Recent comments in /f/explainlikeimfive

RibsNGibs t1_je91mys wrote

My experience as an American who moved to NZ several years ago is that you can probably get better care in the US if you have a lot of money. (Full disclosure - I have a lot of money and in the US I always had great healthcare through my employer so I had arguably about the best healthcare experience in the US aside from like… “actual” rich people or congressmen.)

But 99% of the time the experience in NZ is superior. Hard to tell how much of that is because of universal healthcare and how much of it is because it’s NZ (way too many confounding factors and variables).

But my experience in the US was… call my doctor.. wait, no first I have to do research to find a doctor on my plan… wait no first I have to figure out which plan I want to get (my employer offered several): do I want a high deductible health plan or the PPO? Catastrophic only? Ok let’s look at my last 5 years health expenses and crack open Excel - how much money would I have spent given my healthcare usage in the past? How about if I get unlucky and break my leg or get cancer? Should I get an HSA? What if I don’t use it? What if I do use it? How do I get the money out of it? What if I want to use it for something besides health?

Ok now find a doctor on my plan.

Call and make an appointment, next available is 2 weeks from now.

Go in, he’s running 30 min late. Receptionist: “are you on the same plan as last time? Have you moved since your last visit? Can I see your card? Blah blah blah”

See doctor. He’s super competent, no doubt, but he’s rushed, wants me out the door. But yes, very good.

On the way out: sometimes I just pay the copay, but for some reason sometimes it’s “put it on your card and here’s the itemized receipt - now go submit that to your insurance company”. Sometimes it’s “insurance company didn’t want to cover this one out of 30 items”. Those last two examples might be for when I saw specialists not on my plan, I forget.

Go to pharmacy. “Are you on the same plan? Can I see your card? Have you moved?” And “come back in an hour or two”. Poor pharmacist has to spend ages calling the insurance company - maybe they only cover the generic? Maybe the doctor prescribed 60 days but the insurance company only wants to cover 30. Who fucking knows. Come back in an hour, perhaps pay a small amount, perhaps pay a lot.

Potentially fight with insurance company.

In NZ it’s like: call and get an appt for that afternoon. Go in and have a pleasant chat with the doctor (I would say so far the quality of the healthcare has been fine, and a much better personal experience in terms of feeling like you can spend some time talking to the dr and having them really listen or explain things without feeling rushed). Pay a moderate amount out the door (or none if it was a result of an accident or for my kid), walk into the pharmacy, pick up the meds, maybe pay $5, done.

So, I dunno, if the expertise and equipment is 5% better, is that worth the stress and headache and time and all that fucking mental overhead? It’s exhausting just writing about it. In NZ if I decide to see the doctor about my funky ankle or cough, the total time expenditure is like an hour. Maybe less.

We also had a kid here. Months of home midwife visits, 3 days of induction in a pretty slick, modern birthing suit with nice recliners and a jacuzzi hot tub thing and gobs of medical equipment all over the place with armies of midwives and nurses and doctors and anaesthetists or whatever, emergency C section with super professional doctors and surgeons and nurses, blood, hearing, vision tests and specialists after that, 3 days recovery in a maternity ward with latching specialists and more help, then home with a few more months of home visits from the midwife… total charge was like $110 in parking. I spent more on food from the hospital cafe than I did on that!

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Due_Signature_5497 t1_je91boc wrote

Not being mentioned here and honestly want some non- propaganda answers from people living on socialized medicine. 1) I constantly hear about ridiculous wait times for non emergency treatment. In fact, I have many friends that have traveled from the UK and Canada to get treatment in the U.S. Can someone that has experienced this please weigh in? Someone has to pay for it so how does this affect your tax burden? I keep reading that the NHS is failing people in a big way? UK, what do you think of them? There is a huge industry on bot the Northern and Southern borders of the US of hospitals and Medical care where people from our neighboring countries come for medical care. Why would you pay these prices if you socialized medicine is working for you? Hoping for honest thoughts, not people subscribing to an idea without actual knowledge. Thank you.

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tiredstars t1_je914ac wrote

There are a range of comparisons around, and they're often not easy to use. The OECD gathers data but I think it's deliberately shy of making comparisons easy. The UK-based Nuffield Trust does a report comparing systems, which I think is based on the OECD data.

I'm sure I've seen some others but don't have time to look them up right now.

COVID 19 has made things more complicated, so I think most comparisons are two or three years old now. Not that I imagine much has changed - though I think the US had a particularly bad experience of COVID, which is not unrelated to the problems in its healthcare system.

As a general rule, compared to other wealthy countries, the US:

  • has middling health outcomes

  • has some really great healthcare. If you can pay for it, you can get absolutely world-leading healthcare in the US

  • but access to healthcare is poor, and the system drives some perverse behaviour - the classic example is putting off dealing with a problem until it requires emergency treatment

  • at a country level this is one factor that makes US health spending extremely inefficient in terms of outcomes - focusing a lot of attention on expensive treatment with marginal benefits, as compared to wider availability of lower cost treatment and prevention

  • other aspects of US society and the economy contribute to poor outcomes - eg. Americans work longer hours, have fewer holidays, less access to sick pay and less security in their jobs than most rich countries

  • it's also worth noting that even the rich can't completely isolate themselves from the effects of the health of others - if your housekeeper comes in to work when they're ill because they can't afford to see a doctor and can't afford a day off, you're at risk of catching whatever they've got

  • the US spends far more than any other country as a proportion of GDP. Not only that, but government spending is higher than almost any other OECD country. Put another way: if you could magically transplant the NHS to the US, the US government would spend less on healthcare.

The general rule in international comparisons is that there are a range of ways of funding and providing healthcare and there's debate about which models work better - except for the US model, which nobody wants.

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ero_senin05 t1_je8zybd wrote

>Not trying to be a dick or anything just showing that the term "cornichon" has been used in Australia at one of the largest supermarkets in the country

True, but the original claim that started this conversation was that Aussies use this name "often." I've never heard the word out loud before and hadn't even read it until today.

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RibsNGibs t1_je8zwfa wrote

Most countries ration by need. The US rations by wealth. The former is obviously morally and ethically right.

And usually in countries with universal healthcare you still have the option of buying private insurance on top, which is usually super cheap (because universal healthcare takes care of almost everything anyway) but gets you faster care if you need it.

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mugenhunt t1_je8zoaj wrote

The basic idea is that if we take a lot of the money that currently goes to the police in order to catch people who have committed crimes, and instead invest that money into education, into healthcare, into social services, we can help prevent crimes from happening in the first place. Likewise, we have police doing a lot of jobs that might better be suited for social workers or medical professionals, and giving those groups more money so they can deal with those problems instead, so that police can focus on what they're best suited for, is also seen as a better idea.

Instead of having a police officer deal with a homeless person with a drug addiction, a counselor or social worker with specific training for this situation would do the job better.

Basically, if we try to prevent crime from happening in the first place by addressing the issues that lead to it, we won't need as many police in the first place, and we'll have less police brutality as a result.

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Gibsorz t1_je8zjcb wrote

No. Defending would result in more use of force. The work would have to be done on the front end to fund the other services, and then removing funding for police once that is no longer needed.

Otherwise you get less police around, which means they feel less safe when they are in violent situations, and they move to lethal force faster.

Extreme ends of the spectrum but a 5 person pig pile is safer for the person being arrested and resisting the arrest than a 1 on 1 fight, because the 1 on 1 fight is more likely to end in the cop fearing they are going to get hurt and shooting the person.

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Alokir t1_je8za6c wrote

The easiest way to picture it is the correlation between meter and centimeter.

1 meter is 100 centimeters, but 2 meters are not 101 centimeters but 200. The relationship is linear because you use a linear function to convert from one unit to the other. In this case it's meter = 100 cm.

In case fahrenheit it's more complex to calculate in your head, but simple if written down: Celsius = (Fahrenheit - 32) x 5/9.

To imagine a non-linear correlation you can think of something like how the amount of chocolate you eat relates to your enjoyment.

You eat a bar of chocolate, that's cool. You eat two, it's better. But as you keep eating more and more you start to get full and by the time you eat your 25th bar of chocolate you'll want to puke. So if you'd want to illustrate it on a chart, the line would start to rise and quickly drop at a point the more chocolate you eat.

The relationship would be linear if your enjoyment would increase by the same logic regardless of how many chocolate you ate (or more precisely, if there was a linear function that you could use to calculate it).

Edit: clarification

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