NY MomFeb 20, 2024
somcak 🐌​

I have had skin cancer surgeries in 2 countries: the U.S., with "hope you can afford the deductible" insurance, and Portugal with single-payer/universal/socialized medicine.

In the U.S. (in 2001): Notice growth on ear. Call to see primary care. Get into appointment 2 days later. Get a referral to a dermatologist. Wait 2 weeks for the insurance company to approve referral. Get into dermatologist 1 week later and have a biopsy. The biopsy showed it was squamous cell carcinoma, a type of cancer usually found in folks over 60 (I was 23 or 24). Dermatologist puts in for an approval for surgery which is denied twice over 3 weeks because “the biopsy was wrong.” Get in 2 days later for another biopsy, which, surprise!, shows it really is squamous cell carcinoma. After another week of wrangling with the insurance company, we finally get approval for surgery. Surgery is scheduled for 1 week later. So, from noticing the growth to surgery about 8 weeks.

In Portugal (5 years later): Notice growth on ear. I call primary care and am transferred to the dermatologist. Get same day appointment. Dermatologist looks at it, picks up the phone and calls the plastic surgeon. We walk down the hall to the plastic surgeon. Both doctors consult their schedules, and I’m scheduled for surgery 2 days later. So, from noticing the growth on the ear to surgery about 2 days.

Again, to show you the difference: In the U.S. without universal healthcare, about $1000 out-of-pocket and 8 weeks until surgery. In Portugal with universal healthcare, about $60 out-of-pocket and 2 days until surgery.

When Congress says we can’t afford universal healthcare, they are saying, “We can’t afford to not make the insurance companies money because they fund our campaigns.” It isn’t about the best interest of Americans, it’s about their own best interest.

Feb 19, 2024 at 4:01pmWeb
Show threadElizabeth S.Feb 19, 2024
@somcak I'm so sorry you had to go through that twice (or at all!), particularly the US experience, but your story is a great example and clear message that more people need to hear.
Show threadDr Susi ArnottFeb 25, 2024
@jinglepostman @somcak How many USA-based dramatic narratives would disappear in a welfare state? At random: in 'Meet John Doe', journalist made redundant lies to feed her dependant parent&sibs, JD colludes on promise of payment for orthopaedic surgery. 'Breaking Bad' involves a science teacher turning to the meth business after being diagnosed with cancer and unable to imagine paying for treatment +/or supporting spouse&kids
Show threadDana das Grau 🧙🏻🧝‍♂️Feb 19, 2024
@somcak oh but in capitalist America, what is good for the corporation is is good for Americans. That is the convoluted logic anyway.
Show threadDavid Fleetwood - RG AdminFeb 19, 2024

@somcak This has been my literal experience. I took care of my aunt in my home for 8 years as she declined in dementia. She had a lot of health problems. Despite excellent health care (military) in the USA everything was a litany of meetings and approvals for procedures.

I moved her to Portugal in 2021. She had a similar cancer to yours (tumor in her ear), a heart attack after surgery, month in the hospital, dementia related care, etc.

Care was top notch and relatively quick. Spent 20 euros.

Show threadAnneFeb 19, 2024
@somcak Our system in Canada isn't perfect, but I will take it any day over the US system. No one needs to go bankrupt from an illness and we have great care.
Someone I know will have only a 6-week total time between noticing a possible squamous cell carcinoma, Dr. appointment, a biopsy, and then a full removal. No insurance hassles. No money out of pocket.
Show threaderrgFeb 19, 2024
@somcak I think a lot of the problem is that the vast majority of people have never had any healthcare experiences in other countries and just can't believe how much better it is.
Show threadMartin VassorFeb 19, 2024
@somcak Reading such stories always makes me think about Papanicolas' paper: https://pubmed.ncbi.nlm.nih.gov/29536101/ :
"The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries."
Health Care Spending in the United States and Other High-Income Countries - PubMed

The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drive …

PubMed
Show threadP StewartFeb 19, 2024
@somcak The really infuriating thing about the US example is you mention (at least!) four points in it where the decisionmaking process could get people killed, none of which involved medical professionals, and *all* of which involved people whose job is specifically to prevent healthcare from occurring.
Show threadEric the half-a-beeFeb 20, 2024

@pstewart @somcak

Exactly 100%!

Show threadStephen CerrutiFeb 19, 2024
@somcak I have a history of skin cancer. When I noticed my ear problems it took me weeks to get an appointment with my primary. So I used the insurance telemedicine to get a referral but the insurance company told me I had to get the referral from my primary. So I asked if I could see my dermatologist without a referral, they told me yes if I paid myself. But the dermatologist wouldn't see me without a referral, despite my insurance company on the phone with them telling them it was okay.
Show threadErik EllestadFeb 19, 2024
@somcak Anyone who says the US has the best options for healthcare has never really used healthcare in the US.
Show threadJohn ChapmanFeb 19, 2024
@somcak This is so obvious to most of the world but in the US, when money for big business is concerned, it causes selective deafness.
Show threadDavid Mitchell Feb 19, 2024

@somcak

Yeah, I feel ya’ man: ‘socialism’ is the worst

/s/

Show threadJenniferFeb 19, 2024
@somcak 100% correct!!
Show threadBodhipaksaFeb 19, 2024

@somcak The US health insurance system makes money by not letting people get the treatment they've (over)paid for.

A government-run universal insurance system would cost much less to run and could focus on maximizing long-term health so that money can be spent where it's most needed. It works literally everywhere else. It's only starting to break down in countries where the rich who run governments want it to fail so that they can make money by owning health insurance companies.

Show threadSean Eric FaganFeb 19, 2024
@somcak And yet, here -- Ireland:
• Spouse has ringing in ear, *very bad*, in 2022
• Sees doctor in early 2023, says "use these drops"
• Those drops don't stop it
• Sees doctor again in Sep 2023
• Doctor refers to specialist
• Specialist has first available appointment in March 2024
• Specialist will not see spouse ahead of time
• No other specialist will see spouse without referral from doctor
Show threadMirishuliFeb 19, 2024

@somcak. This is perfectly stated. We need to make it a poster!

"When Congress says we can’t afford universal healthcare, they are saying, “We can’t afford to not make the insurance companies money because they fund our campaigns.” It isn’t about the best interest of Americans, it’s about their own best interest."

Show threadPusher Of Pixels (old account)Feb 19, 2024

@somcak the US system is beyond insane and cruel by design.

How does Portugal solve the provider problem? Where there aren't enough providers? Things are covered but it takes months/years to get the needed appts in many cases.

Show threadMarshall EubanksFeb 19, 2024
@somcak That is certainly my experience in France versus the US.
Show threadnaturaldynamicsFeb 19, 2024
@somcak Lucky guy, in all of Canada there is a big shortage of medical access
Walk in clinics are few and far between and require a few hours of wait lines,
Still I feel safe with free Medicare here, housing is very expensive esp those unfortunate to rent that could easily eat a whole pension cheque if you need to find something now
Show threadpenpencilbrush🇨🇦Feb 19, 2024
@natureshelperokanaganhighlands @somcak That's not my experience in Canada. Call the dr office, get an appointment promptly, depending on urgency of problem. All the preventative testing covered, colon, pap, mammogram, blood tests, no charge, referred by family physician.
Universal healthcare is the way to go. Canada is dealing with physician shortages caused by provincial premiers effing up.
The federal 🇨🇦 gov't is committed to Universal Healthcare.
Show threadnaturaldynamicsFeb 20, 2024
@penpencilbrush @somcak doctor shortage is a problem here, but i agree that our healthcare does a good job treating people as needed, even during the covid shutdown walk in clinics continued under special rules, i have never had any issue getting the help i need, for zero cost out of my pocket.
Show threadnaugturFeb 19, 2024
@somcak it was also a lot cheaper because of how it worked (no extra procedures and paper pushers involved, less work out into diagnostics) and an order of magnitude cheaper per work done because the system has reverse incentives and prices won't get inflated because it's insurance company that pays it.
Show threadLordWoolamalooFeb 19, 2024
@somcak My father required major heart surgery, which didn't go well, a few days in Intensive Care then a week in general ward before home became weeks and weeks of him barely clinging to life. There is no way our family could have afforded those months of constant care, but because we all pay into the system for the NHS, it was there when we needed it, and I've still got my dad. To hell with everyone who thinks available medical help is only for anyone who can afford it.
Show threadNjordFeb 19, 2024
@somcak YEP. Companies alone spend far more providing insurance than it would cost them in payroll tax to provide medicare to all Americans, for example.
Show threadPatrick McLaughlinFeb 19, 2024

@somcak

In the US the health system exists principally to make money — care is merely a regrettably necessary byproduct that should be minimized for the average person as much as possible (so as to maximize profits).

ALSO, it should be particularly minimized where it might provide health care to minority groups, and *particularly* Black people, even if that leads to other regrettable consequences.

Show threadJ.Sʜᴀʀᴘ🌍🇺🇦Fʀᴇᴇᴅᴏᴍ&DᴇᴍᴏᴄʀᴀᴄʏFeb 19, 2024

@somcak

Absolutely. It's an insurance racket.

As everyday passes by, Bernie Saunders sounds wiser and wiser to more and more folks.

Show threadBob DeLaurentisFeb 19, 2024
@somcak thanks for the info on health care. My spouse and I are considering moving to Portugal now that we are retired and our health insurance is $$. I would love your view on Portugal as a place to live. Advice. Hidden downside. Whatever. Thank you.
Show threadAviva GaryFeb 19, 2024
@somcak About right
Show threadBarbara MonacoFeb 19, 2024
@somcak Thank you for this valuable perspective. Americans have been told for decades that "we have the best healthcare in the world", which is simply untrue.
I studied pros and cons of universal healthcare for my debate team when I was in middle school, and have been a proponent since then. That was decades ago, and and the problems we have in the US have only worsened since that time.
Show threadDesRoin Feb 19, 2024
@somcak lucky you got that appointment in Germany it's 6 months waiting time to get an appointment unless you're planning to stay in urgent care in the hospital for over 8 hours without supplies 😵‍💫
Show threadlp0 on fire Feb 19, 2024

And that's one of the reasons why I've never so much as visited the USA.

Unfortunately, the ----ing Tories seem to be doing everything they can to run down the NHS and push us all towards private…

Show threadSamuelJohnsonFeb 19, 2024

@somcak Greetings from Ireland where many like to complain about our healthcare system because you have to pay to see a doctor (usually the same day, paying or not) unless you are a child or a student or unemployed or a pensioner etc.

Look at child mortality and life expectancy metrics. The US is, for a developed country, a disaster*. The idea of many untraveled Americans that the US is any kind of shining city on hill is an absurd conceit.

*YMMV if you're vastly wealthy

Show threadCatherine is not complacentFeb 19, 2024
@somcak 66.5% of bankruptcies in the US are the result of medical bills.
Show threadKim Spence-Jones 🇬🇧😷Feb 19, 2024
@somcak Most Americans simply don’t believe these stories of how well stuff works in other countries. They’ve been so brainwashed with “America is the best country in the world” that they cannot accept evidence to the contrary.
Show threadinfrathin ꙮFeb 19, 2024
@somcak in addition to congress being beholden to the insurance industry lobby, there are a lot of individual US citizens who can't stand the thought of their tax money going to people who don't look like them. Even if it costs them more and ends up hurting their own care, they can't stomach solidarity with other races.
Show threadMister SpinalzoFeb 19, 2024
@somcak $1000 and 8 weeks is less expensive and quicker than I would have expected from US medical care.
Show threadRookFeb 20, 2024
@somcak Does Portugal have 300000000+ people in it? also, the UK has similar health care but most of the time from what I've heard, it's a 6-month or more wait because they're short staffed and if its a life or death type surgery, you're better off paying private health care. So you have to wonder the quality of the stuff you're getting. Yeah, health care is expensive in America. But unlike Portugal, we performed actual diagnosis whereas you look at a growth and just assume it's cancer. Luckily it was but what if it hadn't been? Dunno, I'd rather trust people actually doing tests with my vital organs than just quickly getting me in and out because they have a back log of patients.
Show threadSamuelJohnsonFeb 20, 2024
@rooktallon @somcak Serious want of logic here. The population of a country is irrelevant unless supply of healthcare services is fixed. Invoking the current circumstances of the NHS in the UK, after 14 years of deliberate underfunding by the worst, most incompetent and corrupt govt in the country's history as an argument against publicly funded or single payer healthcare is absurd. You're obviously unfamiliar w public health metrics. Even now UK beats US & I'd prefer it (have lived in both).
Show threadTattieFeb 20, 2024
@rooktallon this is such a stupid argument. Things like population density and average income will change how you provide healthcare, but what possible difference does your overall population figure make? And yet I see it trotted out again and again as some sort of "gotcha" about how the US is fundamentally different from other places.
@somcak
Show threadteacher ciatApr 24, 2024
@rooktallon @somcak The US may have that much population, but is also a leading economic powerhouse with many, MANY countries under their imperialist yoke. I live in Argentina, a country routinely strangled by the US with a fraction of your GDP, and we have stellar free universal public healthcare. The US has no excuse, and is no better for leaving the poor to die to better treat those with top dollar. "Fuck you got mine" is not a humane or effective way of public health policy.
Show threadEric the half-a-beeFeb 20, 2024

@somcak

Only 354 boosts so far!

C’mon you guys! Let’s boost the living crap out of this post!

US healthcare has nothing to do with saving lives. It’s all about money making and political bribery.

Show threadPeter MolemanFeb 20, 2024
@somcak Can you add what the hospitals in US and Portugal charged for the entire treatment. not to you but the insurance companies?
Show threadeliaFeb 20, 2024
@somcak when it's an emergency they tend to schedule you quickly, but as soon as it's something that can wait it can take years to see the right doctor, at least it's free.
Show threadEric BowersFeb 20, 2024
@somcak Very sorry to hear about your experience but glad that you've had it taken care of, and you've made a great point. Our country is terrible at health insurance. Thanks for sharing this.
Show threadInsertUserFeb 20, 2024
@somcak unfortunately the UK's single payer system would be nowhere near they second timeline these days. You'd be lucky if you got the first timeline.
Show threadJames BrookeFeb 20, 2024
@somcak As you say-
US citizens can’t have affordable healthcare, because insurance companies fund expensive Congressional campaigns with excessive profits.
Show threadKathryn KaiserFeb 20, 2024
@somcak this exactly.
Show threadrickweinbergFeb 20, 2024
@somcak if we could figure out real healthcare in America, we would attract businesses and turn around our economy.
Show threadhakaseFeb 20, 2024

@somcak Three weeks ago I had an ultrasound where we discovered what's wrong with me. I still have one more week before the appointment where we get to actually talk about what we're going to do about it...and then the clock will start again, I'm sure, on when that thing actually gets to *happen*.

The stress of *waiting* is the worst part. What will the doctor recommend? Will insurance cover it? How long will it take? Tune in next week to find out~

Show threadQuinn NortonFeb 20, 2024
@somcak My story is that I needed spinal surgery, and just didn't get it and declined for years until I lost the use of one arm. moved to Luxembourg, doc referred me to specialist surgeon in France, got the surgery, total cost was roughly $15000, all paid by national insurance. I'm never going back.
Show threadnodenameFeb 21, 2024
@somcak Taiwan about 5 years ago: two weeks in hospital, about $2000. That's not the copay, it's the entire bill. If I were on their national health insurance it would have been near zero.
Show threadcultdevFeb 21, 2024
@somcak i’m never going back to america. such an evil, fetid dump
Show threadNick's worldFeb 21, 2024
@somcak In this way, I agree. though on other issues I'm conservative, I believe that healthcare should be a right, not something to be given to those who can afford it.
Show threadFeb 21, 2024

@somcak

Get permits and march and you will win.

Show threadWill OrrFeb 25, 2024
@somcak In Portugal, did you go through the public or private system?
Show threadTor KingdonFeb 25, 2024
@somcak got into a dermatologist in a week? I know someone in the US looking at an estimated wait of 1 year.
Show threadMoniFeb 25, 2024
@somcak @ccohanlon insane. a society without universal healthcare is a fail, i cannot get my head around these insurances businesses being totally legitimated and (in most cases) free to operate in the most inhumane way possible… im sorry for you distressful experience and hope everything is well now!
Show threadKevin Karhan Feb 26, 2024
@somcak EXACTLY!!!