Single-Payer/Universal Health Care Experiences, Part I

The following is adapted from a Facebook link advocating single-payer health care that I posted last Friday. My motivation in posting it derives from several threads in which a friend, whose views I respect but with whom I frequently disagree, has expressed his opposition.

In asking friends to comment with their direct experiences with national health systems, my original hypothesis was that respondents would gush about how wonderful these systems are—not necessarily ideal, but a great improvement over the profit-driven model found in the US. My guess came close: There were more negatives than I'd envisioned, but most comments were favorable overall toward single-payer and similar systems.

General consensus, among those who have experienced it directly and the mostly American bunch whose friends and relatives have lived under it, is that the competence of those administering the system is an important factor. There are some not-so-good single-payer systems in existence, and they don't always fix the problems of capitalist health care immediately. Those stories of ridiculous waiting times in Canada may be somewhat exaggerated, but such instances do occur. The UK's National Health Service had problems in the early stages, but the people running that system have learned from earlier mistakes and put those lessons in to practice.

I'm still waiting for some respondents to reply as to whether they will permit me to repost their comments here, so this should be Part I of two.

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Original Post
I have a friend with libertarian sympathies whose reaction to any suggestion of single-payer health care is one of dread. He comments with links on my threads about the horrors of single-payer health care: patients & families losing control over their own medical destiny, patients who die waiting for promised treatment, etc.

This post is NOT—repeat NOT—an invitation to slag my friend, or libertarianism with a capital or lowercase L. So don't. That shit will be deleted with all due haste.

Instead, I'd like to see stories of experiences with health care in nations with single-payer or hybrid systems, positive or negative. I invite the following to address the issue.

Chris in the UK

I will relate my most recent experience with our UK NHS, which is easily the most serious medical experience I have had to date.

In June 2016 I suddenly began to experience episodes of near-fainting and occasional visual disturbances. These often occurred while driving, so I was forced to virtually give up driving for several months. During this period I had 4 or 5 consultations with General Practitioners, 3 blood tests, an ambulatory blood pressure monitor fitted for a day, an ambulatory heart monitor fitted for a week, two ECGs, an echocardiogram, an MRI of my brain, a consultation with an ENT specialist, two consultations with a cardiologist, a consultation with a neurologist, a tilt test carried out by a nurse specialist, and a subcutaneous heart monitor inserted in my chest (which I still have 3 months later). All of this was free.

The doctors were all pretty obviously baffled by my symptoms, but eventually it was the tilt test and accompanying consultation with the nurse specialist that provided the diagnosis – reflex vasovagal syncope, caused (would you believe) by my drinking too much caffeine. I now drink no caffeine, have no symptoms, and am driving normally.

Relevant points are:
- the treatment was free under the NHS
- I got a diagnosis
- the diagnosis took about 7 months.

What seems to have prevented the doctors quickly arriving at the correct diagnosis was that syncope normally involves actual fainting and happens mainly to people standing up, whereas mine did not involve actual fainting and occurred mostly when I was sitting down. Also there were odd visual symptoms which with hindsight were perhaps a distraction. Would doctors elsewhere in the world have been cleverer, or would a different healthcare system have allowed them to get there quicker? I have no way of knowing.

Tim, formerly in Canada

In Canada, several years ago, my ex-wife
- had a dickens of a time finding a GP in Manitoba; most female GPs had patient waiting lists, and she only managed to get on a female GP's rolls because her sister was already a patient
- was sent to an orthopedic specialist by her GP, who determined that yes, there was an operable knee problem & scheduled an outpatient surgery
- ...for about six months away, as nothing else was available sooner
- which, combined with her weight and work environment, resulted in her needing a similar surgery for her other knee well before she was able to receive treatment for the first

In Canada, several years ago, I
- went to a walk-in clinic for a throat issue, saw a doctor within 15 minutes, was prescribed antibiotics in 20, showed them my SIN card, and walked across the corner to the drugstore to buy my generics

In Canada, several years ago, my ex-wife's buddy
- was concussed playing hockey
- was accompanied to the nearest emergency room by us
- sat with us for ~4 hours before seeing a doctor and receiving the standard cautions and temporary prohibitions

The speed with which one receives care really depends on the situation, but can be pretty poor if one needs a surgical procedure. There's still the enormous upside of the surgeries not bankrupting our "college student and unskilled worker" household; not having those surgeries sooner made my ex-wife unable to work, putting additional stress on our finances.

It's a mixed bag; it's not magical. It does save families from being swamped by gigantic debts...if one of the families' breadwinners isn't on a waiting list.

Dan in Germany

Germany doesn't have a single payer system but everyone must have some form of health insurance. The big difference is that many insurance companies, like mine, are non profit organizations. I have immediate access to my general practitioner, or Hausarzt, and can make appointments with any specialist I choose. My total health care expenses in 2016 were 482 euro, less than most Americans pay each month.

Christine, who grew up partly in Norway and Japan

I have lived and traveled in countries with national health care systems. I and family members received excellent care at no cost. Nothing but good experiences!

Jorge, formerly in Mexico (definitely not single-payer)

My brother fell of the side of a mountain hiking in Mexico. This is Mexico so he got fired since he could not go to work. No work, no money, no insurance. He is alive. He did not have to pay anything.
Could the service be a lot better? YES. 
Is he alive and not broke because of medical bills? YES.