Hi all my Canadian friends,

I'm in a heated debate with an "expert" doctor back here in the states. I have a couple of questions for you:

1. Would any of you give up your health care system for one like we have in the states? And why?

2. Is there really an 18 month waiting or ever has been an 18 month waiting list to get any surgery? Or is that some number he pulled out of his "expert" @$$?

3. How much paperwork do you need to go thru to get your health care bills paid?

4. What percent (generally) of your income do you spend on health insurance?

5. Any other advantages of your system I may not be aware of that you care to share?

Thanks so much in advance!!!!

Health care is provincial, so it differs a lot from province to province. For Quebec, answers would be:

1. No, improve it maybe, but not replace it. Mostly because it is available to everyone.

2. No. Surgeries that can wait (no discomfort, no danger to life...) may have in certain cases that long a wait, but it is not usually unduely long. I do not have stats under my hand.

3. Public insurance (goverment sponsored): none at all (you go at your drugstore and the drugstore bills you (minimal) and the bulk of the bill goes to governement. For private insurances, some have that service (cost the same as public one) or a little less and then you have to fill a 2 minutes form.

4. Hard to compute since it is moslty through income taxes. The additional health care insurances (dental, meds and so on) amount (for me) at about 0.8% of my net salary.

5. I would have to study more for that one.

Thanks for the response EF! I'm being called a moron and just wanted to double check to see if maybe that's true. Don't answer that please!!!!

Any idea as to how to improve it?

Out here in Alberta we do pay a Health care premium opposed to it being factored into taxes. As a family we pay only (not sure exactly as my employer pays it for me), something like $90/month. This only includes family doctors and hospitals. Eye doctors/Dentists are paid by yourself or third party insurance as well as meds.

I wouldn't trade our system in for any other, if we would just pay our doctors closer to what they get down there we might be able to hang on to them longer, this is what is causing some of the wait times.

Any serious matters are looked at right away which does mean you could wait months or years for some non life threatening surgeries. I know of one person that waited 10 months for knee surgery but she wasn't in constant pain and had a desk job, the injury didn't affect her life style much.

Thanks Jason. It looks like I'm less of moron than I thought. Again, please don't respond to that.

Very true, I can't tell you the number of Physcians fron Canada I've met that practice in the states for the income.

But then wouldn't you end up paying the same amount for health care as we do? I mean not factoring in all the waste of money that the duplication of services that insurance companies cause?

The costs would certainly be closer. There are still other efficiencies that come with universality, plus the provincial governments seem to have pretty significant clout when negotiating drug prices as well.

The one thing our health care system hasn't figured out yet is how to let people pay extra for even better service while feeding that extra money back into the general system, ie without splitting into a public/private system.

Overall, though, I have been *very* impressed with our health care system. With a few exceptions, it seems to be "cheap in the right places" but spends money where it's needed. It makes effective use of (generally small) private companies where they make sense but doesn't dump big expensive operations like hospitals into the for-profit sector.

I do believe that having a universal health care system (implemented properly) can be quite a bit more efficient than the multiple levels of administration you need for a more complex system where employers and HMOs have to be in the loop as well. Some of the proposals being bandied around in the US do *not* seem to be real well conceived -- forcing universality onto the cyrrent private system is missing part of the point -- that the simplification resulting from universality can result in improved efficiency, not just "covering everyone".

I'm in Ontario, btw.

Thanks for the response Bridgman.

Those are really great points!

Can't say I would, either. In fact most Americans I know would love to have access to the Canadian Health Care system. Case in point we were recently hiring a couple of people in our Company's Boston office and the fact that we offer a "Canadian Health Care" equivalence benefit was a big attraction. Lifespans of the typical American was 77.7 years in 2005 compared to 80.1 for the average Canadian. Despite the many similarities between the two groups, the main reasons attributing to this difference are access to universal health care and cheap medication as well as lower crime rates in Canada.



I've never heard of anyone waiting that long. Though priority is given to people with more serious problems. On the other hand the one advantage of the US system is that if you can afford it there are no wait times. Having said that the care given to elderly Canadians is first rate. Both of my parents for example needed intensive care related to heart problems which were dealt with immediately and with no extra cost. Similar treatment would have run to over $150,000 at a US hospital, a cost they would not have been able to afford at their age.



What paperwork? You flash your healthcard at the hospital and that's it.



Very little but the real cost is in the higher taxes we pay. Universal health care for all means people in higher tax brackets pay more so less affluent people can get the same standard of care. That's good and bad. Good if you are in a low income tax bracket and bad if you make more money. Also except for progressive places like Alberta and Quebec most places in Canada do not allow you to pay extra for other services you may want. That's why some wealthy Canadians with serious problems prefer to go to the top US clinics.



Anyone with an emergency or serious illness is treated right away. Medication is much cheaper here as sadly indicated by the busloads of elderly Americans from around the Great Lakes that visit Toronto frequently for the sole purpose of stocking up on their necessary prescriptions. Physicians fees are regulated here which is why universality is so strongly opposed by all US physician associations.

Many Canadians are critical of the inefficiencies associated with universal health care but what price do you put on improving the quality of life of a country's citizens and extending their lifespan. It seems to me that should be the top priority of any responsible society. Our system does need to get more efficient and evolve. Alberta and Quebec are leading the way toward providing additional services for for those who want to pay for them themselves.

Thanks John for the response. I wish there could be some kind of survey that the USA could do of the Canadian citizens that could show our doctors here just exactly how the Canadian people feel. The doctors here are continually spreading scare tactics of the bad Canadian Health Care system with 18 month waiting lists, etc, etc. And calling people like me morons for not believing them.

Some American doctors I know are supportive, but generally speaking the US medical associations have a common view to oppose universal health care and do lobby extensively against it (along with HMOs, insurance companies and pharmaceutical companies). There are just too many powerful vested interests with big economic stakes standing in the way, so I doubt you will get it anytime soon.

Based on my many discussion over the years on this topic starting from my college days in Boston and now with my many friends in Florida and California, just about all Americans I know want some form of universal health care.

What's ironic is that if just a small fraction of that huge military budget was redirected toward health care (the cost of the Iraq Occupation for example), the quality of life for tens of millions of Americans would be vastly improved and lifespans would start to reach Canadian levels. Elderly Americans should not have to travel on organized bus junkets to Canada because they can't afford to pay for prescriptions where they live. It's sad to see and its not right.

I brought up the waste of money we spent in Iraq also. Once again, I'm a moron. Maybe I should do what they suggest and move to Canada. It's not that far away and you have great beer too.

If it wouldn't cut into my audio habit (i.e. cut my wages) too much, then I'm all for universal health care. As a psychiatrist, so much of my day (and even more of my nurse's day) is spent haggling with pain-in-the-ass insurance companies that one payer (the gub-ment) with one set of rules sounds really good to me. Every insurance company does things its own way, and each one has an endless variety of policies that vary in their details.

With managed care/HMOs, I have to write off about 35% of my charges because they will only pay me what they want to. Makes me want to only pay them a like percentage of my health insurance premium every month.

The U.S. already has some small systems of universal health care, such as the Indian Health Service and the VA (Veterans Affairs) health system. When I trained at the VA, they already had electronic medical records, ahead of the curve, and the hospitals were just as efficient as the others in town.

However, I just don't see how we are ever going to get any real reform on health care. I foresee more of the same old Band Aids being applied, when the "patient" really needs a transplant. Or, in another depressing analogy, effecting any kind of system overhaul would be like trying to change a flat tire while you are still doing 55 mph.

To get real change, we're going to have to have a heck of a plan as well as leaders that can get it into law despite the outcry of various providers, clinics, insurance companies, and Big Pharma. I'm not holding my breath.

That's it, then. Here I come, Canada.

I remember a conversation about 8 years ago at COMDEX and he was talking about how much (as in quite a bit) of his salary went towards the Canadian health care system. I have no idea where he lived in Canada, but using his numbers, it would cost me a few more percentages more from my salary (about another 7% if I remember correctly) to be under the plan he was. He hated it.

Of course, I have no idea of his living situation, general health, etc. He WAS just a stranger at a tech conference.

I have heard talk from people against a government run health care, which seems to match up with some comments above this, that it drives costs down, which sounds good to the consumer, but also means that doctors get paid a lot less and thus they go elsewhere to make more money, so then you could end up with sub-par physicians, or a doctor "shortage" sometimes. Not saying that all doctors in the USofA are great, but I've heard horror stories about some in other countries. Of course, you never hear of the good ones, just the ones that make for good stories, right?

The only other issue I see with some of the "plans" being pushed by certain presidential candidates is that a couple of them also plan on including the government paid health care to people who are here illegally. So those of us "good" citizens who would be paying our taxes to get government run health care, would also have to pay taxes to cover those people who aren't paying any taxes at all. I am not talking about the poor, or unfortuntate people, but the people who are working, but since they are illegally here, they don't pay taxes. That is something like 15Million people, so it would have to have an impact on what we pay.

Oh, one other question for our Canadian friends since they have more experience with all of this.

How do you deal with some of the people in Canada who are of the "free-loader" type where they have tons of kids, don't work, and let the government pay them money so that they can live (which gets spend on smokes and booze a lot of the time) with no incentive to ever get out from government assisted programs? They don't pay hardly anything, IF anything in taxes, yet have a whole slew of kids that all need medical care.

Or is that just a problem in the USofA with our generally lazy society?

I live in Ontario and pay no insurance premium (other than that of my income tax and my employer has a benefit program the helps with drugs, dental, etc.). It depends on your personal status if you are in favor of the Canadian system or the US system.

If you are a young single healthy person making a large salary, you would prefer the American system. However if you are a middle aged with a family with multiple kids and are starting to feel the aging process, your view changes rather quickly. What’s interesting about this scenario is that most young single healthy people become middle aged family people with kids.

About 4 weeks ago my 4 year old son woke up at midnight with a very swollen neck, high fever, stuffy nose, the works. We rushed to the hospital where a very pleasant nurse attended to him immediately, taking his vitals, administering Tylenol for his fever, blood pressure, etc. We waited another 30 min. and he was attended to by a doctor who told us he had strep throat and the infection had spread to his gland in his neck. She administered antibiotics and gave us a prescription. We were back home by 2:30 am. The total cost and was an $8.00 dispensing fee at Wal-Mart the next day for filling the prescription. With in a week he was cured. BTW my wife and I never even had to sign anything yet alone fill out paper work.

Last spring my wife waited 12 weeks for a non life threatening, mildly annoying gal bladder surgery. Sure it would have been nice if the 12 weeks was 6 or 4. But it’s a far cry from the 18 months posted here.

I do know that Ontario’s MRI machines are running 24 hours a day due to the demand and depending on your situation you could wait up to 6 months, again sig less than the 18 months reported here.

Yes, my taxes are higher but knowing that I will never get a phone call saying that anyone in my family will be denied healthcare based on something as trivial as money, is a great comfort (when peoples lives are at stake, money should never be an issue)!

Doctors in the US may make more than in Canada, (I have not data to confirm this) but that doesn’t mean that they are standing in the soup lines here either. Doctors in Canada do quit well (I don’t have any stats) but I assure you none of them are going hungry.

Great points Nick. I don't think we should read that the Canadian health style system is perfect by any means. I have my gripes as well, some of what you heard. Taxes. Tell me about it. In our country the high "progressive"?? income tax means more of the cost of these welfare programs are disproportionately borne by people in higher income brackets. On the flip side people with lesser financial means pay relatively little for the same quality of care. Like I said earlier whether that is fair or not, good or bad really depends on ones financial status and your view about what it means to be a responsible society. Universal health care has to get paid by somebody.

Like most places there are no doctor shortages in big urban centres, but I do hear about them occasionally in smaller communities. I don't know what to make of it. I haven't detected any difference in quality of physicians but I do know that the top docs are aggressively recruited by the well known American clinics and many do go south. That's the problem with a regulated market where top people's incomes get too regulated and points to a negative outcome of universal medicine. Interestingly I know a few Canadian doctors who returned to Canada after a few years at US clinics, citing concerns about crime, lifesyle issues, a changing government attitude to being able to bill for other services, are just plain homesickness. Maybe it is the beer.

Plenty of freeloaders in this country as well and with our bigger social safety net many have less of an incentive to find meaningful jobs. More needs to be done to curtail welfare abuse which isn't just limited to health care. With the tighter US immigration policies, we seem to be getting a larger influx of people entering Canada who are immediately given access to our health care and other welfare programs. I suppose they have been screened but it would be nice to have them make some sort of a contribution before given social security.

Anyway no system is perfect and all are subject to some abuse. Still, I get back to viewing these issues in terms of what are the primary goals and priorities of an advanced society. I have to say that being something of a numbers guy, I get some comfort knowing the lifespan data. What price do you put on the lower anxiety of Canadians knowing they have free access to high quality medical care and subsidized drugs? Higher taxes and inefficiencies are the costs for sure but I doubt the vast majority of Canadians would ever forego it now. That's why our politicians fall over themselves making speeches about their commitment to universal health care.

I know where you are coming from. However, if it means the difference between the kids not suffering because of the parents laziness, then I am glad that we have a system that allows everyone health care regardless of their income. It's not the kids fault that their parents are not contributing to society.

We see it here more on the side of employment insurance verses health care. In my province, PEI, we have so much seasonal work (farming, fishing, tourism) that many old school folks feel that getting employment insurance for the winter months is a God given right as opposed to a service that should assist your income if absolutely no other work is available. The sad part is that the government still promotes this mentality by providing for jobs that start and end suspiciously in just the right amount of time to make sure you are eligible for EI.

However, I certainly would not trade our health system for the American system. If I lived in the states, I'd probably have false teath right now as I needed 'non-cosmetic' help with my teeth that my family would never have been able to afford. They were hard working but didn't make enough that they would likely have had good health insurance if we lived in the states.

Also, my Mom would probably be crippled as she has had just about every medical issue known to Man. Bad back, bad knee, inner ear dizziness causing a fall rupturing her spleen, her stomach is a veritable road map of scar tissue from miscellaneous internal issues. I'm not even sure if she would be alive today if we had grown up without our health care system.

I don't know what % I pay in my taxes but it's one tax I'm actually proud to pay.

I hate to get into the political threads, but I have 2 points.

1. We're already paying for low income/illegal health services. It's called emergency services. They're available to everyone, and it's pretty easy to get out without paying.

2. Presumably (ha ha ha), since employers would no longer be paying for health care coverage, salaries could go up. I know my employer pays a fair percentage of my total compensation towards health care.

Of course, point 2 only applies if you already have employer sponsored health care, so YMMV.

Excellent points Murph!

When you (nickbuol) talk about "free-loaders", I don't think they're can be such a thing in the Canadian (European) health system. If you are sick, you deserve to be treated and get better, regardles of your age, sex, income, habits, etc. This is the basis of a civilized society and basic human rights. There has been talk about doctors not helping smokers, and other issues pertaining to over weight and heart problems, but these are rare. Remember, most doctors became doctors primarily becasuse they want to help people.

We have a health card that we are required to show a medical facility to stop non Canadian citizens from abusing the system. However, if you are in a serious car accident, I don't believe they need to see you health card before they treat you (unlike stories I have heard in the US).

Ofcoarse, if the US adopted a health system similar to Canada, we wouldn't have the "cross boarder shoppers" like we do now.

Where's Bren?

This would not happen because of the increased taxes the employer (and us I'm afraid to say) would have to fork out. Nothing but nothing is free. If we think the companies here in th U.S. are going overseas at an alarming rate now be careful what we wish for.

Yeah, but the employer would also not have to pay insurance costs. It could balance out.

Not all employers do Ken, alot of them only pay a portion of the bill. With national health care the choice is no longer theirs to make, it's the goverment.

The plain thuth is I don't trust this goverment to run anything effectivly.

And I don't trust insurance companies at all. Guess we'll just have to disagree--which is a good thing, and one of the greatest things about this country.

Believe me I don't trust most of them either, no disagreement there. Taking about health care I'm off to the cardiologist. Got to see how the old hearts holding up. It's a good thread so far, I hope it is kept this way.

That's the paradox of the situation. Society has a moral obligation to help others. It is the humane thing to do. However, there are a group of these "others that need help" that don't feel morally obligated to even attempt to contribute to society. I guess when you hear of people that specifically say that they had 'X' number of kids just to get into another government plan, you know that they don't care or possibly even love their kids. They are just "things" that let them get more free hand-outs. Should the kids suffer? Heck no. It isn't their fault at all, but these "parents" are the ones I have a problem with.

How "fair" is it if you have a couple where niether are working a regular job, they have 7 kids, get Welfare, low-income health care, and other government provided services. Then you have a single mom, with 2 kids, working 2 jobs, but having to pay for day care, she has a very basic health care plan. Lets say that both moms are in a car accident. The 1st mom is covered by the government, but the second mom has to pay a huge deductible and out of pocket maximum. The second mom has to suffer higher expenses because she is actually trying to do what is morally right and trying to work for what she needs. How fair is that?

I guess it can be a moral issue versus a fairness issue. Of course, no matter which plan you have or where you live, you will always have someone trying to get something for nothing, and you will have innocent people (kids or others) who could suffer if something isn't there to help them out.

This is a pretty interesting conversation to me. I am sorry if I am being a pain in the butt about anything, but with the elections coming up in the USofA in several months, it is nice to hear some "inside track" on what it means to have some of these government services.

How much of an election issue is this for the candidates? I thought this was more a regional issue, places like New England for example, and not a national one?

There is something morally wrong when CEO's and upper level mangers of HMO's are making millions and billions of dollars and less fortunate people are denied health care resulting in chronic pain and death. The fact the government not only allows this to happen but actually supports the system is not just disturbing, it is appalling!

The fact that this happens in the richest country in the world and is often quoted by its own people as the best country in the world is repulsive!

I can’t believe Americans actually stand for this and allow it to happen in 2008. In Canada, England, Germany, Holland, France and many other countries (which have an average better standard of living than US citizens) there would be a revolution if a government tried to implement a system like the US.

Paul

Staying out of anything that resembles politics or religion.

I like our system... it's not perfect, but it works pretty well. I mean, as a young-ish professional living with the same, she goes to the doctor every 6 months (because she's female... and their parts require maintentance), I've been... three times in ten years I think? Chances are that I'm paying more in taxes then I get back from the system, but if you look past your own bubble... I'm also paying for the guy standing beside me at a concert to get his bronchitis looked after so he doesn't give it to me... I'm also paying for my grandmother's health care... and for all the less-selfish people out there that have kids to form the next generation.

I'm not sick now, but I could be someday... I could drop dead at 85 having never had a major illness (and damn, I gambled all that tax money on a system I never used), or I could be shot on opening day of hunting season this year and require a level of care that would economically cripple my family if I didn't have the coverage. I like the former idea... at worst, I've helped cover the bill for some poor kid somewhere born with a defect of some kind.

Bren R.

Thanks, Bro. I appreciate the opportunity to learn from the perspective of my Canadian friends.

You realize I'm unaccustomed to be asked for my personal opinion on something (as opposed to cracking out my head and dumping technical knowledge out)?

Bren R.

We'll just consider it a Health Care Opinion Omelet and admire it.

I was surprised to find this article in Wikipedia that deals directly with this thread topic. Seems fairly balanced going through the pros and cons. I did not realize that the USA is the ONLY wealthy industrialized country that does not have some form of universal health care. Here is a copy of the summary with a link to the full article:



http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

Just offering a personal experience on this one . . . Ian was booked to get an MRI on his knee (so not life-threatening, but certainly something that pained him every day) - booked the appointment in May . . . and the MRI was scheduled for the following June, 13 months later, at 8:30 pm, 185 km away. A month before it was due, he got a call pushing it out a month longer. So he waited just over 14 months in total.

Two months after the MRI he called the doctor's office to find out why he hadn't heard any results, only to find the time had been so long that his doctor had actually died in the meantime!

Obviously the death of the doctor is just a strange sidebar, but the wait time and distance were certainly real.

As the other Canadians have said, YMMV!

Not to open a different can of worms... but I liken it to public versus private auto insurance... as you Albertans know... you take it up the hoop for your insurance... while those of us under public insurance get off pretty easy... it's actually something the government does better than private companies do.

The big problems with public insurance being things like the monopoly, where the insurer starts saying things like "If you don't have an immobilizer, we won't insure you!" and "We won't pay out your claim, your car had an immobilizer, it COULDN'T have been stolen!"... (a hot topic for Manitobans, as MPI starts making the addition of 3rd party vehicle immobilizers being hacked into your car mandatory, and refusing to take any responsibility for the problems they cause)

Bren R.

Well, the CEOs and beholden to the shareholders, and the upper-level managers are beholden to the CEO. So you have to look at the shareholders, ultimately. As long as the primary concern is profit, then morals are the first thing to be defenestrated.

I don't know about that Brent. I have looked into the costs of insuring my 2006 F150 and 2007 Rav4 in BC and Sask I get mine cheaper here in Alberta, by a few bucks. It is only those with bad driving records that are paying through the nose for their insurance, as it should be. They are also usually the ones screaming about insurance being cheaper else where.

My dad had been having some knee problems over the last year. Finally, around the last week of November, his knee 'went out'. He was in a lot of pain, but could walk a little. He saw a doctor two days later, got an MRI (again two days later), and three weeks later was able to get the surgery he needed. His condition was certainly not life threatening, but it did greatly affect his quality of life.

So, in the Canadian health-care system - how long would it take to see a specialist, get an MRI and then get an operation?

I work in the Healthcare field and
1.I would not like the US system.

2. There are not 18month waits for surgery. In fact most provinces have published wait times online which has driven demand to bring surgical wait times. A health region in BC has mandated they will reduce their orthopaedic waits by 11% this year.

3. I really dont do much paperwork to get my healthcare, just pay my monthly family premium of $88.

4. $264 a quarter for my family of 4 isnt large, but we get taxed to pay for the system.

5. I sell medical equipment and one nurse that worked in the US and Canada said to me a lot of the equipment in the US is disposable because its used and that cost is billed to the HMO of the patient. In canada most of the equip is reuseable because its much less costly and not to mention environmentally friendly.

Its like using paper plates at home and throwing them out or buying some plates. As a result in Canada the Sterile Processing Staff are much more educated to reprocess the equipment than in the US, where you can be working at Burger king on Monday and sterilizing a resectoscope the very next day with no qualifications.

Some things like MRI have long wait times, but you can pay if you really want to. The NBA and NHL teams in Toronto get MRI's because they pay for use. The province may not adequately fund a MRI centre's operation and they do some work for a cost to meet the financial needs. Vince Carter of the Raptors had an MRI a few years back and that was the response of the manager of the site.

I also ran into a US citizen at a B&B where I stay in BC and he was talking about this whole "socialist" healthcare system with his bad knee from skiing. He asked how much to get a knee done in Canada and what are the requirements. When I told him it was covered by taxation and no extra out of pocket costs and the only requirement was that his Dr. said it needed to be operated he changed his tune. It seems that he is 45 and loves skiing and soccer, but his HMO doesnt deem his bum knee a hinderance to his everyday life, just his recreational life, so he cant get a knee replacement which would cost around $20k.

For the most part, the US has great Dr.'s and if you really need care its not a long wait, but you pay thru the nose as a patient because healthcare is a business.

In Canada its seen as a public service offered and because some people believe that if something is free, they should take all they can....the system can get bogged down. Waits on Vascular, Orthopaedic and general surgery are not too long and there are some amazing surgeons that I have seen. Care is great and cost is not an issue which makes me grateful. When my 4 year old is coughing to the point of passing out from whoopingcough, I am only thinking of his wellbeing in the ER at 3am........not that I may have to cancel the family vacation because of what this is gonna cost.

Depends on where you are and if you want to pay. I know a friend and his 12 yr old son had knee problems from a football game. He seemed to get care rather quickly, probably 3-4 weeks to get referred to a ortho specialist to get an mri, but the surgery wait was going to be a couple months, so he went to another hospital an hour away in Banff. The surgeon there does all the knees for the national ski team and international skiiers regard him well also.

I have heard of other older neighbours experiences with getting knee replacements that took longer. I think its a priority basis in some cases where a 60 year old with a limp isnt as much a priority as a 12 yr old that is still growing who needs ACL surgery.

The other option is there is a private clinic in the city that is run by surgeons with priviliges at local hospitals. Also there is a private MRI facility. If you wanted, you could pay for your MRI and knee surgery here in Calgary if you wanted.

Well, it is encouraging to hear that most of you are pleased with your health-care system (since we are definitely heading towards government run health care).

We have a huge problem with illegal immigration here though. How are non-citizens handled?

Not really sure. our borders are with the US, but I guess if you say EH enough you can get healthcare. I'm sure it goes on but I guess some borrowing of ID or fake ID might grease thru the system.

Here's a link to the province of alberta surgical wait list.

http://www.ahw.gov.ab.ca/waitlist/CategoryOverview.jsp

And here is one for British Columbia

http://www.health.gov.bc.ca/waitlist/


I also forgot to mention Pharmaceuticals. I would inquire as to why the same drugs are so much more expensive in the US than in Canada, even when they come from the same drug company? I have a friend in Pharmaceuticals with some insight as some of you may have also.

Ask some Dr's where the nicest Pharma sponsored CME was that they attended? Bahama's, Bermuda, Hawaii, Strasbourg, Paris, Rome???

Pharma companies rules on entertaining physicians changed in canada a couple years ago, so they cant do as much as they used to.

What an interesting thread and people are staying civilized! I love this board.

To receive subsidized health care in Canada, you have to produce your Health Card. You need to be a citizen to get one. Of course, I'm sure it could be faked but so can citizenship. I have never heard of such being a problem so I must assume it's pretty rare. If you were a visitor from the States, you would be asked to provide insurance information, but the good news is that if your life is threatened, you will never be refused. I have no idea what we do when you wake up from your life saving operation and you still have no insurance in your home country.

I assume we ship you to our National Prison Igloo and force you to build the holes in Tom Horten's doughnuts using nothing but broken hockey stick blades for tools until you can be reintroduced into society in a work term as a Celine Dion roadie.

A little precision (at least valid in Quebec). You don't need citizenship per se. If you are a landed immigrant or a refugie or have some other form of visa (working permits and so on), you can obtain coverage after six months through official channels and a Health Card with photo is handed out.

And I agree with Murph that it is very nice to have threads like this and everything is done in a civilized manner.

Is any part of the health care system subsidized through taxes on goods and services?

I don't think any level of Canadian governements is that specific on which element of revenue is used for what. They all add it to the big pile and spend from it. Then again, I might be completely wrong!

GST/PST normally just go into General Revenue - nothing is specifically earmarked for Health per se, other than Health Care Premiums.

How would one firgure the total cost of ones health care. Say a person makes 100K a year what portion could be ear marked for health care.

There are stats available (different ones as it depends often on what is considered "health care" or not). You would need to research it. You may want to just check on of the provinces' web-site. Sometimes there are surprising info there. Statistics Canada would another potential source or Universities with important Health Care or Social Science programs.

Great thread, keep the posts coming. I’ve always wanted to hear first-hand opinions on this subject. IMHO, for what is worth, the problem I see with the private only health-care system is that insurance companies are not required to insure people with pre-existing health conditions or disorders. Precisely those are the ones that really need to be insured. I know that imposing private insurance companies to insure everyone regardless of medical history without exorbitant premiums for the unhealthy is virtually impossible; so the only possibility I see is going universal.

The costs are picked up mainly through personal higher income tax rates and through an employer health tax which varies from province to province. Here in Ontario the EHT is 2% of employee income. People who make low incomes or unemployed bear very little of the cost.

Another good point. There is something fundamentally wrong with a health care system in which private insurance companies have a motivated interest to deny care and minimize benefits for their customers so that their shareholders will profit.

I can tell you this, I am so sick of my insurance company. I won't go into the long details, but my wife needed sinus surgery this year, and it has been a battle to get them to pay what they are supposed to. It was a 2 part procedure, so after the battle for the first piece, they forced us to switch to a different doctor, and now we got a bill from that doctor for $7500 because our insurance didn't pay yet because it is being reviewed to see if it was needed or not. My wife talked to the insurance company literally dozens of times to find out which doctor the insurance company would cover and when she went to that doctor and got the procedure done, we started getting flooded with paperwork including no less than 6 of the exact same form but with different "procedure" numbers on them basically asking if she is covered under any other insurance, blah blah blah... Like I said, seeing the bill today for $7500 has me a little miffed to say it nicely. My wife was already at her maximum out of pocket from the first surgery, so this should have been paid 100%, no questions asked....

Dumb insurance companies.

Is the person who wrote the post the same person who owns that SIG line?

A coupe other points.

The fact that Canada is 1-10th of the population of the US might make this easier to administer, but it still isnt easy.

Often the public healthcare system is not a profitable operation, so the purchase of new equipment, sterilizers, beds, surgical tables, etc. isnt easy. Often a new piece of cardiac equipment makes more headlines and gets the funding, while a sterilizer unit that should have been replaced long ago still has to be repaired and used.

Its kind of like Jakewash's old sub having to be tolerated because he needed to buy the new LCD TV for his better half. Man, I gotta help him out with capital planning and replacing depreciated assets.

Hi all,

I started this thread and haven't had a chance to get back to it until now. I was going to assume that people would be calling other people morons by now like that doctor is calling me. In fact, I was going to request Amie to pull it from the Website because I was almost certain of it. Wow!!!! That has not happened. Well at least not yet. It just goes to show you that first class people buy first class products from first class companies. Amie - Do I get extra points for sucking up???????

I really appreciate all of your responses and I'm going to call my discussion quits with my so called "expert" doctor back here in the states. When he insults our good Canadia neighbors, it shows he doesn't know what he's talking about. Here's an example(Don't shoot the messenger and AS ALWAYS - IT'S ONLY HIS COMMENT AND DOES NOT REPRESENT THE FEELINGS OF THE GOOD AMERICAN PEOPLE DOWN HERE!!!!)

This is the response I got from him when I told him that the Canadian people I've talked to wouldn't change their system to ours:

Of course Canadians wouldn't change their system, they're addicted to nanny state socialism, they're motivation for doing something themselves is gone...

There's no point in my continuing my conversation with him.

Should we ask Amie to close this thread? Or has it been enlightening? That is before someone gets out of hand?

Again. Thank you all for your participation.

I learned the other day -- and it blew me away -- that Canada's population is the same as that of California.

We got a lot of people here, eh?

Hi all,

I started this thread and haven't had a chance to get back to it until now. I was going to assume that people would be calling other people morons by now like that doctor is calling me. In fact, I was going to request Amie to pull it from the Website because I was almost certain of it. Wow!!!! That has not happened. Well at least not yet. It just goes to show you that first class people buy first class products from first class companies. Amie - Do I get extra points for sucking up???????

I really appreciate all of your responses and I'm going to call my discussion quits with my so called "expert" doctor back here in the states. When he insults our good Canadia neighbors, it shows he doesn't know what he's talking about. Here's an example(Don't shoot the messenger and AS ALWAYS - IT'S ONLY HIS COMMENT AND DOES NOT REPRESENT THE FEELINGS OF THE GOOD AMERICAN PEOPLE DOWN HERE!!!!)

This is the response I got from him when I told him that the Canadian people I've talked to wouldn't change their system to ours:

Of course Canadians wouldn't change their system, they're addicted to nanny state socialism, they're motivation for doing something themselves is gone...

There's no point in my continuing my conversation with him.

Should we ask Amie to close this thread? Or has it been enlightening? That is before someone gets out of hand?

Again. Thank you all for your participation.

Ooh, creepy double post!

Sorry about the double post. Operator error.

I think we're all familiar with that one.

Thanks for sharing that last quote from your interlocutor. Really funny. By now you must know that some nanny-state-socialist-addicted states have a sense of humor too!

Yes. Thankfully.

>>This is the response I got from him when I told him that the Canadian people I've talked to wouldn't change their system to ours: "Of course Canadians wouldn't change their system, they're addicted to nanny state socialism, they're motivation for doing something themselves is gone..."

Ask your friend about gun control

What is a nanny-state-socialist???

Why is it when faced with facts and the possibility of being wrong, we naturally digress to the 3rd grade and call each other names?

I bet your esteemed Dr. friend thinks we socialists should probably just fall in line behind the mighty USA and contribute our efforts to finding those "weapons of mass destruction" in the middle east too. Never mind the oil significance of Iraq.

He no doubt thinks we should let everybody buy guns like a pack of Winstons at the 7-11 on the corner so we can all truly have the free right to bear arms. Thats what keeps the trauma Dr.'s and undertakers in business.

I love the ignorance of some(and not all) in the US that think we are an inch away from a communist state that oppresses its masses when in fact we helped slaves flee to freedom from the southern US and their oppressors.

I must admitt that as a nation we are naturally too polite and not as proud of our heritage and history as the US. But that naturally leads us to look out for each other, instead of conquering each other... and the healthcare system is a reflection of that.

Rather than try to profit off our fellow neighbours by charging to keep them healthy and alive, we just have them contribute to a fund and if somebody needs care to keep them healthy or alive, we all bear the cost of it. Kind of strange concept, but really just insurance like the great corporations of the US...Met Life, Wawenesa, Prudential, Allstate, etc.

Do you know the difference between Doctors and God?? God doesnt think he is a doctor.

Alas, I am too fat to stand on the soapbox any longer and am done with this topic.

I really like the US and most americans I have met, but when I considered doing a masters degree in Massachusets I was distressed to find out I would have to pay $3000 a year for healthcare insurance....or even worse if I did get sick. I couldnt afford it.

Have no fear, I have a plan....

There is one thing I find annoying, here in Alberta anyway, when you really need emergency services - an ambulance, you have to pay for it! This makes no sense to me what so ever, but once you are at the hospital you have no charges at all.

I do remember when this came about(many, many years ago) and the reason why(to cut down on people calling for one due to a slight cut, etc), but it still made no sense to me. I always thought if it wasn't a true emergency, like a cut artery etc., then you get charged, otherwise it should be covered like the rest of the system.

You have to pay for it in the US, too. Just wait until the ambulance bill shows up. Or worse yet, the medevac helicopter.

An outcome of our health system is that most Canadians feel its their God given right to not have to pay for anything indirectly related to medical costs. I dunno but having the plan pay for transportation to the facility looks excessive to me. Its demands like that which makes our system onerously expensive and really burdens the budgets of the provincial governments. I'm waiting for further developments in a two-tier universal plan where people who can afford it can pay for different services. For me that is an annoying weakeness of our current system. Ontario appears to be lagging more progressive provinces in this area.

To me it just seems wrong to be charged for a health care expense when you are at your most dire need for it.

I wouldn't mind possibly funding it by a $20 fee every time you go to the doctor on your own or even an increase in our health care premiums we pay here.

It's a really interesting topic and chez Colquhoun we do a fair amount of reading about it. One source I like is the Fraser Institute because it examines Canada against the world, rather than against the US (which is a much more common thing to do in this country). At one point (I believe 2004) we had the second most expensive healthcare system in the world (only Iceland's cost more) but the 32nd most effective in terms of access to care. I don't think the US is measured in that scale, since the Fraser Institute compares countries with socialized medicine against each other.

Just bringing it up because of Jakeman's comments on the cost of the system.

I think you might find the governments of those countries to be more efficient than ours as well

LOL!

That is the slipperiest of slopes... once the chock holding "universal health care" in place is weakened by two-tier, the government (no matter which one) will begin the slide to a US-like system... it'll creep in little by little... nothing big enough at a time to warrant anyone getting too up in arms... 10 years later, everyone looks around and says "oops - how did we get here?"

If you want something to stay the same - keep asking for more, they'll bargain you down to what you have now... if you give an inch, they'll take the proverbial mile.

Bren R.

There's the usual slippery slope argument...

Seriously I think there's definitely a big risk of that happening. Also who gets to determine what's covered by the regular universal health care and what's part of the 2md tier "luxury" treatment? I mean some things are easily a matter of preference and not essential, but I just don't know if I would trust the govt. to decide whether a treatment is too costly to be included in the regular plan.

Although . . . I'm not sure how 'grey' tatoo removal and plastic surgery to repair holes from random facial piercings are . . . both are covered by the Canadian system.

I guess that backs up your point about trusting the gov't to make these calls!

Those Fraser Institute studies which Amie posted make for interesting reading. While the Canadian model is held up as the ideal by all the developed industrialized countries, back at the ranch I hear the creaking of a system bloated by excessive costs and too many inefficiencies. I also believe the state has no right prohibiting my access to additional care. In that respect Canada is alone in the world.

Slippery slope for whom? The whole country is on a slipperly slope trying to maintain this one tier plan in light of the ballooning aging population. Even Canada's enormous natural wealth won't be enough to fund that scale of care without some change.

Some food for thought from Amie's Fraser articles:



One other item of note which is sadly confirmed yet again in these articles is that our good friends down south are out of step with the rest of the developed world by not providing some form of universal health plan.

I'm not sure if it was mentioned elsewhere in this thread, but I bet every Canadian here would agree that it's the system that is 'creaking', not the people working in it - I have always had very hard-working, respectful people administering to myself or to my family.

Of course! I don't think anybody here is complaining about the people working in healthcare, their work is top notch.

I'm fine with "pay extra for more service" as long as all the money goes into the same facilities. That still leaves a small slippery slope (sort of a slippery bunny hill) but only in the sense that the government could "cheap out" on what the standard plan covers in order to reduce the amount of $$ which had to be put into the system in the first place -- but that's no different from the situation today where the government decides how much money to put into health care.

The real slippery slope is where "two tier" means two different facilities, typically one profit and one non-profit, where the extra money spent for premium services does not benefit the core services.

One nice thing I see about a government run system is that people are much more comfortable making private donations to local hospitals -- no guarantee the money will be spent perfectly wisely, but at least their donations won't be helping to pad a for-profit company's bottom line.

We already have a two-tier system here in Canada. Dental and drugs are not supported by the government. I am lucky that my company pays for most of these things. However, if I was unemployed or retired without a company pension, I would have to pay for these things out of my own pocket. Has anyone ever priced out what braces for a 12 year old costs or durgs for a cancer patient. You would have to seek private insurance in these cases, unless you were very wealthy.

I think there could be a system for the rich and not so rich. If you take a person that has worked all his life and made a good living, payed off his home and has a nice next egg. Why would this person have to wait months for an MRI when he is able and willing to pay for one?

If we could set up this type of system it would help fund more MRI machines in Canada, and would reduce wait times. However both systems need to be regulated by the government to prevent the outragous spending in the US. The conversation would be like this.

"Sir, you need an MRI for you knee, you have two choices. You can wait 8 months and it's free, or you can get one tomorrow but it will cost you $1500" (not sure what the price would be).

The patient now depending on his pain and financial situation, can make a choice.

Paul

Addendum: Quebec has introduced a mandatory drug plan 15 years ago. If you do not have private insurance (which must be better than the public one), then you are covered by the goverment sponsered one, which works a lot like private insurance and introduces maximums like 871$ total for the year and things like that.

So far it is a HUGE success and allowed people to go back to work because they don't need to be on wellfare anymore to pay for their exensive medication. I think the whole country should follow with such (or even better ones) policies.

Had an MRI a couple years ago for my back. Waited about four months (on Vancouver Island) and they said that if I missed the appointment I'd have to pay for the next one at about $5000.

Wow, I guess you were on time for that one, huh. Still there are many people in this country (and others) that view $5000 like you and I view $50 or even $5. To them, it's a drop in the bucket.

I know this to be true cuz I see many exotic cars driving in Toronto every summer. If you can afford $250,000 for a ferrari, you can afford 5 grand for an MRI.

My goal is to be one of those people .... someday.

Paul

Wow, I guess you were on time for that one, huh. Still there are many people in this country (and others) that view $5000 like you and I view $50 or even $5. To them, it's a drop in the bucket.

I know this to be true cuz I see many exotic cars driving in Toronto every summer. If you can afford $250,000 plus for a ferrari you can only drive in the summer, you can afford 5 grand for an MRI.

My goal is to be one of those people .... someday.

Paul

Wow, I guess you were on time for that one, huh. Still there are many people in this country (and others) that view $5000 like you and I view $50 or even $5. To them, it's a drop in the bucket.

I know this to be true cuz I see many exotic cars driving in Toronto every summer. If you can afford $250,000 plus for a ferrari you can only drive in the summer, you can afford 5 grand for an MRI.

My goal is to be one of those people .... someday.

Paul

Wow nice triple post!

Paul wants to make sure he gets his point across

Oops!!! Sorry for that. You can thank VIA Rail's flaky Wi Fi for the tripple post.

I thought it didn't send, and then I hit the send button again, and obviously, a third time.

Paul

The main point is in the last paragraphs if you want to skip the babbling about my personal experience working for the Health Department.

AS a defender of the need for Universal Health care, I will also admit to our system having many flaws. I myself left a job working in the Health Care system as a PC and Network Support tech because I was getting stressed out being the only tech for an entire county's worth of facilities. It was probably the job I enjoyed most in my career. I could even flaunt that I had an office with my own bathroom and shower built in (because it was office space in a retired medical ward of the hospital.)

However, as the network grew they couldn't afford more help and I was on call 7x24, and getting called in almost every second night and the weekends were guaranteed! They finally hired a second tech to help out and he quit after 6 months because there was too much work for two of us. I wasn't long going after that.

Ironically, the add to replace me was for three positions.

So Yes, it has flaws but I'm glad it's there, nonetheless.

But here is something that you won't often hear discussed or addressed. My wife was once a nurse (she has since retrained into a business role) and she worked for the hospital then later for several doctor's in private clinics.

((When I say a private clinic, it is still subsidized by Medicare, I just mean it is operated by doctor's as opposed to a government hospital. Universal subsidized health care still applies.)) From her many years working there I learned another sad truth about how the system can be abused by the doctors themselves.

The Doctor's are paid by the government for many common procedures, exams and consultations. there are some guidelines to prevent abuse, like min and maximum times, but there are some Doctors who ensure they maximize all of their available billings regardless of how long they spent with you. For instance, you may actually see the nurse or doctor for 30 seconds for a subscription renewal but the doctor records and bills for the maximum alloted time or procedure that could arguably apply.

If the doctor works 8 hours in his clinic, doing some simple math on his billing might add up to 14 hours of work.

Now, I don't want to be too hard on them because that same doctor probably spent 3 hours doing rounds earlier that morning before he even got to his clinic and then it may be his turn to work the ER that evening. Around here, A doctor is generally VERY hard working and deserves a lot of credit.

However, can one argue that we should not closer audit his clinical billing practices because he does work so hard for the public
or
Could one argue that it his own questionable billing practices that is helping drain the health system of dollars, forcing a shortage of funds for additional doctors to assist his workload?

I honestly don't know if I can answer that question, but I suspect that argument number one wins out over the government because they are scared to death of losing a doctor by questioning his business, when we already have a serious doctor shortage.

So yes, many flaws. However, I comfort myself in knowing that if I lose my job and my standard of living drops, I will still get emergency health care when I need it and won't have to sell my liver to pay for the ruptured spleen I had removed earlier.

Like the way I pay for "2 hours" of labour on a starter replacement on my car and they push it out after 30 minutes?

BTW, prescription... not subscription unless you're being prescribed "Time" or "People"

It's true... the Canadian system is the worst possible available... except for all the alternatives.

Bren R.

Well if they pushed it out after 30 min. I guess you needed to take it some place where they could actually replace it properly

Hoist by my own colourful use of the language!

Bren R.