
Americans dont seem to get that when we complain about our health system, it doesnt mean we want theirs. We want our issues fixed, not more issues and going bankrupt because of a small medical problem.
When I was a kid, in America, I got a huge gash in my head that required stitches. It took them so long to see me in the waiting room they had to reopen the wound to stitch it shut.
Same, I fell at summer camp and spent so long in the ER I dozed off, they just used a butterfly bandaid on my head though (nice scar under my eyebrow). My parents were pissed about the bill.
Americans literally live their lives without hope of going to the doctor.
Not frustration at it taking so long.
Literal despair that they will never get to go to the doctor, paired with fear that if they do, they will have to pay literally tens of thousands.
It's like if there's a homeless person, and you tell them "I could bring you some food in 12 hours, or I could just never bring it to you. Which do you prefer?" And the Republicans will straight-up claim the homeless person would choose to never get the food because 12 hours is too long to wait.
Though I totally agree that triage is important, you can absolutely be left waiting for more than an hour with an emergency. It's just not as pressing of an emergency as other people. There's plenty that an urgent care can't do for you that requires an ER but that is not life threatening within the next few hours.
Some people would die. In the end the survivors would be far better off. Question is mostly how long it would take. Could the medical/insurance industry make it without changing a thing for more than a month without health insurance? More than 6?
A comparison of Canada vs the USA is hard. All my instruments need to be recalibrated for imperial shithole country scales, but the conclusion is always the same: THE USA SUCKS.
I had a rich guy leaving Canada claim that since he can get healthcare for $120 and see a doctor faster by flashing money in some 3rd world country, public healthcare is a scam. Like yea dude im sure if they privatized here the treatment would still be $120.
I had my appendix burst and waited for 18 hours in the ER. I nearly died, and owed thousands even though I have insurance. I live in the USA. Freedumb.
I was in such a good spot for this year. My 1 year old son had to have a life saving surgery in march which left us with a $36,000 bill to be paid, but also meant we hit out deductible and out of pocket max so everything for the rest of the year was free. I finally booked an appointment with a new cardiologist (we moved and I haven't been in 2 years even though I'm supposed to go every 6 months), a new GP, I was ready to book a therapist and all the other little health things I just can't afford but should do. About a week before my first appointment with the new cardiologist I went to pick up my refill for my heart medication and my insurance wasn't working so I had to pay $120 for it since they were closing soon and I was already out. When I got home I checked and my insurance was terminated. Turns out my company switched insurance providers and sent the cards to my old address so I had no clue.
Hopefully my heart will be fine for a few more years. Thank god my old cardiologist is still filling my script.
(American) I went to the ER back in May and still don't know what it will cost me. Insurance keeps denying the hospital's bill, asking for more documentation.
Or you finally get into the OR and the insurance broker calls the surgeon in the middle of the operation to debate on how necessary a heart transplant is.
People who complain about 12 hour wait times in Canada are there for minor things on the triage list, anything life threatening is handled immediately and without hesitation. They always have rooms available for those who need it, the problem is people expect everything to be handled immediately - even when it's not serious.
I've spent way too many months in the hospital, ICU's, and being rushed to hospital bleeding out or near death, and everytime they saved my life very quickly. Not a broken system at all, I left there with zero bills.
Most people don't have a family doctor, so hospitals are unfortunately the only option. Walk-ins are hit or miss. The last walk-in I went to required appointments and they were fully booked up for weeks.
My family doctor was pressured into taking a much higher patient load to help alleviate shortages and I can see the effect it's had on him. Where before I got excellent personalized care now he's trying to refer me to specialists to offload the burden. I still only wait a week max to see him, and in emergencies I can get a same day appointment but I can see the toll it's taking on him and it worries me about his long term health.
Had to follow up to get it taken out - they only did drain removals one afternoon of the week. Something that took me thirty seconds to do when I got fed up and did it myself.
Last time I went to the ER was because I slipped on the stairs, dropped a coffee mug, bashed my elbow into the shards of shattered mug (RIP beloved TARDIS mug) and needed to get the pieces removed, elbow stitched up, and an X-ray to make sure nothing was left inside.
Total time at the ER from parking in the parking lot to getting in the car to drive home was about 3 hours. I think the co-pay was $500.
That's a suburban hospital on a relatively quiet evening. However, I've had other, similar experiences at that ER, and I don't think I've ever had an unreasonable wait time there. They used to guarantee that you'd see a doctor in 30 minutes, but I think they abandoned that policy when they were absorbed into a larger health system.
If I was headed to a major, inner-city hospital, I would expect to be in the waiting area for a long time. I've definitely had ER visits that were 12 hours from start to finish at the downtown ER.
Fun trick if you don't want to hang around in the waiting area:
Bring an obviously pregnant woman along. I've had the ER rush me along when my pregnant wife took me there. They are so conditioned to move pregnant women out of the ER that they'll rush you through even if the pregnant woman is just your ride home (kidding kind of).
They are so conditioned to move pregnant women out of the ER that they'll rush you through even if the pregnant woman is just your ride home (kidding kind of).
That's probably for the best. Pregnant women (and their fetuses) are at much greater risk if they should catch a communicable disease and you never know what might be circulating in that waiting area.
A lot of people sincerely do not understand how the triage process works.
That said, triage sometimes gets things wrong. I've twice had my personal doctors call or bring me to the ER directly so that they could ensure I was seen immediately/ASAP.
As someone with ulcerative colitis, I frequent the ER regularly. I have never waited less then 12 hours, even when blood just keeps leaving my body and I'm severely dehydrated.
Where we really excel is in the variety of treatment. You need some brand new cancer treatment? In the US you can likely get it if you can pay. Fancy tests like running a genome check to see if you'll respond to a medication? We've got that. In general we've got the high end expensive parts of healthcare available at a high price.
Other than that the only thing we've really got going for us is extremely fast turnaround for trans healthcare by global standards.
I dislocated my shoulder earlier this year. I walked into the hospital at 1:15. I didn’t walk out until 8:00. I didn’t get brought to the room until 4:00.
I slipped on ice this winter, and hurt my knee. I thought it was going to get better, but it didn't, so the next day I went to the emergency room. This is in Quebec, the province with one of the highest waiting times in Canada.
I saw the triage nurse within 5 minutes, had an x-ray 30 minutes after that, and the doctor came to see me 30 minutes after that. I total of 90 minutes after arriving, I was walking out the door with a (free) leg brace and a diagnosis that the knee was only strained.
I didn't even have to pay for parking, because my small local hospital doesn't charge.
Okay, this was an unusual case because the weather was pretty bad so a lot of people who would have gone to the hospital didn't. The normal wait time would probably have been about 4 hours. I like our rural healthcare!
Anyone care to guess how much I would have owed had this been in the States somewhere?
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12 hours and $35k? Stop your bullshit. I've dealt extensively with healthcare in the US. It's more like 10 months and $110k.
My partner is literally waiting 10 months to see a rheumatologist for debilitating joint pain. A virtual visit, no less.
Last year my best friend got diagnosed with cancer, and his VA docs let him sit 3 months between appointments. By the time they offered a treatment plan, he had become terminal, almost a year in. He died last June. It's really quietly horrifying to see it play out in real-time.
That's heartbreaking. I'm so sorry for your loss.
But on the bright side, the insurance company probably saved a lot of money. And as you know, line going up is more important than quality of life going up or even staying alive. /s
I’m sorry about your friend, nobody deserves that.
He said VA. No insurance there.
My ex got diagnosed with stage 4 cancer and was cured in a few months. Canadian, here.
Are these doctors just seeing patients all day, every day? If not, I can't imagine how they could possibly justify making someone wait 10 months for a virtual visit.
A rheumatologist? Basically. Any ‘old person’ specialty is hard to get an appointment in because they’re booked out for ages, unless you’re lucky and live near a bunch of them or have insurance with a really big network of providers.
Honestly? A lot of them are. They also might have a few hours during the day where they review lab results or imaging for their various patients.
A lot of the specialists don't work for a hospital or anything, so they're basically a doctor and also a small business owner in a business with a very long ramp up time and uncertain demand on the timeframe that you can make the decision to work in the field. So you end up with "how many people do you think will have arthritis in five years, and how many people do you think will have decided to become rheumatologists by then?" And if you're wrong you're still a rheumatologist and you basically just need to move someplace that needs one and hope you can run a business.
You might luck out if you're near a big medical facility that's involved in teaching, because then you might end up with several doing teaching and research.
It can easily happen anywhere.
E.g. in the UK, someone I know had to wait 18 months for an (online) assessment for ADHD. I was along as a character reference, since I have ADHD myself, so could point out the bits they forgot (due to ADHD).
At the end, they apologised again for the delay. Apparently, since COVID, they have been receiving almost as many referrals in a week than they used to in a year. It takes a long time to train new doctors, particularly in specialist positions. They were swamped.
Many specialists are in the same boat, even before insurance companies get involved.
The American healthcare system killed my grandpa by waiting so long to care for his severe foot infection that his heart (which was already damaged from a heart attack 15ish years prior) couldn't handle the strain anymore and he passed away. I will never forgive that hospital or the insurance companies involved, and I never even got to say goodbye to him. That kind of shit doesn't happen as frequently here in Canada and I am thankful for the system we do have, flaws and all.
Are you saying people are sitting around waiting at the emergency room for 10 months at a time and it's a regular thing in the US?
They send you away for everything except imminent death. You then have to book an appointment with a specialist instead, and it’s at least a month from now.l if you’re lucky.
Look, some sacrifices are gonna have to be made if we want to continue having the best healthcare on earth.
Fortunately, we've mastered the sacrificing part, now we just have to tackle beginning "to continue having."
You guys are having good healthcare?
No, but I'd say we have the most growth potential out of any Western country! - cough cough - Ow my existence.
To be fair I had to have an organ removed due to exploding or something. It took less than 24 hours. Then insurance denied it-no way to tell if said exploding organ was an elective surgery or required by the doctor who required us to do it.
Apparently all the cool kids are doing elective organ removal these days.
I had a 14ga puncture wound last year in Canada, about 1" from my femoral artery. Rapidly flowing blood, tourniquet applied on-scene just below the groin.
Ambulance was on scene quickly, I was immediately put into the trauma center in the ER, stapled, full body CT with contrast, tetanus booster and some more stuff I don't remember. Time in ER waiting room: zero. Time in hospital: ~1.5 hr total, mostly spent waiting for a follow up outside the ER.
I paid $250 for the ambulance and nothing else. Canada's healthcare system is GREAT at keeping you alive (if you're not indigenous, which is a true national shame).
Canada's healthcare system is not amazing at keeping you healthy. Something minor and chronic? Get fucked, it's a 2 year wait for a specialist referral. Minorly hurt but not at risk of death? Yeah enjoy the 4-10 hour wait in the ER room. When will you be seen? Idk when we can get to it. Want to see a doctor? Walkin will see you for free in about 45 minutes. Want to see your doctor? Yea they're out this month working at the hospital, how's 3 months from now?
All of this is vastly better than my time growing up in the US where the hospital missed diagnosing me with pneumonia and gave me permanent lung scarring. Or missed my fractured ankle on the xray and said I was fine. And then billed my parents 10's of thousands of dollars.
This is perhaps the most accurate explanation I’ve ever heard for our healthcare system here in Canada. I’m definitely going to use this in future.
I will say, in my city, our family doctor is in office at least 4 days a week.
If you dont have a scheduled slot, you can see another in the same clinic tho, but usually you wanna schedule if possible.
If you give them a few hours heads up before leaving, you can usually be in and out in lile an hour total which is fine imo for non-energency.
For emergencies you are not spending any time in the waiting room yeah, they are pretty good at fixing you up fast.
If you just go to a hospital 15 minutes out of town at a smaller city, non emergency wait times plummet tremendously.
We have like 3 hospital options where I live, to go to, that are an extra 15min drive but 1/10th the wait times for non-emergency.
Politicians love to pick the one hospital dead center of the city that is the busiest one and cherry pick its busiest time of year as average wait times.
In reality its the exception and most other hospitals are faster, and 1 city out from the major one and hospital wait times are negligible.
American here. Reluctantly went to the ER because I had been vomiting for a couple of days. Turned out that my gallbladder just stopped working. Was immediately placed into a room, given IV antibiotics, and had surgery the next morning.
Had to stay for 4 days to make sure I was in good shape. The surgery wasn’t super expensive, but the room itself cost me way too much.
Total cost was just over $24k. No insurance (contractor). Even on payments, it’s insane.
My plan is to just never get sick for the rest of my life so I don’t go into another debt hole.
I ended up in the emergency room last year.
The ambulance ride was something like $1200, which I've come to learn was "cheap" comparatively speaking, as they're typically thousands of dollars each. My insurance didn't cover the cost of that ambulance because the particular service that picked me up was out-of-network. Insurance also didn't cover the ibuprofen I was given for pain citing the fact that they require prior authorization for it. Two ibuprofen alone cost me $40.
You can haggle with them. Save up a few k and then call them offering to pay a lump sum to settle the debt. A few years ago I broke my wrist and ended up with a 16k bill. I got 3k together, called them, told them I'm poor AF, that they could take the 3k or nothing. They took the 3k.
There's a horror in having to haggle for the price of your healthcare whilst in the hospital.
Similar story back when I didn't have insurance for a bit. In my case the hospital billing actively offered a settlement when I called and asked about options.
"Wasn't super expensive", " 24k", sorry what the actual fuck?
The worse part is that this is totally dependent on who your insurance is, and you don't know prices on anything until the bill shows up 3 months later. You or your doctor also might have to fight your insurance to prove a procedure is necessary, or that a medication needs to be covered. Most times you can expect your procedure to not be covered, so you have to tell the insurance company that yes, this is covered, here's why it was necessary (usually this first round of rejection is done via having an algorithm or ML setup "review" the case).
You seemed to miss the part where he said the surgery wasn't all that expensive, it was the stay in the hospital that was.
In some sense the US system is more reflective of the "true" cost of healthcare, just in the least humane way possible.
Take a country with "bad" socialized healthcare: Patient pays some percentage of visit cost, government pays the rest.
You break your leg: ambulance with two EMTs is $100/hr, 2 x-rays at $10/per, $30 in assorted bandages and plaster, and $150/hr for a doctor. Total patient cost: some percentage of $300.
The US system charges all those, but also reflects the cost of those things existing and being available as reflected in patient usage. The socialized system sees the ambulance ride as distinct from when the community needs a new ambulance, or the cost of having EMTs available 24/7/365.
Likewise, you get charged not just for the bandaging, but the cost of the person who brought the bandage to the nurse applying them, the cost of the person tracking the inventory, and the cost of the nurse isn't included in the medical care. Your room isn't charged as a room but as the room plus the services of everyone who keeps a hospital room ready to go.
A socialized system just happily says "of course a hospital needs skilled janitors and maintenance people, but only an idiot would call what they do patient care"
No one notices the cost of every hospital janitor and HVAC specialist in an entire country being divided amongst the entire tax base. You do when your share of the salary of all of them at your local hospital gets added to a bill addressed to you.
Our system is the way it is because otherwise no one pays for the pharmacist, and insurance caps things weirdly. Also, you have to multiply everything by 3 because the insurance company will refuse to pay anything above 1/3 of "list" price.
It may be outstandingly cruel, but it is
goodalso terrible at providing cost transparency. Which is worthless to everyone except accountants at work paying for healthcare.So yeah. That's cheap, and the WTF goes deeper than most people can imagine.
Don't all of those costs have a profit counted into them? I've always thought that a socialized system is incentivized to be as cheap as possible, to have as few "customers" as possible, which means that the whole system, from education to taxation, should make policies that improve people's health, to make sure they need to use the hospital as rarely as possible.
Yes, but that's socialism and therefore bad.
/S just in case
Edit: actually, it's lost potential revenue which is even worse.
That depends a lot on the medical system. Some systems target profit, but some are non-profits, affiliated with universities or other arrangements that make sense for a medical system.
The city I live in has two main hospitals. One is run by a for profit corporation. The other was a non-profit that got government funding to cover the difference because they were the main "ER as only healthcare" hospital in the area, since the other was built on the rural side of the suburbs and this one was in the middle of the population center. Then they got bought by, of all things, another non-profit operated by a public university. The first non-profit also owned a for-profit insurance company and a fitness center. I think the disposition of those is an ongoing legal question, since the university also owns an insurance company and there's some weird conflict of interest interplay.
It's a clusterfuck but the redeeming side is that the hospitals are actually extremely good.
Having at some point or another used all three systems I can say that the prices were basically the same. The staff all like that they can transfer patients to the university easier, but dislike the new parking system.
Yeah it's actually a serious problem how many hospitals in the US are non profits run by religious organizations. Like, your local ER has a decent chance of being owned by the catholic church and you won't know until you need medical care they don't approve of.
Yup, it's preposterously cruddy. I like my random bits of research so I happen to know the ownership details of my local institutions, but that's far from common. And even if it was, it's not like you even get a choice if you're in need, if you even had options to choose from.
The previous non-profit, the one that got purchased by the university, started as a charitable outreach from a local women's group in the 1890s. Then a business man donated some land and money and they made a proper hospital.
The Catholic "hospital" was a ghoulish dive that was basically a small ER with a few other beds and offices. Eventually they got bought out by the womens group hospital and turned into a sleep medicine and medical imaging annex.
I'm just realizing we have three hospitals which feels like a lot for a city this size.
Yes and, insurance companies spread out their costs among all their enrollees, whether or not they have to use those hospital services and equipment, in the form of premiums. (And of course they add on the cost of their CEO's yacht, etc. because evil.) So that's how they "save you" a portion of the billed amount.
But having so many uninsured people, whether healthy or sick, that aren't even part of the system hurts everyone.
Which is why we need to eliminate the insurance racket, make healthcare universal and pay for it through taxes, perhaps a sliding scale based on net worth as long as I'm fantasizing.
Medical debt aside, (not that it's not important) you are an example of something that's true about both systems: If you are at death's door you'll get treatment immediately, even if it's just to stop you actively dying and stabilize you enough to wait for admission to the ICU. If you are waiting 12 hours in the ER before being seen by anyone but Triage, you're probably the least sick/wounded person there.
Maybe instead of cursing the nurses and doctors, muster up the most powerful curse you can conjure, and send it to the germs and cancer cells in the Children's Ward. Can't hurt, might help. I like to start with "Fuck you, you filthy neuroblastomas! With your disgusting corrupted DNA and misshapen tumors oozing and squooging into places you don't belong! Just fucking shrivel up and die! Don't you know nobody wants you here? You're fucking waste, so waste yourself and go out the shithole!"
Then see if you can call some good vibes for a quick resolution to the people who look miserable enough to be ahead of you. You're on your own there, I'm not so good at prayers or that kind of thing.
Also a summertime reminder: a lot of people in the ER these months will be getting an IV because they're severely dehydrated. And others will be getting an IV because their ability to withstand whatever else they have will be improved by getting better hydrated. You can help keep yourself and your friends out of there by pre-emptively drinking more water and non-alcoholic no-caffeine drinks, and being a ...did "hydro homie" get ruined when I wasn't paying attention?
hydro homie is not ruined yet, as far as I'm aware.
I'm sure Canadian doctors do something similar
Yes I agree, both systems. That's what triage is for.
Remember, you can make payments, they just don't have to be the suggested amount. $10 a month for life.
I don't recall if medical debt impacts credit ratings like others. It shouldn't in a sane world, but here we are.
So far, that total hasn’t, but there was a $985 bill for something relating to the stay that did hit my credit as a “derogatory mark.”
I hate this system lol.
Based on the price and it affecting your credit, it must have been something that you asked for, rather than needed. Like a couple of Tylenol for pain.
I'm beginning to think if I need to call 911 for myself, I should grab a couple Tylenol to take with me, even if I'm not sure it's a good idea to actually take them. In my experience it's possible to get permission from a doctor to take one's usual home meds and the nurse will chart that you did so. In my husband's case it was Evrysdi, which they were very glad we could provide, and his insurance (Platinum Plan because he needs it) did cover Tylenol, but I bet mine doesn't.
I recently wound up with a ~$300 ER bill while unemployed for an extended period. I tried to negotiate a payment plan, and they insisted the minimum payment was $100/month. So, they got zero.
unfortunately we all become disabled. It's just a matter of time.
Not if you die violently on the assembly line
That instant room you got is nothing special, but just how triage works. I came to the emergency room some years ago, shitting and vomiting my guts out, and they placed me in quarantine faster than I could hand over my insurance card. Come with a sore ankle and wait until the other patients are stabilized.
(Germany)
That's a great plan until it's not. If you're able to, I'd highly recommend looking into getting Obamacare if you can't get insurance through an employer due to being a contractor. I don't know your personal situation, but Obamacare plans are often more reasonable than people imagine.
Obamacare is getting gutted bit by bit. You might have noticed the enrollment has dropped. This is because the premiums are way up, it’s now harder to get a subsidy to offset this, there are less insurance companies available, and the plans that are there now cover less. If Dems don’t win in the midterms, it’s toast.
Romneycare*
Never let Republicans forget that the best socialized healthcare system in the country was copied from a Republican system created and approved by voters in one of the most leftist states in the nation. It makes them so mad that they can't blame a black guy for it when you do.
My gf had a mini stroke a few weeks ago. We were traveling so didn't go to the hospital right away, mostly because she hates them and is terrified of the bill. On the way home and got way worse. We went immediately. They tried to tell us it was nothing more then a headache, and charged us 18k. I'm also a contractor so even if I could get insurance, because I'm not married to her I would have to pay double. Fuck this system.
When I went to Econ class, the professor explained that we call it "Free Market Economics" because of four freedoms:
The reward is that free markets are efficient: they lead to the lowest prices and greatest exchange of goods. That is the reason we have them.
When the four freedoms are not mandated, the market fails in different ways, and that's absolutely expected. When information is available to some before it is to others, we get price distortions - that's where insider trading laws come from.
Health care, the prof explained, suffers from the fact there is no freedom of participation. You either buy care or you suffer the potentially deadly consequences. That's why free markets and health care are fundamentally incompatible: they are expected to be.
Healthcare is the literal example of inelastic demand my prof used to teach us the concept. If you die without it, then there is no price where a reasonable actor can choose to stop participating in the market.
Well, it's a little elastic.
Non-fatal health conditions that lots of people put up with. Someone I knew went to ER for first kidney stone, then just endured the pain the second time until they could get a non-emergency appointment, since it's non-fatal but agonizing, and a non-emergency visit is like 80% cheaper.
Lots of people just accept chronic problems, for example joint pain without seeking medical examination.
Of course, in many cases, hard to make an informed decision on whether it is or is not one of those life or death scenarios in many cases.
Yeah, but that holds as much water as my argument in macro 100 about gas being elastic because of how many people scoff at the shell price and look for a sunoco. I did it when I drove every day (in a city with a high density of gas stations), and I will now take other forms of transportation if gas is too expensive, but that’s not common behavior, nor is it normally logical (saving five cents per gallon, driving an extra five miles, and wasting twenty minutes is not a true savings for most people).
It’s technically true, but in an academically idealized market, it wouldn’t be.
I feel like #3 no longer exists for anything in the US economy. You get one product in each niche either owned by 3 companies whose executives all have lunch together (egg farms, meat, ram manufacturers, etc) or where its just absolutely so black boxed its unclear what the product actually is (windows, google, ai etc)
That's why monopolies are supposed to be illegal.
Its also why pricefixing is illegal.
#4 is on the way out too. USA! USA! USA!
There's no freedom of information either. Good luck getting your healthcare provider (your doctor, the hospital) to tell you how much any given procedure will cost in advance.
Are free markets efficient? I think that's an open question.
#4 Doesn’t seem to be a thing anymore, president seems to get away with all the insider trading he wants PLTR tweets and what not
I believe it's called inelastic demand: things you don't stop buying even when prices go up.
See also: housing, food (though you may eat less or eat other foods, but you still need food).
Cut my finger off twice, almost lost my foot to sepsis whilst camping, and was witness/transport for 2 different heart attacks.
Longest I've waited for serious treatment is about 5 minutes, most expensive was a 50$ parking ticket.
You're being fleeced like fools
Bro take more precautions
So, out of curiousity, do you work as a sword juggler or is it more of a hobby?
same one or nah
Left thumb and left middle.
Different tools. Multiple years apart
Shame you didn't chop them at the same time you could have switched them and had a middle thumb
Where is your God now?
If your leg is hanging off you don't have to wait 12 hours. Idiot don't know about triage
It's unfortunately common for some to assume that they are the only sick person in the entire healthcare system.
Um, excuse me! Don't you know how important I think I am!
People who think America has better healthcare are either wealthy, or don't have any health issues they deal with regularly.
Even upper middle class Americans have shitty healthcare. But many or most of them are proud of learning the system so they refuse to consider that they could have been getting fucked their whole lives.
That's a good point. If I had a dollar for every time someone smugly explained a horrific aspect of American healthcare like I'm an idiot for not knowing it, well, I still wouldn't have enough dollars to go see a doctor, but it has happened a lot.
Or they haven't experienced healthcare elsewhere, so all they have for comparison is what pharma is talking them
Just out of curiosity, what are American wait times like for the uninsured? Infinite?
Currently, emergency rooms are bound by law to provide care to all patients, regardless of insurance status. Busy emergency rooms will triage patients, ensuring those who need care the most get it first. Unfortunately for uninsured patients, the hospital will hand them a bill as they leave; something simple as wound cleaning and a few stitches will run upwards of several thousand dollars. That total can exceed tens, if not hundreds of thousands of dollars depending on level care and length of stay.
A family member of mine recently had a medical episode while we were at a restaurant. Spontaneous syncope followed by prolonged lightheartedness and loss of balance. The ambulance ride to the hospital alone cost over $7000. They arrived at the ER around 4pm and was released shortly before midnight. Within a couple hours of arriving my family member felt and that they had fully recovered, but the ER would not release them until a doctor was available to discuss test results. Around 10pm the doctor finally called them back; they found nothing out of the ordinary in the blood work, heart seemed to be working fine. We waited two more hours before they gave the okay for release.
The bill for the ambulance, ER care, and about a baker's dozen of various fees and incidentals, was over $23000. Thankfully they had insurance, which covered most of it, but they still had to pay several thousand out of pocket for going to an "out of network" hospital. That alone is infuriating because not only is the entire concept of in-or-out of network medical providers a predatory practice, the choice of which ER to go to was up to the paramedics, it was never up to us. Even if it was up to us, we had no way of quickly knowing which local hospitals, if any, were "in network."
It depends on the situation. Emergency rooms are required by law to stabilize emergency medical issues, regardless of the patient’s potential ability to pay. This is because there used to be a big issue with ERs dumping non-paying patients. If the hospital didn’t think a patient could pay, security would literally wheel them across the street, then just leave them there to figure their own shit out.
ERs run on triage, (and lots of people go to the ER for things which could be handled by an urgent care or family doctor instead), which means wait times entirely depend on your specific situation. Mildly upset stomach? You’ll probably be waiting at least a few hours, especially if it’s a busy night with lots of more urgent patients. Chest pains with a history of heart disease? You’ll have EKG leads stuck to you before you’re even finished telling the intake nurse what your issue is.
And the big key thing is that ERs are required to stabilize an emergency medical issue. They aren’t required to provide follow-up care, long-term support, etc… If you show up with a cut that needs stitches, they’ll stitch you up. But they’ll tell you to follow up with your regular doctor to make sure it’s healing properly, and to remove the stitches in a few weeks. Don’t have a regular doctor because you’re uninsured? Good luck, hope it doesn’t get infected, then maybe chew some Tylenol and remove the stitches in your bathroom.
Canada is the same, I went in bleeding badly and was seen right away. But another time I went in just needing my finger sewn and it took around 3 hours to be seen.
Personally, I've never had particularly long waits in the ER, but I only ever went to the ER when something was seriously wrong.
But it can really depend on where you are, time of year, holiday weekend, etc etc. Hospitals do triage, So chest pains and broken legs tend to be seen before someone there with a runny nose, and the runny nose person will probably have a significantly longer wait time than someone coming in with the left side of their body sagging and uncontrollable. .
Your insured status has (allegedly) no impact on wait times in the US.
They'll hound you for payment while you're actively being seen by doctors, but they won't delay you just because you can't pay.
- Have been to the ER uninsured in the US
No, just like anywhere else, wait times are based on urgency. A severed limb will be taken instantly, a bloody nose will wait until there’s an empty bed. Doesn’t matter if you’re insured or not.
Uninsured will just get billed a full amount after the fact (payable in installments to the hospital), vs insured who might have to pay a copay, and then a few month later will get billed a reduced amount, after the insurance company chooses what they’ll cover.
I speak from experience. I was uninsured for a short time, and of course my appendix chose that time to rupture. I was admitted and in the ER instantly. Spent three days recovering in the hospital. Before I left the hospital had a bill for me. It was very high. I set up a payment plan. Eventually I stopped making payments, because I was broke. Hospital sent my bill to a collector. I blew them off.
Was unable to get a loan for a house for 10 years.
So insane that they see "oh he didn't pay 10s of thousands for an unexpected medical debt, must be irresponsable with money."
It’s largely because the “tens of thousands” is usually a result of being uninsured. And if you’re uninsured, it’s usually because you’re unemployed. And lenders tend to get squirmy at the idea of giving a loan to anyone who hasn’t been fully employed since the day they were born.
There was actually a rule implemented by the Consumer Finance Protection Bureau shortly after the pandemic, to prevent medical debt from impacting your credit history. Because lots of Americans were suddenly finding themselves in an awful job market with tons of medical debt from being sick. But last year, the fifth circuit court of appeals (the one that presides over Texas and Louisiana, and which is stacked with conservative judges as part of the Southern Strategy) voided the rule and allowed medical debt to appear on credit reports again. The ruling from the conservative court also prohibited the CFPB from implementing similar rules in the future.
you have to wonder what kind of soulless, hateful, worthless pile of shit roughly packed into a humanoid shaped bag would look at medical debt not ruining peoples lives and go "You know what, thats not right. people need to be more fucking miserable" and sue to get it overturned.
I imagine it was something like "but the lenders deserve to know if you were in medical debt ever!! They didn't save millions in case anything went wrong ever!!"
That's a great username btw
medical debt should never end up on a credit report.
Of course medical debt shouldnt exist as a concept. Funny how all but 1 of the major countries on earth have figured this out.
In America they shut down hospitals because the publicly traded corporation which bought the hospital realized it was more profitable to run 1 hospital per 5 counties.
An ex had bad abdominal pain one night.
Trip to ER deemed emergency: free.
Night doctor determined likely gall stone, kept overnight in ER to be confirmed by morning ER doc: free. Morning doctor determined non-critical issue, added to wait list and scheduled checkin with specialist in 2 months All free.
Same pain next night. Same song and dance, ambulance, same ER night doctor, this time he stays overtime to ensure that it gets an ultrasound booked. Ultrasound later that morning determines it needs to come out. Admitted same day for surgery. Bumped two days because literal life and death surgeries(c-sections and a motorcycle v car accident victim) and some time to let the surgeon have some sleep. He shows up and gets it done first thing.
Two weeks later, end up getting minor surgery for drain removal because her parent's cat purred on her nonstop and overhealed the drain scar.
All free.
Tldr: the Canadian system works on priority and is hobbled by conservatives.
Every conservative government cuts funding for every provincial healthcare system and then acts like the idea is flawed after they kneecapped it by limiting nursing hiring, freezing/reducing funding, and doing the 400th reorg to "find efficiencies". They shuttered 3 ERs in my city against the pleas of the College of Physicians and our ER wait times went up a couple hours overnight.
Who could have guessed?
I will vote Liberal, I will vote NDP, I will vote Green, I will never vote conservative.
This is common and a literal conservative tactic called "starving the beast". You strangle off funding to a thing you wanna cut, wait a couple months for the service to go to shit because they have to realign to compensate for having no money, and then go "wow look this sucks, better just kill it".
Reagan did it in the 80s.
The "beast" in their narrative is "money going to poor people instead of me and my friends" lest you think any shred of what they do is defensible.
The UK? If so, Tories are assholes. If not, Tories are assholes.
6 month wait for a gall bladder removal in Ontario.
That is the non critical wait time. If there is a risk at all of it bursting, that drops dramatically.
Tbh it would be nice to get those numbers down. Obviously not by privatising, but extending existing public capacity
Some fellow Canadians bash our system but usually its those that don't get what triage is.
Like my wife felt Ill we went to emerge, maybe waited 4-6 hours. Low blood sugar doctor recommended eating higher protein snacks in between meals.
But when they figured out I had cancer it was fast track for everything.
No point in explaining. If you go to the ER in America you’re waiting 12 hours, at least, unless you’re actively dying.
Oh and it will cost you a nice new car.
When the Australian Emergency department keeps me waiting for less than 15 minutes, I really start to worry.
Yeah the reason I haven't waited that long in the ER isn't because I'm American. Ok actually it is, as an American I'm not going to the ER unless I'm certain I have to. Head trauma, blood loss, issues breathing, anaphalaxis… I think a bone might be broken? I can go to the urgent care in the morning
Today i crushed my finger in a metal door and it started bleeding a LOT because the metal cut my skin.
In the beginning i did not want to go to the ER, but then my SO persuaded me "what if you get sepsis and it needs to be amputated???"
I went there and i waited 1 hour only for triage (i can understand it, everyone was dying on a hospital bed while i had this little cut on the finger)
after triage the doctor says we need to xray. Xray?? Don't need it's just a cut, not broken, i don't feel painful. She persuades me to wait another hour for the xray and i am a bit pissed because now i have to waste time for xraying a finger that's definitely not broken, just cut and bleeding.
Result: i broke my index finger. WHAT?? I did not expect this conclusion.
Total paid €0, total time 3 hours
Accurate. I had an afib issue recently, went to the hospital at 9pm and sat there in the emergency room bed all night because they told me the cardiologist needed to see me before they could treat me. The cardiologist got in at 9am, and I continued to wait until 12:30pm without seeing them. It finally went back to normal rhythm at that point and I was discharged a few hours later. Luckily I have health insurance, so I didn’t have to pay much, but I don’t live in bumblefuck; I live in a pretty populated area of New York and was sitting there waiting for treatment for over 15 hours. It’s a dumb argument that we don’t have to wait for treatment as long as countries with socialized healthcare.
Yeah it's super disingenuous. They like to pretend like we don't have wait times for specialists too. It's ridiculous that people still try to use those arguments.
Oh that’s another thing; it’s two months to see a cardiologist by me… so they wanted me to follow up with a cardiologist after I got out of the emergency room and it’s a two month wait.
It's weird, I had a-fib recently and the hospital didn't let me see a cardiologist. I asked several times in the 3 days I was there, and the answer was always no. Until they discharged me, and then it was "you should see a cardiologist ASAP."
That’s ridiculous. They didn’t shock you out of it? They’re not supposed to let it go more than 48 hours because your blood starts clotting in your heart around that time and can lead to a stroke. I guess they probably gave you blood thinners to prevent that though.
No shock, and they did give me a blood thinner after the first night. If I had known what I know now, I might have tried to advocate for myself more, but unfortunately that doesn't always help.
I think the main risk with it is stroke from the clotting, so the blood thinners alleviate that risk. It’s odd that they didn’t try to shock you out of it tho, I’ve gone to the hospital about five times for it and converted back on my own, but twice they were going to shock me. Usually it’s that threat that scares me back to normal.
I have never waited for more than a couple hours in public (work-linked) health care or private (own insurance) hospitals in mexico
The thing about Canadian care is that it usually works well for urgent and life saving care. If you don't like the wait for non urgent items, you have to option to pay - you just need to travel somewhere to get it done. The media likes to go on about the cases when people die while waiting but some of them were so sick they weren't going to make it anyway. Having quick access to ER isn't a guarantee that you will survive the heart attack symptoms you've been ignoring for the last month.
Uh huh, what about all the times it's the medical cretins who are doing the ignoring?
ego of medical professionals is something thats a little tougher to control systematically.
It should be as easy as caving their heads in with a tire iron.
$35,000 USD for surgery is on the low end. The US healthcare system is a complete shitshow.
I believe it means $35,000 AFTER insurance.
The post doesn't mention surgery; it's just the ER trip.
Triage.... I've spent a few hours in the ED waiting room for basic stuff. I've walked right through with serious stuff.
Lol if you got a real problem in Canada, you're in and out. No fucking around. Trauma, injury, blood everywhere, yah you get stabilized and attention right away. Hell, I've gotten into a car accident. Bad one, no injuries though, got home started to feel rough after the adrenalin kicked out went to hospital said what's up, in 40 min I had xray, CT scan, and an all clear, see ya.
You come with a flu? Go sit your ass down maybe they will see you tommorow.
I had heart arrythmia. Was in within 5 minutes and hooked up to monitors. If Im in for something less serious, I'll wait. No big deal.
Americans dont seem to get that when we complain about our health system, it doesnt mean we want theirs. We want our issues fixed, not more issues and going bankrupt because of a small medical problem.
When I was a kid, in America, I got a huge gash in my head that required stitches. It took them so long to see me in the waiting room they had to reopen the wound to stitch it shut.
Same, I fell at summer camp and spent so long in the ER I dozed off, they just used a butterfly bandaid on my head though (nice scar under my eyebrow). My parents were pissed about the bill.
That's especially nuts since head injuries usually get priority.
In america you die
Americans would KILL for a 12-hour wait.
Americans literally live their lives without hope of going to the doctor.
Not frustration at it taking so long.
Literal despair that they will never get to go to the doctor, paired with fear that if they do, they will have to pay literally tens of thousands.
It's like if there's a homeless person, and you tell them "I could bring you some food in 12 hours, or I could just never bring it to you. Which do you prefer?" And the Republicans will straight-up claim the homeless person would choose to never get the food because 12 hours is too long to wait.
how do people not understand triage? The longer you wait, the less of an emergency it is.
If your experience with ER is waiting for longer than an hour, then you went to the Emergency Room without an Emergency.
Though I totally agree that triage is important, you can absolutely be left waiting for more than an hour with an emergency. It's just not as pressing of an emergency as other people. There's plenty that an urgent care can't do for you that requires an ER but that is not life threatening within the next few hours.
Me explaining to US friends that I'm upset that after leaving the hospital after surgery they had me buy my own antibiotics
What would happen if everyone cancelled their health insurance and stopped paying outrageous surprise medical bills?
Because doing the "right" thing and hoping it will get better someday isn't working very well.
Some people would die. In the end the survivors would be far better off. Question is mostly how long it would take. Could the medical/insurance industry make it without changing a thing for more than a month without health insurance? More than 6?
That's the hard part. But as a random pedantic internet asshole, I have to point out that the current system is also causing deaths.
The only issues with Canadian Health Care system is american capitalism and "business".
A comparison of Canada vs the USA is hard. All my instruments need to be recalibrated for imperial shithole country scales, but the conclusion is always the same: THE USA SUCKS.
I had a rich guy leaving Canada claim that since he can get healthcare for $120 and see a doctor faster by flashing money in some 3rd world country, public healthcare is a scam. Like yea dude im sure if they privatized here the treatment would still be $120.
I had my appendix burst and waited for 18 hours in the ER. I nearly died, and owed thousands even though I have insurance. I live in the USA. Freedumb.
Yeah I don't hear the long waiting lines argument anymore
I had to wait in line with unhoused people at 8 am to get my prescriptions renewed for free. Emotional devastation.
I need my medical care to be segregated by social class damn it!
/s
I was in such a good spot for this year. My 1 year old son had to have a life saving surgery in march which left us with a $36,000 bill to be paid, but also meant we hit out deductible and out of pocket max so everything for the rest of the year was free. I finally booked an appointment with a new cardiologist (we moved and I haven't been in 2 years even though I'm supposed to go every 6 months), a new GP, I was ready to book a therapist and all the other little health things I just can't afford but should do. About a week before my first appointment with the new cardiologist I went to pick up my refill for my heart medication and my insurance wasn't working so I had to pay $120 for it since they were closing soon and I was already out. When I got home I checked and my insurance was terminated. Turns out my company switched insurance providers and sent the cards to my old address so I had no clue.
Hopefully my heart will be fine for a few more years. Thank god my old cardiologist is still filling my script.
(American) I went to the ER back in May and still don't know what it will cost me. Insurance keeps denying the hospital's bill, asking for more documentation.
Or you finally get into the OR and the insurance broker calls the surgeon in the middle of the operation to debate on how necessary a heart transplant is.
12 hrs is pretty standard wait time where I live in the US...
People who complain about 12 hour wait times in Canada are there for minor things on the triage list, anything life threatening is handled immediately and without hesitation. They always have rooms available for those who need it, the problem is people expect everything to be handled immediately - even when it's not serious.
I've spent way too many months in the hospital, ICU's, and being rushed to hospital bleeding out or near death, and everytime they saved my life very quickly. Not a broken system at all, I left there with zero bills.
Most people don't have a family doctor, so hospitals are unfortunately the only option. Walk-ins are hit or miss. The last walk-in I went to required appointments and they were fully booked up for weeks.
My family doctor was pressured into taking a much higher patient load to help alleviate shortages and I can see the effect it's had on him. Where before I got excellent personalized care now he's trying to refer me to specialists to offload the burden. I still only wait a week max to see him, and in emergencies I can get a same day appointment but I can see the toll it's taking on him and it worries me about his long term health.
I left the hospital with a drain in me.
Had to follow up to get it taken out - they only did drain removals one afternoon of the week. Something that took me thirty seconds to do when I got fed up and did it myself.
And that is just the referral
yeah.. we're sorry. but you having a cancer is an "act of god".
Fellow Americans. Whenever possible go to a local urgent care.
I've gotten xrays, stitches, prescriptions etc. Usually pay $50-$200
Last time I went to the ER was because I slipped on the stairs, dropped a coffee mug, bashed my elbow into the shards of shattered mug (RIP beloved TARDIS mug) and needed to get the pieces removed, elbow stitched up, and an X-ray to make sure nothing was left inside.
Total time at the ER from parking in the parking lot to getting in the car to drive home was about 3 hours. I think the co-pay was $500.
That's a suburban hospital on a relatively quiet evening. However, I've had other, similar experiences at that ER, and I don't think I've ever had an unreasonable wait time there. They used to guarantee that you'd see a doctor in 30 minutes, but I think they abandoned that policy when they were absorbed into a larger health system.
If I was headed to a major, inner-city hospital, I would expect to be in the waiting area for a long time. I've definitely had ER visits that were 12 hours from start to finish at the downtown ER.
Fun trick if you don't want to hang around in the waiting area:
Bring an obviously pregnant woman along. I've had the ER rush me along when my pregnant wife took me there. They are so conditioned to move pregnant women out of the ER that they'll rush you through even if the pregnant woman is just your ride home (kidding kind of).
That's probably for the best. Pregnant women (and their fetuses) are at much greater risk if they should catch a communicable disease and you never know what might be circulating in that waiting area.
If you're waiting 12 hours for an ER, you have no idea what an ER is.
First of all, there is no line.
A lot of people sincerely do not understand how the triage process works.
That said, triage sometimes gets things wrong. I've twice had my personal doctors call or bring me to the ER directly so that they could ensure I was seen immediately/ASAP.
For the non-Americans out there:
This isn't even an exaggeration. This was literally my exact experience going to the ER after I got fired.
As someone with ulcerative colitis, I frequent the ER regularly. I have never waited less then 12 hours, even when blood just keeps leaving my body and I'm severely dehydrated.
And some people in my (developing) country think healthcare is better over there.
Where we really excel is in the variety of treatment. You need some brand new cancer treatment? In the US you can likely get it if you can pay. Fancy tests like running a genome check to see if you'll respond to a medication? We've got that. In general we've got the high end expensive parts of healthcare available at a high price.
Other than that the only thing we've really got going for us is extremely fast turnaround for trans healthcare by global standards.
send them $10/month to keep it out of collections. hey making an effort. after 7 years they write it off.
I can't see my general practitioner for the next five weeks and that's with insurance.
I dislocated my shoulder earlier this year. I walked into the hospital at 1:15. I didn’t walk out until 8:00. I didn’t get brought to the room until 4:00.
I slipped on ice this winter, and hurt my knee. I thought it was going to get better, but it didn't, so the next day I went to the emergency room. This is in Quebec, the province with one of the highest waiting times in Canada.
I saw the triage nurse within 5 minutes, had an x-ray 30 minutes after that, and the doctor came to see me 30 minutes after that. I total of 90 minutes after arriving, I was walking out the door with a (free) leg brace and a diagnosis that the knee was only strained.
I didn't even have to pay for parking, because my small local hospital doesn't charge.
Okay, this was an unusual case because the weather was pretty bad so a lot of people who would have gone to the hospital didn't. The normal wait time would probably have been about 4 hours. I like our rural healthcare!
Anyone care to guess how much I would have owed had this been in the States somewhere?
No idea but my out of pocket for my visit was 2.7k. And that’s after my insurance.
Does canada have private healthcare as well?
Yes.
Never waited more than 2 hours. I've waited longer at a walk-in clinic.
But maybe it's because I only go when it's an emergency?