DH battled cancer for 7 years here in Ontario before he died last year. By and large, I was pretty happy with the Ontario healthcare system - although of course, we ran into some issues along the way.
He was also American and in the first couple of years, kept up health insurance in the US so we could have the option of going there for treatment. We did go to the US for a second opinion and they recommended the same thing our Ontario doctors did. So he chose to get treated in Ontario (wayyyy cheaper with no co-pays!).
I will agree it is good to save some extra money. As his disease grew more complex, we had to travel 2-4hours away to bigger cities for treatment. We even had to stay for a six week span for daily radiation once. At another point, we were doing an 8hr roundtrip every week. And so I learned some of the benefits of urban life. We claimed an average of $3-5k/yr in medical travel alone.
In Ontario, it helps that there are heavy subsidies available for medical equipment. The Assistive Devices Program paid for 75% of the cost of major equipment and his insurance covered most of the rest. So a $6500 wheelchair cost us $400 out of pocket (good thing as he only got to use it for 2 weeks!).
At one point, there was the strong possibility that Ontario would not pay for his immunotherapy treatments as his was a more rare cancer and there hasn’t been enough patients to run enough clinical trials (since we have a small population to start with). We were getting to the point of being willing to pay $10k/mo privately. But the doctor worded the application carefully enough that the govt shocked us all by agreeing to fund it (Side note: it didn’t work for him).
As for scans, Ontario doctors are generally reluctant to order tests. Like many others, doctors spent months brushing off his symptoms as allergies or stress so he had to be persistent and pushy to finally get his diagnosis (I don’t know if it would have been more than a little faster in the US as his initial symptoms were really mild).
Most countries order PET scans constantly, but doctors here said it wasn’t necessary for him. Sometimes we didn’t like it, sometimes we did (DH worried about the exposure to extra radiation, etc). But more or less followed similar standards to the rest of the world (we were part of various FB support groups for his cancer).
And yes, it’s hard to get appointments for CT scans and MRIs (we dealt with hospitals in 2 cities). We soon discovered calling constantly for last minute openings usually got him a scan in a timely manner.
We’ve also sat many, many, many hours in ERs (which seems to be a systemic issue that really deserves attention). The one time it was really serious (but not hair on fire urgent), we sent DH by ambulance and he got the necessary scans a few hours later.
Advocating for medical care for us meant constantly following up on doctor orders. A lot of things often got lost in translation. For example, after chemo treatments in the hospital, DH was referred to homecare for IV fluids at home. Sometimes the homecare org didn’t get the order. Sometimes it was the pharmacy not getting the order to send the supplies. Another example is sometimes the MRI department would get the order for a scan that didn’t include all the parts needed (even though DH always got the same scan for the same parts lol). So we learned to follow up to make sure they got the correct order from the doctor’s office.
I don’t know if it would have been any better in the US as a lot of the problems were the various departments talking to each other correctly.
E-health doesn’t always help either. One time a nurse didn’t key in his medications correctly (apparently there are some steps involved and she missed one). All the oncology nurses just gave him the meds seen on the screen and didn’t notice his nausea meds were not there. It was a day or two before I questioned it as I remembered the doctor explaining the schedule of meds to me.
The majority of health care professionals we met were caring although like others said, it probably helped greatly that we spoke their lingo. I will say that when DH was in the hospital for a week and couldn’t advocate for himself, I was never completely satisfied with the care he received when I wasn’t present. The understaffing was obvious then and they weren’t able to attend to him as frequently as I felt he needed (which left me concerned about inequity for patients without someone at their bedside all the time. At least I was able to be there from morning to night).
Anyway, there were some issues with his healthcare. But although we had the option (and the funds) to move to the US for care anytime through those 7 years, we chose to stay in Ontario and were content with our decision. And actually, I am grateful for the care we received. I do come from a country with just ok public healthcare and private healthcare is expensive (although wow is it an eye-opener when an oncologist is available by text to answer questions
)
From a purely money perspective, it really didn’t cost more than an extra $5-10k/yr, which we were able to manage in our FIRE budget. Of course, everyone’s illness (and the expenses involved) is different and we were fortunate that he had very good extended health insurance from his work.
For me, I am paying almost $4000 a year for my extended health plan premiums. Mostly because it feels safer to keep it. I might change my mind ( it really is $$!) but it is a nice safety net. If I ever have major needs, this would make a big difference (as it did for DH).
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