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mygif

You should be writing the fucking legion!

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mygif

I’m fairly sure that the reason many Germans want to scrap their health care system and build something new has nothing to do with quality or availability of health care. Because really, it’s excellent. The problem is that the German system is leaking money like crazy, and piecemeal reforms hasn’t got it under control.
I’m Swedish, myself, so I could be wrong. Any Germans out there are invited to correct me.

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mygif

Hell, you should write a Dr. Gym’ll miniseries at least.

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mygif

I’m a Canadian married to an American living in the UK. The British *love* to complain about the National Health Service, but when I start telling them about my wife’s adventures as an uninsured person in America, they all start shutting up. And when I tell them how much prescriptions cost in North America, compared to the £7.20 every single prescription costs in England, they finish shutting up. (Wales doesn’t pay anything, and Scotland and Northern Ireland will also be charge free in the next couple of years). The NHS has a lot of issues, but there is no way in Hell I would want to go back to living in the American system, even if I did have health care when I lived there.

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Chris Russell said on August 3rd, 2009 at 10:00 am

Point of order: your point about sample size is incorrect. For a population of roughly 310 million, a sample size of less than 3500 generally falls within accepted boundaries. Your margin of error would be ~1.7% with 95% confidence. 2600 people in Canada is about the same.

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mygif

The British love to complain about everything, dont mistake that for contempt of anything on our part. The national health service is more of a beloved national institution here than the monarchy, maybe more than Steven Fry.

We will always complain about its flaws and waste, but we’d abhor any party who seriously suggested a privatised system to replace it. Its quintessentially British, like bowler hats and sending gunboats to colonies.

When I first did my travelling as a young man I had no idea emergency healthcare had a cost attached to it, when I had my australian girlfriend staying with me in England she started getting really sick while I was at work and when I got back she wanted me to get her in a taxi and take her to A&E. I asked her why she didnt just call an ambulance if she was this bad and she said she didnt have the money to pay for ambulances. The mind boggles.

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mygif

I heard Obama’s new plan was going to take my 70 year old grandmother out back and put two in her brain pan.

When you assassinate your elderly in Canada, do you herd them into concentration camps and gas them, send roving death squads door to door and leave the bodies where they fall, or do you go with the Soylent Green approach?

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mygif

The biggest problem, as I see it, is that the politicians here in America are more interested in perusing their party’s interests and screwing each other over as opposed to doing what’s right for the people they represent- to the point of ridiculousness. The media then follows behind and chooses sides or sensationalizes it as much as possible- it doesn’t matter how fuggin stupid the shit that comes out of the politicians mouths are.

From there mob mentality takes over with much of the American public because they only know what they’re told by their news outlet of choice- and God forbid that be someone like Fox news that couldn’t report a story straight up if it killed them. I swear they’re like the drunks at a bar that tell the same story every night but it changes and gets more outrageous each time they tell it. “President Obama isn’t an American! In fact he’s a Muslim alien from the Alpha Centari star system here to take all our women and inject them with his alien spawn under the clever guise of a national health care system. It will be the end of our civilization, and we’ve got an ‘expert’ to tell you why!”

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Katzedecimal said on August 3rd, 2009 at 11:24 am

@Zifnab:
Good heavens, what a barbaric way to treat your cherished grandparents! Heavens no! We Canadians house our honoured seniors in retirement homes, make them happy with morphine then give them flu shots and let them pass away of the resulting pneumonia. It’s much more civilised. *removes tongue from cheek*

I also like how these ‘studies’ all give the idea that Canadian healthcare programs are the same, province to province, when the authors clearly know that they’re not, because an experienced Canadian can spot which province they’re cherry-picking their data from. “Only in Ontario, dude.. no, that’s just in BC… Alright, that’s Alberta but completely the opposite in Manitoba..”

All I know for sure is two things: 1) I wouldn’t be here now if not for my health care system, because I was way too poor to pay for the operations that gave me my life back (one month’s wait seemed like a fair trade-off for me, considering how long I’d been suffering already), and 2) I am now considered a very high insurance risk by American health care insurers, but still welcomed for care in my province. My health care taxes are taxes that I don’t mind paying, because I know they’ll come back to me when I need it.

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mygif

I don’t see how anyone who can count above ten with their shoes on can possibly think the US health care system is a shining light. I haven’t even had any unusually bad issues, just the normal experience, and that’s plenty wretched enough. My “covered” physical therapy for my bad knee still cost me several hundred bucks. I generally have to schedule any routine appointments 2-3 months in advance, which is not a big deal, but if you call up because something has actually gone wrong with your bod, you often STILL can’t get a date for a week or two. Bah.

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mygif

Regarding point 10 (medical innovation) here’s a founder of RedState (super conservative blog) talking about where medical innovations actually come from – http://newledger.com/2009/07/how-medical-breakthroughs-happen-a-response-to-megan-mcardle/

The nickel summary is the government funds them through grants to universities.

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CandidGamera said on August 3rd, 2009 at 11:27 am

Bravo, Zifnab. Bravo.

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Gustopher said on August 3rd, 2009 at 11:47 am

MGK: “I speak for just about all Canadians when I say that this is one of the things that really pisses me off about Americans (who are generally quite a decent bunch, all things considered), because the root assumption Americans make when they say that Canadians have shit healthcare and die waiting in line and so forth is that we are a nation of idiots who don’t know any better, considering that we live right next door to the capitalist paradise that is American health care.”

So, you’re saying that the United States is a nation of idiots who don’t know any better, with 40 million uninsured, and countless more underinsured, who don’t have access to the best health care money can buy because they don’t have the money, all while living right next door to the perfectly functional and better for the majority of people socialist health care system right next door?

Sigh. That’s all true.

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Lister Sage said on August 3rd, 2009 at 11:59 am

Zifnab: I’d rather the government do it now then you or I when she comes back as a zombie.

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mygif

Sure, but do you Canadians have a sexy “Night Nurse” to secretly tend Daredevil’s many injuries? Huh? Do ya? Huh?

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mygif

OK, I have a serious question. By which I mean, I’m asking for information.

Years ago, when reading up on the topic, I read an article that basically said that it was the Canadian ability to purchase US excess capacity for health care, that allowed the Canadian system to function.

Meaning that it was expensive as heck to build a healthcare system that covers 100% of everyone, since things like hospitals and such come in inconvenient units. So you would either overbuild, or underbuild and cover the balance of services another way.

Given that such a large percentage of the Canadian population lives closer to the US border (said the article), it was cheaper for Canada to slightly under-resource and purchase any remaining balance of services from the US.

If the US system shifted immediately to the Canadian system, it would profoundly and adversely affect the Canadian system: said the article, which also talked about the US cost of building a system that covered 100% of the US requirements, since it would not have the ability to outsource under-built areas of service.

The serious question: how much of that theory is utter BS? Or worse, how true? I have no idea, but the thought’s been stuck in my head since the early 90s, when the US debated what is now known as HilaryCare.

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ps238principal said on August 3rd, 2009 at 12:44 pm

At the end of point #2, it reads: “Oh, and our system covers half of what yours does and we cover everybody.”

You might wanna amend that to “costs half” before someone like Bill O’Reilly quotes you. :)

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mygif

All I know for sure is two things: 1) I wouldn’t be here now if not for my health care system, because I was way too poor to pay for the operations that gave me my life back (one month’s wait seemed like a fair trade-off for me, considering how long I’d been suffering already), and 2) I am now considered a very high insurance risk by American health care insurers, but still welcomed for care in my province. My health care taxes are taxes that I don’t mind paying, because I know they’ll come back to me when I need it.

Hey, I am under no delusions that if Medicare didn’t exist, insurance companies would have a blanket “drop’m when they hit 65″ policy anyway.

And I don’t mind paying taxes either. I just like to get a return on my investment. Right now, the 25% I kick back to Uncle Sam plus the 6.5% for Social Security plus the 1.2% for Medicare (plus the 8% I give to my state in sales taxes and the uncalculated sum I pay in property taxes, plus vehicle licensing and other unmentionables) give me a very marginal return at best.

I get roads, I get some basic public services, and I get entertaining CNN coverage of our fighting men and women in Iraq and Afghanistan. But education in my state has been in decline for over a decade, the roads I’ve got are getting increasingly converted to tolls, and the War on Some Drugs for Some People hasn’t really benefited me one way or another as far as I can tell.

I already drop another 15% of my income on private health care coverage anyway, so if the government wanted to give me the same rate for coverage that I wasn’t afraid would get yanked on me the moment I actually needed it, I would be all for that proposal.

It’s not nearly as much about the taxes as it is about the perceived return. Under Bush, the way I see it, I might have received a marginally lower tax rate, but for the taxes I did pay in, I feel like I was absolutely robbed. Under Obama, I don’t mind paying higher taxes for higher quality of government.

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mygif

Randy B has it right as far as the debate over health care goes. Republicans tend to represent the wealthy and the Southerners, two groups that tend to represent the “fuck poor people, they don’t deserve my taxes” mentality despite many Southerners being, you know, poor. They don’t actually care about making sure the government keeps their hands out of your pockets, but they do care about getting re-elected.

Democrats, meanwhile, are being fairly labeled socialists. Only, the word socialism has such a negative connotation here in America, that they are denying it at all costs. They don’t care about the poor people either, but since poor people and black people (the two biggest uninsured groups) typically vote Democrat, yay for re-election.

The best and most logical step towards a system of socialized medicine (one that can actually crack the Top 15 or 20 in the WHO rankings) is to introduce a hybrid plan. The gov’t takes a health tax from the wealthiest 5% to pay for the public option. If you don’t want the government option, pay for a HMO or PPO with your own money. Over time, Americans will gradually come over to the public option once they see it costs less, it won’t bail on you when you actually need it, and it covers all human beings living in America.

The issue with simply saying, “Turn your health care over to the government,” is that we Americans don’t like people telling us what to do. It’s our motto.

Oh and I call bullshit on the ignorant argument that the government runs the DMV and Post Office poorly. Last time I checked, I could send an envelope for half the cost via USPS as opposed to FedEx or UPS. And the DMV works fine, people just don’t like waiting in line.

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Tenken347 said on August 3rd, 2009 at 1:16 pm

Right now, my wife works at a hospital, and hospital-provided insurance is the bitchinest insurance there is. Before that, we were both poor enough to use state-funded health care services (one of America’s best-kept secrets: we already have socialized health care. Go find a low-income clinic, and you’ll see that they offer free or reduced-price services for those who qualify. Sadly, a lot of the people who could really benefit from these services never find out about them, and wind up either denying themselves treatment or bankrupting themselves trying to pay for it. Moral of this story – always do your homework). I think Darren K really hit the nail on the head as far as the worst part of the US health care system, though – the price of prescription drugs. The pharmaceutical companies are reaming us on the price, and the government really ought to be doing something to prevent it. Unfortunately, this is one that can be blamed in large part on the Democrats, as one of the compromises that came out of Hilary’s failed health care reforms was allowing the drug companies a lot more leeway with their business practices. It was supposed to help people.

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Lister Sage said on August 3rd, 2009 at 1:57 pm

Tenken347: The moral of this story is never trust a businessman.

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mygif

Years ago, when reading up on the topic, I read an article that basically said that it was the Canadian ability to purchase US excess capacity for health care, that allowed the Canadian system to function.

“While the argument about Canadians flooding south to get medical care withheld from them up north is widely heard, it’s bullshit. Yup, lots of Canadians get care in the US, but that’s because, due to the better weather, the higher incomes, going to college or that NAFTA thing, they eitherlive here, or are on vacation in Florida to escape that terrible winter. Work done by a team led by Steve Katz at University of Michigan with the Evans/Barer/Cardiff team at UBC which looked into this in obsessive detail found essentially no evidence of Canadians crossing the border to get care.”

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Llelldorin said on August 3rd, 2009 at 2:29 pm

Randy B, that’s about half right. We have two problems:

(1) The Republicans are exactly as you describe

(2) The Democrats are effectively 2-3 parties that mutually hate each other, but all which are terrified of Republican rule if they separate. They’re basically what Canadians would get if you took a little bit of glue and loosely combined the Grits, the NDP, and a handful of Tories into something that externally resembles a political party.

Unfortunately, this means that it’s hard to get coherent policy together, because the party doesn’t really agree on any set of principles. There are Democrats who want to scrap the system and build an American NHS, and others who just want to mildly tinker with the existing system. This makes it really hard for the Dems to make a push for health care, particularly when the Republicans are shouting in unison. (Granted, what they’re shouting is usually along the lines of IA! IA! CTHULHU FH’TAGN, but the Dems usually manage enough incoherence that “reviving the dark lords of chaos” sounds like a nice, sensible plan by comparison.)

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Lister Sage said on August 3rd, 2009 at 2:51 pm

Llelldorin: I’m sorry but there’s no way that Republicans would worship Cthulhu. He’s just not evil enough.

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mygif
Sofa King said on August 3rd, 2009 at 3:57 pm

I disagree with you, Chris Bird.

Statins are not, and have never been, delicious.

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mygif

Thank you for the link. I’m not sure that it answered my question, because while he dismissed the idea, later he talked about lots of Canadians fleeing to America for care as well as “Just as Canada takes advantage of America’s over abundance of facilities to buy high-tech services for its patients on the margin (usually before it later adopts them in its own facilities) it also does the same for doctors who want to work in highly-specialized cutting edge technology areas.”

But I think I asked my question badly, because the answer in that article was about Canadian’s jumping the line by purchasing expensive services in the US out of impatience – I rather expected that number would be low. I mean, free is cheaper than not-free, in medical care by a LOT.

But what I was asking about was whether the Canadian system itself would refer patients Down South, and pay for it, rather than overbuilding facilities or overhiring doctors.

Consider this lame case: a doctor can serve 100 patients a week, at a cost of $150,000 a year. But if the 101st patient comes along, it costs another $150,000 a year, just for them, to hire a second doctor. In that case, it would make sense to send them (expensively) to the US for care. (End of lame case.)

That’s what I was wondering. Is it part of the success of the Canadian system that it can purchase excess capacity from the US system for the US market price, and does it do so? If the US went for a purely Canadian system (which would do some a lot of harm, and most a lot of good) – would that adversely impact both systems because there is no convenient place to purchase excess capacity?

Thanks for reading ANOTHER question (or the same question twice, if I misunderstood your answer).

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mygif

Y’know, I got polled the other day on healthcare…mainly focusing on if I think kids should be covered….and while they asked if I had Health Care and if it was private or public etc, they didn’t ask if I was satisfied with it.

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mygif

Ahem. Anyway, the list of things “egregiously twisted out of shape, or even outright made up” by politicians and theoretically-journalists in the United States about the Canadian health care system is fucking legion. It never seems to goddamn end, and let me tell you: as a Canadian, I speak for just about all Canadians when I say that this is one of the things that really pisses me off about Americans (who are generally quite a decent bunch, all things considered), because the root assumption Americans make when they say that Canadians have shit healthcare and die waiting in line and so forth is that we are a nation of idiots who don’t know any better, considering that we live right next door to the capitalist paradise that is American health care. That this sometimes comes out of ignorance makes it no less rude.

Most of the people who get the things wrong are either doing it intentional or their own presumptions about finances and gov’t action make them imagine the worst.

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mygif

Oh, but to be ensured health care! I’m absolutely incapable of buying insurance on the private market. Nothing like a couple of easily managed pre-existing conditions to ensure you will be fucked.

My back up plan, should I lose my job and coverage, is a shot gun marriage to somebody with insurance. I wish this was a joke.

Either that, or to finish the paperwork and move to Canada….

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mygif

I agree with a lot of what you said, but not the part about statins. I think most people would be better off without them.

Cheers!

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mygif

Yes, I have questions. Until quite recently, most health insurance companies didn’t cover mental health at all or did it in a very limited way. I think more people are covered now but it’s not as good as physical health. How does the Canadian system cover mental health issues?

I have kind of the trifecta – mental illness, physical illness, and expensive prescriptions, all of which is darn hard to pay for. It’s a big issue for me, because I don’t think I can pay for both healthcare and rent.

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mygif

Rebecca, part of the thing you have to realize with the “Canadian” system is that we run our healthcare by province, and mental health is a good example. I was diagnosed with Asperger’s a few years ago, and in BC, where I live, you get $5000 a year that goes to help you overcome your disability(In my case, it bought a laptop to help with schooling, and a lifeskills coach. Do note that, I only got the laptop because the disability hindered my ability to do well in class and I had to get doctors permission to spend the money on it so the government didn’t try to make me pay them back for the laptop I spent their money on, they don’t just give you free money with no limitations). However, besides the fact that $5000 is not a lot of money for psychiatric help, it expires at 18. Now, if I lived in Alberta, I would get 100% coverage on anything to help me overcome my mental disability(Though Im not sure if or when said said coverage expires in alberta). Also, though its not mandatory, we also have extended healthcare plans offered by employers. Mine covers a percentage of any dental work, as well as any prescription only costs me $3. If its a bottle of $20 prescription drugs, its $3. If its a $500 prescription drug, it costs $3. (I will admit, being an electrician, my company has to compete with the union workers so I don’t leave them to join the union, so its a pretty damn good extended benefits package) Anyway, I rambled on too long, but basically its not completely universal everywhere in canada, but there is of course the basic “you dont get fucked in the ass for things that arent your fault”.

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mygif

@Llelldorin
I loled.

I’m pretty much fed up with the party system all together because it just doesn’t seem work very well- then again there’s not much about our current democratic process that works as effectively as it probably should. (Why is the electoral college a good idea again? If the people’s vote is really supposed to matter, why not just go by the popular?) That’s not to say I have a perfect solution or anything, just all the posturing, bullshitting, and gladhanding makes me want to go up there and personally knock sense into every one of them. There’s so many people struggling and suffering right now while the rich S.O.B.’s that will never have to face a lot of the issues they’re debating about are more concerned with pushing their own agenda than trying to help.

There should be a “fuck politics” Amendment to the constitution where during times that are considered a national crisis any government representative that offers up debate, ideas, or commentary that isn’t constructive will be cock-punched (or an appropriate equivalent for our female representatives) by a designated “disciplinarian”- which will be chosen at random like jury duty. :-p

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mygif

I have a few American friends online and it’s always a touchy issue when talking about universal healthcare as most of them are fairly liberal. When it’s brough up it’s always seen by them a socialist action.

I talk about Aussie healthcare (which is far from perfection and the Medicare system here has it’s own set of problems) but I just try to explain that when I’m sick, I can go to the doctor and not pay a ridiculous amount on money for treatment. Which I think is pretty cool.

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Peztopiary said on August 4th, 2009 at 6:38 am

But the encyclopedia Britannica? Are you in debt/hock to that then? Even my auto spell check, (site provided and much appreciated) knows how to spell it! We aren’t living five hundred years ago. Wikipedia, anything but an authoritative source. Which might be the problem. We buy into the squid on the chessboard, swarm of bees, fucking hope, we do. Capitalism sells hope, which means you can steal it. Why are you talking in archaisms? If you can not argue your point in pretty language it matters little how correct you are. We our your neighbours, or neighbors, depending. If you can not talk to us, then what is the point of talking? (Well aside from being correct.)

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mygif

Bender- that’s funny. It’s usually conservatives who are against universal health care in the US.

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mygif

I almost ripped a couple friends of mine today on the health care issue. I’m currently uninsured. I moved, am starting my own business, and had an issue with my COBRA carry over. So for now, no coverage.

I think part of the issue is that many Americans really don’t get just how expensive health care is. If you have even basic insurance coverage, your perspective of cost is blunted. People don’t think about the problem of pre-existing conditions, they don’t think about losing a job and being unable to keep up with insane COBRA payments. The perception is, if you have no insurance you are doing something wrong.

It’s not helped by the fact that Medicare/Medicade are “old or poor people” coverage. Reality or not, that’s the perception. America has no history of effective state run services. We have no frame of reference, and no structure to help support that type of transition. The attempts to improve health care have resulted in this horrific patchwork system that is periodically used as proof that national health care can’t work.

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mygif

@NoOne USA does have federal disability benefits but they only apply to people who don’t work fulltime and make less than $980 a month.

I spend about $340 for 90 day supply of antidepressants (they’re generics), $90 a session for therapy (once every week or every two weeks), and more for psychiatric/pdoc appointments for stuff relating to medication. That’s with health insurance. I don’t believe any health insurance company would pay for the cost of a laptop or a life coach no matter the circumstances, really.

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mygif

@No One: Why do you say $5000 is not a lot for psychiatric help? I know we’re talking Canadian money here but if I got $5000 a year, damn.

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mygif

@Rebecca – In Nova Scotia (that’s in Canada in case you were wondering), all forms of mental health is fully covered. Prescription costs are usually covered under your basic insurance up to certain percentages (say you pay 10% or about $10-20 per pickup, depending on your coverage).

The problem with it in our province is that we are seriously understaffed for mental health care everywhere except in Halifax (the only “large” city in Nova Scotia) and even they have difficulties with staffing for that area of health care.

If you have immediate problems, bam, you get help no sweat and, depending on severity, could be hospitilized with regular sessions or what have you. Once you’ve been “stablized” (for lack of better word), you’re relegated to 1-2 month waits for 10-15 minute sessions with your psychiatrist and can also schedule free meetings with social workers if you have need to talk things out (some only need pills, others with psych trauma may need a social worker, etc).

There are also private options for mental health problems and some insurance or jobs cover that. Private social workers/psychiatrists can be seen for anywhere from $100-200/hour or more, but have zero wait times and you get in just about any time you want with zero waiting room time (standard waiting room for mental health issues is a hour past your “appointment”).

However, in general, once you see your psychiatrist, it’s quality care. Just extremely backed up and can be troubling if medicines aren’t working and you are switching between different meds to find the proper balance. If there’s adverse side affects, you can obvously call and make an appointment and get in relatively quickly, but generally, you will be waiting for your next appointment unless in serious condition.

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mygif

@Kirk Warren

Interesting! I had similar problems finding a psychiatrist in Tennessee – that’s in the US in case you were wondering. ;) I ended up waiting seven months, I think, before I saw one. There’s simply not enough psychiatrists practicing. I think the requirements are too stringent or something. The social worker rate is about the same in America too, depending on their education and experience of course.

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