What does a TRUMP presidency look like?

[The Minsky Moment]

It is puzzling how the US managed to get a medical insurance system that, apparently, has few advantages over any comparable system anywhere else.

If you have enormous wealth and don't care about cost, you can get very good quality care without a lot of waiting around. 

[Admiral Yi]

but like garbon said, it'd be nice to know what percentage that is of people actually seeking medical treatment.

Any way you cut it that's 63,000 people who decided to pay for something free.

[Malthus]

It is puzzling how the US managed to get a medical insurance system that, apparently, has few advantages over any comparable system anywhere else.

I thought the "advantage" was that if you have means, the US system is the top medical system in the world hands down.  There's a reason you get many Canadians travelling to the US to get surgeries or procedures that they would have to wait many months for in Canada - if the procedure is even available in Canada.

The US Healthcare system is very advanced, more so than the Canadian; it is a wealthy society with a much larger talent pool of medical professionals, able to support top-tier medical centers and specialists in all areas of practice ... but this is, I think, a function of the size and wealth of the US and of its overall high level of technology.

I dunno if a good argument can be made that, regardless of these factors, the US medical insurance system is the 'cause' for why 'many' Canadians who can afford it would wish to have US specialists to perform their procedures.

Wouldn't that happen even if the systems in both countries were identical?

Canada, an overall slightly poorer nation, has 1/10 the population of the US, so it is hardly surprising that the US has more top-ranked professionals, better economies of scale for specialist medical centers, etc. If you want "the best" talent "in the world" (or at least on the continent), you are always likely to seek for it in the US.

Indeed, it is a strong an ironic contrast, that a wealthy and advanced society, that has such a depth of medical talent, has such uniformly (by objective standards) worse medical outcomes on a population-wide scale than Canada, which is poorer and smaller. That is, unfortunately, something that can be fairly blamed on its dysfunctional health insurance system. 

[Valmy]

And how many Americans go abroad for medical procedures? I know many personally.

[Valmy]

but like garbon said, it'd be nice to know what percentage that is of people actually seeking medical treatment.

Any way you cut it that's 63,000 people who decided to pay for something free.

Hey your life is not something you go cheap on. If you have a weird type of cancer and the best specialist is in Italy you get on that plane to Italy. I don't see how Canadians are outside the norm here.

[Malthus]

but like garbon said, it'd be nice to know what percentage that is of people actually seeking medical treatment.

Any way you cut it that's 63,000 people who decided to pay for something free.

If I wanted a heart surgeon, I'd pay for the best I could afford. Even if the "free" guy was pretty good. Because maybe 'the best' could save my life, while the 'pretty good, but free' could not.

The 'best' is always likely to be located in the larger, wealthier population - in this case, the US - unless some extreme factors prevented it.

[Barrister]

So less than 0.2%?

Yes.  I said many, not most.

Clearly being able to privately pay for medical services is something only the rich are able to do.  And clearly most Canadians, of whatever their means, don't need any kind of medical specialist care in any given year.  But it is a known phenomenon.

[The Minsky Moment]

Is it really?

Maybe I got lucky, but my German health provider had no issue with me choosing whotever doctor I wanted. All I did was google the local Association website to find specialists and make a phonecall to the doctor's office. Two days later I had an appointment. I handed my Krankenkasse card to a nice lady and that was it. The only cash I paid while I was there was the €10 co-pay for the medication at the pharmacy (which in the US probably costs a thousand dollars a pop).

Private insurance in Germany is basically supplementary to an existing state system of compulsory universal insurance.  You can opt out of the public system but since the vast majority of the population is in the system, the US concept of provider networks linked to individual insurance companies doesn't make a lot of sense.  There may be doctors that just take privat but IIRC they aren't balkanized into different private networks.

[Barrister]

And how many Americans go abroad for medical procedures? I know many personally.

That's a different phenomenon though isn't it?  People in the US go to Mexico or the like because a procedure is cheaper than in the US.  Whereas Canadians going to the US is because of long wait lines or procedures unavailable in Canada.

[Valmy]

So less than 0.2%?

Yes.  I said many, not most.

Clearly being able to privately pay for medical services is something only the rich are able to do.  And clearly most Canadians, of whatever their means, don't need any kind of medical specialist care in any given year.  But it is a known phenomenon.

And Texas has shit loads of people crossing the border to get procedures in Mexico every year.

[Valmy]

And how many Americans go abroad for medical procedures? I know many personally.

That's a different phenomenon though isn't it?  People in the US go to Mexico or the like because a procedure is cheaper than in the US.  Whereas Canadians going to the US is because of long wait lines or procedures unavailable in Canada.

Plenty of them also go to Europe or elsewhere because that is where the top care is.

Seems like a completely identical phenomenon to me. You find a service that is better or cheaper being done in another country so you buy it. Sounds like economics or something. Even if Canada had a completely identical health care system to the US there would still be lots of Canadians going abroad for health care procedures.

[Malthus]

And how many Americans go abroad for medical procedures? I know many personally.

That's a different phenomenon though isn't it?  People in the US go to Mexico or the like because a procedure is cheaper than in the US.  Whereas Canadians going to the US is because of long wait lines or procedures unavailable in Canada.

Again, the issue you aren't addressing is that it is difficult to attribute medical tourism from Canada to the US solely or even primarily to different health insurance regimes in the two countries. Even if the systems were identical, such medical tourism would still occur. 

[Valmy]

Damn Malthus and I have some kind of mental connection

[Malthus]

Damn Malthus and I have some kind of mental connection

You should be frightened. 

[Barrister]

And how many Americans go abroad for medical procedures? I know many personally.

That's a different phenomenon though isn't it?  People in the US go to Mexico or the like because a procedure is cheaper than in the US.  Whereas Canadians going to the US is because of long wait lines or procedures unavailable in Canada.

Again, the issue you aren't addressing is that it is difficult to attribute medical tourism from Canada to the US solely or even primarily to different health insurance regimes in the two countries. Even if the systems were identical, such medical tourism would still occur.

I only have anecdotal evidence that the handful of people who have gone to the US for medical treatment cited waiting lists as the reason.  A judge for example said it would have taken 6-12 months for his (hip? I can't quite remember), but he was in a lot of discomfort so he went to the US.

I'm not saying the US has the superior system, but it does have some advantages is all.