There are HMOs, like Kaiser, that solve most of these problems. Unless I'm traveling, I would never have to worry about such extraneous bills. However, for any particular serious condition a particular HMO might not have the top-rated team in the country. This unreasonable fear is used by non-HMO insurance networks to draw customers.

Perhaps what we need is something like the WTO's most-favored-nation rule for domestic insurers, but imposed statutorily. If you're treating an out-of-network patient extemporaneously, you can only charge that person's insurer at the lowest rate you'd charge an in-network provider.

This would remove the incentive for out-of-network providers to eagerly provide many services. That has its own downsides, of course, but it might help to resolve many of these billing nightmares.

But, heck, maybe something like that already exists. Obamacare (aka ACA) comprehensively thought through many of these dilemmas. But enforcement has been gutted by the GOP.

In 99% of cases, you don't need or want cutting edge care— you need basic, efficient, timely care. The rest of the world manages to deliver that as a basic human right.

Yes .. but. Canada is often pointed at by Americans as an example of a functioning healthcare system. I can tell you we have many problems, but they are different. It might mean long queues for basic diagnostics/assessments/procedures, facilities that look ugly, excessive waits in the ER, and still paying an arm and a leg for medication. I have heard of great experiences in Canada but also pretty terrible ones.

I'm a Canadian too. Maybe I've just been lucky, but when I or anyone in my family has needed urgent care, I've never felt like I had to wait excessive amounts of time for it.

As far as whether facilities could be "nicer", I mean... maybe? I actually kind of prefer healthcare to be like schools in this way— if I don't think it's nice enough for me, then I need to lobby the province to collect more taxes and make it nicer for everyone rather than just taking my dollars elsewhere.

And that doesn't even address the whole billing-surprise angle. I would happily wait forever if the alternative was not knowing if I was going to randomly be stuck with a $10M bill.

> Canada is often pointed at by Americans as an example of a functioning healthcare system.

To be fair, Americans have a very low standard for “functioning healthcare system” due to the American healthcare system.