Author Topic: Canadians et al. - How is your health care?  (Read 15426 times)

dougules

  • Handlebar Stache
  • *****
  • Posts: 1641
  • Location: AL
Canadians et al. - How is your health care?
« on: August 25, 2016, 10:43:06 AM »
Canadians - I'm sure you know that government-run healthcare is a lightning-rod political topic in the US here.  One thing that gets thrown around in that mix is Canadian health care.  One side of our political system says it's great.  The other side says Canadian healthcare is terrible with people either suffering or going south for better care.  Unfortunately, it seems like nobody here is willing to brave the moose attacks and frostbite to actually ask Canadians.   

So, now that you have internet up there, how is your health care?  How do you think it compares with the US and the rest of the world quality-wise?  Do you have any gripes?  Any other comments in general?  Has anybody you know gone across the border for health care? If so, why?  I'd especially like to hear from anybody that's had medical issues. 

Folks outside North America - Please chime in on health care in your country, too.   

Folks in the US - I really would like to avoid a flame war even though I'm pretty much asking for one.  Please start another thread if you want to have a discussion with other folks in the US or just get vicious in general. 

PS If there was already a thread on this one, please point me to it. 
« Last Edit: August 25, 2016, 10:56:28 AM by dougules »

terran

  • Handlebar Stache
  • *****
  • Posts: 2256
Re: Canadians et al. - How is your health care?
« Reply #1 on: August 25, 2016, 10:55:43 AM »
Great question! The other common refrain is "sure they don't have to pay for healthcare, but they also pay a ton in taxes so it's not really free."  I'd be interested in hearing a take on this from the forum's Canadian's too. I found this: https://simpletax.ca/calculator -- do the numbers there seem about right based on your experience?

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 14156
  • Age: 38
  • Location: Toronto, Ontario, Canada
Re: Canadians et al. - How is your health care?
« Reply #2 on: August 25, 2016, 11:30:46 AM »
Generally our health care is good.  The physicians are well trained, the nurses are good, the facilities are decent, if you park at a hospital parking lot you will be charged an awful lot of money though.

As far as waiting goes . . . If you have an emergency condition you're seen immediately, and will get whatever tests and procedures are necessary.  If you have an annoying but non life threatening condition (particularly one that needs a specialist) you might need to wait a couple months.  If you go into an ER with a slight cold in December, you might be there for 12 hours before you see the doctor who will tell you to go home and drink lots of fluids.

Not everything is free.  If you want a private room in a hospital you pay for it.  We don't get dental, optometrist, or drug stuff for free.  Our drugs are usually reasonably priced because we do negotiations to buy in bulk and get reasonable discounts.

Generally speaking, while there are some annoyances with the health care (long waits for non-life threatening problems) most people are pretty happy with what we've got . . . especially compared with the situation our southern neighbours 'enjoy'.

south of 61

  • 5 O'Clock Shadow
  • *
  • Posts: 71
Re: Canadians et al. - How is your health care?
« Reply #3 on: August 25, 2016, 11:59:00 AM »
As an immigrant to Canada I have been very impressed with the Canadian medical system.

I was amazed that having a baby cost me NOTHING and I had a private en-suite room that I could stay in for as long as I liked.

Since having my baby I've had a few emergency room visits (allergic reactions, croup etc) and the baby has always been seen almost instantly. I burned myself quite badly and was surprised when the emergency room doctor gave me his schedule for the next week so I could drop back in each day to see him and have the dressing changed.

With all that being said, I do think we have wait lists for surgeries like hip replacements, but my interactions with the health system so far have all been fantastic.

Zikoris

  • Magnum Stache
  • ******
  • Posts: 3511
  • Age: 33
  • Location: Vancouver, BC
  • Vancouverstachian
Re: Canadians et al. - How is your health care?
« Reply #4 on: August 25, 2016, 12:07:23 PM »
It's great. I'll be the first to admit I'm a very low user of the system due to overall excellent health, but the few times I've needed it, it's been there for me. There have been two notable times:

1. When I had my tubal eight years ago. I had to wait a few months, but it wasn't exactly a dire emergency. Free, though it was a lot of work to find a doctor who would do it.

2. When I had meningitis three years ago. I was seen immediately in the ER - as soon as I started describing my symptoms, a wall opened next to me leading directly into isolation. That was pretty surprising, since it looked like as normal wall if I remember correctly (though I was delirious). I wonder what a week in an American hospital, plus a spinal tap and meningitis meds, would have cost me, even with insurance - I imagine it would have been ugly.

As far as taxes go, I don't pay a lot, at least by my interpretation. I believe last year about 6% on our gross income of ~75K.

CarrieWillard

  • 5 O'Clock Shadow
  • *
  • Posts: 95
  • Location: metro Atlanta, GA
    • Not your average frugal, homeschooling mom of 7
Re: Canadians et al. - How is your health care?
« Reply #5 on: August 25, 2016, 12:19:04 PM »
Fwiw, my ex husband is from Canada, and he was convinced that his grandmother (who raised him) would still be alive if it weren't for the long waits in-between tests and treatment for her health concerns.

My father in law lives in Costa Rica and described having to be held down by two huge men when he got a colonoscopy. I guess they try to save money on anesthesia? Nevertheless he sings the praises of the national health there.

backyardfeast

  • Pencil Stache
  • ****
  • Posts: 899
  • Location: Vancouver Island, BC
    • My journal
Re: Canadians et al. - How is your health care?
« Reply #6 on: August 25, 2016, 12:19:28 PM »
Yup.  Outstanding (most of the time; horror stories definitely exist) for health crises.  Having a baby; having a heart attack (or just chest pains); my MIL had a brain tumour; grandfather had an aorta rupture, etc etc.  No worrying about costs, no questions about insurance, just timely, first-world care.

Chronic health conditions or not easily diagnosed non-life-threatening issues?  Sigh.  Long wait times to see specialists, long wait times for routine surgeries, etc.  This is the area where people who can afford it will often do the medical tourism thing.  They will have the diagnosis for the hip replacement or whatever, and simply decide, this is worth spending $10,000 to zip across the border or travel to Mexico and just get it dealt with.

Many employers provide what we call "extended health" benefits to get private hospital rooms, services like massage or physio, dental and optical coverage.  If your employer doesn't, you can also buy this privately for a few hundred dollars a month.

In BC, our government has prioritized low income taxes (I think in our middle bracket--$35,000-75,000 income--we pay about 7.5%?), and charges user-fees for everything else, including health care premiums.  So my DH and I pay $136 combined/month for our health care.  This is the maximum; the premium can be reduced or is waived for those with low incomes.  Employers often cover this as well (ours do).

We also have a pharmacare program here in BC that does help keep prescription costs down, and the concensus seems to be that a national pharmacare program would pay for itself quickly in savings gained by negotiating drug costs nationally instead of provincially.  We'll see if that materializes at some point. 

Most of us, I think it's safe to say, feel like we would still vastly prefer this system than the horror show we see in the US.  And most of us think we can work within the system that we have to improve it--and lord knows there's lots to improve.  There is zero political or social will to stop having a single-payer system, regardless of the myriad of ways in which single-payer systems can be tweaked to be better.  We compare our system to Europe and other single-payer systems, not the US's, for the standards we should be aiming for.  Unless you're rich; in which case there are definitely people in our 1% who would like the option of the healthcare available to the 1% in the US (or how they imagine it is, anyway). :)

Mmm_Donuts

  • Bristles
  • ***
  • Posts: 371
Re: Canadians et al. - How is your health care?
« Reply #7 on: August 25, 2016, 12:23:29 PM »
Our health care system is fantastic. I've been fortunate enough not to need too much care, but just the fact that I can see my doctor anytime, with any concern, and be seen fairly quickly (for free) is something I don't take for granted. I have had 2 emergency room experiences and have received excellent care there as well, and once it was established that I was truly an emergency case, I was seen right away, with no wait.

Well worth the taxes IMO. They are not exorbitant. Plus if you're FI and earning $100k as a couple in qualifying Canadian dividend income it is technically possible to pay zero taxes. I'd say for the purposes of this forum, the health care system makes mustachian early retirement in Canada much more feasible than in the US. (plus we have paid parental leave, I believe it's something like one year at 80% salary.)

K-ice

  • Pencil Stache
  • ****
  • Posts: 931
  • Location: Canada
Re: Canadians et al. - How is your health care?
« Reply #8 on: August 25, 2016, 12:28:33 PM »
Our health care is great but not perfect.  Is anyone's perfect?

There are doctor shortages, wait times etc.

Also medical is covered but not dental, eyes, orthotics (ie. back or knee brace) or prescriptions. You also pay for ambulance trips. You need private-insurance, work insurance or pay out of pocket for those.  Oh IVF is not covered either, except Quebec, and I'm not sure they are still funding that.

Every province (state) deals with health care differently and there can be slight differences between areas. 

Prescriptions can get expensive. I know someone who can be hospitalized and the cost is covered but if she is not admitted one shot costs $3000.

Some special and new treatments are not covered and it takes a while for those new treatments to become the standard. Those are probably the people you hear that travel to the US or mexico for treatment.  Also, cosmetic surgery isn't covered, no should it be. 

Generally, when me or my family has needed care we are happy. I do have a family doctor and found an OBGYN when needed. My C-section was fully covered, not my "plan" but I never had to question what things cost. Oh, yeah, I had a small private en-suite room too. My mom paid a little extra for the larger private room with the full bed for guests. I think some mid-wife costs are also covered but that really varies by area. My SIL in the US had health insurance but no birth coverage. The doc suggested an unnecessary c-section. She was fine with a natural birth, her 4th. One day in the hospital, natural birth $5000 out of pocket. The C-sec would have been $10-20K.  I can't imagine a doctor up-selling. Oh wait,... I can, I go to the dentist.     

I had an emergency CT scan recently after waiting about 5h in the ER, saw the Doc at the 2h mark. In a 6 month period I have been followed up by an appropriate tests and a specialist 3x & all is good.

I think mental health is very hard to deal with and I have been somewhat disappointed for some family members. 

IF you can walk into the ER you don't belong there & then you may wait 12h. But there is a shortage of clinics or proper education of where most people should go for a "minor emergency" (that's an oxymoron, but you know what I mean).  There is now a good web site that shows ER wait times in our area.  Currently 30 min at the Children's, 1 h at the one closest to me but 3:45 at another major hospital. And we can go to any hospital. I have 11 ER choices in the greater area. Don't you have some weird thing in the states where you can only go to some hospitals?  I might pick a small suburban one for stitches, but I will go to the University Hospital if its serious.   

But the huge thing is I know NO ONE that has had to declare medical bankruptcy. 62% of US bankruptcies are for medical reasons.

http://www.amjmed.com/article/S0002-9343(09)00404-5/abstract

If you have a disabled child or a conic illness and can't work the extra costs would add up.

But I can't even imagine that a yearly check-up, ER visits, birth, cancer treatment, heart surgery and trauma surgery would not be covered. 

No one asks to be sick. Sure there are lifestyle choices, so we tax the hell out of cigarettes and booze. 

PS. I've never been critical of MMM before but if his family's health took a turn for the worse they would be welcome back in Canada. Our health care is a very big safety net for a Mustacian.





Shinplaster

  • Handlebar Stache
  • *****
  • Posts: 1393
  • Location: up in Canada complaining about the weather
Re: Canadians et al. - How is your health care?
« Reply #9 on: August 25, 2016, 01:53:57 PM »
I'm old enough to remember life before universal health care.  My parents would debate whether an illness or injury was bad enough to see a doctor, because that would mean the money had to come from another necessity.  I suffered with whooping cough for weeks before finally being taken to the GP.  My Dad had hepatitis that went untreated for a long time, because he didn't think he could afford treatment.  I never want to go back to that time again, or see anyone else in this country have to go there either.   It pains me to know that many in your country forego health care because of the cost.  That people lose their homes, and financial well being because of medical bills.  We don't think of health care as just a commodity to be bought or sold (although it is of course).  I think most of us see it as a basic human right that we're each willing to fund for the good of us all.

The wait times are sometime atrocious.  Hip replacement and cataract surgery are two that I hear about often. Depending on your province, mental health care is full of cracks and holes.  Doctor shortages are often the result of short sighted politicians, who reduce spaces in medical schools, and then wonder why we have no doctors.  The province I live in is still recovering from decisions made decades ago.  But as people said already, when you have an emergency, we are all so glad to whip out our health cards, and know that things will be taken care of.  My sister shattered her ankle a couple of years ago.  It required orthopedic surgery, physical therapy, days in the hospital, etc.  Her bill?  I think a few bucks for the rental of a wheel chair for a few weeks.   Her wait time in emerg?  Zero.  She was in having x-rays within moments of arriving.  My Dad had lung cancer.  Surgery, radiation, chemotherapy, home visits by nurses for wound dressing, prescriptions for ointments, pain killers.......  The list goes on and on.  His costs?  $2.11 per prescription.  That's it.  He received absolutely stellar care.

I look at the discussions Americans have about which health plan to choose, how much it costs, what the restrictions are, what the copays are, can they afford the costs and still retire, and it makes my head hurt.   I don't personally know any Canadian that would give up what we have, warts and all.   We all want improvements to the weaknesses, but in the meantime, what we have is pretty good.

tweezers

  • Stubble
  • **
  • Posts: 189
Re: Canadians et al. - How is your health care?
« Reply #10 on: August 25, 2016, 02:17:45 PM »
I'm a Canadian ex-pat living in the US.  I did a fairly crude calculation a while back and I pay more for health care than I would through my Canadian taxes (and have a lot more angst about what's covered, what's not, etc), but my tax rate overall is lower because I live in a state without income tax and have more deductions (mortgage interest, in particular).  My family is still in Canada and can speak to the triaged care.  My mother's knee replacement surgery was post-poned 4 times (but still free), but when my cousin found a lump in her breast she received a biopsy the next day.




pachnik

  • Handlebar Stache
  • *****
  • Posts: 1833
  • Age: 55
  • Location: Vancouver, BC
Re: Canadians et al. - How is your health care?
« Reply #11 on: August 25, 2016, 03:38:45 PM »
My experience as a healthy middle-aged woman has been pretty good.  I've only ever lived in Canada so have nothing to compare our health care system to. 

I pay $75.00 a month for medical care and this, so far, has covered every doctor visit, specialist visit etc.   I had the same family doctor/g.p. for 23 years until she retired last December.  It took a little bit of doing to find a new family doctor.  In between, I went to a walk-in clinic that I actually really liked.   Prescriptions, dental care, physiotherapy and counseling are not covered under the medical care premium.  However, through my husband's work we have decent coverage for prescriptions and dental care.     

When my parents have had medical problems, they have been happy with the system.  Last year both of them had cataract surgery and my mom broke a bone in her ankle.  So a few hospital visits there.  It seemed efficient and decent to me as an observer since  I often took them to their appointments and to the emergency room when my mom broke a bone. 

human

  • Pencil Stache
  • ****
  • Posts: 791
Re: Canadians et al. - How is your health care?
« Reply #12 on: August 25, 2016, 07:40:21 PM »
I've moved around a lot but I've been in my current location for 10 years now. I can't remember the last time I've had a family doctor, I just go to clinics. If you go to a clinic after 5 there may be less doctors around but also way less patients. I don't know if it's because people are skipping work or what. I've booked a general check up at a clinic, they make you go to other places for a cardiogram and blood work but it was all free.

I've been to the emergency room at the local hospital a few times, the longest I waited was an hour and a half. I know people complain about wait times but if you aren't dying you have no business in a hospital. The only reason why I was there was because my girlfriend thought I should "get it checked out" right away. I've noticed in emergency rooms that if you are there early Sunday morning 6-7 no other patients are around. It seems strange that people show up during business hours only, I think it might demonstrate that most people go for non pressing reasons.

We pay a lot of taxes but we don't worry about what's covered and what isn't (too much). It seems all the threads about the US system are full of Americans contradicting themselves on how the system works - PPO, HMO, ACA, BLKFFKSJDJADJ these threads are insane. I bet if you added up what you guys pay in insurance versus what we pay in taxes you guys lose.

I find it hilarious that anyone would think health insurers are looking after your best interests. I remember reading an article about phantom Doctors. Before going into surgery you have to make sure everyone and everything including the air ducts and janitor are "in network". Then while you are knocked out another Doctor sneaks in and holds up an IV and six months later you get a bill for 140k?? WTF!!? Argh can't find the article!

MrsTuxedocat

  • Bristles
  • ***
  • Posts: 319
  • Location: Canada
Re: Canadians et al. - How is your health care?
« Reply #13 on: August 25, 2016, 08:06:57 PM »
I feel blessed to live in Canada with its amazing heath care. Yes, it can take months to see a specialist and they are physician shortages. People do not go bankrupt when there is a health emergency. The medical staff are well trained with excellent hospitals.

I also would like to mention that are prescription drugs are much more affordable than the States. A couple of years ago, I was researching a drug I was prescribed by my GP. Many of the reviews that I read, stated how expensive it was in the States and I was surprised to learn that info. In Canada, I was paid $12/month and went to look at the cost in America and it was 90+/month. I was dumbfounded. 

snowball

  • 5 O'Clock Shadow
  • *
  • Posts: 66
Re: Canadians et al. - How is your health care?
« Reply #14 on: August 25, 2016, 08:08:21 PM »
I've had four surgeries in the last three years (hopefully no more for a looong time, knock on wood).  I am, in fact, presently at home recovering from the last minor one which they just did this morning.  I think the quality of care throughout has been excellent, and I haven't had to worry about costs at all.  Drugs can get expensive but there are some programs to help with that if you need it (I do hope that setup can be improved, maybe by means of a national pharmacare program as mentioned earlier in the thread.  Here in Alberta there is a provincially subsidized Blue Cross insurance program you can get into if you're underinsured for drug coverage and you're diagnosed with a serious illness - you pay something like $50/month for it, regardless of your condition).

Many provinces do have health insurance premiums that you pay to the province (we don't in Alberta), but the premiums are pegged to your income level, and are capped at a pretty affordable amount...when I lived in BC several years ago, my income was high enough to pay the full premium, and it was < $60/month for a single person at that time.  Some employers pay those premiums as part of your benefits, and lots of employers also have group insurance for the stuff not covered by the province, like dental care etc.

You can go to a walk-in clinic and be seen by a doctor the same day for non-emergency concerns.  You may have to wait some hours depending on how busy they are.  Ditto for the emergency room waiting; it just depends.  I have done this several times and never had any complaints.  I mean...I don't mind waiting if it's not an emergency, and if it really *is* an emergency, you'll be seen right away.

You can choose your own family doctor, but depending on where you live, it's not always easy to find one with openings (especially if you hold out for someone you have a rapport with, as I did, and don't want to go with the one dude who always has openings because people don't like him).  However, there are always the walk-in clinics.  Even if you do have a family doctor you might end up going to the clinic if you want to see someone that same day (amusingly, the last time I did this, it WAS my family doctor I saw at the local clinic, because it was her day to work there!)  No cost for the walk-in clinic of course.

I keep saying "province" because health care is a provincial responsibility;  there isn't really any such thing as a national health care system here (like the Brits have).  I think the system is pretty good in every province, but some things vary between jurisdictions.  There's a HealthLink number in Alberta that you can dial at any time of day or night to talk to a nurse - great if you have a question that isn't serious enough (or you don't know if it's serious enough) to go see a doctor about.  A lot of provinces (maybe all?) probably have something like that.  I called in once and the nurse was very helpful.

It is not perfect.  But even though I've never lived somewhere that didn't have a system like this, I am completely convinced it is much better than having a privatized system.  Every country in the world rations health care to their population in one way or another - by wait times, ability to pay, or both.  I'd so much rather have a system where people are triaged and prioritized by actual medical need than by bank account.  I'm pretty sure most of my fellow Canadians feel the same way.

snowball

  • 5 O'Clock Shadow
  • *
  • Posts: 66
Re: Canadians et al. - How is your health care?
« Reply #15 on: August 25, 2016, 08:24:31 PM »
...and you don't even always have to pay for parking.  For today's surgery, because it was more minor, my surgeon did it at a small town hospital he also works at;  no parking meters.  Free hospital parking totally exists outside the cities.  :)

snowball

  • 5 O'Clock Shadow
  • *
  • Posts: 66
Re: Canadians et al. - How is your health care?
« Reply #16 on: August 25, 2016, 08:32:33 PM »
Great question! The other common refrain is "sure they don't have to pay for healthcare, but they also pay a ton in taxes so it's not really free."  I'd be interested in hearing a take on this from the forum's Canadian's too. I found this: https://simpletax.ca/calculator -- do the numbers there seem about right based on your experience?

And yeah, that's a good site.  I actually use that same site to submit my tax return every year, and it does a great job.

I have the impression that personal income tax rates are mostly pretty similar between Canada and the U.S., but then we have a much lower level of military funding.  We might have higher marginal rates on high income earners too, but I'm never going to reach those stratospheric levels, so I don't really care.  ;)

simplified

  • 5 O'Clock Shadow
  • *
  • Posts: 47
  • Location: SF bay area
Re: Canadians et al. - How is your health care?
« Reply #17 on: August 25, 2016, 08:46:45 PM »
Don't mean to hijack the thread, but I'm interested in knowing the answers to the following questions.

1. If you pay more taxes because you have a high paying job, do you get better health benefits?
2. Is the real cost of care in Canada different from that of the US?
3. Do the rich and the poor feel the same way about public health care in Canada, or are they divided?




human

  • Pencil Stache
  • ****
  • Posts: 791
Re: Canadians et al. - How is your health care?
« Reply #18 on: August 25, 2016, 09:15:55 PM »
If you use the normal universal system all Canadians should get the same level of care. However, private clinics are popping up for things like MRIs, cataract removal. If you find the wait time for non life threatening health concerns come up and an MRI is needed you could get it done at a private clinic. If you are homeless and suffer a heart attack you will get the same level of healthcare as anyone else at that same hospital. It's possible poorer areas have "lesser" hospitals.

Being your own advocate also helps, if you are aggressive or have someone be your advocate with Doctors that definitely helps, however I'm sure this helps in the US as well.

Drugs are not covered, but I believe provinces may have plans in place for those on poverty level incomes. You can of course buy private drug insurance. Any drugs provided while in the hospital are covered.

Is real cost different? It seems to cost twice as much per capita in the US than in Canada: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

As for question three, I think the "feeling" is that many of the rich would like to jump the queue for certain things or allow more private enterprise in areas such as hip and joint replacement. I'm not sure a generalization on how the rich or poor feel about universal health care in Canada is possible. My girlfriend and I make over 250k a year and believe in the Universal health care system, I think I'm filthy rich. Do other plus 250K couples feel the same way? Not sure. I'm not aware of any opinion research done on the subject.
« Last Edit: August 25, 2016, 09:22:54 PM by human »

Prairie Gal

  • Handlebar Stache
  • *****
  • Posts: 1452
  • Location: Somewhere, out there ...
Re: Canadians et al. - How is your health care?
« Reply #19 on: August 25, 2016, 09:42:03 PM »
I agree with pretty much everything that has been said. I feel very lucky to live in Canada where healthcare is universal, not free. We pay for it through taxes. And everyone receives the same level of care.

Three years ago I had an apples to apples comparison of the U.S. and Canadian healthcare systems. My husband had a stroke while we were in Las Vegas. I was required to pay $1500 in the E.R.  even though we had private insurance. (Our universal healthcare does not cover us in other countries.) I'm not sure what would have happened if we didn't have the means to pay the $1500. Anyway, the care in LV was superb, state of the art even. He was in ICU and had a private nurse. Every time she, or anyone entered the room they brought a computer with a scanner and scanned his wristband and whatever medication they were giving him. The hospital seemed very empty, almost deserted, but that may have been because it was over American Thanksgiving. The total cost for one week in the ICU and private air ambulance back to Canada was about $200,000. Word of warning to fellow Canucks, never leave the country without insurance.

When we arrived back in Canada he was taken immediately to the ICU in our hospital. The hospital was much more crowded and seemed a little run-down compared to the one we had just left in LV. But the care was still very good. He was supposed to have his own nurse, but it seemed like several of them would go on breaks at the same time, leaving the others to cover, so I was often hunting someone down when he needed something.  Of course there was no scanning of the wristband, or anything like that. The only cost I had was for parking, as others have mentioned, and it actually wasn't that much. He was only allowed two visitors at a time, and everyone had to leave for an hour during shift change, which was really annoying.

Overall, both hospitals were very good, but I felt that the U.S. one was a bit better, but of course that comes at a premium. And you have to remember that it is a business. One of the doctors who treated him in LV didn't file through the insurance company for some reason and sicked a collection agency on me. I just told them to call the insurance company. It's not my fault they didn't submit the claim. But that just shows how each doctor is running a business.
I think having universal healthcare just removes some of the stress of getting sick or injured. It never even crosses my mind how much something costs, or if it is covered, or if the insurance company is going to deny my claim. Personally, I wish it covered more, like dental, vision, prescriptions, physiotherapy, but I guess there are limits as to what the system can handle, and how much people are willing to pay in taxes.

As an aside, our healthcare here in Alberta is now covering bariatric surgery.


KMMK

  • Handlebar Stache
  • *****
  • Posts: 1472
  • Age: 42
  • Location: Edmonton, AB, Canada
    • Meena Kestirke Insurance
Re: Canadians et al. - How is your health care?
« Reply #20 on: August 25, 2016, 09:45:47 PM »
There is definitely provincial variation. So far in Alberta it's been way better than in Manitoba. It's really hard to get a new doctor in Manitoba but in Alberta it seems there are many doctors accepting new patients. I had three doctor visits recently and I was seen as a walk-in immediately and was always the only one in the waiting room. In Manitoba the walk-in wait was minimum 2 hours.

And in Alberta you have the option to pay for private services, but no such option in Manitoba for most services.

I'm overall very happy with our healthcare system. My income isn't that high so my taxes are quite reasonable. Sometimes it's hard to get a diagnosis but I'm sure that happens everywhere.

snowball

  • 5 O'Clock Shadow
  • *
  • Posts: 66
Re: Canadians et al. - How is your health care?
« Reply #21 on: August 25, 2016, 09:51:52 PM »
Is real cost different? It seems to cost twice as much per capita in the US than in Canada: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

As for question three, I think the "feeling" is that many of the rich would like to jump the queue for certain things or allow more private enterprise in areas such as hip and joint replacement. I'm not sure a generalization on how the rich or poor feel about universal health care in Canada is possible. My girlfriend and I make over 250k a year and believe in the Universal health care system, I think I'm filthy rich. Do other plus 250K couples feel the same way? Not sure. I'm not aware of any opinion research done on the subject.

Yeah, Americans pay more for worse health outcomes, in aggregate.  But all those private profits (and the staff to sort out what sounds like a very complicated billing structure) have to be paid for somehow.

I don't get the sense that we have any major social division between rich and poor about whether we should have publicly funded health care.  It has very strong public support, and (though I haven't seen data on this either), I think that holds true across all socioeconomic classes.  It's not unanimously supported, but what is?  It's strongly supported enough that I don't think it would be politically possible to eliminate it.

I was born after universal health care was introduced;  I have no memory of it being any other way.  Things like American billboards advertising hospitals blow my mind every time I see them.  It just seems wrong for this to be commercialized.  I think that's not an unusual reaction for my generation.  (Just trying to give you an idea of how deeply the cultural support runs.)

radram

  • Pencil Stache
  • ****
  • Posts: 956
Re: Canadians et al. - How is your health care?
« Reply #22 on: August 25, 2016, 10:02:07 PM »
Great question and topic. Thank you to all who have shared.

There are about 36 million people in Canada.  If they all reply as positive as those so far, does anyone think it will make any difference in the U.S.?

Are there really 0 horrible experiences in MMM'land?

I hosted a friend from Ireland for an afternoon last week. I asked him what he thought about his healthcare.  He thought it was ok, but getting better.  Sorry I do not have more to contribute to the thread. 



backyardfeast

  • Pencil Stache
  • ****
  • Posts: 899
  • Location: Vancouver Island, BC
    • My journal
Re: Canadians et al. - How is your health care?
« Reply #23 on: August 25, 2016, 10:03:00 PM »
Don't mean to hijack the thread, but I'm interested in knowing the answers to the following questions.

1. If you pay more taxes because you have a high paying job, do you get better health benefits?
2. Is the real cost of care in Canada different from that of the US?
3. Do the rich and the poor feel the same way about public health care in Canada, or are they divided?

Just wanted to respond to the first question.  Although it's true that we "pay for health care through our taxes", it's not a direct relationship.  Our provinces set our tax rates on a whole variety of issues; all the taxes end up in general revenues, and health care is paid out of that.  Even here, where we do pay a specific health premium, the money that's collected goes into general revenues.  And although health care is a provincial responsibility, it is regulated at the broadest level by the federal government (with a policy that really just says that the provinces have to provide a universal system, doesn't specify any rules, AFAIK) and the feds do transfer $ to the provinces specifically for health care (which of course comes out of our federal taxes, but again, just from general revenues).

So while it's generally true that higher paying jobs have better health plans, this is because of the extended health plans that employers and/or employees pay for through private insurers.  There is no difference in the care received by rich and poor, employed or unemployed, as long as it's accessed through the universal system.  However there can be large discrepancies experienced between those who have good extra benefits, or who can afford to pay out of pocket to speed up particular procedures (as already mentioned).

I think the difference in care experienced between rich and poor is more about the kind of prejudice that exists on the part of health care providers.  There have been terrible stories for years (outlier stories, but still) of the homeless person who goes to the hospital, is assumed to be drunk and/or high, so is pushed to the back of the line and not taken seriously, and who dies in the emerg waiting room of a serious health issue.  Happens to first nations patients occasionally too.  Horrifying.  But not so much about the health care system as our society generally. :(  Ditto that the really poor who don't have extended health benefits can really suffer for lack of dental care or eye care, or mental health services.  There are non-profit groups that help with this, but it's a real problem.

Again, though, I have a hard time believing that those sorts of cracks in the system/prejudices don't happen in the US as well?

Rich or poor can all walk into a clinic or the emergency room and get good quality care, without worrying about the cost.

K-ice

  • Pencil Stache
  • ****
  • Posts: 931
  • Location: Canada
Re: Canadians et al. - How is your health care?
« Reply #24 on: August 25, 2016, 10:03:25 PM »
Don't mean to hijack the thread, but I'm interested in knowing the answers to the following questions.

1. If you pay more taxes because you have a high paying job, do you get better health benefits?


No, the only thing you may be able to pay for is a private room or better after care like physio, etc.


Quote

2. Is the real cost of care in Canada different from that of the US?


I think our Dr are paid less but they also pay less in liability insurance.
I know different fees are negotiated for Rx and implants. I've heard Italy pays very little for implants so companies don't like marketing there.


Quote
3. Do the rich and the poor feel the same way about public health care in Canada, or are they divided?

I think we are all pretty happy.

Ishmael

  • Stubble
  • **
  • Posts: 118
Re: Canadians et al. - How is your health care?
« Reply #25 on: August 26, 2016, 05:28:17 AM »
I've had a few times where I needed to rely heavily on the health care system in Canada. Once, I had an emergency room misdiagnosis that almost let me die. This was Doctor error, and could have happened anywhere though, IMO. 2 days later, when I went back, I was nestled in the bosom of the system until I was well again, including surgeries, medications, care and consults with 3-4 top specialists, round the clock care for a couple of weeks and follow up care at home for months.

It also resulted in follow up surgeries, one of which I had to wait a god-awful long time for, but it was rather low priority (just intermittant pain when I tried to do certain activities).

We've had too many other encounters with the system - wife giving birth twice (including scary Helpp syndrome for the first), chest pains, scares with the kids, etc.

Overall, I give it an A-. It feels unbelievably good to have a top-notch system full of caring people to depend on during times of crisis. It's not perfect, but it's darn excellent, and I live in one of the poorer provinces.

I can't imagine what it's like to have to add financial and administrative worries on top of dealing with a serious health issue. Personally, I think there's a role for the private sector in the system, including possibly a bigger one in Canada, but at the core I want doctors making decisions about my health based on need and not cost (within the affordable limits of our society).

The one thing I find absolutely striking that no one here has mentioned yet is simply how much more efficient the system is overall than the private one in the US. Cost vs outcomes aren't even close, from what I understand. From what I can tell, it's because the US system is so grossly inefficient in its administration - lawyers and doctors and administrators fighting over who pays for what, and administrations inflating treatments required to increase revenues. Also, people have to have a huge amount of personal knowledge about health care plans and legal nuances that ties up a lot of mental energy that would be put to better use understanding their health issues and taking care of themselves.

Also, I fundamentally disagree with the notion that someone's life/health is more valuable simply because they have more money - all people deserve equal access to health care, because we're all people. Some of the best people I've known in my life don't have 2 cents to rub together (mostly because they were generous to a fault). I've also met too many scuzzy rich folks. I don't profess to be in any way qualified to judge who should get better health care - but I know how much money you have in the bank is a ridiculous comparison - so I want everyone to have equal access.

I wouldn't even consider the thought about trading our system for anything that I've learned about in the US. I'd (eagerly) look at other countries that have universal health care to see if there's better ways of implementing ours, but not to get rid of it entirely, or to change it so the rich can get preferred access.

GuitarStv

  • Senior Mustachian
  • ********
  • Posts: 14156
  • Age: 38
  • Location: Toronto, Ontario, Canada
Re: Canadians et al. - How is your health care?
« Reply #26 on: August 26, 2016, 06:10:21 AM »
A bunch of us have no doctor.

My child will wait a year for a specialist appointment, and can then have one once a year after that.

Neuro-care is shit.

The hospital emergency room did absolutely nothing when I had a severe injury, was left to figure it out myself, have a month of bed rest, and spend over $1000 doing so.

I'm glad they kept my kid alive, but was stunned and angry when I learned that hospital is behind parts of Mexico for preemie care.

I have had two excellent doctors. One died, the other I drive nine hours to see.

I've started using private care where it's an option.

Can I ask what the nature of your specialist appointment for your child is, and what province you're in?  What was the severe injury that the ER didn't treat when you went in?  What exactly was your concern with the care for your premature child?

Your uniformly poor experience is different from that of most people I know, I'd be interested in getting more specific details of the problems.

zhelud

  • Stubble
  • **
  • Posts: 229
Re: Canadians et al. - How is your health care?
« Reply #27 on: August 26, 2016, 07:40:15 AM »
When my husband and young son and I visited Quebec about 13-14 years ago (we are US citizens), my son became ill and we took him to an urgent care walk in clinic.  We had to wait about 20 minutes to be seen. Afterwards, the clinic staff apologized profusely that they had to charge us about $20 since we weren't from Quebec. I had to laugh- even with our insurance, an urgent care clinic visit in the US would have required at least a $100 co-pay.  We also had to pay about $20 for his prescription.

Thanks kind Canadians!

dougules

  • Handlebar Stache
  • *****
  • Posts: 1641
  • Location: AL
Re: Canadians et al. - How is your health care?
« Reply #28 on: August 26, 2016, 11:29:19 AM »
One other big question, what do Canadian doctors and nurses think of the differences of working in Canada vs the US?  That's the other side of the equation.  Any Canadian medical types on here? 

-Because of a doctor shortage I haven't been able to switch doctors, even though I'm dissatisfied with mine. (I don't think this would happen in the US, for a bunch of slightly off-topic reasons)

I haven't switched doctors in a while, but I think that's also becoming an issue in the US.  From what I hear a lot of doctors are getting pickier about what insurance they take.  A lot of them aren't accepting new patients either. 

Quote
I have gotten medical care in the US and in Mexico, and I encountered emergency room waits in both places, with the added insult of having the visit cost money.

Emergency room waits can be pretty bad here, too.  I've personally waited like 4 hours.  You probably would get seen sooner if your issues were very serious. 

Did you just happen to be in the US when you needed medical care, or did you specifically go to the US for health reasons? 

Fwiw, my ex husband is from Canada, and he was convinced that his grandmother (who raised him) would still be alive if it weren't for the long waits in-between tests and treatment for her health concerns.

It sounds like the only serious gripe is wait times.  And that sounds like that's only for things that aren't (or don't appear to be) life threatening.  I guess wait times will sometimes make people fall through the cracks if something benign looking turns out to be serious. 

It sounds like y'all are about 90% happy about your situation, though.   

Any theories on why wait times are worse in Canada?  Or are they?  I don't think believe that's an issue here, but I don't know for sure.  Is there possibly some other trade-off we're making for less of a wait?  Cost?


I think mental health is very hard to deal with and I have been somewhat disappointed for some family members. 

Mental health is no cakewalk in the US either.  Here in Alabama one insurer has a near monopoly on health insurance.  Until a few years ago they only covered two psychiatrist in the whole state.  The company I worked for happened to be headquartered in New Jersey.  They used the same insurance company, but they had a NJ-based plan that covered a lot more psychiatrists including mine.  I still had a big annoyance because the claims had to be filed through the Alabama division of the insurer.  I had to call multiple times to spell out the fact that I had a NJ-based plan.  Fortunately that all changed before I signed on with a company headquartered here.   


Quote
But the huge thing is I know NO ONE that has had to declare medical bankruptcy. 62% of US bankruptcies are for medical reasons.

http://www.amjmed.com/article/S0002-9343(09)00404-5/abstract

If you have a disabled child or a conic illness and can't work the extra costs would add up.

But I can't even imagine that a yearly check-up, ER visits, birth, cancer treatment, heart surgery and trauma surgery would not be covered. 

No one asks to be sick. Sure there are lifestyle choices, so we tax the hell out of cigarettes and booze. 

PS. I've never been critical of MMM before but if his family's health took a turn for the worse they would be welcome back in Canada. Our health care is a very big safety net for a Mustacian.

Yes medical bankruptcy is a huge issue that a lot of people here just seem to accept as a fact of life.  I'm a little skeptical of MMM's take on budgeting for US health care, especially given regular psychiatrist visits for my prescription.  A chronic condition could be way worse on the budget than a big short term problem if you have catastrophic coverage with a big deductible.  MMM doesn't have to really worry about it since he could go back to Canada if the SHTF.  I guess there's always Mexico for me. 

Word of warning to fellow Canucks, never leave the country without insurance.

+1 Being in the US without some kind of medical insurance is playing the lottery in a bad way.  What can Canadians do for insurance if they just want to take a daytrip to the US?  I'm guessing a lot take a big financial risk they're not really thinking about?

A bunch of us have no doctor.

My child will wait a year for a specialist appointment, and can then have one once a year after that.

Neuro-care is shit.

The hospital emergency room did absolutely nothing when I had a severe injury, was left to figure it out myself, have a month of bed rest, and spend over $1000 doing so.

I'm glad they kept my kid alive, but was stunned and angry when I learned that hospital is behind parts of Mexico for preemie care.

I have had two excellent doctors. One died, the other I drive nine hours to see.

I've started using private care where it's an option.

What part of Canada are you in if you don't mind my asking?  US medical care is probably pretty crappy too if you're way way out in the sticks. 

Wow. Long Post. 

dess1313

  • Bristles
  • ***
  • Posts: 441
  • Location: Manitoba Canada
Re: Canadians et al. - How is your health care?
« Reply #29 on: August 27, 2016, 04:52:11 AM »
Canadian Health Care worker here

Is our system perfect?  No. 
Wait times are longer, but thats because fewer people are being left out. 
We also have a very aging population making high demands on the system.  Every tom dick and harry can access a doctor.  It might take a while, but it is possible.
And more people are having more complicated health problems every year. 
And because everyone has easy and mostly free access to the system some do abuse it.  Its unfortunate but there are only so many resources to go around.
For example a day in the Intensive Care Unit for one person is $5000-8000.  its a lot of money to keep very sick people alive

Ive been sick and had to wait weeks and months for MRI scans, and later orthopedic surgery.  But it got done and now i'm healthy with out huge medical bills. 
I didn't loose my house or my job over it.

I wish we had some private parts to the system, such as scans and simple testing.  it would ease the back log because the people that are able to afford it and feel urgent enough could pay, leaving room for more other people to use the free resources.
« Last Edit: August 27, 2016, 04:54:17 AM by dess1313 »

RetiredAt63

  • Senior Mustachian
  • ********
  • Posts: 11622
  • Location: Eastern Ontario, Canada
Re: Canadians et al. - How is your health care?
« Reply #30 on: August 27, 2016, 07:40:02 AM »
We know our systems have issues but go to private health care? No way.  Small places tend to have fewer resources but people get transferred to nearby cites if necessary.  I had been depending on walk-in clinics but when a new doctor arrived I got on her client list.  In the last few months I have had my first appointment with her, had my tetanus and pneumococcal vaccinations (I will have to pay if I decide to get the shingles vaccine, it is not covered, but my private insurance will probably pay for most or all of it), my pap smear and mammogram, knee x-rays, blood work and some minor surgery, a followup visit with my doctor, and have another appointment in November for more followup.  My total cost has been $4 for parking.  I had the knee X-rays same hospital and time as the mammogram, and then just walked across the street for the blood sample.  A few years ago I would have said our local hospital was not very good, but there has been a lot of effort lately to improve it, and I was pleasantly surprised how well and professionally done everything has been this summer.

On a broader scale, I have had friends and relatives with all sorts of major health issues, and they were handled well and promptly.  I am talking heart valve replacement, kidney transplant, knee and hip replacements, lung transplant, breast cancer surgery level of care.  All covered by Ontario and Quebec health insurance plans.

People get private health insurance to cover the things the provincial plans don't cover.  When I was retiring I had my choice of decent low-cost insurance through my previous workplace (my union had arranged a group policy for its members who retired), alumni associations, and Costco.
« Last Edit: August 27, 2016, 07:41:38 AM by RetiredAt63 »

totoro

  • Handlebar Stache
  • *****
  • Posts: 2101
Re: Canadians et al. - How is your health care?
« Reply #31 on: August 27, 2016, 08:04:57 AM »
Our health care system is not perfect, but it is pretty good.    I do believe this is a government responsibility that should be funded by taxpayers.  I pay a lot of taxes and get no better services than a low income user and I'm fine with this. I am more than willing to pay towards a system that supports good health outcomes for the entire society by removing financial barriers.

I think triage is a good way to explain what happens with medical care here.  Urgent conditions tend to get seen quickly.  From personal family experience, cancer surgery/treatment is swift and fantastic and free. 

We have annual limits on prescription fees for covered drugs - the remainder is subsidized.

There are long wait times for non-urgent and elective surgeries.  Finding a family doctor is difficult in many places due to shortages.  Walk-in clinics tend to back stop this gap.

Regular dental care is not covered and mental health services are only in some situations.

My husband's employer provides extended medical coverage so we are also covered for dental, physio, counselling, acupuncture etc.   The cost to the employer is about $300/month for the entire family.   

I can't tell you how grateful I am not to have had the stress of wondering how to cover unexpected medical bills ever in my life. 

Cookie78

  • Handlebar Stache
  • *****
  • Posts: 1893
  • Location: Canada
Re: Canadians et al. - How is your health care?
« Reply #32 on: August 27, 2016, 08:16:51 AM »
When my husband and young son and I visited Quebec about 13-14 years ago (we are US citizens), my son became ill and we took him to an urgent care walk in clinic.  We had to wait about 20 minutes to be seen. Afterwards, the clinic staff apologized profusely that they had to charge us about $20 since we weren't from Quebec. I had to laugh- even with our insurance, an urgent care clinic visit in the US would have required at least a $100 co-pay.  We also had to pay about $20 for his prescription.

Thanks kind Canadians!

This was my American boyfriend's experience too. He had an emergency eye problem on a Saturday, got an appointment that afternoon. The apologized for charging him $50 because he wasn't from Alberta, diagnosed the problem and gave him a $30 prescription. They also told him to come back Monday and they wouldn't charge him anything for a checkup. He went back to the US the next day, had a final checkup there later that week which cost him over $100 iirc.

I'm quite healthy and have no chronic health problems and am always amazed at the speed at which we receive health care here. Like everyone else said, if it's urgent, you get care fast. If not, you may wait.

My opinion may be a little skewed due to the fantastic employer coverage I have in addition to universal coverage.

I only know one person who has gone to Mexico for faster and cheaper dental surgery. The people I know, rich or poor, wouldn't trade our system for the US system.

iris lily

  • Magnum Stache
  • ******
  • Posts: 3354
Re: Canadians et al. - How is your health care?
« Reply #33 on: August 27, 2016, 08:34:01 AM »
A bunch of us have no doctor.

My child will wait a year for a specialist appointment, and can then have one once a year after that.

Neuro-care is shit.

The hospital emergency room did absolutely nothing when I had a severe injury, was left to figure it out myself, have a month of bed rest, and spend over $1000 doing so.

I'm glad they kept my kid alive, but was stunned and angry when I learned that hospital is behind parts of Mexico for preemie care.

I have had two excellent doctors. One died, the other I drive nine hours to see.

I've started using private care where it's an option.
I had the impressin that private pay physician services are not allowd in Canada. Am
I wromg? Or was that some  province by province thing?

totoro

  • Handlebar Stache
  • *****
  • Posts: 2101
Re: Canadians et al. - How is your health care?
« Reply #34 on: August 27, 2016, 09:29:17 AM »
>Others have to get a doctor's note, after they've recovered, saying they had a cold on a given day thus could not be at work.

My understanding is that this is not a requirement of the medical system at all, but may be required by your employer when you are absent.

I'm glad you've been able to advocate and get to a good level of knowledge.  My family and I haven't had your experience with the medical system, although we have experienced misdiagnosis and this is frustrating - and waits for non-urgent care.  I agree that a good family doctor can be really helpful and they are hard to find.

KMMK

  • Handlebar Stache
  • *****
  • Posts: 1472
  • Age: 42
  • Location: Edmonton, AB, Canada
    • Meena Kestirke Insurance
Re: Canadians et al. - How is your health care?
« Reply #35 on: August 27, 2016, 09:42:31 AM »
A bunch of us have no doctor.

My child will wait a year for a specialist appointment, and can then have one once a year after that.

Neuro-care is shit.

The hospital emergency room did absolutely nothing when I had a severe injury, was left to figure it out myself, have a month of bed rest, and spend over $1000 doing so.

I'm glad they kept my kid alive, but was stunned and angry when I learned that hospital is behind parts of Mexico for preemie care.

I have had two excellent doctors. One died, the other I drive nine hours to see.

I've started using private care where it's an option.
I had the impressin that private pay physician services are not allowd in Canada. Am
I wromg? Or was that some  province by province thing?

Yes, it's province by province. Here I can pay for my own MRI, not in my last province and I've always had the option to go to some associated services (physiotherapist in my situation usually) and just pay myself- skip the doctor altogether. In the Northwest Territories eye exams were also covered under provincial health care, but in other places are usually pay for self or under an extended health care insurance plan.

backyardfeast

  • Pencil Stache
  • ****
  • Posts: 899
  • Location: Vancouver Island, BC
    • My journal
Re: Canadians et al. - How is your health care?
« Reply #36 on: August 27, 2016, 09:45:03 AM »


 
Quote
   I've started using private care where it's an option.

I had the impressin that private pay physician services are not allowd in Canada. Am
I wromg? Or was that some  province by province thing?


You are not wrong; there are no private pay physician services (although the occasional private clinic has tested those boundaries in various ways).  However, there are lots of other kinds of private services: alternative therapies, naturopaths, etc and many services are "subcontracted": private service providers contract to the government, who covers our costs to them.  So MRIs, blood work, prosthetics, etc, etc--anything that's not primary care--are all done by private companies.  When you are referred there by your GP, all payment is done by the health system.  However it's also often possible to pay directly for their services without going through your GP or the health system.  This may be true for other specialists, too? I'm not sure.  I think this is what Scrubby was referring to, though; that she now prefers to stay outside the health system and go directly to the services she wants herself and pay out of pocket.  You can't do this for emergency care or primary care, though.  You can't walk into a hospital and pay for services (although as others have described, if you're not a resident, you may be charged a nominal fee).

K-ice

  • Pencil Stache
  • ****
  • Posts: 931
  • Location: Canada
Re: Canadians et al. - How is your health care?
« Reply #37 on: August 27, 2016, 10:45:16 AM »
When we travel we need seperate insurance.

I have never had to use it but I am afraid of the loopholes if I did.

I have 15 days covered if I book my flights with my travel card. I reciently added 2 more weeks for my family for less than $100.

They are actually quite good about it & you can be on day 10 (prob even 15) of your trip & call to add the coverage.

There are often horror stories of pre-mature babies being born or a more recient one where a trip delay went over the 15 days of coverage, the husband got sick on day 16  & stuck with a big bill.

They also deny for pre-existing conditions. So what if you have had 2 minor health things in the past,  get them checked & everything is "fine". No ongoing treatment. So now do you have a pre-existing condition?

A friend had a mild heart attach in his 40s. Is he screwed from traveling now?

Travel health insurance horror stories give us a taste of how good it is in Canada.

Cathy

  • Handlebar Stache
  • *****
  • Posts: 1046
Re: Canadians et al. - How is your health care?
« Reply #38 on: August 27, 2016, 11:31:16 AM »
>Others have to get a doctor's note, after they've recovered, saying they had a cold on a given day thus could not be at work.

My understanding is that this is not a requirement of the medical system at all, but may be required by your employer when you are absent.

A plain reading of scrubbyfish's post reveals that she was clearly not under the impression that "the medical system" requires employers to mandate notes from doctors. Her actual complaint, with which you did not engage, was that the medical system "allows" employers to condition sick days on obtaining a note from a doctor, which (according to her) is a drain on the resources of the public. Since provincial legislatures have the power to regulate contracts between employers and employees (see, e.g., Canada (Attorney General) v. Ontario (Attorney General), [1937] UKPC 7 at *2, aff'g [1936] SCR 427, 1936 CanLII 30), it is arguably fair to lay the blame for scrubbyfish's complaint, as she does, on "the medical system" insofar as it is presumably within the power of the provincial legislatures to require employers to offer employees a certain number of sick days per year, where a "sick day" is defined as a day of absence where no notice is given by the employee, and where an employee is not required to provide any documentary evidence in support of the absence or the lack of notice therefor, other than an assertion that he or she was sick. The fact that provincial legislatures have not enacted such a provision into law could arguably be construed as a failing of "the medical system". I offer no view on the the merits of this legislative proposal, other than to observe that you did not read scrubbyfish's post fairly.
« Last Edit: August 27, 2016, 11:39:06 AM by Cathy »

daverobev

  • Magnum Stache
  • ******
  • Posts: 3394
  • Location: France
Re: Canadians et al. - How is your health care?
« Reply #39 on: August 27, 2016, 11:59:26 AM »
Pretty good. I'd say it's generally as good as the NHS was before I left the UK, except: dental and vision isn't covered.

I mean, I know teeth and eyes are optional extras, but still!

In the UK an eye exam was about $50, and dental for one set of treatments was capped at about $90 iirc. That was nearly a decade ago, and I believe things have declined somewhat since then.

Edit: this is Ontario. There is an additional healthcare tax, too.
« Last Edit: August 27, 2016, 02:58:48 PM by daverobev »

radram

  • Pencil Stache
  • ****
  • Posts: 956
Re: Canadians et al. - How is your health care?
« Reply #40 on: August 27, 2016, 12:54:30 PM »
A bunch of us have no doctor.

My child will wait a year for a specialist appointment, and can then have one once a year after that.

Neuro-care is shit.

The hospital emergency room did absolutely nothing when I had a severe injury, was left to figure it out myself, have a month of bed rest, and spend over $1000 doing so.

I'm glad they kept my kid alive, but was stunned and angry when I learned that hospital is behind parts of Mexico for preemie care.

I have had two excellent doctors. One died, the other I drive nine hours to see.

I've started using private care where it's an option.

Can I ask what the nature of your specialist appointment for your child is, and what province you're in?  What was the severe injury that the ER didn't treat when you went in?  What exactly was your concern with the care for your premature child?

Your uniformly poor experience is different from that of most people I know, I'd be interested in getting more specific details of the problems.

The original scrubbyfish post is gone, which so far was he only full negative post of the Canadian system.  Why?  Was it a troll post?  Did scrubby have a change of heart?  Are all of the negative posts being removed, or are there truly 0 full negative experiences?

Thank you to all who have shared.

totoro

  • Handlebar Stache
  • *****
  • Posts: 2101
Re: Canadians et al. - How is your health care?
« Reply #41 on: August 27, 2016, 01:08:17 PM »
>Others have to get a doctor's note, after they've recovered, saying they had a cold on a given day thus could not be at work.

My understanding is that this is not a requirement of the medical system at all, but may be required by your employer when you are absent.

Her actual complaint, with which you did not engage, was that the medical system "allows" employers to condition sick days on obtaining a note from a doctor, which (according to her) is a drain on the resources of the public.

The medical system does not "allow" this.  The medical system is both provincially and federally regulated. The province sets the standards for workers governed by the provincial legislation but the federal government sets it for federal employees.

In order to get a doctor's note in Canada for an absence from work there is a private pay fee.  It is not a drain on the medical system.  Employers usually do not require a note unless they suspect misuse of paid vacation days.  Seems like a reasonable requirement in such cases and is a negotiated term of most union agreements.

Many provinces have formal sick-leave legislation requiring all employers to provide unpaid sick leave.  I've never known an employer to require a note where vacation days are not paid.

Cathy

  • Handlebar Stache
  • *****
  • Posts: 1046
Re: Canadians et al. - How is your health care?
« Reply #42 on: August 27, 2016, 01:28:24 PM »
The original scrubbyfish post is gone, which so far was he only full negative post of the Canadian system.  Why?  Was it a troll post?  Did scrubby have a change of heart? ...

The scrubbyfish post was clearly not a troll post, and I would be surprised to learn that her opinion that apparently was based on years of experience would have changed overnight based on the contents of this thread. It's more likely that she was exacerbated with and unimpressed by the replies, at least some of which appeared to be sceptical of her account and demanded details rather than just accepting what she said.


Are all of the negative posts being removed, or are there truly 0 full negative experiences?

There are plenty of negative experiences with "the" healthcare system (see below), but the nature of the topic is such that fully explaining one's negative experiences may require disclosing information that the poster is not comfortable disclosing or simply not willing to disclose, especially in this somewhat hostile environment, as the scrubbyfish example shows. This thread is not a reasonable way to evaluate the merits of any healthcare system that may exist in Canada.

Also, as noted by others, and in many of my past posts, there is no such thing as "the Canadian [healthcare] system". The fact that the system does not exist also precludes reviews of it.
« Last Edit: August 27, 2016, 01:30:25 PM by Cathy »

Prairie Gal

  • Handlebar Stache
  • *****
  • Posts: 1452
  • Location: Somewhere, out there ...
Re: Canadians et al. - How is your health care?
« Reply #43 on: August 27, 2016, 02:11:50 PM »
Quote
They also deny for pre-existing conditions. So what if you have had 2 minor health things in the past,  get them checked & everything is "fine". No ongoing treatment. So now do you have a pre-existing condition?

A friend had a mild heart attach in his 40s. Is he screwed from traveling now?

You can buy travel insurance that covers pre-existing conditions, but of course it costs more because there is more risk. So the answer to your question is no, he is not screwed from travelling.

Shinplaster

  • Handlebar Stache
  • *****
  • Posts: 1393
  • Location: up in Canada complaining about the weather
Re: Canadians et al. - How is your health care?
« Reply #44 on: August 27, 2016, 03:21:42 PM »
Quote
They also deny for pre-existing conditions. So what if you have had 2 minor health things in the past,  get them checked & everything is "fine". No ongoing treatment. So now do you have a pre-existing condition?

A friend had a mild heart attach in his 40s. Is he screwed from traveling now?

You can buy travel insurance that covers pre-existing conditions, but of course it costs more because there is more risk. So the answer to your question is no, he is not screwed from travelling.

Exactly.  If you are a Royal Bank customer in Canada, they offer insurance that will rate you a "C" for pre-existing conditions as long as you have been stable for 6 months, with no medical questionnaire required.  I have a minor heart problem, and very few companies will insure me.   So I pay twice as much as my husband for insurance, but am grateful to get it.

Re:  Scrubbyfish.  No, NOT a troll.  About as far away from a troll as you can get!  She has had some truly awful medical experiences, and as she explains in her journal, this thread has stirred up bad feelings and memories.  So she has chosen to remove her posts, and herself, from the discussion.

okits

  • Walrus Stache
  • *******
  • Posts: 9004
  • Location: Canada
Re: Canadians et al. - How is your health care?
« Reply #45 on: August 27, 2016, 09:09:08 PM »
But I can't even imagine that a yearly check-up, ER visits, birth, cancer treatment, heart surgery and trauma surgery would not be covered. 

Ontario Health Insurance Plan no longer covers a yearly check-up.

I feel like I see, over time, cuts and signs of scarcity (our province is a fiscal disaster).  Longer wait times.  Medical staff even more rushed and stretched thin.  Reductions in service.  I receive great care from a general practitioner and a few specialists, but I got on their patient lists years and years ago.  I don't think I would get the same level of access now (or not without a lengthy wait).

I greatly appreciate that health care is funded by our taxes and that once you can access care, the quality I have experienced has been excellent.  I do like that there's always the possibility to cross the border and privately pay for services in the U.S. if something isn't offered here or the wait time would seriously harm my health.  (So in reality, two-tiered health care does exist: those who can pay for medical tourism and those who are captive to their home system.



Upthread someone mentioned "one-year paid maternity leave".  Employment Insurance pays 55% of your gross wages from the past year (on which you have paid EI premiums) or $537 a week ($26,850 for 50 weeks), whichever is less.  The benefit is taxable.  Mothers receive 15 paid weeks to recover from pregnancy and childbirth, and either parent can take an additional 35 paid weeks to care for the child.  You must have worked at least 600 hours (and paid EI premiums on the earnings from these hours) in the preceding year to qualify for benefits (so a student or self-employed person who didn't pay EI premiums does not receive this paid leave).  There are restrictions surrounding working while receiving these benefits (depending on the circumstances, your EI benefit may be clawed back by 0, 50, or 100% of what you earn by working).  It's another taxpayer funded program that is very nice to have in place, but isn't quite universal or utopian.  (Some employers will top up the benefits to match a higher percentage or all of your pre-leave pay, but not everyone has this job perk.)

radram

  • Pencil Stache
  • ****
  • Posts: 956
Re: Canadians et al. - How is your health care?
« Reply #46 on: August 27, 2016, 09:42:39 PM »
The original scrubbyfish post is gone, which so far was he only full negative post of the Canadian system.  Why?  Was it a troll post?  Did scrubby have a change of heart? ...

The scrubbyfish post was clearly not a troll post, and I would be surprised to learn that her opinion that apparently was based on years of experience would have changed overnight based on the contents of this thread. It's more likely that she was exacerbated with and unimpressed by the replies, at least some of which appeared to be sceptical of her account and demanded details rather than just accepting what she said.


Are all of the negative posts being removed, or are there truly 0 full negative experiences?

There are plenty of negative experiences with "the" healthcare system (see below), but the nature of the topic is such that fully explaining one's negative experiences may require disclosing information that the poster is not comfortable disclosing or simply not willing to disclose, especially in this somewhat hostile environment, as the scrubbyfish example shows. This thread is not a reasonable way to evaluate the merits of any healthcare system that may exist in Canada.

Also, as noted by others, and in many of my past posts, there is no such thing as "the Canadian [healthcare] system". The fact that the system does not exist also precludes reviews of it.

So is it really 10 independent Providences and therefore 10 different systems (or 13 systems including the territories) instead of "the Canadian" system.  Is that correct? 

If so then we can get anecdotal accounts of those 10 systems instead of the "one" nonexistent Canadian system.  I would ask other reviewers of those systems to repeat their stories here (or link to them).

Thank you for adding what you know regarding scrubbyfish.






backyardfeast

  • Pencil Stache
  • ****
  • Posts: 899
  • Location: Vancouver Island, BC
    • My journal
Re: Canadians et al. - How is your health care?
« Reply #47 on: August 28, 2016, 12:08:56 AM »
Here's a good link to some of the basics we've all been describing: http://www.canadian-healthcare.org/

There is a "Canadian Health Care System" in the sense that the provinces MUST deliver health care under certain guidelines.  And I believe all the provincial systems follow the same basic framework: every resident in the country gets a provincial health card; health care is coordinated through your personal GP.  If you don't have your own family doctor, walk-in clinics staffed by GPs can coordinate your care.  All service providers are private businesses (even GPs) who bill the government for their services in regulated ways. 

Obviously the system is highly complex and even covers elder care, etc (areas we haven't touched on yet).

There is variation among the provinces at the granular level in what extended health care services might be covered, for how long, at what cost, etc.  They vary in whether residents are required to pay premiums, etc.  There is some variation in how long wait times are for various procedures province to province, or certain innovative programs that might be available here and not there.  There are similar issues everywhere, though, as is probably clear from our responses so far, though different provinces might try to address these in slightly different ways.  Health care services in rural and northern/remote areas is a big issue.  Health care for First Nations and other marginalized people can still be very problematic.  After all, the system is built by and reflects our society at large, many warts and all.

I'm not totally sure what kind of anecdotal stories you're looking for, though, OP, or what you're trying to find out about our system?  I think the responses here are pretty consistent: we have care quality that is consistent with other first world countries, higher public health outcomes than the US for a lower cost.  We as patients generally don't have to consider cost at all when being confronted with health issues.

The system isn't perfect: it is a large bureaucracy that can be slow to innovate and change, has been slow to adapt, and is grappling with the same issues that most other health care systems in the world are grappling with, including in the US.  Changing demographics (aging populations), changing care needs (especially around mental health), and growing demands and expenses as health care becomes more technologically driven. 

We do not have death panels; I do not recognize our system in the fear-mongering tirades about the horrors of public health care that we see on tv in the states.  Because we are familiar with the exaggerated rhetoric, Canadians can be defensive about our system and emphasize the gratitude we have that we are not living in a private, for-profit system.  That doesn't negate the patients who fall through the cracks or who are deeply traumatized (like Scrubby) by their experiences with a system that hasn't served them.  However, in my mind this is more a problem with the western medical model generally than a particular provincial set up.

Sorry to go on and on.  Canadians can talk about health care like we can talk about the weather. :) 

radram

  • Pencil Stache
  • ****
  • Posts: 956
Re: Canadians et al. - How is your health care?
« Reply #48 on: August 28, 2016, 08:09:02 AM »
Here's a good link to some of the basics we've all been describing: http://www.canadian-healthcare.org/

There is a "Canadian Health Care System" in the sense that the provinces MUST deliver health care under certain guidelines.  And I believe all the provincial systems follow the same basic framework: every resident in the country gets a provincial health card; health care is coordinated through your personal GP.  If you don't have your own family doctor, walk-in clinics staffed by GPs can coordinate your care.  All service providers are private businesses (even GPs) who bill the government for their services in regulated ways. 

Obviously the system is highly complex and even covers elder care, etc (areas we haven't touched on yet).

There is variation among the provinces at the granular level in what extended health care services might be covered, for how long, at what cost, etc.  They vary in whether residents are required to pay premiums, etc.  There is some variation in how long wait times are for various procedures province to province, or certain innovative programs that might be available here and not there.  There are similar issues everywhere, though, as is probably clear from our responses so far, though different provinces might try to address these in slightly different ways.  Health care services in rural and northern/remote areas is a big issue.  Health care for First Nations and other marginalized people can still be very problematic.  After all, the system is built by and reflects our society at large, many warts and all.

I'm not totally sure what kind of anecdotal stories you're looking for, though, OP, or what you're trying to find out about our system?  I think the responses here are pretty consistent: we have care quality that is consistent with other first world countries, higher public health outcomes than the US for a lower cost.  We as patients generally don't have to consider cost at all when being confronted with health issues.

The system isn't perfect: it is a large bureaucracy that can be slow to innovate and change, has been slow to adapt, and is grappling with the same issues that most other health care systems in the world are grappling with, including in the US.  Changing demographics (aging populations), changing care needs (especially around mental health), and growing demands and expenses as health care becomes more technologically driven. 

We do not have death panels; I do not recognize our system in the fear-mongering tirades about the horrors of public health care that we see on tv in the states.  Because we are familiar with the exaggerated rhetoric, Canadians can be defensive about our system and emphasize the gratitude we have that we are not living in a private, for-profit system.  That doesn't negate the patients who fall through the cracks or who are deeply traumatized (like Scrubby) by their experiences with a system that hasn't served them.  However, in my mind this is more a problem with the western medical model generally than a particular provincial set up.

Sorry to go on and on.  Canadians can talk about health care like we can talk about the weather. :)

Thank you for your clarity.  I am not the OP, but I am seeking something from this thread.  The U.S. system is what it is.  Before ACA, it was what is was.  I am still looking for ways to transform what we now have into something better.

Well before ACA, I was one of the chosen ones.  My plan was paid for by my employer, I paid very little (about $30 a month), had a $200 annual family deductible, full choice of doctors, the works.  My employer was paying a ridiculous amount for that coverage, and I received this benefit tax free.  Did I earn it? Well, maybe you could say so. I eventually earned my masters degree and always got rave reviews.  But every day on my way to work, I would see countless workers also working hard, most of them harder than me (anyone ever roof a house) and I knew if they even had coverage, it was not even close to what I had.  It didn't sit right with me.  Then the health care costs went out of control for more than a decade, my coverage was quickly reduced and the shared costs were increased. Even less of those workers I passed along the way had coverage.  It was clear to me something needed to be done, and now we have ACA.  Some things are better, some things are worse, and just like before ACA I think the present system is unsustainable.


In any system I understand there will be those who benefit, those who pay more than they get, those that are not properly cared for, etc. I simply want something better than we have now.  It seems as though almost all Canadians, no matter the providence, think their system as a whole is better than ours because it costs less, provides better outcomes and you do not run the risk of a medical situation bankrupting your family. Even many of those with real horror stories still end it with "at least we don't have the U.S. system".  I am embarrassed by it.  I then hear we can not do that here because death panels, ER waits until you die, no meds, and every other fear tactic.

Right now I do not think our friends to the north have the model for us.  Your 10(or 13) systems would need to be 50 (plus DC, plus 5 inherited territories) for us.  Sounds incredibly expensive just to set up, but the alternative would be coming together as a nation to solve a problem. I do not think we have it in us politically and that is exactly how some of us want it.

If the constitution does not allow this problem to be solved, then I think it is time the constitution is changed.  We changed it twice to decide what we are allowed to drink.  Why can't we change it to provide basic care to its citizens.  I know the questions of what is basic care, sex change operations, birth control, illegal immigrants blah blah blah. Prohibition was a valid reason, but not the health of the citizenry.  REALLY?  I know, not gonna happen, but why isn't it being asked?

This thread has already been a benefit to me, because I always thought there was 1 healthcare system in Canada, not 1 mandate that was solved 10(13) ways.

I do have 1 more question.  How does your healthcare system work while traveling within your different Providences?

RetiredAt63

  • Senior Mustachian
  • ********
  • Posts: 11622
  • Location: Eastern Ontario, Canada
Re: Canadians et al. - How is your health care?
« Reply #49 on: August 28, 2016, 08:36:22 AM »
BackYard Feast was right, the original legislation was federal but it was implemented by the provinces.  This is a result of our constitution, where anything not specific to the federal government is generally provincial.  This applies to health care and to education, so anyone moving between provinces has two major adjustments to make.

Radram, are there not many things that are state controlled?  I don't see an issue (from here) of health care having to be federal.  Our federal government has basic requirements, and does a lot of the funding, and I would suppose your federal government could do the same.  It is hard for a poorer province/state to fund at the same level as a richer province/state without federal subsidies.