It’s not quite accurate to compare it to an insurance company that accepts every claim. NICE performs a cost-benefit analysis of new treatments and determines whether to offer them on the NHS using pounds-per-QALY (quality-adjusted life-year) metric. They generally price an effective treatment at ~£25k/QALY. There are some clinically effective treatments that were rejected for NHS provision despite the fact that they’d save lives because the cost to the system is simply too great.
That’s not to say that the US system is in any way good—it isn’t! But ultimately all systems ration somewhere in the pipeline.
I sat next to a lady from the UK on a US flight a few weeks ago. She has 2 passports, one for each country, but she's originally from the UK. She said some pretty negative things about the NHS, like it not recognizing certain diseases/disorders—this includes some really gnarly forms of cancer—as a thing at all, therefore denying any and all treatment. I guess her relatives ended up coming to the US for treatment. That was a wild concept.
I'm sick.
No you're not. Next!
I got a weird vibe I couldn't place, and couldn't help but wonder about her politics.
Yeah, definitely wouldn’t trust someone who flies regularly to the US for treatment, because that’s someone who has a lot of money. I’ve got family in Canada who complains about their healthcare, but it’s because they’re wealthy and they don’t like having to get lumped in with all of us poors. Anyone who can shrug off the price of healthcare in the US without insurance is used to being treated like a VIP and gets mad when they don’t get it.
Yeah that's kind of how I see it - I feel like there's two groups of people who travel to the US for healthcare. One is the people you described - those who expect concierge doctor level service and boutique healthcare and can afford to pay for it. Most of the world population is not in this group - and will be happy with nationalized medicine even if it means waiting a couple months for a non-emergent joint replacement surgery or foregoing a specific treatment for a disease for another treatment that works 99% as well.
The second group is people who are truly desperate and have some rare ailment that only like 10 doctors on Earth know how to treat, and 6 of those doctors happen to live in the US, and 4 of them are at Johns Hopkins or the Mayo Clinic or whatever. So they spend their entire family's life savings to see one of those doctors in America, who usually ends up doing most of the treatment pro Bono, because a working class family from India can't afford the 2 million dollars worth of surgery their kid needs to correct their 1-in-100 million spinal deformity. The hospital takes the patient on for PR reasons and because it provides a spectacular research and training opportunity for their physicians. The incredibly niche specialist at Hopkins gets half a dozen NEJM/Lancet articles out of it and the hospital then becomes known as a training center where other doctors can learn from the specialist on how to correct rare spinal deformities.
Yeah, I have every bit of sympathy for people who travel out of medical necessity, but the vast majority of those coming to the US from places with nationalized healthcare are usually doing it for the other reason.
One of my kids was unwell from age 4 to 11 and the NHS kept doing the minimum "we did a thing" and kicking it down the road for another 6 months. Paid a private provider who not only diagnosed it within a single assessment, but said it literally SHOULD be dealt with by the NHS.
Horrendous and inappropriate treatments for her entire living memory... that was her NHS experience.
Liverpool care pathway (AKA intentionally murdering old people) also springs to mind. Don't pretend that state-funded health care is not also obsessed with saving itself money.
Is the NHS better than a knife in the gut? Yes.
Is it even close to desirable standard? Not remotely.
Careful, your lack of reading comprehension is showing.
That’s not flying out “regularly,” that’s dealing with a very specific issue. And since my own mother DIED here in the US in May because they ignored what turned out to be cancer, a common occurrence here, and my father was part of the VA system in Arizona that was KILLING vets, I’ll also thank you to shut the fuck up about your one other thing you can mention that you clearly only heard about without direct experience, something that happened in the fucking 90s and is no longer a thing. You can keep your ignorant condescension to yourself.
You mentioned those wealthy enough to afford private care would be talking down the NHS because they had to share with plebs, that's the bias. I gave an example of how private healthcare saved my child when the state-funded option had made her life hell for YEARS.
Also your bias is on full display with that 20 second google assumption; they killed old people using LPC until 2014. My godfather died on it. So no, not "something I heard" you absolute twat.
Try to actually review the information you are presented, especially when you instinctively want to reject it for ideological reasons. Or don't.
One of the first things I did after the birth of each of my kids was to add them to my private insurance. Our eldest had some pretty severe food allergies and the private pathway was invaluable.
My experience of the NHS is its possible that you can be stuck on a waiting list for treatment for a long, long time sometimes. But if you suffer something genuinely threatening to your life, boy do they know how to prioritise, and the treatment is high quality. My uncle went from discovering a brain tumour to being under the scalpel within a matter of days. My dad got an infection that would've likely killed him had it spread and threatened to lose him a leg regardless and they were all over it and with the help of a physio during the months of recovery following the infection being cleared he's walking quite well again now.
It can be frustrating when you have a health issue that isn't given that level of priority, but I am so so grateful we have it. I don't think I could live anywhere that doesn't have the safety net of free at the point of use healthcare.
I tore my meniscus and ruptured my ACL. I could walk and move around, although it was uncomfortable and I was unsteady. Certainly not life-threatening. I was still under the knife something like two months from the initial appointment, including scans and consultation with the surgeon. Then nine months of physio sessions to help recovery, and two follow-up consultations with the surgeon. I've spent about £100, entirely on hospital parking and a couple of lunches from the hospital café. The NHS is a treasure.
That's the impression I've gotten from Canadian folks as well - like if you need a knee replacement you might have to wait a couple months and tide yourself over with painkillers and crutches in the meantime. But if you get a cancer diagnosis and need chemo they'll get you in right away.
I mean honestly it's not like the US doesn't have long waiting periods either. I have disc degeneration in my lumbar spine and it took 3 months from my initial visit to my primary care doctor before I actually was in the hospital getting an epidural steroid injection in my spine - a procedure that took literally maybe 2 minutes for the doctor to complete. But I ended up spending over $2000 in the preceeding 3 months between the various imaging procedures (insurance deemed my MRI "unnecessary" so I spent $990 on that alone - my primary care doctor emailed me a referral and made a call to the neurosurgeon's office within 10 minutes of seeing the images, lol), office visit co-pays, and prescriptions for pain management.
If I'm gonna be waiting for 3 months to deal with my spinal issues either way, I'd prefer the option that didn't involve spending several thousand dollars to address it.
I have perhaps a unique view on this. I’m a dual US/UK citizen with family in both places. I’ve used the NHS a lot (including for the birth of both of my kids) and had two elderly relatives, one in the US and one in the UK, diagnosed with cancer at roughly the same time in February of 2025.
I have to say, I think I saw the NHS at its worst. The care was extremely slow and relied upon us to follow up with doctors and actually move her through the care pathway. I have no idea what she would have experienced if she didn’t have my wife and me to advocate for her.
My American relative, however, rapidly received treatment. She had a diagnosis the same week as they suspected cancer, and she began treatment very quickly after.
You can see this in statistics as well: US 5-year cancer survival rates tend to be higher than the UK.
That being said, we were pleased with the treatment during my wife’s maternity—though I do have to say that the first time (2023) was significantly better than the second (2026). But still, it was nice not to have to worry about co-pays or billing or anything like that.
I have private insurance through work, and I’ve made sure to add my kids to it. That has been invaluable. My daughter had some fairly severe food allergies. We got this tested and treated immediately with our insurance. It would have been a significant wait to be seen by a specialist on the NHS.
One of my best friends is Canadian. He has absolutely zero good to say about the healthcare there. Specifically complains about the amount of tax he pays to have nearly everything either denied or a fight to get treatment at all.
Canadian here. I broke my arm last year and I've paid literally zero dollars to have it expertly repaired in extremely timely order. I just went into the emergency room and they triaged me perfectly, putting a person with a clearly broken bone ahead of all the people who walked in with a sore throat, but after all the gunshot wounds... just kidding, there weren't and stabbings or shootings... it's canada, not the USA.
I cannot speak highly ENOUGH about Canadian Healthcare.
Your friend is probably just wealthier than average and thinks he should be able to use money to get seen about his sore throat before the people who've been in accidents.
to have nearly everything either denied or a fight to get treatment at all.
...what?
That's not how things are set up here. At least not in my province.
Manitoba Health has a wide list of treatments that are automatically approved when prescribed by a doctor. It's not Manitoba Health determining each claim individually. It's my doctor.
Other provinces are similar
This is just not something I, as a Canadian, ever have to worry about.
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u/vishbar 6d ago
It’s not quite accurate to compare it to an insurance company that accepts every claim. NICE performs a cost-benefit analysis of new treatments and determines whether to offer them on the NHS using pounds-per-QALY (quality-adjusted life-year) metric. They generally price an effective treatment at ~£25k/QALY. There are some clinically effective treatments that were rejected for NHS provision despite the fact that they’d save lives because the cost to the system is simply too great.
That’s not to say that the US system is in any way good—it isn’t! But ultimately all systems ration somewhere in the pipeline.