A Canadian's View on Health Care

As right and leftwing Americans swing fists at each other over the government's proposal to change health care in the USA, we here in Canada watch in amazement at the misinformation being fed Americans by those pro and con the changes.

For example, there was this subhead in one online publication this morning:

Government medicine has proved an excruciating disaster in the U.K. and Canada.

Actually, not.

Let me explain how it works in Canada.

I pay about $1300 a year for my entire family for health insurance to the government. (This is a provincial quirk; some province don't have this surcharge. Poor people, like my son, pay nothing.)

In return, I  get quick service for emergencies, and slow service for "elective surgeries," which is the codeword for, "You can live with the pain since it isn't killing you." My wife has a curious skin condition on part of her body; our GP (family doctor) sent her to a specialist, who will see her in October.  All that is free.

Many things are free; some are not. We have to pay for:

- ambulance rides

- all prescription drugs (up to about $2,500, and then we get 80% refunded, unless we are poor and then we don't pay anything).

- eyes and teeth. Oh my, teeth are expensive!

- chiropractic, naturalpathic, physiotherapy, etc.

- travel costs for being sent to a hospital in another city or province.

- all medical treatment outside of our province (might be covered by extra insurance).

- certain treatments and tests. For instance, women get free breast exams for cancer, but men have to pay to be tested for prostate cancer. Makes no sense to anyone, except the bureaucrat who made that decision.

Anything medical we have to pay for (eye exams, preceiptions glasses, dentistry, prescriptions, etc) we can deduct from our income tax -- after a deductible of 3% of our income. Unless you are poor, in which case you get it all back. 

It's Not All Public

It's only the hospitals and ambulances that are run by the government (code for "run inefficiently"). Everything else is private. Doctors run their own business, billing the government (or the patient, if the service is not covered). Labs are private; pharmacies are private; dentist, et al are all private. 

Despite all the government funding (+ what we pay for non-covered items), hospitals run lotteries for fund raising. I've never understood that.


The Exceptional Ones

So we can see our GP immediately and get a lot of medical work done quickly. It's mostly big ticket items that are slow, like elective surgery and CAT scans.  It's not that they are not available; it's that hospital administrators like to redirect government funding to their paycheques. 

But there are the exceptional ones, those who get special service (an hour with the GP, instead of just 7.5 minutes), and go to the front of the line. These are:

- WCB = workers compensation board claimants
- ICBC = government-run car insurance claimants
- MPs = members of parliament have their own hospital in Ottawa
- Sport stars = the game must go on with quickly recovered players

If you have the money, you just get treatment in the USA, as Canadian politicians are fond of doing.


Too Far Either Way

Just as rightwingers are freaking out over the Democrats plans to "socialize" medicine in the USA, liberals in Canada freak out anytime some entrepreneur wants to improve the medical system by offering private services. "Everyone must be served equally poorly," is the meaning behind "equal access for all."

We have so much already privatized in Canada, even the leftwing's beloved abortion clinics are for the most part privately run. Yet if a rich businessman wants to help reduce waiting lists by opening an MRI service for a fee, the liberals freak out. There seems to be no comprehension that taking rich people off the waiting lists means that the middle class gets public service faster.

For the most part, we Canadians are content with our "free" medical care, just a bit frustrated by occasional long waits and confusion over what is covered.
 
If there is a real concern, it is the way that hospitals are run in grossly inefficient manner, which sucks huge amounts of tax dollars from government budgets. (Our hospital is the only place in town to charge for parking -- $2/hr.) I feel strongly that our hospitals need a Toyota-like makerover to drive out unecessary expenses.

Comments

[Mike]

Funny you don't mention the outrageously high income taxes that Canadians are forced to pay to cover the 'free' health insurance. No thanks, you can keep socialized medicine up north. I myself will continue to strive to do good at what I do so I can maintain a job thats good enough to provide me with the coverage I need, at little cost($600 yr), and low income taxes.

[ralphg]

From the editor:

That's because British Columbia (where I live) has amongst the lowest taxes in the world, especially for small businesses like my own (around 15%). Plus, we can income split here in Canada (unlike the USA), so the first $50,000 can be tax-free in a family of five.

[Norm C.]

It is truly baffling to see how our south neighbors are polarized (I'd even say, provocatively, unsophisticated) in regard to politics. The rightwing weirdos and nutjobs calling Obama a socialist (as if it was a dirty word!!!) for his medicare reform are unbelievable. Thugs, really. Am I condescending? You bet! Come on, your political system has never had ANY "left" party in its history AFAIK. The Dems' leftwing is probably to the right of most of the countries in the democratic world.

There are studies that show that the Canadian and British healthcare systems cost less per capita than the American one. But you don't want to believe that anyway. It's not about getting unbiased information, it's all about dogma.

Even if it's not perfect and we complain a lot, we are happy with our "socialist" (sigh) programs.

A note, Ralph: I find the equation government run = inefficient to be unfair. A lot (and I mean A LOT) of private businesses are run as poorly. Just pick up a paper and read the financial pages, you're sure to get examples everyday. I think any big organization, be it private or government, gets to a point where it's unmanageable.

[Tony]

Actually, Canada's total taxation (taxes as percent as GDP) is significantly higher than the US.

OTOH, if you're talking out of pocket (ignoring the other people who pay the costs, e.g. employer or other (richer?) taxpayers), I'm not impressed. I pay nothing for medical, dental, and vision insurance; on my current plan, I do pay for non-routine doctor visits, but those rarely happen, and the out of pocket max (including drugs) is $3,000 -- and everything is tax deductible, including dental visits.

I've personally experienced the benefits of hospital choice.

Maybe the BC way is nicer if you're self-employed.

[Brian D]

Much of what is currently being said by politicians and pundits in the US about the UK NHS is simply factually incorrect. There are a couple of useful articles in the Guardian today that set the facts straight (http://www.guardian.co.uk/world/2009/aug/11/nhs-united-states-republican-health and http://www.guardian.co.uk/society/2009/aug/11/nhs-sick-healthcare-reform). A key point overall is that the UK spends less on healthcare per head than the US, but has a higher life expectancy. Many commentators also seem to miss the fact that in the UK you can choose to use the NHS or pay for private health care if you prefer (many people do both).

However, the real thing commentators are missing is how much respect and affection ordinary people have for the NHS. While I've seen its bureaucratic inefficiencies on several occasions, neither I nor anyone I know would swap it for the American model - we are generally treated well.