As well as health care, you are literally dodging the bullets up there in the True North, strong and free!

1. "ER" means EMERGENCY room. Needing a prescription is not an emergency.
2. If it's a controlled substance, there's very little chance an ER doc would prescribe it, at least in the US.

ER = sometimes the only available doctor you can get without having to wait weeks on end, and sometimes literally the only doctor.

Lots of ER's in Canada also act as urgent care and walk in services due to the lack of GP's we have in many regions.

Takes 4 to 6 weeks for me just to get an appointment with my GP for example.


On point 2, I do agree. My local ER has a sign saying they will not prescribe controlled substances unless you have an existing patient/doctor relationship with the doctor on duty. (such as your already on the med and the ER doc on duty is the doctor treating you.)

Our ER is small so all the doctors who work there are the GP's who practice in town, they are not dedicated ER doctors, they all have practices in town for the most part.

Worth reminding people that unless you are in an ambulance and actually at risk of dying, it might be best to avoid the ER. Perhaps look for an urgent care clinic like cvs minute clinic which can usually write a prescription.

The difference in copay alone can be ridiculous!

Yes, $10 UC vs $50 ER for us. I think it was the same when we were on Kaiser Permanente: their UC facility was at the opposite end of the hospital to ER and more than once I've wondered exactly where the line is drawn between an mild emergency and a very urgent case. Judging by a couple of people I saw in ER once, they don't know either - one wanted pain relief for a backache she'd been having all week (in good spirits and chatting/laughing away with the check-in nurse); can't remember what the other one was but it wasn't even urgent, let alone an emergency.

I once had 2nd degree burns to my wrist and went to UC - certainly didn't think it was much more than urgent. But the nurse on reception bandaged my hand before checking me in, and within a minute of checking in, and a full waiting room, I was called in to be seen. Maybe that was more urgent than I thought!

Mine is $20 v $150, but I've seen worse. Plus in ER you are more likely to get other bills later.

It definitely pays to know where your urgent clinics are and the services they offer. There is a nice one near me that I think does x-rays and bone settings. It's staffed by real doctors rather than whatever they have at CVS minute clinics (RNs I think).

Almost forgot. Be careful with UCs associated with actual hospitals. We went to one once and they decided to bill it through as an ER visit. Took about a year to fix that mess.

I think the only ER/UC places we can go to ARE the hospital ones (barring ambulance trips which would be to our nearest hospital apparently). But then the insurance comes from the wife who is an RN in said hospital!

If you suffer from a chronic condition and you need that prescription in order to stay alive, it most certainly is an emergency if you're running out and haven't been able to get hold of your GP.

I agree. There are a lot of things wrong, but with good insurance it is just like you described.
I got pretty sick back in 2005 shortly after the birth of my daughter. Even with no insurance I received very good care. When going to the doctor and surgeon appointment I simply checked the box that said I had applied for financial assistance through the hospital, and I never had to pay.
My husband got a new job, and we have very good insurance now. Low co pays and we pay 70 dollars a week into it.
In regards to the article where the man ended up bent over in the snow hacking due to a lung infection, why was he going to a plastic surgeon in the first place? He had been here in the US for how long and had never sought out a general physician? If he had seen a general physician and it was out of network, he would have been seen, just paid the out of network costs.
My children get state insurance to cover what our employee insurance doesn't, but still I do not take them to the doctor much. The doctors here love to hand out antibiotics as if it is a cure all. My mother who is a registered nurse working in the intensive care unit of a local hospital goes to the doctor for every cold, flu, and cough. Every time she comes away with a prescription for an antibiotic. I will catch her cold or flu and she will pester me to go to the doctor. No thank you, I do not need antibiotics to get over a virus.

All that said the US needs to work on it's healthcare. It is far too expensive, and people are denied care for lack of insurance. It isn't fair that people who get jobs with good insurance, and the financially well off get good care, while those working in jobs without insurance, and can't afford it are denied care. It is unacceptable for a country such as this to allow certain people to suffer.

Back to the topic of US Healthcare being a "pain in the arse."

My wife and I were shopping in the local Weis Market and the checkout clerk told us that when the ACA went into effect she lost her health coverage at Weis because they dropped her hours from 40 to 25. She had to take a second job at WalMart, also for only 25 hours per week, also without coverage there. So she's working 50 hours a week, but has to pay $300.00 per month for her subsidized health plan. So she has to work an extra 40 hours per month for a net increase of $100.00 income. Also, her Bronze Plan now has a $5,000 deductible, before the plan starts covering 60% of her health expenses. For all intents and purposes, this single 45 year old woman has no health coverage since she cannot afford the first $5,000 of medical expenses and can therefore not afford to be sick. Before Obamacare she says Weis had a good plan, she was happy with it and had used it. I didn't have the heart to ask her whether or not she voted for Obama.

How does this compare with NHS coverage for a 45 year-old woman in similar circumstances?

So prior to the ACA, this employer was happy to provide this full-time employee with health insurance. But post ACA they chose to make her part time so as to avoid providing her (and presumably other employees) with... health insurance. I'll hazard a guess that either (i) the employer is disingenuously blaming the ACA for its cost-cutting; or (ii) the pre-ACA insurance it provided was rather "lacking". Even if Weiss's insurance costs had increased, they could have chosen to provide insurance and got employees to pick up more of the tab.

Here's a description of Weiss's plans in the first year of the ACA for those still able to receive them:

https://www.capbluecross.com/wps/wcm...df?MOD=AJPERES

It even acknowledges that the rate of increase of health costs has slowed. This makes me suspect that (i) is what is happening here.

In all likelihood Weis Market was taking advantage of the option of dropping its employees to part-time status, dropping their plans and paying the less-expensive penalty. In other words, they were rationally doing what was best for the employer, not the employee - and the law made it perfectly clear that this was OK.

Blame the law for providing the loophole, or blame the employer for legally saving money. Your choice. But that poor woman was screwed. Was this really an unintended consequence? Again, how does it work in the UK?

How does it work in the UK? Healthcare provision is free at the point of delivery.

Huh? They did nothing they couldn't also have done prior to the ACA. So blaming the ACA for this is merely attempting to shift the blame for Weis Markets' own cost-cutting. As I said, pretty disingenuous on their part.

That poor woman was "screwed" by her employer.

You're missing the point. This wasn't a criticism of the ACA, but rather of the way the system is now set up in the US. Whether the system was better before or after isn't the issue.

Nothing is disingenuous on Weis Market's part - they would be negligent to their stockholders if they didn't take advantage of the law as it was written. Yes, the woman is screwed, on that we are in agreement.

As for the NHS, agreed it is free at the point of delivery. But how is it funded, and is it underfunded? I know the system in Germany is underfunded, as my sister is married to a German doctor and he has explained their system in detail to me. Canada is a mishmash of provincial health systems rather than a unified national plan.

My own take is that the liberals were probably right, that the system should have been set up as single payer, rather than a hodge podge of employer plans and individual plans, with sometimes huge deductibles. The service is world class, payment for it isn't.