Not really, no.
We don’t "register’ with a doctor (but I’ve had Americans INSIST that I am assigned a doctor by the government, and I must not know what I’m talking about!).
We can pick whatever GP we like (if they are accepting patients into their practice). They are mostly self-employed professionals paid on a fee for service basis (not by the number of patients). There are some salaried doctors, but they’re generally not GP’s
And as I wrote in my previous post, you shouldn’t only compare the US system with the British/Canadian ones, which are precisely the public healthcare systems known for the “waiting list” issue. For instance, in the link previously provided by another poster, this is mentionned in the “concerns” list for the UK system, but not
for the German, Japanese, Swiss, etc… systems.
If I’m not mistaken about the Canadian/British system, I suspect that this issue might be due to the fact that 1) it seems it’s difficult there to find another doctor covered by the public healthcare sysem if you’re unhappy with the one treating you 2) Those doctors are paid on the basis of the number of patients they have, and not on the basis of the care they actually provide. This might cause a lack of incentive to actually provide said care in a timely manner. This is just a guess, and I might be completely off base. It could simply be due to an insuficient funding of the public hospitals, for instance. In which case, it could probably be solved by spending more than the UK currently do, but in all likehood probably less than what is spent in the USA.
While I think about it, redundancy (which is the problem opposite to the rationning we’re talking about) is sometimes mentionned as one of the reasons of the higher cost of healthcare in the USA. The idea being that the usual large hospital being a private for-profit entity with concurrents, it will tend to have more specialized teams, or equipments, than necessary. Teams and equipments that will have to be paid for by the patients either by unecessary procedures or by higher bills. While when the usual large hospital is public, you’ll be instead sent to another hospital with the specialized team/equipment you need.
I’m mentionning this in particular because it’s one of the reasons why I’m warry of private hospitals here. Twice, a (diffrent) medical practitionner (I suspect with interests in a particular hospital) wanted to send me to a specific private hospital for a specific procedure. Both times, it turned out, after seeing another doctor in one case, consulting in a public hospital in the other, that the procedure was not only not warranted but even harmful. Note that in both cases it was minor procedures, but you can understand that it makes me warry of private hospitals. I can’t help but think that, had it been serious, those unscrupulous doctors/private hospital shareholders could have frightened me into undertaking an unecessary and even possibly dangerous procedure to make a buck.
Note that in an universal health care system, everybody who can pay for its insurance has to, be it from taxes or from payments by his employer (which in the end is the same as paying directly). 
Though medical care is one of the ressources for which this statement is the less true. I’ll happily accept free bread, a free car, or free vacations, but you’re not going to make me accept free heart surgery if I don’t really need it.
I didn’t mean that you were assigned a doctor. But anyway, my main point was that canadian doctors were paid on a per patient basis, and not on a fee for services basis, and I was wrong. I stand corrected.
However, I’ve noted the “if they are accepting patients into their practice” part, and I’ve read (here) a number of comments about the difficulty of finding a doctor accepting patients in Canada. I’ve never had a doctor telling me (or anybody else I knew) that he wasn’t accepting new patients. The only exception I’m aware of here are pychiatrists, and that’s because there’s a shortage of those (and I’ve no clue why, especially since they aren’t the less well paid specialists, by a long shot). So, I’m assuming it can only be because there’s a shortage of generalists? If so, what is the reason?
So, I was wrong about the Canadian system. Was I similarily wrong about the British system?
As I understand it, employment-based health insurance was introduced by private corporations during WWII in order to help retain workers who were otherwise going off to war. Then during the boom years up to the 1970s, there was simply no way to undo it as there was still full employment. Is this incorrect? If not, then government incompetence has nothing to do with it.
In larger cities, there is usually no problem finding a family doctor. It is in the more remote areas (and we have some really remote areas!) where there are difficulties. Different provinces have been looking at various methods of getting and keeping family docs in smaller towns. It’s not easy though. Money is the big motivator for a lot of docs, and there is more to be made in the city.
Is it very easy to find a family doctor in “small town USA” I wonder…
I’ve been reading through all the threads with interest and I’m picking up little things I didn’t know or was wrong about. I wish the program I had watched was more research and less magazine article.
To your point. Yes, I agree it’s basically the same IF it’s done privately and people can choose their insurance. As I said earlier, my insurance needs change as I age and I don’t want a government run, one size fits all money hole.
Actually, as I understand it, average salaries in rural areas are actually higher than city salaries, precisely because fewer doctors want to work there, all else being equal.
The issue is not who started it, the issue is why it’s so widespread. That’s because of the favorable tax treatment given to employers by the federal government. Private individuals do not get this favorable treatment and that’s why most people are insured through their job.
Some anecdotal info:
A (US) relative on Medicare and with supplemental health insurance (Health Net Seniority Plus, $80 per month) recently underwent throat cancer treatment. Her cancer was caught early and fortunately she only had to undergo radiation, no chemo or surgery. Her out-of-pocket expenses were under $100; co-pays for drugs and the first office visit for each of the various docs she saw.
The form of radiation she had is IMRT (Intensity-Modulated Radiation Therapy), described in Wiki as “…an advanced type of high-precision radiation.” IMRT is the accepted standard in the US for certain types of cancer.
She belongs to a head and neck cancer message board that originates in the UK. The board moderator, a UK doctor, periodically presents NICE with arguments for the therapy. In his last presentation, 8 Nov., 2007, he stated, “The modulation of the radiation beam in IMRT allows precise delivery to cancerous tissue while sparing surrounding normal tissue from exposure. It is therefore suitable for the delivery of radiation to locations where diseased tissue is located close to vital structures (like saliva glands).” “There is one Hi-Art System (delivering helical tomotherapy) in use in the UK at present. Currently there are no helical tomotherapy systems available in the NHS. The availability of other IMRT systems is not known.”
The doc also said, not as part of the presentation, “No downside, but it takes longer to plan (programme the computer) the treatment. So if we don’t have enough oncoradiologists, the rest might have to wait longer!”
OK, so there’s this hugely expensive but highly effective method of radiation (radiotherapy) that is denied UK sufferers because of cost. A new very effective drug, Erbitux, is also given for some HNC patients here and again is not offered in the UK because of cost. I surmise there are other treatments unavailable for other ailments because of cost.
A friend in Manchester (UK not NH) has been treated for breast cancer and for a heart problem. She completed breast cancer treatment a short time ago and her heart problem has been taken care of, all with NHS and her own private insurance. She did not go through weeks or months long waits as some here seem to think exist. Because she believed she had cancer (visible breast lumps), she was seen immediately and her treatment commenced quickly. She said that if she had to have a knee or hip replacement that would probably take months and months before she would have the surgery. Other routine procedures (colonoscopies, for example) also require many months waiting, unless the person were bleeding or suffering in some way (or whatever - I’m not a doc) and the matter was considered to be an emergency.
Now it gets a little crazy. My friend is a full time employee, an accountant, and still receives disability because she’s essentially disabled! There’s also some sort of Mobility program where the NHS gave her a car and paid her auto insurance for one year. She had her own car which she promptly gave to her daughter in college. She also received home health care weekly, something else not covered here unless the patient is gravely ill and feeble, not simply for standard breast cancer treatment. When telling friends about the Mobility program for people who are already mobile, the response is usually something like “Socialism gone rampant.”
A free car, insurance for the car, disability although working, home health care - these are paid for rather than the treatments and drugs that may keep the patient alive.
I think both systems need to be overhauled and quickly - we’re living longer and longer and will require more care as we age.