A Canadian experience with Canadian health-care

[Andy9o8 2]

http://watchingthewatchers.org/article/26101/canadian-experience-canadian

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A Canadian experience with Canadian health-care

Thu Jul 16, 2009 at 06:41:41 AM PDT

Watching the debate in the US over health-care from a Canadian point of view, is probably another diary all together, but I would like to share a typical Canadian experience with our good but not-perfect health-care system.

First off, as a Canadian and living in Ontario, I am covered by our provincial health-care system, OHIP. If I was living in another province, I would be covered by that provincial system, like Quebec or BC.

In addition, I have a health insurance plan from my employer, which pays for a lot of the items not covered by the government health-care, medication, dentist, private hospital rooms, ambulance, optical, etc..

Last September, my wife and I gave birth to our very first child, a 5lbs 4 oz little boy. A little small, but otherwise healthy baby boy. After a very short delivery, we were transferred to our private room, where we spent the first morning getting visits by nurses and our midwife who helped with the birth at the hospital. They took blood about every 6 hours, to check for various tests, and noticed pretty quickly that he was jaundiced.

So we were transferred to pediatric care, lost our private room, but ended up in a semi private room with no other patient with us. The main difference in this was in the private room my wife was the main patient, in pediatrics, our son was the patient, and we were simply guests - well my wife had a bed of course, I slept on a chair. The care in this place was the best, the nurses and doctors were very personable, extremely nice, almost to the point we were shocked how friendly they all were - that is until you realize where you are, and that healthy babies are not they have to deal with everyday.

Fast forward 1 day, and we were home and everyone was fine and healthy. We then got a call from our doctor that a test for his thyroid level came back a little funny, and they needed us to get more tests done. As some background, the Ontario Newborn Screening Program is for all babies born in Ontario, which was designed to catch serious health problems before they arise.

Except this time we were asked to go to Sick Kids Hospital, en entire hospital dedicated to Child care.

When the tests came back - we went in for a visit with the doctor, now at Sick Kids, and our boy was prescribed synthroid to bring his levels back to normal.

The pills were picked up at our local WalMart pharmacy counter, and after a few more visits to the hospital and our family doctor, his levels are now normal, and he's a healthy, beautiful baby boy, now in the middle of his regular vaccination schedule.

The costs:

Widwife (6 months office, plus home visits after birth), hospital delivery, pediatric care, blood work and screening, visit to Sick Kids hospital, radioactive iodine scan, visit to family doctor, more blood tests, vaccinations - all covered by our provincial health plan - paid for by our taxes.

Private room, synthroid ($10 total cost) - covered by employer health Insurance.

Elective vaccinations (Hep B, Rotovirus "Rotateq") - not covered any health plan or insurance.

I don't know what this would have cost in the US, or if even if the level of screening and care is available. I'm sure it is if you pay for it, or are sure you have the proper insurance, but that's not the point.

What I removed from the story above, was the sheer panic of not knowing what was going on, seeing your brand new baby subjected to multiple tests, with not many people telling you what's going on. The unknown of what to do, and the general feeling of helplessness. Add to that, your wife is feeling the same thing, except she has the added effect of hormones which is doing all sorts of things...and she just passed something the size of a large football, but I digress.

At NO point did the thought of "How am I going to pay for all this" even entered my mind. Money was not a factor in making any medical decision for my child's health. I cannot imagine having to pick between massive debt, and a series of tests that could prevent serious health problems.

I cannot imagine the hospital telling us that we had to drive to another location to give birth, because our insurance company didn't "like" that hospital.

I cannot imagine having to decide between food or overpriced medication.

In hindsight, our story isn't that interesting, nor serious. The pills are cheap, the tests were not that bad, and he's in perfect health now.

So, as you all have this debate about "socialized medicine" note one thing about my story - I never had to fill out a form, call a 1-800 number for permission, visit a government office, and the only time I used my credit card was to buy a sandwich in the cafeteria.

Ok, I have one complaint - in a private hospital I'm sure I could have found better coffee at 4AM. You win.

Update:

Thank you for all your comments, I thought I would share one more thing... [click on the link to see the pic at the bottom]

[quade 4]

You just have to realize that in the US it's WAY more scary because that's what the insurance companies keep telling Rush Limbaugh.

quade -
The World's Most Boring Skydiver

[lawrocket 3]

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The costs:

Widwife (6 months office, plus home visits after birth), hospital delivery, pediatric care, blood work and screening, visit to Sick Kids hospital, radioactive iodine scan, visit to family doctor, more blood tests, vaccinations - all covered by our provincial health plan - paid for by our taxes.

Hmm. Mine paid for by insurance.

[Reply]Private room, synthroid ($10 total cost) - covered by employer health Insurance.

[quade 4]

Great! Now that you've established you can get roughly the same treatment, maybe you can both tell us what you are each PAYING in health insurance premiums per year?

quade -
The World's Most Boring Skydiver

[mnealtx 0]

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You just have to realize that in the US it's WAY more scary because that's what the insurance companies keep telling Rush Limbaugh.

So I guess in Canada, it's not so scary because that's what Obama keeps telling Keith Olbermann?

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Mountain-bike enthusiast Suzanne Aucoin had to fight more than her Stage IV colon cancer. Her doctor suggested Erbitux—a proven cancer drug that targets cancer cells exclusively, unlike conventional chemotherapies that more crudely kill all fast-growing cells in the body—and Aucoin went to a clinic to begin treatment. But if Erbitux offered hope, Aucoin’s insurance didn’t: she received one inscrutable form letter after another, rejecting her claim for reimbursement. Yet another example of the callous hand of managed care, depriving someone of needed medical help, right? Guess again. Erbitux is standard treatment, covered by insurance companies—in the United States. Aucoin lives in Ontario, Canada.

When Aucoin appealed to an official ombudsman, the Ontario government claimed that her treatment was unproven and that she had gone to an unaccredited clinic. But the FDA in the U.S. had approved Erbitux, and her clinic was a cancer center affiliated with a prominent Catholic hospital in Buffalo. This January, the ombudsman ruled in Aucoin’s favor, awarding her the cost of treatment. She represents a dramatic new trend in Canadian health-care advocacy: finding the treatment you need in another country, and then fighting Canadian bureaucrats (and often suing) to get them to pick up the tab.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[kbordson 8]

As the majority of my patients are medicaid at this point... that story wouldn't seem too far off for many of the American women that I treat.

EXCEPT..... as the physician, the government tells me that I can't write for zofran if she is nauseated and has hyperemesis - I have to write for phenergan. Still works, but has more side effects and the government has decided that it would rather control costs by limiting options. Or if she has reflux, I can't wirte for pepcid... again, too expensive for the government to cover, so I have to write for zantac. And... to get approval for certain tests (like follow up ultrasounds) requires several calls by my nurse or office staff to get authorization.

I'm not saying that Medicaid is horrible, nor that the Canadian system is bad... Just that that system DOES ALREADY exist in the US... and it has problems. Turning it all over to that? Don't know if I would like that.

Is the current system perfect? Nope.

But (as I've stated for several years) I do NOT trust the politicians (Democrat OR Republican). And I fear what they might be creating.

[quade 4]

Hey Neal, considering my health insurance would NOT cover a colon cancer SCREENING for me on my 50th birthday, I still have to say the Canadian system is better.

quade -
The World's Most Boring Skydiver

[mnealtx 0]

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Hey Neal, considering my health insurance would NOT cover a colon cancer SCREENING for me on my 50th birthday, I still have to say the Canadian system is better.

Yup, so much better that the guy that dreamt it up now says private insurance is needed.

So, you can add that to your 50% Canadian taxes.
Link

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(AP) A letter from the Moncton Hospital to a New Brunswick heart patient in need of an electrocardiogram said the appointment would be in three months. It added: "If the person named on this computer-generated letter is deceased, please accept our sincere apologies."

The patient wasn't dead, according to the doctor who showed the letter to The Associated Press on condition of anonymity. But there are many Canadians who claim the long wait for the test and the frigid formality of the letter are indicative of a health system badly in need of emergency care.

Americans who flock to Canada for cheap flu shots often come away impressed at the free and first-class medical care available to Canadians, rich or poor. But tell that to hospital administrators constantly having to cut staff for lack of funds, or to the mother whose teenager was advised she would have to wait up to three years for surgery to repair a torn knee ligament.

"It's like somebody's telling you that you can buy this car, and you've paid for the car, but you can't have it right now," said Jane Pelton. Rather than leave daughter Emily in pain and a knee brace, the Ottawa family opted to pay $3,300 for arthroscopic surgery at a private clinic in Vancouver, with no help from the government.

"Every day we're paying for health care, yet when we go to access it, it's just not there," said Pelton.

The average Canadian family pays about 48 percent of its income in taxes each year, partly to fund the health care system. Rates vary from province to province, but Ontario, the most populous, spends roughly 40 percent of every tax dollar on health care, according to the Canadian Taxpayers Federation.

The system is going broke, says the federation, which campaigns for tax reform and private enterprise in health care.

It calculates that at present rates, Ontario will be spending 85 percent of its budget on health care by 2035. "We can't afford a state monopoly on health care anymore," says Tasha Kheiriddin, Ontario director of the federation. "We have to examine private alternatives as well."

The federal government and virtually every province acknowledge there's a crisis: a lack of physicians and nurses, state-of-the-art equipment and funding. In Ontario, more than 10,000 nurses and hospital workers are facing layoffs over the next two years unless the provincial government boosts funding, says the Ontario Hospital Association, which represents health care providers in the province.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[kelpdiver 2]

good counters, there.

[lawrocket 3]

I pay less in health insurance that I pay in witholdings for state and federal taxes, FICA, etc.

Here's the thing - I choose what health care plan I want. Most people want the low deductible stuff and high monthly payment. I go high deductible and low monthly payment (35/70 plan) and an HSA. So, I spend under $500 per month for myself and family, another $150 for catastrophic coverage and have over $6k in an HSA.

When my son had surgery 3 years ago it cost me $3200 - I had over $4k in my HSA so it was tax free. Then I had no copays and got treated well for my low monthly rate the rest of the year.

I suspect that my government health care plan will cost me more than $6k per year. it will also ensure that I hqave fewer choices. I've been declined coverage once - over $8k for a surgery on my sinus and septum. It was fixed within 5 days with a certificate of credible coverage and cost me a grand total of $110.

My thing is I'm not paying to cover those who refuse to cover themselves (how many people can afford to skydive but have no health coverage?). I am paying with others who are paying.

Of course it will cost the payors more when they are paying for coverage of others who are not. When Congress exempts itself from the health plan it proposes, what the rfuck do you think they are giving?

Yes, Paul, I pay a pretty penny for my health coverage. It'd be about half the income from a full time minimum wage job.

I'm also no spring chicken. I have kids and a wife and people other than me to think of so my coverage is greater than when I was single and childless. If it means I don't have HBO, haven't been to a movie since 03, etc., then so be it.

Tell me, Paul, should I be allowed to keep my coverage and pay more so others ca, get it, too? This would mean that I don't get my coverage.

Is a wise government policy to punish me? That's what it would be - I'd get less for more.

My wife is hotter than your wife.

[lawrocket 3]

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Hey Neal, considering my health insurance would NOT cover a colon cancer SCREENING for me on my 50th birthday, I still have to say the Canadian system is better.

Considering my insurance covered my cardiac stress test at age 35 (after meeting my deductible - rough year last year that proved the value of my choices to cover my ass), which I could have gotten that day (and ultrasound doppler study) if I wanted (it was a week later that I chose for it) I found that I like my system.

See, Paul, the rules or our system are known and can be navigated by those who want to do so.

I consider it a given that I will eventually suffer from some condition that will cause my death. That's expensive. Dying now would mean hardship for my family. I'm paying for $2 million in coverage - enough to pay for 30 years of my income. Ironically - my retirement age is 30 years from now. Hmmm...

I reckon it's given I'll get sued for malpractice. I'm insured - in addition to my job I pay more.

The main article's point, paul, is that he wouldn't want to have to worry about how he'd pay. I've got another term for that - peace of mind.

Funny - as a matter of fact (and, in California, a matter of LAW (google "Crisci and insurance bad faith") "peace of mind" is the purpose for insurance. I am insured over under sideways down. For peace of mind.

I haven't needed to use my auto, life, disability, E&O, hoemowners, CGL, workers comp, etc. EVER. Insurance companies have made lots of money off of me because they provide me peace of mind.

The government has never done that. I would suggest that "worry" has a price tag. If one is worried, buy insurance. Not worth it? Then you have made the decision to suck it up.

I will make sure Dr. Bordson gets paid. She deserves it.

My wife is hotter than your wife.

[tkhayes 348]

wonderful that you can afford the insurance and that YOUR insurance company is so wonderful that they would cover ALL those costs without the burden of any co-ppays, deductibles, paperwork, rejection letters, denials, or any other red tape.

So many more of us do not share your experience.

[Rookie120 0]

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So many more of us do not share your experience.

Why not? You cannot pay for insurance? Or just bad experience with insurance?

If you find yourself in a fair fight, your tactics suck!

[lawrocket 3]

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wonderful that you can afford the insurance and that YOUR insurance company is so wonderful that they would cover ALL those costs without the burden of any co-ppays, deductibles, paperwork, rejection letters, denials, or any other red tape.

So many more of us do not share your experience.

Can? Yes. I "can" because I put insurance as a "priority" right after "housing.". No, I couldn't afford it if I dropped $1k per month on skydiving/golf/travel.

It's interesting how many people CHOOSE not to get insurance. How many uninsured have it available through work and don't take it.

You mentioned something interesting about not dealing with rejection letters/denials. You didn't read my post, did you?

My wife is hotter than your wife.

[lawrocket 3]

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So many more of us do not share your experience.

Why not? You cannot pay for insurance? Or just bad experience with insurance?

He HAS insurance. His insurance didn't cover everything in the past and he has some exclusions now and pays more because of it.

My wife is hotter than your wife.

[Rookie120 0]

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and pays more because of it.

How much more?

If you find yourself in a fair fight, your tactics suck!

[Nataly 38]

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wonderful that you can afford the insurance and that YOUR insurance company is so wonderful that they would cover ALL those costs without the burden of any co-ppays, deductibles, paperwork, rejection letters, denials, or any other red tape.

So many more of us do not share your experience.

I think it's fair to say that the Canadian system can't afford all the latest technologies and procedures.. So if you need a very rare or extremely complex procedure, you might be out of luck..

But in my opinion, it deals with 99% of what people need, irrespective of how poor/rich you are..

Not being American myself, I'm of course less familiar with the system over there, but it seems to me that if you're poor you can't afford insurance, and therefore you're pretty fucked if you get so much as a broken leg.

Obviously, I don't know all the ins and outs of US healthcare, but I have to say I think the Canadian system is pretty amazing.

"There is no problem so bad you can't make it worse."
- Chris Hadfield
« Sors le martinet et flagelle toi indigne contrôleuse de gestion. »
- my boss

[pgassett 0]

off, as a Canadian and living in Ontario, I am covered by our provincial health-care system, OHIP. If I was living in another province, I would be covered by that provincial system, like Quebec or BC.

In addition, I have a health insurance plan from my employer, which pays for a lot of the items not covered by the government health-care, medication, dentist, private hospital rooms, ambulance, optical, etc..


So essentially you are a family with dual coverage insurance...this is not the same as being only on the state run health plan. You still have a choice, and you have become one of the chosen patients whom the Dr.'s and facilities love to see because they can actually collect money from your insurance. Your experience with socialized medicine is not what someone only on the state run program would have...

[TomAiello 26]

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Can? Yes. I "can" because I put insurance as a "priority" right after "housing.". No, I couldn't afford it if I dropped $1k per month on skydiving/golf/travel.

Obviously, you don't understand. Moving to another country to skydive is a right. If you exercise that right and end up with no money to pay for healthcare...well, then clearly your right to healthcare is being violated, too!

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[SivaGanesha 2]

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http://watchingthewatchers.org/article/26101/canadian-experience-canadian

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A Canadian experience with Canadian health-care

Thu Jul 16, 2009 at 06:41:41 AM PDT

Watching the debate in the US over health-care from a Canadian point of view, is probably another diary all together, but I would like to share a typical Canadian experience with our good but not-perfect health-care system.

First off, as a Canadian and living in Ontario, I am covered by our provincial health-care system, OHIP. If I was living in another province, I would be covered by that provincial system, like Quebec or BC.

...

The question that I would pose--although I'm not sure I could answer it--is to what extent the Canadian system benefits from the 'safety valve' of having a capitalist American health care system nearby. The Canadian provincial governments always have the option of sending patients across the border to the US and paying the going American rate. Although this option may not be exercised that often, its availability probably greatly reduces the number of 'horror stories' in the Canadian system.

Think of it this way--in government-provided Canadian health care, the Canadian hospitals serve as the 'main' health care system but the nearby American hospitals serve as the 'reserve'.

If America goes to a Canadian-style system, the safety valve of the capitalist system would be removed (throughout North America). Just because 1000 people in a row have a wonderful experience with the 'main' isn't a good reason to abandon the practice of always having a 'reserve'.

My thought would be that if America wants to evaluate how socialized medicine might look like by looking at the experience in a country with otherwise similar economic conditions, it would be better to look at the European experience and not the Canadian experience.

"It's hard to have fun at 4-way unless your whole team gets down to the ground safely to do it again!"--Northern California Skydiving League re USPA Safety Day, March 8, 2014

[jloirsdaan 0]

Congrats on the new baby Andy!

I still just can't figure out why so many people just don't get it.......

People talk about getting the same level of care, blah blah blah. Well how nice it must be to make enough money to afford all of that coverage. I am with Quade, how much do you pay, lawrocket, and how much does Andy pay? That is the key.

The argument from the other side, to me, is summed up as "it sucks to be you, make more money and buy insurance".

Spent 6 years in the Army, deployed 2 times, I get out, can't find a job, no health insurance for my family. Had a few MINOR things happen. My son fell off his bike, we thought he broke his arm. That cost over $5000. Just for the xrays, a few tests, we spent less than 4 hours in the ER. So now I owe the local hospital 5k. My daughter got hit with a baseball in the face, and it broke her nose. That was just over $7k. Two little things, and now we are in debt over $12,000. My wife is now in the Coast Guard, it seems the military are the only ones hiring now. ....

So the story has somewhat of a happy ending...we are good to go now....but I still owe all that money to the hospital. I'll get it taken care of, it'll take a while. A few Christmas's might be a little "light". But I'll get it paid off. My point is, you can't convince me the system isn't broken. Medicaid is nice, as I am sure that'll be brought up....but, in S. Carolina at least, they go by the total income for the HOUSEHOLD....we were living with my wifes parents and didn't qualify.

The system is broken, you can't argue otherwise. For the people that are well (enough) off, the system might not be that bad, I guess. For those of us that are a bit worse off, we are just screwed.

edit to add: I should read a little more before posting. I see the costs lawrocket put down. Yep, out of reach for us at the time....seeing as we were making $0 a year.

Jordan

Go Fast, Dock Soft.

[tkhayes 348]

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Why not? You cannot pay for insurance? Or just bad experience with insurance?

all of the above. I have insurance - not nearly as 'glorious' as lawrocket's apparently, $900/month, so budget wise - it IS actually right after housing.

And I have bad experiences, since they seem to exclude pretty much everything now that they used to include. Of course i have not had to 'test it' with cancer or massive trauma,

But I still write checks for stuff every time I go to the doctor.

[TomAiello 26]

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Not being American myself, I'm of course less familiar with the system over there, but it seems to me that if you're poor you can't afford insurance, and therefore you're pretty fucked if you get so much as a broken leg.

I'm just going to say that you obviously haven't any experience with the US system, and leave it at that.

-- Tom Aiello

Tom@SnakeRiverBASE.com
SnakeRiverBASE.com

[tkhayes 348]

i am not sure that I have ever seen a case where a Canadian Province sent someone to the USA for treatment and paid the bill.

I would be interested is seeing those examples.

Yes, some Canadians have the ways and means to afford 'right now' treatment and if they want, they can do that.

And I think some private options are a good idea, even in Canada. Obviously if I can afford it, I am willing to pay for it.

A mix of private and public would ensure that everyone gets SOME level of treatment. Right now, many Americans do NOT go to see the doctor because they cannot afford it.

They also cannot afford the insurance, or in my case, I shop around for better policies, but they do not actually exist, so i either pay my life's savings for insurance or I get a policy that is reasonably priced, but excludes pretty much everything that i do....

At least in Canada, they are delivering HEALTHCARE - they are not debating INSURANCE.

In the USA we are debating how to get everyone INSURED, not how to deliver HEALTHCARE.....

I see a significant difference.

I am all for INSURANCE, if the insurance companies actually cared about delivering health care, but they do not - they only care about making money - by delivering as little health care as they can.

In Canada, while they may be delivering slightly 'less' health care, they are at least trying to deliver the most health care for the most people, not trying to find ways to deliver less and less.

[jloirsdaan 0]

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Not being American myself, I'm of course less familiar with the system over there, but it seems to me that if you're poor you can't afford insurance, and therefore you're pretty fucked if you get so much as a broken leg.

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I'm just going to say that you obviously haven't any experience with the US system, and leave it at that.

I am going to say she is pretty much right, and leave it at that. They'll take you into the ER and fix you up, but it ends there.

Jordan

Go Fast, Dock Soft.