Author Topic: Canadians et al. - How is your health care?  (Read 15455 times)

Cpa Cat

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Re: Canadians et al. - How is your health care?
« Reply #50 on: August 28, 2016, 09:42:53 AM »
I wasn't a heavy user of the Canadian health care system (Ontario), but there are some minor things I like better about the US system.

In the US, I can book a specialist appointment without a referral. This gives me the flexibility to get second opinions easily, or even a first opinion without wasting a bunch of time. And the technology tends to be a little fancier in American health facilities.

Why does it matter? In Ontario, I didn't have a GP. As others have mentioned, it could be hard to get one and even if you did have one, it wasn't always easy to get an appointment. I used a local walk in clinic, instead. This worked out fine until one incident - I was very ill and the doctor at the walk in clinic said that the reason I was sick was because I was allergic to my cats. He said this without an allergy test or any history of pet allergies. When I argued with him, he told me "Who's the doctor here?! Get rid of your cats or you won't get better." I don't know why he hated cats so badly. He refused to refer me to an allergist to get tested for this hypothetical cat allergy, and since this was in Canada, I did not have the ability to make my own allergist appointment because that's a specialist.

My brother's GP was in the same building, but not accepting new patients, so I walked up there and begged them to let me on their roster and get me an appointment. They did (I might have been crying), but I had to wait a week. In the meantime, I got more and more sick. In the end, it turned out that I had mono and a case of the flu on top of that. But enough time had passed that it had basically run its course and the doctor said there wasn't much he could do for me.

Another anecdote: My brother has severe bipolar disorder. He's used mental health services in Ontario, BC, and Alberta. He says that each province is different and the level of care varies considerably. I can't remember which one was best and which one was worst, though. He was in major cities in each province, too (Ottawa, Vancouver, Edmonton). For all of that, he has had access to services in each province and inpatient treatment when needed - however, good outpatient care keeps him from needing inpatient care. The Canadian healthcare system has created a safety net for him that I don't think really exists to the same extent in the US.

When he was first diagnosed, he had a psychotic episode. The police were called. He claimed that he had weapons (he didn't - he was delusional - but they didn't know that). They dealt with him compassionately, helped calm him down, got him to the hospital, where he was immediately admitted and stayed for over a month while he recovered. I don't really have confidence that the system would have worked so smoothly for him if he were in the US when that had happened.

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I wish the US government would negotiate drug costs on our behalf, and I wish they would regulate hospital costs better. As a user of healthcare in the US, it can be incredibly difficult to find out what something is going to cost you. There is no way to be an informed consumer of healthcare, because you have no way to "shop around." In that kind of consumer environment, we rely on the government to protect us. But the US government fails utterly to do so.

I think ACA has made a lot of strides with pre-existing condition and not letting insurance put a cap on care. Pre-ACA, my friend had some health concerns, and after visiting a specialist, it seemed that he might have Multiple Sclerosis (relapsing remitting). The specialist told him that since the symptoms weren't bad and since this was a first occurrence, it might be better NOT to get a diagnosis. It could be years before there was a re-occurence and there might never be one - but if my friend had a "pre-existing condition," he would have a very difficult time getting insurance, possibly for the rest of his life. In the meantime, the treatments for MS wouldn't necessarily be helpful to him until the MS progressed. He chose not to pursue a diagnosis or treatment.

On the other hand, now that insurance providers can't charge you extra for pre-existing conditions, costs under ACA have escalated dramatically. They say that people in the US are sicker than anyone predicted! Go figure. I think this strongly illustrates why our government needs to step in and regulate costs. Health insurance companies might not be making any money under ACA, but drug companies and healthcare providers/hospitals certainly are.


I'm still sometimes unsure, if I was diagnosed with a serious illness, such as cancer, whether I would stay in the US for treatment or go to Canada. I'm still a little afraid that there could be some loophole in my insurance that could cost me hundreds of thousands of dollars. I still don't "trust" the US healthcare system.

Prairie Gal

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Re: Canadians et al. - How is your health care?
« Reply #51 on: August 28, 2016, 10:02:54 AM »
Quote
I do have 1 more question.  How does your healthcare system work while traveling within your different Providences?

I think the province that you are treated in just bills your home province. I know that when my daughter in law was visiting here from Ontario she came down with a bladder infection. It was a Sunday, and there were no walk in clinics open here that day (I live in a small city). So she went to the E.R. and was seen and got a prescription. All she had to do was show her Ontario health care card.

Here is a link that might answer some of your questions. http://www.hc-sc.gc.ca/hcs-sss/medi-assur/faq-eng.php


gaja

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Re: Canadians et al. - How is your health care?
« Reply #52 on: August 28, 2016, 10:51:00 AM »
Since you asked for et al.: Northern Europe here. We have a co-pay of up to $350 a year. This covers all medical and drugs, but not dental. Kids don't have any co-pay, and dental is also free until you are 18. Those that need it the most get help first, but there are waiting lists for less important stuff. A few things that hasn't been mentioned:

- Healthy people can work and pay taxes. Handing out free hearing aids will get more children through school and keep adults able to do their jobs. Disabled people are very costly in a welfare state, but I would imagine this is true to a certain degree also in the US?
- Doctors that are paid to look after the population instead of the customer, have the power to say no to unnecessary surgery and medicine. Recent studies show that up to 75% of the people waiting for a knee operation could be cured by physical therapy instead: https://www.sciencedaily.com/releases/2016/07/160722093239.htm There are plenty of studies about how back surgery can worsen the situation rather than improve it. The same goes for drugs; we can't get antibiotics unless the doctors are certain that the infection is caused by bacteria. Unless proven otherwise, the sore throat or pink eyes are probably caused by viruses, and you'll just have to wait it out. This also leads to us having the least MRSA deaths in the western world.

pachnik

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Re: Canadians et al. - How is your health care?
« Reply #53 on: August 28, 2016, 10:57:37 AM »
Since you asked for et al.: Northern Europe here. We have a co-pay of up to $350 a year. This covers all medical and drugs, but not dental. Kids don't have any co-pay, and dental is also free until you are 18. Those that need it the most get help first, but there are waiting lists for less important stuff. A few things that hasn't been mentioned:

- Healthy people can work and pay taxes. Handing out free hearing aids will get more children through school and keep adults able to do their jobs. Disabled people are very costly in a welfare state, but I would imagine this is true to a certain degree also in the US?
- Doctors that are paid to look after the population instead of the customer, have the power to say no to unnecessary surgery and medicine. Recent studies show that up to 75% of the people waiting for a knee operation could be cured by physical therapy instead: https://www.sciencedaily.com/releases/2016/07/160722093239.htm There are plenty of studies about how back surgery can worsen the situation rather than improve it. The same goes for drugs; we can't get antibiotics unless the doctors are certain that the infection is caused by bacteria. Unless proven otherwise, the sore throat or pink eyes are probably caused by viruses, and you'll just have to wait it out. This also leads to us having the least MRSA deaths in the western world.

Thanks Gaja.  That's very interesting.  Especially that physio could cure so much rather than surgery.  Back surgery is something I would be very wary of.  I've had 2 friends who had back surgeries that didn't help.  It reminds me of the time years ago when I was having some pain in one of my knees and my doctor told me I had a choice:  get more exercise or take this prescription.  I chose to get more exercise and haven't had any trouble since then which is maybe 20 years ago. 

ETA:  I started doing yoga about 4 months ago and I've noticed some differences already.  Much easier to do a shoulder check while driving and my knee doesn't pop as much anymore.   I never knew I was so stiff. 
« Last Edit: August 28, 2016, 11:30:25 AM by pachnik »

Cathy

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Re: Canadians et al. - How is your health care?
« Reply #54 on: August 28, 2016, 11:27:30 AM »
There is a "Canadian Health Care System" in the sense that the provinces MUST deliver health care under certain guidelines. ...

Not exactly. "It would be open to [a province] to adopt a U.S.-style health care system. No one suggests that there is anything in our Constitution to prevent it. But to do so would be contrary to the policy of ... the other provinces and the federal Parliament." Chaoulli v. Quebec (Attorney General), [2005] 1 SCR 791, 2005 SCC 35 at 176 (Binnie and LeBel JJ, dissenting but not on this point).

In other words, a province could legally abolish its public healthcare system, but that would be very unexpected (although not impossible) because of the settled policy in Canada of having public healthcare.
« Last Edit: August 28, 2016, 11:29:48 AM by Cathy »

radram

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Re: Canadians et al. - How is your health care?
« Reply #55 on: August 28, 2016, 11:35:00 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.

I think you hit on the 2 topics that have changed drastically in the past 250 years.  I believe our constitution should be changed to include them.

I would be fine with having the federal government issue minimum requirements or guidelines, or whatever you want to call them, and then give each state the flexibility to achieve them how they wish.  I think ACA is that attempt with healthcare and common core is that  attempt with education.  Many believe those are unconstitutional ideas and they might in fact be so. I believe they should be constitutional ideas and I would support amendments that would end those questions of constitutionality . I believe we will forever be in conflict with what those mandates should include, as we should be.


Yes, there are many things controlled by states, and with that you almost always see vast differences in effectiveness.  I believe that is why the ACA exists in the first place.  If ACA was proposed when most or all states were able to provide basic medical services for their constituents, most everyone would have said "go suck an egg", we are fine.  But that was not where we were.  Same thing now.  More are covered, but still not all, and at a cost that is not sustainable.  Something else will need to change.   It doesn't need to be a national system, but it makes the most sense to me today based on challenges already discussed.

Likewise, if all 2nd graders (age is not the best way to group, but that is a matter for another day) were learning x,y, and z and a child from any state could move to any other state and still understand what was going on, common core would not even be a discussion.  The vast differences between states is not sustainable long term for a successful nation.  I very much agree with the idea of common core, though very much disagree with some of what it contains.




RetiredAt63

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Re: Canadians et al. - How is your health care?
« Reply #56 on: August 28, 2016, 12:11:54 PM »
There is a "Canadian Health Care System" in the sense that the provinces MUST deliver health care under certain guidelines. ...

Not exactly. "It would be open to [a province] to adopt a U.S.-style health care system. No one suggests that there is anything in our Constitution to prevent it. But to do so would be contrary to the policy of ... the other provinces and the federal Parliament." Chaoulli v. Quebec (Attorney General), [2005] 1 SCR 791, 2005 SCC 35 at 176 (Binnie and LeBel JJ, dissenting but not on this point).

In other words, a province could legally abolish its public healthcare system, but that would be very unexpected (although not impossible) because of the settled policy in Canada of having public healthcare.

Hi Cathy - Yes a province could, but it would be political suicide to do so.  After all it is not part of the constitution, it is just federal legislation, and that can always change.  And if they opted out, the cost would be totally theirs.  Look at Quebec and separate income tax, QPP instead of CPP, etc.

kally

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Re: Canadians et al. - How is your health care?
« Reply #57 on: August 28, 2016, 01:19:13 PM »
Here is how it works for me.

Since I was a child if you need to go to the doctor you just go.
If you feel like you should be in emergency you just get there.
You don't ever ever consider the money of the whole thing.

Sure some things can take a long wait - an MRI, that sort of thing. But if you need to you can just pay for that $6- 700 a photo. So you can do that if you want. You can also go to India or somewhere else for something if you want to move faster. Most people don't. Some people with money do. Their choice.

I have had 2 surgeries in the last 10 years. Cost me nothing. I have been to emergency probably 4 times too. Cost me nothing.

I think it is a pretty good system (it has some flaws) because you are proactive with your health. I look at all the online websites where people are paying to talk to MDs online and I think it is a shame. I hear about all the people who would retire, but they need their healthcare and I think it is a shame.

Whether you work in a laundry or are a lawyer you get healthcare.

I can never understand why the US citizens don't just demand it.

Goldielocks

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Re: Canadians et al. - How is your health care?
« Reply #58 on: August 28, 2016, 10:03:47 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?

I moved from the cheapest tax province in Canada,(Alberta) to California, one of the higher taxed income / property tax states with a  job with a "gold standard" company health plan  (I chose an HMO plan... e.g., $20 copays only for non-preventative care, etc. less receipt submissions, etc)


My take home after taxes, SS, health premiums was nearly identical in the two locations, for the similar pay.   (not including itemized deductions at annual tax time).   So taxes are higher in Canada, and with 40% of taxes going to healthcare, (instead of the military), that has to be some of it...  (Welfare being the other part)

I was shocked and amazed when a co-worker, at 42, was going in for elective knee surgery due to pain / diffiuculties, with only 6 week wait, a few thousand dollars, so that he could continue to play softball as he had done all his life.   In Canada, joint surgery like this is limited to severe life quality impairment / unable to walk or unable to work issues only.  Hip relplacements = yes, funded, but knees & shoulders = very long wait list due to quota type system.

One advantage of public healthcare is that, a bit like HMO's, they work hard to avoid costly surgeries, so c-sections, and surgeries are typically the last option after rounds of non-invasive supports.

I was also surprised when I realized that the US private health insurance providers had to cover emergency services for people who show up for treatment (life saving) but were indigent  / poverty line.  Passing those cost directly onto the remainder who pays for insurance, instead of spreading it across the whole state.  It seemed there was a lot of this.

Admin costs are CRAZY in the USA...   they need to track every bandage to every patient, but in Canada, it is "ward supply" and not worth bothering about.   I think 1/3 of the nurse's time in the US is related to invoicing, and each room needed its own supply cabinet, ideally.    The submitting invoices / receipts in the USA drove me nuts,  imagine life not needing to do that...  (except for vision, dental, etc)

------------

Husband's grandfather had a sister growing up  (Canada) who got polio, had many surgeries, and eventually died when she was 30...   It wiped out an otherwise wealthy family, and was before universal health care was voted in place in Canada.  I don't think I wish that risk on anyone, and I am very glad to pay my share to ensure average, reasonable medical care available to all.    When a loved one is sick is the LAST time you want to have to worry about money and debt.


Goldielocks

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Re: Canadians et al. - How is your health care?
« Reply #59 on: August 28, 2016, 10:34:08 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?
Fat Chance.  Only if you fly to Thailand or Singapore...  etc.
2. Is the real cost of care in Canada different from that of the US?
Yes,  US insurance funds some pretty cutting edge and very, very expensive services, many more elective surgeries, to attract customers... and these rooms / hospital and "extras" are not always there for Canadians, only the moderately priced health care options are...    Plus there are less administrative overhead costs... a lot less, in Canada.


3. Do the rich and the poor feel the same way about public health care in Canada, or are they divided?
Everyone wants universal care, at a good level for all  (or at least, it is not an income based split). 

However, those that are rich want to be able to buy extra services, like a shorter waitlist for elective MRI, or optional surgeries, but can't.   The fear is that we end up with two tier healthcare if we paid private doctors directly.   The weird part is that Canada (some provinces) is now accepting some foreigners for elective (fully privately paid) surgeries to offset hospital costs, procedures or surgery room time slots that are not available to Canadians.  Why? Sometimes the operating room is built, and there is a doctor, but no funding for the operation above the quota amount allowed.

Also,
I actually think that the poor sometimes have better healthcare than the people with (family / money) support systems do...

K-ice

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Re: Canadians et al. - How is your health care?
« Reply #60 on: August 30, 2016, 08:22:04 PM »
The Epipen scandal.

I thought I would post this here:

http://www.vancouversun.com/health/canadians+with+allergies+subject+same+epipen+price+hike+consumers/12159857/story.html


The cost went way up to $600 in the US.

Thankfully it is only $120 CAD here.

I am glad our government negotiates a fair price & keeps things in check.

hunniebun

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Re: Canadians et al. - How is your health care?
« Reply #61 on: August 30, 2016, 08:42:17 PM »
Thankfully  I haven't had many requirements for our healthcare system, but would say that my limited experiences have been pretty exceptional.  Two weeks ago, I cut my foot badly on some metal. Debated between which emergency room since there are 3 within a 10 minute drive. Picked one, rolled up to have 1 hour free parking right out front.  Was check in by a triage nurse and waited about 45 minutes to see a Dr.  After 15 minutes, I was sewn up, had a booster shoot and instructions for care and getting the stitches out.  4 days later my family Dr.'s nurse called to check on me because they received the report and wanted to know if I had an questions or on-going pain,  infection etc.  Overall...it could not have gone better in my opinion. Out of pocket cost. Zero.    Having said that, I have heard a fair number of upsetting tails about wait times for cancer treatments etc. that make me so grateful that I haven't crossed that bridge with any loved ones yet.

pudding

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Re: Canadians et al. - How is your health care?
« Reply #62 on: August 30, 2016, 09:29:42 PM »
I'm in British Columbia Canada.

It's not really free, I get a bill every month for about $80 so I sometimes wonder why people say it's free.

If I get a prescription I have to pay 100% of the cost, if I go to the chiropractor I have to pay 100% also, same with the dentist and eyes.

Visiting the doctor has no charge, if you get in accident and go to hospital I think theres no charge.

I don't have a family doctor as theres a shortage of them here and they have a waiting list.

I looked into it once and the doctor didn't take patients with a close family member that had had cancer. Not exactly sure why, but if I remember rightly it had to do with money.

I suppose its good because everyone is covered for the heavy stuff and also the most routine stuff. Beyond that if I'm unlucky enough to get something nasty I hope I have enough money to jet down to the U.S.

ptenn

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Re: Canadians et al. - How is your health care?
« Reply #63 on: August 31, 2016, 04:31:23 AM »
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 believe they changed the name to a "personal health visit" that is free once every 12 months.

I will echo the generally positive sentiments in this thread about Canadian healthcare. Wait times can be very long for non-emergency/elective procedures but emergencies will be dealt with immediately. I have heard complaints that your recovery stay in a hospital can be quite short - staying overnight in a hospital (outside of the emergency waiting room) is something hospitals seem to be trying to avoid.

There are also good private add-on type services you can pay for outside of the hospital/clinic environment. For example, my grandfather had a stroke about a year ago (healthcare system took great acute care of him) but ever since he was released home he has been paying for a private home care company to visit him most days. They do stuff like help him go to the bathroom, help him in and out of bed, and basically all the other stuff that is hard for his 82 year old wife to help him with.

And I'll add that just outside of Toronto there is an absolutely world-class hernia clinic called Shouldice Hospital. They are still private (they existed pre-OHIP and have some kind of special arrangement in place) and are amazing.

dougules

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Re: Canadians et al. - How is your health care?
« Reply #64 on: August 31, 2016, 11:47:09 AM »
One other curiosity, does the Canadian federal government help out the poorer/smaller provinces?

On the other hand, now that insurance providers can't charge you extra for pre-existing conditions, costs under ACA have escalated dramatically. They say that people in the US are sicker than anyone predicted! Go figure. I think this strongly illustrates why our government needs to step in and regulate costs. Health insurance companies might not be making any money under ACA, but drug companies and healthcare providers/hospitals certainly are.

Somebody is paying the costs for people with pre-existing conditions whether it's through tax dollars, insurance premiums, or out of pock.  Either that or people are just getting by. 

Do you think people are healthier in general in Canada?  The US is not great at prevention.  There are way too many contributors like no exercise, car accidents, terrible diet, obesity, crime, mental health, etc etc.  Canada has a lot of those factors, too, but I don't know what the comparison is. 

Quote
I'm still sometimes unsure, if I was diagnosed with a serious illness, such as cancer, whether I would stay in the US for treatment or go to Canada. I'm still a little afraid that there could be some loophole in my insurance that could cost me hundreds of thousands of dollars. I still don't "trust" the US healthcare system.

I can't blame you at all.  You never know what the bill will be.  I might just settle for only getting a single bill.  You go to the hospital and get different bills in the mail for months.  You get one from the hospital, the GP, the Anesthesiologist, the lab, and anybody else who happened to be walking by the room at the time.  Can they really not consolidate them?  It's hard not to turn this into a thread about the US, although the comparison is good to hear.

Since you asked for et al.: Northern Europe here. We have a co-pay of up to $350 a year. This covers all medical and drugs, but not dental. Kids don't have any co-pay, and dental is also free until you are 18. Those that need it the most get help first, but there are waiting lists for less important stuff. A few things that hasn't been mentioned:

- Healthy people can work and pay taxes. Handing out free hearing aids will get more children through school and keep adults able to do their jobs. Disabled people are very costly in a welfare state, but I would imagine this is true to a certain degree also in the US?
- Doctors that are paid to look after the population instead of the customer, have the power to say no to unnecessary surgery and medicine. Recent studies show that up to 75% of the people waiting for a knee operation could be cured by physical therapy instead: https://www.sciencedaily.com/releases/2016/07/160722093239.htm There are plenty of studies about how back surgery can worsen the situation rather than improve it. The same goes for drugs; we can't get antibiotics unless the doctors are certain that the infection is caused by bacteria. Unless proven otherwise, the sore throat or pink eyes are probably caused by viruses, and you'll just have to wait it out. This also leads to us having the least MRSA deaths in the western world.

Thanks.  I was hoping non-North Americans would chime in, too, even if Canada's the main country in discussion in the US on government involvement in health care.

Disabled people may just have to do what they can or rely on family and friends like in a lot of the world.  And yes, profit motive can be a big factor in the US, so that might definitely play into cost comparison whether good or bad.  We could have a long long discussion on either of those, but I'm trying to stay as neutral as I can on US health care for this thread.  To say it's a heated topic here is understatement.   

2. Is the real cost of care in Canada different from that of the US?
Yes,  US insurance funds some pretty cutting edge and very, very expensive services, many more elective surgeries, to attract customers... and these rooms / hospital and "extras" are not always there for Canadians, only the moderately priced health care options are...    Plus there are less administrative overhead costs... a lot less, in Canada.

There is definitely the claim that high healthcare costs in the US fund research.  Can anybody speak to how medical research in Canada or other countries compares with the US, especially when you take private and public funding into account? 
« Last Edit: August 31, 2016, 11:49:06 AM by dougules »

GuitarStv

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Re: Canadians et al. - How is your health care?
« Reply #65 on: August 31, 2016, 11:49:46 AM »
One other curiosity, does the Canadian federal government help out the poorer/smaller provinces?

Yes, but not specifically to do with health care.  There are equalization payments made to the provinces that are poorest from the federal government.

CanuckExpat

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Re: Canadians et al. - How is your health care?
« Reply #66 on: August 31, 2016, 03:24:55 PM »
One other curiosity, does the Canadian federal government help out the poorer/smaller provinces?

Yes, but not specifically to do with health care.  There are equalization payments made to the provinces that are poorest from the federal government.

Not quite. There is a seperate mechanism for Health Transfer:
https://www.fin.gc.ca/fedprov/cht-eng.asp
https://en.wikipedia.org/wiki/Canada_Health_Transfer

It's a bit different from equalization in that the money must be spent specifically on health funding by the provinces. Equalization payments can be spent on anything.

TexasRunner

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Re: Canadians et al. - How is your health care?
« Reply #67 on: August 31, 2016, 04:16:32 PM »
Mostly posting to follow.

Thank you for the insight into single-payer, and for being so cordial, eh!

RetiredAt63

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Re: Canadians et al. - How is your health care?
« Reply #68 on: August 31, 2016, 04:54:32 PM »
I have no idea if other jurisdictions do this, but this low-cost ($20) dog/cat vaccination clinic is sponsored by the Eastern Ontario Health Unit. 

GuitarStv

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Re: Canadians et al. - How is your health care?
« Reply #69 on: September 01, 2016, 06:16:56 AM »
One other curiosity, does the Canadian federal government help out the poorer/smaller provinces?

Yes, but not specifically to do with health care.  There are equalization payments made to the provinces that are poorest from the federal government.

Not quite. There is a seperate mechanism for Health Transfer:
https://www.fin.gc.ca/fedprov/cht-eng.asp
https://en.wikipedia.org/wiki/Canada_Health_Transfer

It's a bit different from equalization in that the money must be spent specifically on health funding by the provinces. Equalization payments can be spent on anything.

Oh, I knew about the equalization but not the health transfer.  Thanks!

thriftyc

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Re: Canadians et al. - How is your health care?
« Reply #70 on: September 02, 2016, 08:27:09 AM »
My family and I have had excellent care - no complaints nor do we take it for granted. 

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Re: Canadians et al. - How is your health care?
« Reply #71 on: September 02, 2016, 02:00:12 PM »
Cathy mentions that a province is free to do what it wants. This is true but they could potentially lose out on federal funding. I think that would be a good way to lose your spot as the premier of a province, and I doubt anyone would get elected with the plan of eliminating the concept of "universality" in the Canada Health Act.

daverobev

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Re: Canadians et al. - How is your health care?
« Reply #72 on: September 02, 2016, 04:26:20 PM »
Cathy mentions that a province is free to do what it wants. This is true but they could potentially lose out on federal funding. I think that would be a good way to lose your spot as the premier of a province, and I doubt anyone would get elected with the plan of eliminating the concept of "universality" in the Canada Health Act.

Not sure if you've noticed, but politicians tend not to campaign on the controversial; they just do those things once they are in.

Sure, they may then get voted out, but often the opposition will let it slide - if it's good for them.

human

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Re: Canadians et al. - How is your health care?
« Reply #73 on: September 03, 2016, 03:09:13 PM »
Abolish the Canada Health Act? Not likely . . .

gldms

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Re: Canadians et al. - How is your health care?
« Reply #74 on: September 05, 2016, 03:13:39 AM »
I'll also come in as an "et al".  I'm an American living in the UK and have experienced both the US systems (with employer provided Blue Cross/Blue Shield) and the UK National Health service.  I've raised four children in the UK (with births, chronic asthma etc).  My ex-wife had a cancerous breast lump.  I had a shoulder operation.  My experience is that the National Health service was basically outstanding.  Yes, my shoulder thing had a 6 month wait, but when my ex-wife had a suspicious lump they dealt with it immediately.  Emergency room visits for child asthma attacks, stupid injuries etc. were dealt with right away (immediate triage).  Oh, by the way, my taxes are about the same as they would be if I lived in, say California or Oregon. 

I found the US health care system to be mixed.  Wait times are just as long.  The specialist in the US could not diagnose/treat my shoulder.  I remember a doctor who wouldn't give me a prescription for Nicorette gum (to help me quit smoking) unless he could do a full "work-up" (so he can bill the insurance company for various tests). 

I'll tell you why many Americans are against universal coverage.  It has nothing to do with cost/efficiency etc. It is sad to write this, but the basic reason for many Americans is that they "don't want some goddamn __________ to get something I have that they don't".  (I'll let you fill in the blank, boys and girls).  Even in 2016, this sentiment is absolutely fundamental to much of American society.

Meggslynn

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Re: Canadians et al. - How is your health care?
« Reply #75 on: September 08, 2016, 09:36:20 AM »
I'm in British Columbia Canada.

It's not really free, I get a bill every month for about $80 so I sometimes wonder why people say it's free.

If I get a prescription I have to pay 100% of the cost, if I go to the chiropractor I have to pay 100% also, same with the dentist and eyes.

Visiting the doctor has no charge, if you get in accident and go to hospital I think theres no charge.

I don't have a family doctor as theres a shortage of them here and they have a waiting list.

I looked into it once and the doctor didn't take patients with a close family member that had had cancer. Not exactly sure why, but if I remember rightly it had to do with money.

I suppose its good because everyone is covered for the heavy stuff and also the most routine stuff. Beyond that if I'm unlucky enough to get something nasty I hope I have enough money to jet down to the U.S.

This is true in BC but not in Alberta.


Meggslynn

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Re: Canadians et al. - How is your health care?
« Reply #76 on: September 08, 2016, 09:52:56 AM »
As a Canadian mother of a child with a chronic health issue I have nothing but good things to say. For the first 3 years of my sons life we were at the local children's hospital every 4-6 weeks. Sometimes just a day a visit, sometimes a week. Every visit I was thankful that I didn't have to worry about what it is costing us on top of worrying about my child's health. We received outstanding care each time and waited no longer than 30-60 minutes for a doctor to see us.
My mother found a lump in her breast. In a week she had all the tests done that confirmed breast cancer, and within another week she had a double mastectomy.

Yes, taxes are higher here. In Alberta (the province with the lowest provincial income taxes) I pay approximately 23.5% in taxes on our household income after the personal deduction limit.

Also, yes we do have to pay for dental, prescriptions and paramedical services but typically employer health benefits assist you in these costs. When my husband and I are both working and we both have benefits for the family we rarely see a bill for these services and with my sons prescriptions and my use of paramedical (massage, chiro and acupuncture) for a chronic pain condition it saves us at least $2500 a year.

The negatives I have heard is that if you have condition that is extremely rare there is often no treatment available in Canada and these persons have to travel to the US for that care. Often, if the treatment is a known cure then the provincial health care will pay the cost of the treatment but if is an experimental treatment than they will not. There was a local girl with a debilitating disease (which for the life of me I can not remember name of) and there was only one doctor in North America that would operate on her brain to try and help her and this doctor was located in Texas. The surgery was $250K and the provincial health care system would not pay for it. Her parents took out the equity on their house to the tune for $100K and the community and local businesses fund raised to come up with the rest.
Also, I have heard there is typically long waits for things like hip and knee replacements.

Drifterrider

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Re: Canadians et al. - How is your health care?
« Reply #77 on: September 08, 2016, 10:36:46 AM »
For the Canadians:

It seems you've all addressed the working of the national health (or whatever you guys call it).  Do you have the ability to go private (to a doctor of your choice and you pay for it)?  OR, is there no private health care up north?

CanuckExpat

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Re: Canadians et al. - How is your health care?
« Reply #78 on: September 08, 2016, 12:43:32 PM »
For the Canadians:

It seems you've all addressed the working of the national health (or whatever you guys call it).  Do you have the ability to go private (to a doctor of your choice and you pay for it)?  OR, is there no private health care up north?

I think your question will be hard to answer. One, because as was discussed, the specifics depend on your province. (https://en.wikipedia.org/wiki/Two-tier_healthcare#Canada)

Second, it depends on your definition of private. For example, in Ontario, if you go to see a family doctor, that provider is a private practice, a small business, who happens to bill the public health insurance. Is that private or public?


nereo

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Re: Canadians et al. - How is your health care?
« Reply #79 on: September 08, 2016, 12:58:59 PM »
For the Canadians:

It seems you've all addressed the working of the national health (or whatever you guys call it).  Do you have the ability to go private (to a doctor of your choice and you pay for it)?  OR, is there no private health care up north?

I keep drifting through this thread, hesitant to add my own experiences as someone who moved fromt he US to Canada several years ago.

As others have indicated, there is no "national health care" - but a system of provincial health care systems (see Cathy's post).  As such every province has different levels of care, restrictions, etc.  To get at your question, things that we'd call a 'private practice' do exist here in Canada, but since they all bill the exact same provincial health care system the line is a heck of a lot more blurry.  You can choose your own doctor providing they are accepting patients; we've been on waiting lists for over a year. Smaller towns typically have only a single hospital where you to go for everything, from annual checkups to acute emergencies.

There are also (at least here in Quebec) clinics that deal with secondary insurance or out-of-pocket costs.  There you typically have shorter wait times and amenities like private wait rooms and physical therapists that will work with you one-on-one.  My advisor's wife went to one to get an additional post-op care that wasn't available through the bread-and-butter provincial health care system.

TrMama

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Re: Canadians et al. - How is your health care?
« Reply #80 on: September 08, 2016, 05:07:42 PM »
I've received care in 3 different provinces. I can attest that the level of care can vary pretty widely. Here in BC we get timely care and Drs treat their patients with care and respect. Ditto for the one ER trip I had in NS.

However, the story was very different when we lived in Quebec. Crazy long wait times, overcrowded clinics and hospitals, level of care 20 years behind the standard treatment for whatever condition you had and many Drs treated their patients with callous disrespect. Though we loved living there, the awful medical care is the only reason I won't move back. In all other respects it was wonderful.

For the person who asked about what happens when Canadians need care outside their home province, the treatment is paid to the provider by the home province, at the home province's rate. If you move between provinces, your insurance switches to the new provinces plan 3 months after the move. For example, when we moved from BC to QC when I was pregnant I had to go for weekly checkups. Each visit I filled out a form allowing the Dr to bill BC for the visit. The Dr was thrilled b/c BC paid $70/visit, while he could only charge a QC resident $36/visit.

The only exception I'm aware of is that Quebec doesn't seem to pay BC for any visits their residents need. QC residents needing care in BC have to pay out of pocket.

In terms of level of care for rich/poor, the difference seems to actually be in whether you have a job that provides good extended insurance or not. Both DH and I have decent jobs with good insurance. We opted for coverage from both (we have 2 kids and expected to spend more on care than on the extra premiums) so our cost for many "extra" services (dental, vision, mental health, prescriptions, etc) is $0. Families with no, or crappy, extended health insurance have to make harder decisions about what extras they can afford.

GuitarStv

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Re: Canadians et al. - How is your health care?
« Reply #81 on: September 09, 2016, 06:03:16 AM »
However, the story was very different when we lived in Quebec. Crazy long wait times, overcrowded clinics and hospitals, level of care 20 years behind the standard treatment for whatever condition you had and many Drs treated their patients with callous disrespect. Though we loved living there, the awful medical care is the only reason I won't move back. In all other respects it was wonderful.

Were you speaking English in Quebec?  I've had some experience that suggests the quality of service received there depends somewhat on your demonstrated fluency in French.  :P

nereo

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Re: Canadians et al. - How is your health care?
« Reply #82 on: September 09, 2016, 06:20:59 AM »
However, the story was very different when we lived in Quebec. Crazy long wait times, overcrowded clinics and hospitals, level of care 20 years behind the standard treatment for whatever condition you had and many Drs treated their patients with callous disrespect. Though we loved living there, the awful medical care is the only reason I won't move back. In all other respects it was wonderful.

Were you speaking English in Quebec?  I've had some experience that suggests the quality of service received there depends somewhat on your demonstrated fluency in French.  :P

We have had difficulties with several doctors and nurses here in Quebec because of the language barrier.  We always try to speak french and normally we do ok, but when it comes to technical medical explanations we often don't understand what is precisely what is being said (after all, many of the words don't come up in daily conversations). Several times seemingly overworked and short tempered doctors and nurses have told us they can't give us an explanation in english when we don't understand the french completely, and we've been pushed out the door.  Occasionally it's a nice, patient doctor, but in our experiences it's about 50/50.

GuitarStv

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Re: Canadians et al. - How is your health care?
« Reply #83 on: September 09, 2016, 06:46:04 AM »
However, the story was very different when we lived in Quebec. Crazy long wait times, overcrowded clinics and hospitals, level of care 20 years behind the standard treatment for whatever condition you had and many Drs treated their patients with callous disrespect. Though we loved living there, the awful medical care is the only reason I won't move back. In all other respects it was wonderful.

Were you speaking English in Quebec?  I've had some experience that suggests the quality of service received there depends somewhat on your demonstrated fluency in French.  :P

We have had difficulties with several doctors and nurses here in Quebec because of the language barrier.  We always try to speak french and normally we do ok, but when it comes to technical medical explanations we often don't understand what is precisely what is being said (after all, many of the words don't come up in daily conversations). Several times seemingly overworked and short tempered doctors and nurses have told us they can't give us an explanation in english when we don't understand the french completely, and we've been pushed out the door.  Occasionally it's a nice, patient doctor, but in our experiences it's about 50/50.

The best part is that many of those nurses and doctors are lying and speak English fluently, they just don't like you because you're obviously an English speaker.  This is a thing in Quebec.

nereo

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Re: Canadians et al. - How is your health care?
« Reply #84 on: September 09, 2016, 07:13:06 AM »

The best part is that many of those nurses and doctors are lying and speak English fluently, they just don't like you because you're obviously an English speaker.  This is a thing in Quebec.
I'm well aware of this.  Still makes it frustrating... no matter how hard I try I'll always have accented french.

Goldielocks

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Re: Canadians et al. - How is your health care?
« Reply #85 on: September 09, 2016, 11:55:31 AM »
For the Canadians:

It seems you've all addressed the working of the national health (or whatever you guys call it).  Do you have the ability to go private (to a doctor of your choice and you pay for it)?  OR, is there no private health care up north?

Why, yes, sir.  We can just drive across the border into Bellingham, WA! 

In reality, Alberta is a bit more lenient about private practice for cosmetic surgeries, and optional care, but BC remains fundamentally opposed to the "slippery slope".  There is a legal action right now to change it.  In BC, you can join a private clinic, which provides extended care (diet / physio, etc) and consolidted administration services together with the doctors care... and pay for a bit more time with doctors team, but the doctors are paid for their medical services from the government payment program.

Everyone gets a doctor of their choice, unless they go to the ER.  Like choosing a dentist in the USA, really.  Your choice depends on who is taking new patients.  You just need to get a referral first, before "bothering" the specialists with appointments.

TrMama

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Re: Canadians et al. - How is your health care?
« Reply #86 on: September 09, 2016, 03:59:38 PM »
However, the story was very different when we lived in Quebec. Crazy long wait times, overcrowded clinics and hospitals, level of care 20 years behind the standard treatment for whatever condition you had and many Drs treated their patients with callous disrespect. Though we loved living there, the awful medical care is the only reason I won't move back. In all other respects it was wonderful.

Were you speaking English in Quebec?  I've had some experience that suggests the quality of service received there depends somewhat on your demonstrated fluency in French.  :P

We have had difficulties with several doctors and nurses here in Quebec because of the language barrier.  We always try to speak french and normally we do ok, but when it comes to technical medical explanations we often don't understand what is precisely what is being said (after all, many of the words don't come up in daily conversations). Several times seemingly overworked and short tempered doctors and nurses have told us they can't give us an explanation in english when we don't understand the french completely, and we've been pushed out the door.  Occasionally it's a nice, patient doctor, but in our experiences it's about 50/50.

It's false that Quebecers are rude to non-francophones. They're actually rude to everyone, including each other. Anglophones just happen to take it personally.

I speak fluent French with an English accent, and no not all the poor treatment was because of my accent. My last name is french, I look Quebecoise. Many systems are set up in a way that are disrespectful to all patients, regardless of language, color, gender, etc. For example:

- The hospital I gave birth to YDD in was seriously overcrowded. The room I was in was actually only meant to be a single room, but there were 2 beds shoved into it. The bathroom was shared with the room next door (aka 4 post partum women sharing a bathroom meant for 2). My bed didn't have a privacy curtain so I got to breastfeed in full view of the public hallway. This was the case for all the maternity rooms in that wing. There were dozens and dozens of rooms set up like this.

- We were lucky enough to find a family GP. He started his day promptly at 9am. However, he instructed his nurse to begin making appointments for him at 8am.  Patients were never told about this arrangement. If you weren't there at 8am they'd threaten to give your spot away. So, no matter what you had to show up at 8am so you could save your spot for your 9am appointment. There was a 5 week wait to see him for any appointment.

- My 3yo had her tonsils out while we were there. The ENT used the same scheduling system as our GP for the recall follow up. Foolishly, I showed up for the recall appointment at the time I was told. I waited in the hallway for 2 hours with my 3yo and 1yo for a checkup to make sure she was healing properly. There were 3 other people ahead of me in line. None of them were ever called. After 2 hours I gave up and took the wild toddlers home. The nurse would never tell me how late the Dr was running and insisted we stay. No one ever called to check on us. In BC, when a Dr is running late, their receptionist will happily tell you when you'll be seen so you can go home/go for coffee/whatever instead of sitting around sharing germs with all the other sick people. If you miss an appointment for something important, the office calls you back to reschedule and check on you.

- I had 2 toddlers who were frequently sick when we lived there. It can be hard to tell on your own if your kid just has a cold and/or also has an ear infection and/or is just teething. Sometimes, when they really seemed to be in pain I'd take them to the walk in to get their ears checked. About half the time they had an ear infection. If they didn't have an infection, I'd get berated for bringing them in and wasting the Drs time with my "healthy" kids. How the fuck was I supposed to know if their ears were OK? They were screaming in pain. In BC, Drs never have this reaction.

- The nurse line advised me to stay home when my 3yo was running a 104F fever. She'd had it for 3 days and had become lethargic. Luckily we didn't listen. Turns out she had pneumonia.

- All clinics insisted on taking young children's temperature rectally. If you complained, you were told it was the only accurate way to do it. Have you ever held your 3yo down while some stranger shoved something up her butt knowing full well there's a quick non-invasive alternative?

This was in Quebec City, not some backwater. I have more examples, these are just the ones that pissed me off the most.

human

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Re: Canadians et al. - How is your health care?
« Reply #87 on: September 09, 2016, 05:05:34 PM »
The ER in Gatineau is pretty bad: http://www.cbc.ca/news/canada/ottawa/gatineau-hospital-coroners-report-1.3736927

Many of the issues in QC health care simply revolve around doctor shortages and funding. Post secondary education is pretty top notch and cheap, tons of other social service but they have let the medical system slide.

I lived in QC for about 10 years, never went to a hospital and the few times I needed to see a DR. I went to a clinic, one time with a really badly burned hand and I found if you were lucky enough to get am actual appointment you didn't wait long. I did get berated once when they had my brother's file instead of mine. Apparently I should have known to tell them I had a brother, giving my name and carte de soleil obviously wasn't enough. I actually complied and told them the next few times and they still grabbed my brother's file. This is when I burned my hand badly and needed a dressing change so nothing to serious.
« Last Edit: September 12, 2016, 10:10:38 PM by human »

Goldielocks

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Re: Canadians et al. - How is your health care?
« Reply #88 on: September 11, 2016, 06:31:20 PM »

- The hospital I gave birth to YDD in was seriously overcrowded. The room I was in was actually only meant to be a single room, but there were 2 beds shoved into it. The bathroom was shared with the room next door (aka 4 post partum women sharing a bathroom meant for 2). My bed didn't have a privacy curtain so I got to breastfeed in full view of the public hallway. This was the case for all the maternity rooms in that wing. There were dozens and dozens of rooms set up like this.

I thought my experience in calgary was unusual... It was about 5 years after the peak of the oil boom, and they had a "baby boom".

Not quite your experience, but I was sent home form the hospital twice (with apointment to be induced) due to overcrowding.  On the third time, I was 14 days overdue, so they weren't allowed to turn me away anymore.

Although I asked for a private recovery room (the birthing room was private), none were left, so I shared a room with a woman from the nearby reservation, her husband and kids until 9pm at night, sometimes later...   (visitor hours were supposed to end at 7 or something...)  Yet my husband was only allowed in to see me for a couple of hours a day, it seemed.

For the second, I had some birthing complications, (large / stuck baby) the doctor was busy with a emergency c-section for another woman, so I delivered an 11 lb baby vaginally, with only a nurse.  Baby ended up in ICU for 3-4 days, then was on oxygen at home for the next 6 weeks.  Sometimes I wonder if I should have had a c-section  (but no doctor available).

BUT -- all that was due to sudden population boom, and I did not pay a single dime, not even for the oxygen / home care.

Drifterrider

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Re: Canadians et al. - How is your health care?
« Reply #89 on: September 12, 2016, 05:30:03 AM »
For the Canadians:

It seems you've all addressed the working of the national health (or whatever you guys call it).  Do you have the ability to go private (to a doctor of your choice and you pay for it)?  OR, is there no private health care up north?

I keep drifting through this thread, hesitant to add my own experiences as someone who moved fromt he US to Canada several years ago.

As others have indicated, there is no "national health care" - but a system of provincial health care systems (see Cathy's post).  As such every province has different levels of care, restrictions, etc.  To get at your question, things that we'd call a 'private practice' do exist here in Canada, but since they all bill the exact same provincial health care system the line is a heck of a lot more blurry.  You can choose your own doctor providing they are accepting patients; we've been on waiting lists for over a year. Smaller towns typically have only a single hospital where you to go for everything, from annual checkups to acute emergencies.

There are also (at least here in Quebec) clinics that deal with secondary insurance or out-of-pocket costs.  There you typically have shorter wait times and amenities like private wait rooms and physical therapists that will work with you one-on-one.  My advisor's wife went to one to get an additional post-op care that wasn't available through the bread-and-butter provincial health care system.

This is what I mean by private.  Outside the system where cash is king. 

I can go to a provider inside my plan, I can go to one outside my plan and pay more out of pocket, I can go to one who does not take my insurance or any insurance and pay out of pocket.