In the US with private insurance. I basically just go online, search for providers in my insurance’s network, and then check a different list of different procedures and their costs according to my insurance. Sometimes it’s $30 if I’m seeing my main doctor, $30 for a specialist, $40 for urgent care, $0 for a specific telehealth provider, 20% for an ER visit etc. The main thing I genuinely like about my plan is that the monthly out-of-pocket price cap for generic medications is pretty low. That being said, I know a few people who pay $0 for 90% of what they need with everything else being cheap
Healthcare is all free to the patient (the one caveat being a small, fixed charge for prescription medication - which is free for some groups), all paid for via national taxes based on wealth. UK.
If we need a specialist Doctor, we are referred to one. There’s no money involved for the patient whatsoever.
Attaching an unaffordable fee to healthcare would be a clear barrier for anyone who is not upper class, and this would be seen as deeply discriminatory and thus unacceptable.
There is also a private health care sector, with its own hospitals. A lot of consultants work in both the public (NHS) and private sectors, e.g., one day a week they will have a private clinic at a private hospital. The private sector is funded by insurance, and this is often a perk offered by employers. Waiting lists are generally shorter in the private sector, but, in my experience, the expertise and level of care is no better than the NHS.
In Mexico the government has their own health care system, if you are a Mexican citizen you have access to it for free (if you are a student or you work legally), it’s sustained by taxes that employers pay to the government, there are two health care systems IMSS and ISSSTE, depending on if you work for the government you get one or another.
These institutions will give you the treatment that you need and surgerys as well, except cosmetic stuff. Since these institutions aren’t optimal (usually takes a long time to get attention) you might prefer to use a private health care, and you just pay a private company for what you need or pay monthly for an insurance plan, which will cover certain hospitals and specific diseases
Define slow. I have to wait months or more for an appointment in the US. Is it that slow? Emergency visits take hours, sometimes charging people who wait but don’t get service. Is it that slow?
Not the other poster but a Canadian too. It varies. To see my GP I can get an appointment within the week, usually same day, though most people here need to wait a couple weeks. Then there GP refers me to specialists, that’s usually between 1-6 months wait.
Emergency yeah you are usually looking at 4 hours wait absolute minimum. Though you don’t get charged for it at least. Though I guess it depends on severity, they will prioritize by how serious it is not by first arrival.
The other thing the other poster didn’t mention is that medication is not covered so you have to pay full for that unless you have insurance. Also for some reason dental isn’t covered at all without insurance (or I think recently for low income families but I’m not 100% sure if that’s implemented yet or not)
Depends. I have had a bunch of specialist appointments for cardiologists, endocrinologists, reproductive health specialists and pulmonologists. The average wait for an appointment is about three months.
We are very fond of calling the Canadian system slow but my understanding is it’s decently comparable to a lot of the States and is actually pretty impressive considering how spread out and small our population is.
Not only province, but doctor/hospital but mostly urgency.
If you’ve got something critical, it’s super fast, otherwise it can be pretty slow.
Examples:
went to the emergency for something stuck in my eye, 3am. Went in, waited 3 minutes to be checked, saw a doctor 15 minutes later, by the 1h mark I was out with 1 nurse and 1 doctor who had seen me and removed what I had and another nurse who had given me a vaccine shot.
On my way out, I talked to someone in the waiting room I had seen at 8PM getting a softball to the side of the eye, she finally saw someone around 11h after getting to the E.R. (they quickly evaluate the urgency when you arrive).
Almost 4 years later, I’m still waiting for my vasectomy appointment.
USA. Others have covered cost but I’d like to add how long it takes to see a doctor.
I have an established primary care physician that I’ve seen for years. Now though if I want an appointment I have to wait at least two months. So I have a membership with an urgent care near me that puts a $180 cap on visits to their chain of urgent cares. There is obviously no on going care with them but most of the time that’s okay.
A friend of mine doesn’t have an established PCP and to get one he must wait at least a calendar year….
I haven’t seen my pcp in like 3 years. $200 to go in for no reason and have them tell me I’m fat? No thanks.
I should probably diy bloodwork though just to make sure I don’t have elevated white blood cell counts or sth
Edit: the wait for pcps is structural bc they don’t earn the same exorbitant salaries as specialists but still have to pay backbreaking med school costs, so there’s a shortage.
I had an appointment for my annual physical in June that I had to reschedule. I called a couple of days beforehand, and the first time they could see me was in November.
We really are lucky as Americans not to have the crazy long wait times that other countries do, right?
Holy shit, that’s crazy. So if you have like, a really bad cold or something and need to see the doctor, you’ll be recovered by the time you get an appointment??
Makes me pretty grateful to be able to get same-day appointments, or at worst, the day after.
If you’ve recovered from your cold before you can get to a doctor, then you didn’t need to see a doctor. It’s almost as if humans have some kind of immune system to deal with common viral infections
If you are wondering why it takes months to see a GP it’s because fully 50% of my consults are healthy people with self limiting viral illnesses.
Each one of those appointments makes me unavailable to see someone else who may or may not have offensive vaginal discharge.
If people just got out of the mindset of “my kid has a cold, I need to see a doctor to get checked out” or even worse " I have a cold, I need antibiotics" then maybe I can spend my day treating actual medical problems instead of telling people to go home, have some vitamin C and drink plenty of fluids.
Where do you live that makes you wait a year for an appointment with a PCP? I’ve only ever waited a month or more for a particular set of specialists where I’m at.
U.S.A., I have a “high deductible PPO” plan, more or less what my parents would have called “Major Medical”.
It covers only some preventative care, for $0 out of pocket, whatever is mandated by the government basically so annual wellness, annual woman-care, birth control, one dermatologist visit.
Then nothing, until we spend some ridiculous amount in one year, I think it’s $7,000? At which point it starts paying 80% until we have paid an even bigger $, then it pays 100%.
So we don’t have healthcare, exactly, we have limited liability for healthcare cost.
Specialist I can just schedule, do not need to be referred by GP. Prescriptions are subject to that same high deductible.
This plan costs, out of my paycheck, kind of a lot for family coverage, and employer puts back some of it onto a “health savings account” that can be used to pay towards the cost. Not anywhere near that $7k but some, and what is not used stays in there. I also put money in that account out of my paycheck to build it up so that when we do eventually have a bad year again, the money will hopefully be there to use.
Yes it is. And besides the premium and other costs, we also pay taxes for care for the sickest and the oldest. These private insurers are cherry-picking the group they insure and still charging the outrageous fees, raking in profit and outsourcing the more expensive groups to the rest of us to pay for. So I get about half of my paycheck as netpay after medical, tax, HSA and 401k; same as someone in a socialized nation, but without the assurance of healthcare or a pension.
Here in the US, if you have health insurance, any time you go to the doctor it’s $200. That’s if you have a doctor to go to. So we mostly don’t go, until it’s really bad, then maybe you have to go to the hospital, which may be a few thousand bucks on the low end and bankruptcy on the high end. You have no idea what you will pay when you go, they send you a bill in the mail that arrives 2-3 weeks later.
So we pretty much avoid interacting with the medical system at all costs.
If you do want to see a doctor or specialist it’s pretty easy since they are businesses, you just call them up and make an appointment. But what do I look like over here, John D. Rockefeller?
Your experience is real and is the case for millions of Americans, but healthcare insurance plans vary widely.
I work in a union job for a large nonprofit and I have excellent insurance. Visits to my PCP for preventative care are free, visits for anything else is $20. Specialists are generally $25. It’s also $25 for urgent care, $150 for the ER, though that’s refunded if you’re admitted. Hospital stays have no copay or deductible if they’re in network. All the major medical facilities near me are in network.
Monthly I pay ~$300 for my insurance, which is 12% of the cost, the other 88% is paid for by my employer. That covers me, my wife and my daughter.
Last year our insurance provider had a greater % of profit from our companies plan then legally allowed, so they had to refund a portion of our payments. My company refunded all that to us, so I got about a months worth refunded.
I’m fairly certain I’m in the top couple percent for healthcare quality, and it’s a real draw to me staying with my employer, though they’re great in pretty much every respect so it’s not the only draw.
I strongly support single payer healthcare because my experience is not the norm in the US and everyone should have the health security I have and feel.
America. Ideally you have insurance through work. Going to your PCP may be ~$50, same for specialists. Urgent care and ER will be higher, then there will be additional bills depending on what needs to be done and your insurance. Then there’s “in-network” and “out-of-network”. In-network will be covered more by insurance than out-of-network. It’s tricky for hospital stays. In my area there are doctors who are out-of-network working at in-network hospitals. So you will get 2 separate bills - one from the hospital and one from the doctor.
Honestly it’s terrifying having an emergency because you really don’t know how much it could cost. Most insurance plans have a max out of pocket. One number for the individual, one for the family. The lowest I’ve seen is $2k/$6k while the highest was ~$16k/30k. I’m in a LCOL city though. Max or of pocket is the maximum you should ever have to pay for a single year. You will almost definitely hit this if you have a baby or need more than a couple days in a hospital.
For people with low income there are sometimes assistance programs at hospitals. One common outcome is you go into a payment plan and maybe years later your remaining debt is forgiven. The payment plans can be very cheap. I’ve heard of $25/mo. Still it’s probably for a bill that’s in the thousands if not 5 or 6 digits.
If you don’t have insurance through work you can buy your own insurance but many people just wing it. Most hospitals will charge less when there is no insurance to bill. Maybe 1/3 what they would charge insurance. This will still be in the 4-6 digit range. So you go into a payment plan, or maybe there’s additional financial assistance from the hospital, or you just ignore the bill and take the credit hit when it goes to collections.
There are programs through the government, Medicare and Medicaid. They cover quite a lot but if you’re under 65 then I believe you have to be disabled to qualify.
The quality of care is generally high though, so that’s cool.
I write or call my GP, they call me in for preliminary examination and/or conversation to determine the best course of action. Blood tests are usually done directly at the GP, either on the spot or within the week. Other simple tests like blood pressure are done at the GP too. I get the results in an app, and the app also tells me if the result is low or high or whatever.
If I need to see a specialist, the GP gives me a referral and I find one I like, or they queue me up and I get the appointment sent to me in the government’s digital mail system. The appointment times vary but I’ve yet to be dissatisfied.
I go to the specialist, and they do their thing. Tests, interview, whatever. They decide on a diagnosis and prescribe medication. It’s assigned to me digitally, and I can either get the meds at most pharmacies or immediately on the spot depending on what you need. You might see a specialist more than once to change or adjust treatment.
This is where you might start reaching for the wallet. All appointments, examinations, tests, etc. are paid for with taxes. In total, my income tax is 43% and VAT is 25%. That’s totally fine by me. Medication prices vary of course. Some are free, some are cheap, some are expensive. Broadly speaking, people can afford their medication.
It’s not a perfect system, but I have confidence in it, and am generally satisfied. Most issues are human in nature - I understand that women and immigrants (like myself) might not get the same quality of treatment, which of course sucks, and shouldn’t happen. I haven’t noticed any poor treatment but that might be due to my personality, gender, race, etc. Dental care isn’t covered and is prohibitively expensive. I’d like this changed. Psychiatric care is rough, and doesn’t really apply unless you have… significant issues. I don’t know if you can get therapy through the system but the private stuff is prohibitively expensive.
Overall my experience has been a solid 8/10, and I’ve interacted with various elements of the healthcare system in Denmark
UK here. Everything is free at point of use (paid via taxes) except prescriptions. It’s around £10 per item. But they are free if you have certain long term health conditions, are pregnant etc.
To see a specialist your doctor writes a letter and they contact you.
Sweden: Healthcare is mostly tax-funded. There is a small fee (for adults between 20-85 ) for each appointment. This fee lies between 150-330 SEK (~15-33 €), depending on which region you’re in. Emergency care is usually about 10 € more (40€), and an ambulance trip double (so ~60€). If you’re admitted to a hospital the fee is 120 SEK/day (in my region). Total fees paid for appointments during a year is capped at 1300 SEK (130 €), after that they’re cost-free.
The above is regarding “necessary” care, so things like cosmetic surgery, vasectomies, etc. you’ll have to pay more.
Access to specialist doctors varies, some you can contact directly (usually private practice), and others you’ll have to first make an appointment with a general practitioner at a health center, then get a referall if they deem it necessary. In my region there’s quite a long wait time for many specialists (I had to wait 6 months for a head MRI), and sometimes you’ll have to travel quite far because the care is only offered in one hospital in the region (My wife had to drive 200 km for a surgery).
Expanding on this: what is deemed necessary varies a bit between regions, in my region a vasectomy is covered, so total cost (3 visits) would be ~45€. Waiting time is about 6 months. But waiting time also varies a lot.
Romania you pay taxes from your salary or if you are a student then you are automatically covered. To access specialists you need a piece of paper from your designated doctor that confirms from him/her that you need a specialist.
The reality tho is that the state of the medical system is bad. Understaffed and equipment older then 40+ years.
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