Is the US health system collapsing?

[Anonymous]

Anonymous wrote:

Anonymous wrote:In Canada, my family member waited for *seven months* for a biopsy of a suspected lymphoma. (Turned out to be a benign tumor so the person is still alive by sheer luck. Also, the biopsy was botched so another surgery is now needed.)

A different, elderly family member had surgery on the wrong kidney. Of course no one took responsibility.

We pay through the nose but at least DH got to an MRI machine within 48 hours of being sent there.

Anonymous wrote:Which province?

Anonymous wrote:Ontario

That's really weird. Ontario's ADAP (the Accelerated Diagnostic Assessment Program) decreased the average time from initial referral to biopsy from 41 days to 17 days, including hematologic cancers like lymphoma. It's open to patients through primary doctors and emergency rooms.

I wonder what made your family member have an experience so drastically different than typical. Really sorry to hear it.

JCO Oncol Pract. 2023 Apr;19(4):e511-e519. doi: 10.1200/OP.22.00551. Epub 2023 Jan 19.
Impact of an Accelerated Diagnostic Assessment Program on the Timeliness of Cancer Diagnosis and Treatment

Purpose: The Accelerated Diagnostic Assessment Program (ADAP) manages patients with imaging abnormalities, with or without concomitant symptoms, where cancer is suspected. The ADAP is offered to primary care practitioners and emergency departments with cases triaged by a medical oncologist.

Methods: We performed a retrospective patient chart review of electronic medical records from January 2019 until June 2021 to validate the program. We collected information on the referral pathways, patient demographics, wait-times, and diagnostic results. T... The ADAP had decreased wait-times from referral to biopsy collection (17.6 days ± 10.7 [standard deviation (SD)]; n = 43) when compared with the control group (41.2 days ± 40.0 [SD]; n = 67; P < .001). ADAP patients with malignancies saw a treating specialist 7.6 ± 7.6 days [SD] after their follow-up appointment at the ADAP.

https://pubmed.ncbi.nlm.nih.gov/36657095/

That dataset has some of 2019 and then the pandemic! People weren’t going in unless they absolutely had to.

Unfortunately my family members’ (plural) experiences are not unusual. I’m guessing Ford cuts had something to do with it but also, socialized healthcare is renowned for long wait times. The wrong kidney error (never acknowledged, btw) was insane.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

Typically, medical tourists recover and stay in that country a bit longer until they are fully recovered.

Harder to do in the more expensive countries like Canada and UK.

I think if you go to cheaper countries, there are medical care packages you can buy. It covers the cost of the medical treatment, stay at a place where you can recover and you get care.

*If* something happens months later, I guess you have to go back or try to find a US doctor who will deal with it (most probably won't due to malpractice).

But, when you don't have the money for medical care, you are going to take that small risk of something happening to get that care that you can afford.

When complications arise when patients return to the US, they appear in ERs and doctors are not happy about being faced with someone else's mess. Probably more with people who go to Mexico since part of the idea is likely not have to spend money on boht travel and extended stay in another country.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

In Thailand it is like a combination of hospital and hotel .
The hospital has all the specialties you need and when you are better you recover in the hotel.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

In Thailand it is like a combination of hospital and hotel .
The hospital has all the specialties you need and when you are better you recover in the hotel.

I take months or years to recover or never do due to autoimmune issues. I don't think a hotel stay would cover it. Too risky for me.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In Canada, my family member waited for *seven months* for a biopsy of a suspected lymphoma. (Turned out to be a benign tumor so the person is still alive by sheer luck. Also, the biopsy was botched so another surgery is now needed.)

A different, elderly family member had surgery on the wrong kidney. Of course no one took responsibility.

We pay through the nose but at least DH got to an MRI machine within 48 hours of being sent there.

Anonymous wrote:Which province?

Anonymous wrote:Ontario

That's really weird. Ontario's ADAP (the Accelerated Diagnostic Assessment Program) decreased the average time from initial referral to biopsy from 41 days to 17 days, including hematologic cancers like lymphoma. It's open to patients through primary doctors and emergency rooms.

I wonder what made your family member have an experience so drastically different than typical. Really sorry to hear it.

JCO Oncol Pract. 2023 Apr;19(4):e511-e519. doi: 10.1200/OP.22.00551. Epub 2023 Jan 19.
Impact of an Accelerated Diagnostic Assessment Program on the Timeliness of Cancer Diagnosis and Treatment

Purpose: The Accelerated Diagnostic Assessment Program (ADAP) manages patients with imaging abnormalities, with or without concomitant symptoms, where cancer is suspected. The ADAP is offered to primary care practitioners and emergency departments with cases triaged by a medical oncologist.

Methods: We performed a retrospective patient chart review of electronic medical records from January 2019 until June 2021 to validate the program. We collected information on the referral pathways, patient demographics, wait-times, and diagnostic results. T... The ADAP had decreased wait-times from referral to biopsy collection (17.6 days ± 10.7 [standard deviation (SD)]; n = 43) when compared with the control group (41.2 days ± 40.0 [SD]; n = 67; P < .001). ADAP patients with malignancies saw a treating specialist 7.6 ± 7.6 days [SD] after their follow-up appointment at the ADAP.

https://pubmed.ncbi.nlm.nih.gov/36657095/

That dataset has some of 2019 and then the pandemic! People weren’t going in unless they absolutely had to.

Unfortunately my family members’ (plural) experiences are not unusual. I’m guessing Ford cuts had something to do with it but also, socialized healthcare is renowned for long wait times. The wrong kidney error (never acknowledged, btw) was insane.

So let me understand here: you think people were getting medical treatment faster in the middle of the pandemic?

The datasets are separated out by year as well, you know.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In Canada, my family member waited for *seven months* for a biopsy of a suspected lymphoma. (Turned out to be a benign tumor so the person is still alive by sheer luck. Also, the biopsy was botched so another surgery is now needed.)

A different, elderly family member had surgery on the wrong kidney. Of course no one took responsibility.

We pay through the nose but at least DH got to an MRI machine within 48 hours of being sent there.

Anonymous wrote:Which province?

Anonymous wrote:Ontario

That's really weird. Ontario's ADAP (the Accelerated Diagnostic Assessment Program) decreased the average time from initial referral to biopsy from 41 days to 17 days, including hematologic cancers like lymphoma. It's open to patients through primary doctors and emergency rooms.

I wonder what made your family member have an experience so drastically different than typical. Really sorry to hear it.

JCO Oncol Pract. 2023 Apr;19(4):e511-e519. doi: 10.1200/OP.22.00551. Epub 2023 Jan 19.
Impact of an Accelerated Diagnostic Assessment Program on the Timeliness of Cancer Diagnosis and Treatment

Purpose: The Accelerated Diagnostic Assessment Program (ADAP) manages patients with imaging abnormalities, with or without concomitant symptoms, where cancer is suspected. The ADAP is offered to primary care practitioners and emergency departments with cases triaged by a medical oncologist.

Methods: We performed a retrospective patient chart review of electronic medical records from January 2019 until June 2021 to validate the program. We collected information on the referral pathways, patient demographics, wait-times, and diagnostic results. T... The ADAP had decreased wait-times from referral to biopsy collection (17.6 days ± 10.7 [standard deviation (SD)]; n = 43) when compared with the control group (41.2 days ± 40.0 [SD]; n = 67; P < .001). ADAP patients with malignancies saw a treating specialist 7.6 ± 7.6 days [SD] after their follow-up appointment at the ADAP.

https://pubmed.ncbi.nlm.nih.gov/36657095/

That dataset has some of 2019 and then the pandemic! People weren’t going in unless they absolutely had to.

Unfortunately my family members’ (plural) experiences are not unusual. I’m guessing Ford cuts had something to do with it but also, socialized healthcare is renowned for long wait times. The wrong kidney error (never acknowledged, btw) was insane.

What year did your relative experience the delay?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

This is a legitimate concern. There was a YouTube video of a woman documenting her butt lift that she got in Turkey. The surgery went well but when she got back home it got infected (as a side note, butt lifts/implants are the cosmetic surgery that get most frequently infected, for reasons you can guess). She was unable to find a doctor willing to take her case and had to fly back to Turkey.

[Anonymous]

On the positive note I think the US health care is good for Trauma care.
If I was in bad car accident, getting a heart attack or stroke I would like to be here.

[Anonymous]

Anonymous wrote:On the positive note I think the US health care is good for Trauma care.
If I was in bad car accident, getting a heart attack or stroke I would like to be here.

No doubt. But hopefully you have great health insurance that covers it all. Otherwise you might end up bankrupt.

[Anonymous]

Anonymous wrote:

Anonymous wrote:On the positive note I think the US health care is good for Trauma care.
If I was in bad car accident, getting a heart attack or stroke I would like to be here.

No doubt. But hopefully you have great health insurance that covers it all. Otherwise you might end up bankrupt.

It will be the air ambulance ride that puts you in the poorhouse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

Typically, medical tourists recover and stay in that country a bit longer until they are fully recovered.

Harder to do in the more expensive countries like Canada and UK.

I think if you go to cheaper countries, there are medical care packages you can buy. It covers the cost of the medical treatment, stay at a place where you can recover and you get care.

*If* something happens months later, I guess you have to go back or try to find a US doctor who will deal with it (most probably won't due to malpractice).

But, when you don't have the money for medical care, you are going to take that small risk of something happening to get that care that you can afford.

When complications arise when patients return to the US, they appear in ERs and doctors are not happy about being faced with someone else's mess. Probably more with people who go to Mexico since part of the idea is likely not have to spend money on boht travel and extended stay in another country.

This is the typical scare tactic to dissuade people from traveling abroad for much cheaper medical care, how is that any different than in the U.S.? If I get a hip replacement done by a crappy surgeon in California, move to Virginia, and then need to go to the EE because of the crappy surgery, the ER doc in VA is still going to be dealing with crappy work left behind by a doctor far away.


American doctors think they’re the best in the world and that the rest of the world is incapable of training just as good physicians. What a farce. Typical dumb scare tactics used to convince Americans they should keep paying 10-1000x more for the same procedures that are done elsewhere in the world at just as good if not better standards than what you get here.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:On the positive note I think the US health care is good for Trauma care.
If I was in bad car accident, getting a heart attack or stroke I would like to be here.

No doubt. But hopefully you have great health insurance that covers it all. Otherwise you might end up bankrupt.

It will be the air ambulance ride that puts you in the poorhouse.

Also a regular Ambulance Service is expensive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

Typically, medical tourists recover and stay in that country a bit longer until they are fully recovered.

Harder to do in the more expensive countries like Canada and UK.

I think if you go to cheaper countries, there are medical care packages you can buy. It covers the cost of the medical treatment, stay at a place where you can recover and you get care.

*If* something happens months later, I guess you have to go back or try to find a US doctor who will deal with it (most probably won't due to malpractice).

But, when you don't have the money for medical care, you are going to take that small risk of something happening to get that care that you can afford.

When complications arise when patients return to the US, they appear in ERs and doctors are not happy about being faced with someone else's mess. Probably more with people who go to Mexico since part of the idea is likely not have to spend money on boht travel and extended stay in another country.

This is the typical scare tactic to dissuade people from traveling abroad for much cheaper medical care, how is that any different than in the U.S.? If I get a hip replacement done by a crappy surgeon in California, move to Virginia, and then need to go to the EE because of the crappy surgery, the ER doc in VA is still going to be dealing with crappy work left behind by a doctor far away.


American doctors think they’re the best in the world and that the rest of the world is incapable of training just as good physicians. What a farce. Typical dumb scare tactics used to convince Americans they should keep paying 10-1000x more for the same procedures that are done elsewhere in the world at just as good if not better standards than what you get here.

This. The difference in cost isn't because our doctors or equipment are better, it's due to many factors.

1) Doctors have to make enough to compensate for huge student debt and many years of not earning enough to pay it off. Otherwise nobody will be going into medical profession
2) Insurance companies are not non-profits and will be looking out to maximize returns.
3) Big Pharma and medical equipment industry will lobby hard to get their products pushed to general public and incentivize medical professionals to give them to patients. This may not often be in patient's interests due to high prices or drugs/equipment later proven to be unsafe.
4) Malpractice insurance is very costly here and doesn't exist overseas. If someone screws up your surgery overseas, can you sue?
5) Not every hospital can turn away uninsured, some have to take in patients who are expensive to treat and will never pay. This cost is prorated to the paying customers in the form of exorbitant and irrational fees for the same procedures/meds provided in other clinics and urgent care centers for a fraction of the cost.
6) Big hospital systems have huge admin overheads and dont' care to compete on prices with smaller clinics or radiology centers.
7) hospital rooms cost more than 5 star hotels and this doesn't include care

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Lots of people go overseas for cheaper care, and that includes Americans.

https://www.magazine.medicaltourism.com/article/top-10-medical-tourism-destinations-world

Canada and the UK are on the list of countries people go to for medical care. Non residents would pay out of pocket, of course, so they don't use the national care service.

US is not on the list. Most people in the world cannot afford American medical prices.

https://www.insidermonkey.com/blog/top-5-medical-tourism-destinations-in-the-world-1176780/5/

This one lists in order from the first link (Medical tourism link)
1. Canada
2. Singapore
3. Japan
4. Spain
5. UK

Example of hip replacement surgery in different countries (hint: US is the most expensive; UK is less than half the cost of the US, and India is the cheapest):

https://www.medicaltourismco.com/hip-replacement-surgery-abroad/

How do you get follow up care if you have a hip replacement or other procedure abroad? I'm part of the "if anything can go wrong it will go wrong" category of patients.

Typically, medical tourists recover and stay in that country a bit longer until they are fully recovered.

Harder to do in the more expensive countries like Canada and UK.

I think if you go to cheaper countries, there are medical care packages you can buy. It covers the cost of the medical treatment, stay at a place where you can recover and you get care.

*If* something happens months later, I guess you have to go back or try to find a US doctor who will deal with it (most probably won't due to malpractice).

But, when you don't have the money for medical care, you are going to take that small risk of something happening to get that care that you can afford.

When complications arise when patients return to the US, they appear in ERs and doctors are not happy about being faced with someone else's mess. Probably more with people who go to Mexico since part of the idea is likely not have to spend money on boht travel and extended stay in another country.

This is the typical scare tactic to dissuade people from traveling abroad for much cheaper medical care, how is that any different than in the U.S.? If I get a hip replacement done by a crappy surgeon in California, move to Virginia, and then need to go to the EE because of the crappy surgery, the ER doc in VA is still going to be dealing with crappy work left behind by a doctor far away.


American doctors think they’re the best in the world and that the rest of the world is incapable of training just as good physicians. What a farce. Typical dumb scare tactics used to convince Americans they should keep paying 10-1000x more for the same procedures that are done elsewhere in the world at just as good if not better standards than what you get here.

This. The difference in cost isn't because our doctors or equipment are better, it's due to many factors.

1) Doctors have to make enough to compensate for huge student debt and many years of not earning enough to pay it off. Otherwise nobody will be going into medical profession
2) Insurance companies are not non-profits and will be looking out to maximize returns.
3) Big Pharma and medical equipment industry will lobby hard to get their products pushed to general public and incentivize medical professionals to give them to patients. This may not often be in patient's interests due to high prices or drugs/equipment later proven to be unsafe.
4) Malpractice insurance is very costly here and doesn't exist overseas. If someone screws up your surgery overseas, can you sue?
5) Not every hospital can turn away uninsured, some have to take in patients who are expensive to treat and will never pay. This cost is prorated to the paying customers in the form of exorbitant and irrational fees for the same procedures/meds provided in other clinics and urgent care centers for a fraction of the cost.
6) Big hospital systems have huge admin overheads and dont' care to compete on prices with smaller clinics or radiology centers.
7) hospital rooms cost more than 5 star hotels and this doesn't include care

These are standard insurance industry talking points. PP, are you affiliated with an insurance company of payer.

[Anonymous]

Anonymous wrote:On the positive note I think the US health care is good for Trauma care.
If I was in bad car accident, getting a heart attack or stroke I would like to be here.

Only I hear praising US healthcare is uninsured going to ERs