Which country actually has the best healthcare system?

[Anonymous]

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

We have lived in Europe as well and the US system seems to prioritise testing and preventive care and on an individual level, those make a difference in adverse outcomes- i.e. cancer screening which catch cancer early is great for that individual but on a societal level- which socialised medicine prioritises, it doesn't really do much. So the US spends more money on testing and screening without much impact to society. Of course if you are the one with cancer who was saved, you'd be all for it.

Every system has to ration care because there simply isn't enough to go around. Some countries try to do it on the basis of fairness or need. The United States chooses to ration it based on the ability to afford it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

+1. My adult DD, with ties to both France and the US, preferred to live in France during the pandemic, where she knew that she had good healthcare and wouldn't go bankrupt or die because she didn't have enough money for treatment. It was a huge relief to her and everyone around her to know that she would be cared for and if the system got overwhelmed it would be handled in an equitable way - not just those with money or connections get care.

This is often repeated but do you know anyone personally who has gone bankrupt or didn’t have enough money for treatment?

I know the statistic about bankruptcies but it’s misleading because it simply means the person who filed bankruptcy had outstanding medical bills. It could even be a $50 copay. It’s like saying the people who filed bankruptcy did so from cell phone bills since they likely also owed a small amount to Verizon.

Seems like the number of people who 1) Don’t qualify for Medicaid 2) Don’t have employer provided healthcare or aren’t married to someone who does 3) Can’t afford to purchase a plan through the exchange is very low. 4) Is under 65 or over 26.

French wages on the other hand are much, so you’re likely better off in the US and simply finding a job that provides health insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

We have lived in Europe as well and the US system seems to prioritise testing and preventive care and on an individual level, those make a difference in adverse outcomes- i.e. cancer screening which catch cancer early is great for that individual but on a societal level- which socialised medicine prioritises, it doesn't really do much. So the US spends more money on testing and screening without much impact to society. Of course if you are the one with cancer who was saved, you'd be all for it.

Every system has to ration care because there simply isn't enough to go around. Some countries try to do it on the basis of fairness or need. The United States chooses to ration it based on the ability to afford it.

Then how do you explain Medicaid? Medicare?

The US spends more on healthcare than any other country. Some of this can be attributed to the health of our citizens. But there’s also the fact that Americans may simply receive MORE healthcare. I’m not convinced the rationing here is to the same extent as other western countries.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

+1. My adult DD, with ties to both France and the US, preferred to live in France during the pandemic, where she knew that she had good healthcare and wouldn't go bankrupt or die because she didn't have enough money for treatment. It was a huge relief to her and everyone around her to know that she would be cared for and if the system got overwhelmed it would be handled in an equitable way - not just those with money or connections get care.

This is often repeated but do you know anyone personally who has gone bankrupt or didn’t have enough money for treatment?

I know the statistic about bankruptcies but it’s misleading because it simply means the person who filed bankruptcy had outstanding medical bills. It could even be a $50 copay. It’s like saying the people who filed bankruptcy did so from cell phone bills since they likely also owed a small amount to Verizon.

Seems like the number of people who 1) Don’t qualify for Medicaid 2) Don’t have employer provided healthcare or aren’t married to someone who does 3) Can’t afford to purchase a plan through the exchange is very low. 4) Is under 65 or over 26.

French wages on the other hand are much, so you’re likely better off in the US and simply finding a job that provides health insurance.

This is true, I don't know many people who have no health coverage. But- to me the risk is losing one's job and then having to pay high fees for a plan on the health exchange or COBRA while burning through savings. And even some plans ask you to pay like 20,000 out of pocket maximum (after premiums). That's still more than many people can afford if they have a big health issue.

[Anonymous]

The best system is a universal free at point of service public healthcare system with a supplemental private option for expedited, elective, and highly specialized care.

[Anonymous]

There have been a couple of comments asking if anyone actually knows someone who had gone bankrupt over healthcare costs.

I knew a couple (now both deceased) who had massive health care bills for the wife's cancer treatment. They were upper class and had insurance. I don't know the exact amount, but they owed something over $250,000. Due to their financial situation they were able to pay it over time without too much of an impact on their lifestyle, but for most people that would be extremely difficult or impossible.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

We have lived in Europe as well and the US system seems to prioritise testing and preventive care and on an individual level, those make a difference in adverse outcomes- i.e. cancer screening which catch cancer early is great for that individual but on a societal level- which socialised medicine prioritises, it doesn't really do much. So the US spends more money on testing and screening without much impact to society. Of course if you are the one with cancer who was saved, you'd be all for it.

Every system has to ration care because there simply isn't enough to go around. Some countries try to do it on the basis of fairness or need. The United States chooses to ration it based on the ability to afford it.

Then how do you explain Medicaid? Medicare?

The US spends more on healthcare than any other country. Some of this can be attributed to the health of our citizens. But there’s also the fact that Americans may simply receive MORE healthcare. I’m not convinced the rationing here is to the same extent as other western countries.

Do you think a Medicaid patient receives the same level of care an executive with concierge care? Medicare is the exception because it covers old people who care about their ailments and vote

[Anonymous]

Anonymous wrote:There have been a couple of comments asking if anyone actually knows someone who had gone bankrupt over healthcare costs.

I knew a couple (now both deceased) who had massive health care bills for the wife's cancer treatment. They were upper class and had insurance. I don't know the exact amount, but they owed something over $250,000. Due to their financial situation they were able to pay it over time without too much of an impact on their lifestyle, but for most people that would be extremely difficult or impossible.

I know a family who had a preschooler diagnosed with cancer. They sold their house and moved into a one bedroom apartment. It took them 10 years to get back to where they were pre-diagnosis

[Anonymous]

I hear a lot of people in general, not necessarily here but there have been a few, that the US is better at preventative care. There is one point I learned while living overseas, which was interesting. A lot goes into calculating the recommended intervals of preventative tests, one of those is risk factors to the general population. So for example, and I am just making up numbers for that example, someone in the US could say be recommended to have a mammogram once every 2 years starting at 40 because breast cancer is very prevalent for those over 40 whereas someone in France it might be recommended starting at 50 and in 10 year intervals because its been shown more people develop the cancer after 50 and its not more or less effective to have in more or less frequent intervals. I learned this because where I lived the recommended intervals were different (less frequent/started later) than in the US but tests were approved based on my having spent X amount of time in the US and so my individual risk factors were taken into account, even though the tests would not have been performed at those intervals on individuals from there.

[Anonymous]

Personally I hate the US capitalist system.

It forces people to be stuck in crappy jobs or crappy situations (abusive marriages with a SAHM) because they will lose insurance. Everyone always says "just quit!" crappy jobs or "just leave him!" but losing your insurance is a huge deal. Risking your health or risking your home/work life is an awful decision to make.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

+1. My adult DD, with ties to both France and the US, preferred to live in France during the pandemic, where she knew that she had good healthcare and wouldn't go bankrupt or die because she didn't have enough money for treatment. It was a huge relief to her and everyone around her to know that she would be cared for and if the system got overwhelmed it would be handled in an equitable way - not just those with money or connections get care.

This is often repeated but do you know anyone personally who has gone bankrupt or didn’t have enough money for treatment?

I know the statistic about bankruptcies but it’s misleading because it simply means the person who filed bankruptcy had outstanding medical bills. It could even be a $50 copay. It’s like saying the people who filed bankruptcy did so from cell phone bills since they likely also owed a small amount to Verizon.

Seems like the number of people who 1) Don’t qualify for Medicaid 2) Don’t have employer provided healthcare or aren’t married to someone who does 3) Can’t afford to purchase a plan through the exchange is very low. 4) Is under 65 or over 26.

French wages on the other hand are much, so you’re likely better off in the US and simply finding a job that provides health insurance.

Here's an article that gives some details on numbers of bankruptcies due to medical bills:

https://apnews.com/article/medical-debt-legislation-2a4f2fab7e2c58a68ac4541b8309c7aa#

"Roughly 530,000 people reported falling into bankruptcy annually due partly to medical bills and time away from work, according to a 2019 study from the American Journal of Public Health".

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We lived in France and were on national healthcare with a 75 euro a month top up plan.

One thing that they had that I loved is a national doctor appointment booking website that most doctors used. You can search specialty, neighborhood, languages, etc. by availability. Because of this, we could always get a same day appointment. (We were in Paris.) Most doctors would also upload any health records from the visit to this account so you always have them.

We also had a home doctor visit service for weekend and overnight health issues that didn’t warrant an ER. They also offered off-hour telehealth appointments. It basically was an urgent care, but at your home.

As long as you stay within the system, there is also basically no paperwork to deal with. All of your bills (which usually ran 25-50 max) would get automatically sent to the health service and your linked top up insurance for reimbursement within 48 hours. Prescriptions too.

The negative:
If you go to the ER for something not super serious, waits can be long.
Their testing ages for screening exams like mammogram and colonoscopy are older than the US, so if you want to be screened earlier purely for your own peace of mind and not because if family history, you pay a couple hundred out of pocket.
Dermatologists were in short supply within the system.
Therapy was not easily reimbursed but psychiatrists were.
Doctors are paid less and there are health deserts in rural areas with not enough doctors.

I think I’d still choose the French system though. Never having to worry a medical bill would sink us was such a mental relief I swear it improved my health.

+1. My adult DD, with ties to both France and the US, preferred to live in France during the pandemic, where she knew that she had good healthcare and wouldn't go bankrupt or die because she didn't have enough money for treatment. It was a huge relief to her and everyone around her to know that she would be cared for and if the system got overwhelmed it would be handled in an equitable way - not just those with money or connections get care.

This is often repeated but do you know anyone personally who has gone bankrupt or didn’t have enough money for treatment?

I know the statistic about bankruptcies but it’s misleading because it simply means the person who filed bankruptcy had outstanding medical bills. It could even be a $50 copay. It’s like saying the people who filed bankruptcy did so from cell phone bills since they likely also owed a small amount to Verizon.

Seems like the number of people who 1) Don’t qualify for Medicaid 2) Don’t have employer provided healthcare or aren’t married to someone who does 3) Can’t afford to purchase a plan through the exchange is very low. 4) Is under 65 or over 26.

French wages on the other hand are much, so you’re likely better off in the US and simply finding a job that provides health insurance.

dp.. I do.

My cousin died of leukemia back in the 90s. She worked a low wage job that didn't provide health insurance. By the time she went into the hospital due to severe illness, she was stage 4.

And let's look at the research rather than just anecdotal stories. It's not due to the inability to pay a $50 copay; it's $200K worth of cancer treatments and the like that causes the medical bankruptcy. You say, "Just get a job that has insurance". Not all companies provide health insurance, and ACA can be expensive for some. It would not be possible for every working American to get a job that has medical insurance. Medical insurance shouldn't even be tied to employment.

https://apnews.com/article/medical-debt-legislation-2a4f2fab7e2c58a68ac4541b8309c7aa

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1127305/

https://www.foxbusiness.com/personal-finance/medical-debt-bankruptcy-hospital-bill-forgiveness

[Anonymous]

You can't have it all. If you want a lower cost more universal system then you have to accept that a great deal of your income will be going to pay for those types of benefits via taxation. And even with that get in line and wait for that elective surgery for many, many months. What I'm saying is no system is perfect, it's all about what you're willing to give up to have what you perceive is a "better or best" healthcare system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Probably a European countries like Germany, Denmark, Sweden etc. Certainly not the UK. My English family and friends complain nonstop how horrid the NHS is now.

Ask them if they want the US healthcare system where we pay $1400/month for a family of 4 with a high deductible plan.

My spouse's family is from the UK. They also complain about the NHS, but then we start telling them how much ours cost, and they shut up. UK has private insurance and one can pay out of pocket for private care if they want to. My SIL did this for a specific procedure. It was a fraction of what it would cost here.

This.

[Anonymous]

I've lived in Canada my whole life. I've been very happy with my healthcare.
I've had decades of therapy for free. I had a joint replacement that I didn't need to wait too long for. I'm high risk for breast cancer, so I've had a mammogram, breast ultrasound and breast MRI every year since I turned 35. Due to those screenings, I've had a few biopsies and one "lumpectomy", which was really just a removal of some tissue that looked abnormal. All of the procedures are free and everything is seamless. I've gone to the ER a few times and that's been a long wait, but if I'd been stabbed or was having a heart attack or something, I would have been seen immediately.
Therapy is only free if you go to an MD though and the best therapist I had was a psychologist so I had to pay out of pocket. Meds are not free either. But I don't have health insurance through my job. If I did, that would be covered, along with dental, massage, physio, and other stuff. Some people's health insurance even includes pet care. I don't have kids but giving birth costs nothing.
The thing is though that I'm pretty privileged. I live in a big city so I have access to these services. I am able to get to appointments. I am able to sit on the phone making appointments. I have enough health knowledge to advocate for myself. I have a good relationship with all of my care providers. You can get any care you need, free of charge, but you do need some patience, time and diplomacy.

We also now have MAID and I know of a few people who've used it, some within just a few months of a terminal diagnosis. I am very grateful for that option!