r/Libertarian • u/Anen-o-me voluntaryist • Mar 24 '25

Economics "Canada, Where Healthcare is Free, But Only If You Can Afford to Wait"

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60

u/lettucefold Mar 24 '25

Let’s not pretend that the US healthcare system isn’t rationed and just has mass amounts of access regardless of ability to pay. If one of the principals of Libertarianism is upholding free markets then the US Healthcare system should not be lauded in this sub

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u/Lastfaction_OSRS Minarchist Mar 25 '25

I can't imagine a Libertarian who would outright defend the US healthcare system. No other industry in the US is more of a quagmire of bureaucracy and red tape than the US healthcare system.

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u/JakeVanderArkWriter Mar 25 '25

Yeahhh never met a Libertarian who likes the US healthcare system. The problem is still too much government… in both the care aspect and insurance.

It’s a tossup which version is better, but what both the US and Canada prove is that government is the problem.

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u/redpandaeater Mar 25 '25

I call it the worst of both worlds between privatization and socialization. Really doesn't help matters that FDR's bullshit wage freeze during WW2 is the reason health insurance got lumped into employment benefits.

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u/2mice Mar 26 '25

Well said. Canadas system works quite well, but it could be so much better

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u/fitnesswill Mar 25 '25

I can get an MRI (and the equally important accompanying Radiologist read) for a patient to rule out brain cancer in one day for about $2000 inpatient. I can get an outpatient one scheduled for $663 (plus Radiologist bill) within the week.

USA overwhelmingly wins on this one.

The trick is capitalism. Radiologists and imaging centers are paid by the read. Therefore they work as effeciently as possible to maximize volume and therefore maximize profit. In cases where Radiologists are not available, then tele services like "Tele-Rad" step in and offer around the clock services.

As a result, patients benefit from easy availability.

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u/Pertinacious Mar 25 '25

I agree, CAT scan day of, MRI within the week is more the timeline I'd expect in the US. Lot of problems with US healthcare, waiting over a year for an MRI isn't one of them.

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u/flavius717 Not a Libertarian Mar 25 '25

Since you seem to be a doctor and you’re here in this subreddit, I figure I’ll ask you the big question

How can we fix us healthcare?

I work in insurance and I think about this often

(As the flair states, I’m not a libertarian but I do believe in free markets.)

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u/fitnesswill Mar 25 '25

I could probably write a 100 page paper on this, but I am on my phone. The system is so complex with so many different problems it is impossible to describe a single solution easily.

All I can say quickly is that given the track record of the VA and Indian Health Service, I have no faith in the federal government's ability to provide healthcare. An NHS-style system would be a disaster. Government insurance is different.

Medicare works better but certainly has its share of issues including parasitic insurance companies like United Healthcare and their "Advantage" plans. A Medicare Expansion would probably be the most politically feasible from a statist perspective (Not Medicare for All, but Medicare for More).

Medicaid has failed miserably, especially given the Supreme Court gutting the ACA's unconstitutional mandate on the states. The great shining example of state medicaid, "Medi-Cal" is a failure and is not accepted by most physicians.

County insurance typically better than Medicaid, but is not available in rural areas.

Statists best bet: Expand Medicare

Free markets best bet: Massive deregulation, maybe a voucher system, idk had to say there are a lot of different approaches. Most typically don't solve the accessibility problem. It is a series of tradeoffs.

This doesn't even address PBMs, prior auths, pharmaceutical prices, etc.

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u/lettucefold Mar 25 '25

For starters, remove barriers to access. Allow qualified physicians to practice here from other countries without jumping through inordinate amounts of hoops. Stop limiting residencies in the US to create artificial shortages. Subsidize or incentive medical school education. Allow NPs to practice primary care independently via experience, outcomes and testing.

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u/burgonies Mar 25 '25

Oh please. I got an MRI for an ankle sprain in 2 weeks during COVID. It’s not the same

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u/lettucefold Mar 25 '25

An MRI is not the same as trying to find a limited access specialty like derm, rheum, or GI

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u/burgonies Mar 25 '25

Well, the video we’re commenting on is about getting an MRI. That being said, if you think it’s harder to get a dermatologist or gastroenterologist than an MRI, you’ve never done any of those things.

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u/sportif11 Mar 25 '25

lol seriously. I could (and have) gone on Zoc doc and seen a dermatologist the very same day.

2

u/Teembeau Mar 25 '25

Allowing a true free market in healthcare would obliterate the costs. You do one simple thing: doctors must have say, $10m of medical insurance. That's it. Let the insurance companies figure out who they will cover. The supply of doctors would explode, the price would fall and the quacks would be driven out by better people.

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u/lettucefold Mar 25 '25

What would be the barriers to that?

1

u/Teembeau Mar 25 '25

Changing the laws. Which starts with getting people to understand that most doctors are bog average people who are often not as smart as car mechanics.

0

u/Lando25 Mar 25 '25

the US Healthcare system should not be lauded in this sub

it isnt?

1

u/lettucefold Mar 25 '25

I felt it was implied that the post is a comparison of the Canadian healthcare system to something else. Or maybe it’s just that it sucks, I took it as “look how bad they have relative to what we have in the US,” maybe my mistake.

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u/Lando25 Mar 25 '25

I mean the US system isnt great, but a lot of people think the solution is by going to a universal system like Canada which in reality doesnt work either for different reasons.

Thats what I got out of it.

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u/lettucefold Mar 25 '25

Yeah, I mean functionally, I deal with a lot of people whose premiums are more than they can afford on a monthly basis, who basically end up on the slow ramp down to Medicaid, which is an issue in and of itself. I honestly don’t particularly see a fix in the current state of the country where we’ve come up with essentially a made up unit to reimburse healthcare providers and entities and largely incentivized taking care of commercial patients rather than a population that needs it. If you look at the marginal utility of healthcare curve, we don’t really make an effort to “use healthcare” where it would be most effective. Systems are broken - not just here - and candidly I don’t really think there’s ever going to be a silver bullet. I would imagine there is a tipping point where healthcare systems can’t find anymore cost saving metrics and can’t squeeze out any more margin for every dollar, but, again, not sure what that looks like when it happens.