To Our Canadian Brothers and Sisters

[schoeney]

I was wondering if some of our Canadian members would mind sharing a little bit about your personal experiences, opinion, and details about your healthcare system? Quality of care, service levels, cost and how it impacts your tax rate.

I thought it might be interesting to hear since it looks like the U.S. may be heading in that direction and what we might be able to expect.

Thanks

[ringadingh]

Overall its not bad, you get what you need, if its not life threatening you may have to wait a while. This is where they are trying to bring in private healthcare, which means if your in a hurry pay now. I dont like the private system myself as its seems to be a money grab. The Ontario level of care seems to be as good as any, I have additional medical insurance through my work which gives me semi private room and pays for some procedures not covered by the Ontario plan. Im not sure how much of my taxes are used to pay for it as its all rolled in together.
I think a lot of people are getting all worked up over something that is a good idea. It may have a few bugs in it at first but Im sure they can make it work well for most people.

[cactusjack]

Great post, Schoeney. I was thinking of asking this the other day. I'd really like to know how the Canadian system works, the good and bad of it.

[strobe]

Overall I think the Canadian system works well. I think in any system, public or private, you will find stories of where the system failed.

In Canada the issue we have is doctors and nurses heading south to the US which can cause shortages in some areas. Smaller centers are sometimes understaffed, requiring ER's to be closed for short periods of time which can cause issues obviously, but the larger centers are usually well staffed with great doctors and nurses.

I honestly have been fortunate enough personally not to need to use the system very much so far, but I have been through my dad's prostate cancer and treatment, which went very quickly from the diagnosis to the treatment stage and my brother-in-laws losing fight against cancer last winter where we saw every stage of treatment right through to palliative care just before he passed away and I have nothing but the highest regard for the doctors and nurses that treated him throughout and the way the system worked overall. In the last 10 years of his life he had two cornea transplants for a degenerative eye condition, part of his leg amputated and all his treatment for cancer and final care and he never worried about the costs that this care would have cost or having a treatment rejected by an insurance company.

The pro's is there are no out of pocket expenses for doctor visits, ER stops, hospital stays, etc. Having a baby costs $0, heart attack, same thing. Some newer treatments may not be covered which means then you may have to pay, but most of those seems to get added fairly quickly from what I have seen.

The con's are some waiting. Elective surgery and diagnostics can be slow at times. My riding buddy that blew his knee out could not get an MRI for three months as his injury was not critical, so he paid to have a private MRI done. I have no issue with the pay for fast, non critical care personally.

Tax rate is another issue, we definitely pay more in taxes for the care, and the public system we have is in need of repair. In Alberta we spend more per patient than any other province and we have worse wait times for many procedures. When public money is involved, there just does not seem to be the same priority on getting the most from the money. That being said, I would not want my hospital looking at the bottom line all the time and using those numbers to help determine my level of care.

[schoeney]

The waiting should not be a big issue for most people. It sounds like the cost is just buried in with your income tax? Do you have any idea what portion goes toward medical care? Is dental part of it as well?

How do they deter people from going to the the Doctor's office or hospital when they just have the sniffles?

Is your income tax a flat rate ...like 20% no matter how much you make? Or is it overly complex like our system...we have over 80,000 IRS employees. You need a frickin PHD, two main frame computers, and a translator to do our taxes.

I am pretty worked up about this health bill, not because health reform is a bad idea but because I don't see it being cheaper. I have always believed the best way to reduce cost is to promote competition...the end result is a better product at a better price.

The way this bill is written the private companies will be out of business before too long.

But there is no doubt the cost is out of control...I just don't want it to get worse.

When you start tossing around trillion dollar figures our politicians start angling for what they think is their share.

[strobe]

It is just buried in the income tax. It is a complicated funding situation. Each province actually controls spending, and they put in their amount, then the federal government puts in their share as well. The previous governments had cut the federal component drastically in the 90's but some of that has been restored.

Dental is not included, that is covered typically by employer benefit packages, likely very similar to your existing system.

You bring up likely one of the biggest issues, and my largest pet peeve with the system, there is no deterrent for people running to the doctor or worse yet the ER for the sniffles. There has been talk about possible user fees for non critical ER visits, etc, but that gets very complicated to impose. The wait times in ER can be huge I have heard, but critical patients are given priority obviously.

I am sure there is a percentage that is technically designated to that from tax revenue, but it frequently changes so it is not a static number. In Alberta, provincial income taxes are flat rate (10% of taxable income), then the federal system is more complicated, but from what a co-worker said that came here from Texas, our taxes are a lot simpler than the IRS forms. The federal tax rates range from 15 - 29% (see http://www.cra-arc.gc.ca/tx/ndvdls/fq/txrts-eng.html)

I have not read the bill but given what I have seen happen in the last few months I think you have reason to be worked up. Whatever they say it will cost, it will be much higher. Transitioning will be a mess, and in order for it to truly cost less, people have to make less money, that will cause issues I would expect. Plus there is a whole new bureaucracy that will be set up to run this, more government jobs, bigger government. Private hospitals are profit centers, and that does not mix with a public system. I have to think that while I think protection that this can provide is a good thing, it has not been thought out, and given the expanding debt, this will drive the US deeper than you can imagine right now.

Going from the system you have to this system will be a minefield of problems. Job losses with insurers, and companies will disappear.

Like I said, I prefer the concept of public health care, but the implementation could literally kill people. Likely a few bridges being built in that 3 trillion too :)

[ringadingh]

What happens to the average guy that has no healthcare plan and requires to spend some time in a hospital now? Does he get the treatment required or go without?

[cactusjack]

Originally Posted by Ringadingh

What happens to the average guy that has no healthcare plan and requires to spend some time in a hospital now? Does he get the treatment required or go without?

I don't know about other states, but in AZ no hospital can refuse an indigent patient. They make up for the loss by shifting the costs to those who can pay or have insurance.

Here in the southwest, there are hundreds of thousands of foreign nationals who have no legal right to be in this country. Many of them work for cash, off the books. Many have no benefits. When their kid gets a runny nose, they go to the ER because they know they will receive treatment.

Honest to God, an emergency room in Phoenix resembles Ellis Island, and waits of 6-10 hours or more are not uncommon. I had a bout of cellulitis in my leg several years ago, which is a soft tissue infection. I went to an Urgent Care on my lunch hour and they sent me immediately to the hospital with a 104 degree fever. I got to the hospital and sat in the ER waiting room for NINE HOURS, shivering in a chair like you wouldn't believe. And I have insurance and could pay for my treatment. I ended up spending three days in the hospital on I.V. antibiotics.

[ringadingh]

We have waits here also of a few hours for most things, however if its serious or life threatening you get immediate treatment, as I found out personally a couple years ago. They thought I was having a heart attack and they wheeled me through and had me hooked up in a minute, my wife had a similar experience also a while ago. Like I said earlier its not perfect here but It works pretty good for most instances.
As for people who run to the doctor for every scratch and sniffle, they are also running up the expenses and increasing wait times for others that are having more serious problems.

[croxy]

Hi all. I pretty new here but thought I would chime in on this one. I have to say that I am satisfied with our health care system. I don't know of anyone who has had a major illness and did not receive treatment. If you have a minor issue you may have to wait for certain tests etc. I hope that I am not speaking out of turn with regard to the system in place in the states but I am comforted by the fact that I will not have to worry about losing my house or ending up hopelessly in debt due to an illness in the family. I saw a post here from a fellow Cannuck saying that we do have a bit of a doctor shortage due to practitioners moving south of the border.......what is the enticement.....MONEY......and that pretty much sums up why they go. Doctors here obviously make a healthy income but can make more in the US. That being said I have a doctor and also have the option of going to Emergency at the hospital for serious issues or a walk in clinic if it's not as serious but after hours or on a weekend. These clinics are run out of medical centers where doctors have their offices and the doctors take 'turns' staffing the clinic. Many of them have their own practices as well.

The nice thing I would have to say is that I don't have to worry about being able to 'afford' to be ill. If I go to the doctor, have a blood test, xrays, MRI, ct scan etc.....no cash out of my pocket.

I have seen some news coverage here of opposition to a public health care system in the US and using our system as an example. What I have seen being reported is not representative of my experiences here.

Beware the Lobby Groups.

Is our system perfect....no.....is it good.....yes.

My opinion for what it is worth.

[audiogooroo]

My concern is the Federal Government's track record at managing...well...anything! Remember a few years back when they took over operations of that bordello in Nevada that had tax problems? They couldn't operate a viable business selling sex and alcohol!
Who was it that posted recently that, if you put the Federal Government in charge of the Sahara Desert, they would be out of sand in 5 years? Love that line! :)

[schoeney]

Originally Posted by cactusjack

I don't know about other states, but in AZ no hospital can refuse an indigent patient. They make up for the loss by shifting the costs to those who can pay or have insurance.

Here in the southwest, there are hundreds of thousands of foreign nationals who have no legal right to be in this country. Many of them work for cash, off the books. Many have no benefits. When their kid gets a runny nose, they go to the ER because they know they will receive treatment.

Honest to God, an emergency room in Phoenix resembles Ellis Island, and waits of 6-10 hours or more are not uncommon. I had a bout of cellulitis in my leg several years ago, which is a soft tissue infection. I went to an Urgent Care on my lunch hour and they sent me immediately to the hospital with a 104 degree fever. I got to the hospital and sat in the ER waiting room for NINE HOURS, shivering in a chair like you wouldn't believe. And I have insurance and could pay for my treatment. I ended up spending three days in the hospital on I.V. antibiotics.

Oh man CJ....don't get me going on the illegals...I may just have a coronary...we are on the same page I am sure.

[ringadingh]

I was reading the paper earlier today and it said that people are worried about losing there choice of doctor. Here we can go to any doctor we want, And they bill OHIP ( our provincial plan) for the service they provide to you. All services that are covered have a price that OHIP will pay directly to the doctor. That means there is no shopping around to see who will do it cheaper. The doctors are the ones who are getting the short end of the stick because they can only bill so much in a day, and they are capped at a maximum amount they can earn. This is why some doctors go to the states, it enables them to earn more by charging more for the same treatments.
My doctor came out with something this year that covers a lot of things that are not covered by OHIP such as notes and certain teasts. I pay him $140.00 a year and it looks after all these things. It payed for itself already the first time I used it. I am required to have a medical exam every two years because of the class of drivers licence I have, It is $130.00 and not covered by Ohip, but it was covered by the insurance that I have with him.

[Sin City Stan]

Originally Posted by audiogooroo

Remember a few years back when they took over operations of that bordello in Nevada that had tax problems? They couldn't operate a viable business selling sex and alcohol!

If you can't make money selling alcohol & sex in Nevada or for that matter anywhere, you best keep your nose out of any business..

[Bdog]

I live in a Village of 900 people. The most I've waited to see a doctor is about 2 hrs and thats because I had no appointment. My health care costs me 42 bucks a month. I'm single so its a cheap rate. My extended health care costs me 0 because my employer pays for it. I have no complaints, although the wait list for surgery can be up to 2 months..still no complaints..Bdog