I’ve had a few people over time ask me my opinion about Canada’s Health Care so I thought I’d sit and think about it and maybe write down some thoughts.
Let me start by saying that I was 24 when I came to the U.S. and didn’t use the medical system much as an adult. I was also a student for most of that time. However, that being said, let me start by focusing on my perceptions of the differences in quality of care.
When I was younger, I went to a hospital to get psychiatric help. I wanted to be able to talk with someone to help me through some problem I was having. After my first session I was prescribed medications I didn’t understand and told to book an appointment for a month away. The following three months (and visits) I had to repeat everything to a new doctor (so I didn’t get anywhere) and my meds were changed each time. I stopped going. It worked out. I got lucky.
My grandfather had a sore throat, so he went to the doctor. A variety of tests were done and they gave him a few random things to try but nothing worked. It got worse over a few years. He had trouble breathing for a long time and continued to go to doctors who couldn’t find a problem. Eventually, they thought to look in his throat and found a large growth. It was cancer in it’s final stages. He died a few months later.
I never felt like I had to wait a very long time to get medical service and the process of signing up and having a family doctor is all pretty mundane. Emergency wards look pretty much like they do in the US (as I remember them).
However, tests are a different issue. I do remember that if/when I needed tests that required special equipment (like and EKG) I would have to book it at least a few weeks in advance. I’ve heard, but not experienced myself, that gall bladder surgeries can take 3-6 months to get scheduled. That’s gotta hurt.
Here in the States I’ve had even less first-hand experience with the health care system because I’m fairly healthy and don’t break bones. However, when Heather and I were on vacation she fell and we thought she broke her wrist. We got her to a hospital and had her x rayed. Turned out it was just a bad sprain and they suggested a wrist-brace you can buy at the local store for $20 so that’s what we did.
When my daughter Aleah fell off a friend’s scooter and we thought she might have broken her ankle we took her to the ER and within a short time also found out that she just sprained it and we were sent off with a crutch to keep pressure off it for awhile.
When I have had to make appointments for medical test down here I’ve found I can get most any service within a few weeks.
So the two main differences as far as I can tell is that you wait longer for more specific tests in Canada and honestly, I think it’s less likely that throat cancer would have been missed after three years of complaining and going to doctors about it in the U.S.
So there’s the intangible differences that will vary by person. Now let’s talk money. For over a decade it’s been a known problem that the best and brightest Canadian professionals eventually get lured to the U.S. because of the higher pay. That is especially true of doctors and nurses. Not everyone wants to move South and prefer to stay in Canada. However, I believe many of our better doctors move south for the better wages (they sure helped me pay off my student loans faster). This by default has to bring at least a slight decay of quality of service over-all.
There is a false belief that Canadian Health care is free. It’s not. Not only is it paid for in part by taxes in general, but each person pays a monthly health care fee based on income level. From that stand point, you can receive many services without out-of-pocket expenses although some services do require a co-pay depending on income. Also, medication is not covered except for those on AISH (Assured Income for the Severely Handicapped). So you still have medication expenses to pay. Unfortunately, I don’t know what the exact numbers are currently for any of that. Although I may try to look them up at some point.
I had a health plan down here where so much was taken out of my salary per month and my employer paid some of the cost. I had a co-pay for office visits and medications. I also contributed to the FSA (Flexible Spending Account) so that I could use pre-tax dollars toward regular medical expenses. When Heather sprained her wrist we were out of "network" and that caused us to not be covered because the wrist wasn’t really broken and therefore not actually an emergency. That was extremely frustrating. We paid the bills but when we called to do so the most interesting thing happened. We were offered a discount because we weren’t going through an insurance company! You see, as I’ve read more and learned more it turns out that doctor’s offices don’t like dealing with insurance companies for the same reason most individuals don’t like it. They don’t want to pay.
Now we have an HSA (Health Savings Account) through my company and a high deductible. This allows us to pay the hospital directly, shop around for prices (although some work needs to be done to improve that process), and negotiate with the hospitals on fees when we are paying cash directly to them. This has already saved us probably a couple hundred dollars. In the mean-time, we save up for medical emergencies because we know they will happen. But we are also not as likely to use services we don’t need because it will cost us to do so.
Now, I can hear the cries of "What about people with no insurance or no income?" I have a friend who lives completely off of the government dole. I have no problem with it because she can’t work and I know it. She has enough for food, shelter, clothing, and a little extra for the bingo and cigarettes. Her medicines are all paid for through Medicaid as well as her other medical needs. You see, the U.S. already has a safety net for the impoverished. Is it the cream of the crop? No. But it’s not that much different than what I remember from Canada. So it’s certainly acceptable.
I think the problem with the socialism movement (which is tied to this Universal Healthcare issue) is that people think the nation can afford a middle-class kind of environment for everyone. We can’t. Certainly not in the extravagant living style of American culture. We are the richest nation in the world and our poor live better than many around the world. Are there exceptions? Absolutely, there always will be. But between food pantries, government and non-profit agencies all designed to help the poor in this country it’s silly to say there is nothing there for them.
Universal health care costs more than any American, I think, would really be willing to pay for it. The service levels drop when there is no disincentive to using a limited resource (doctors). Canadians who can afford it and want faster service come to the U.S. and pay full price (I have a family member who did). That should tell you something. Could there be discussion for tweaking the existing system? Absolutely, but the system in place is mostly fair and doable so long as people do their best to take care of themselves and take responsibility for preparing for emergencies. They are going to happen. Spend less, save more, and ask for help when you need it.