August 10, 2009, 5:00 am

Canadian-style healthcare

by: The Financial Blogger    Category: Miscellaneous
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hospitalThis article was written by Kevin Press, Assistant Vice-President Marketing, Sun Life Financial

If you’ve been following the U.S. healthcare debate, you will have no doubt heard warnings about Canadian-style healthcare. By now you know that the system up north is inaccessible, replete with labor shortages and laden with a bureaucracy that can only be described as socialist.

None of this is true. Take it from me, a Canadian.

My name is Kevin. I blog for Sun Life Financial under the name Today’s economy. My family and I live in Toronto. My kids just turned four and two, and my wife and I both depend on prescription drugs to keep serious illness at bay. In other words, we know the healthcare system here on a personal level.

What’s it like to live with Canada’s healthcare system? Frustrating, occasionally. Other times it can make you feel truly fortunate. Just don’t be fooled by stories of Canadians mortgaging their homes so that they can access healthcare in the U.S., or worse, dying while they wait for the system to provide care. These anecdotes are being torqued to scare you.

I won’t rehash the fundamentals of the healthcare system here. That information is widely available on sites like Health Canada and Wikipedia.

What I will do is provide first-hand observations of the Canadian system and its impact on health and personal finances. This blog attracts sophisticated readers – I’ll leave it to you to come to your own conclusions about how all of this should or shouldn’t inform the U.S. healthcare debate.

  • The wait times won’t kill you. The worst experience my wife and I ever had waiting for care happened at The Hospital for Sick Children. It’s not a dramatic story. Our daughter had a fever; we decided to play it safe. We arrived about 11 p.m. We went home six hours later, without having seen a doctor. This kind of thing happens sometimes in Canadian emergency rooms. We were told, on that night, that there were two seriously ill children in the hospital who required the close attention of the hospital’s doctors. On the other hand, a couple of weeks ago our daughter had a croup attack at about 10 p.m. My wife took her into another ER, and was seen about an hour later. They were both home before 2 a.m. It is fair to say that we benefit from a better standard of ER care than you might receive in a smaller Canadian city. It’s not fair to say that Canada’s healthcare system is flawed in such a way that people die as a result of wait times.
    1. The medical professionals, and the care they provide, are world-class. There are Canadian doctors, nurses and other professionals who move to the U.S. for better career opportunities. There’s no denying this. But that hasn’t left us with a sub-standard level of professionalism. My wife’s doctor is an internationally recognized leader in his field. We can’t imagine being with anyone else.
    1. I’ve never even met a healthcare bureaucrat. My wife and I have two sets of healthcare relationships (three if we count one another). A) Our doctors and other healthcare professionals. B) Our insurance company. Period.
    1. Group benefit plans make a big difference. The Wikipedia page referenced above reports that about one-third of Canadian healthcare services are paid for via the private sector. Sixty-five per cent of Canadians have private health insurance, usually sponsored by employers. These plans typically reimburse eligible medical expenses not covered by the member’s provincial plan. That can include prescription drugs, vision care, hospital care, medical services and equipment, paramedical services and assistance with out-of-province emergency travel. Canadians who don’t have this additional coverage, or who have only limited additional coverage, pay out-of-pocket for these healthcare expenses. I posted a primer on employee benefit plans in July. (In the interest of disclosure, my employer is in the group benefits business.)
    1. Canadians enjoy a safety net that prevents personal bankruptcies caused by healthcare expenses. Let me give you another personal example. The drugs my wife and I take would bankrupt us if we had to pay for the portion not covered by our standard provincial and employer-sponsored plans. We were lucky; my wife was invited to participate in a clinical trial that means her meds are provided free of charge. But if that hadn’t happened, we would still have access to Ontario’s Trillium Drug Program. The program provides assistance to people “who have high prescription drug costs in relation to their net household income.” It saves people from bankruptcy.

    Bottom line? You could do a lot worse than Canadian-style healthcare. It isn’t perfect, but a lot of us benefit from it, in both health and financial terms. In fact, a lot of us are proud of our healthcare system.

    In 2004, CBC Television sifted through 1.2 million votes in a contest called The Greatest Canadian. In the end it was Tommy Douglas, former premier of Saskatchewan and the “father of Medicare,” that won the day. I’ve yet to meet anyone who was surprised.

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    Thanks for your post, Kevin.

    I am a Canadian living in the U.S. as an Air Force wife and am fortunate to be covered by Tricare, the health insurance of the U.S. Armed Forces. For me, the transition from Canadian health care to Tricare was imperceptible: I see no bills nor do I often have to deal with insurance representatives. Tricare is even more inclusive than provincial health coverage because it also covers prescriptions, dental, optical, etc. Most Americans do not have this luxury of never worrying about being denied payment for reasonable claims.

    Lately I have been forced to hear the same ridiculous regurgitated conservative propaganda about how government-provided health insurance would “put a bureaucrat between me and my health care” and “limit my health care choices”. Ironically, the only Americans with health care which is both affordable and comprehensive are the very same who are told when and where they are allowed to reside and work in the service of their country.

    The problem as I see it is that although Americans do have a faint inkling that they have a health care system that is unworthy of them, they simply cant believe that they could have been so thoroughly duped by the industry. Competition is always the answer in the U.S. system, isn’t it? How could it fail in health care? Manufacturers and utilities are indicted for creating monopolies or for price fixing, but health and quality of life is such a sacred thing for Americans; they cannot bring themselves to believe that these companies can care more about money than an irreplaceable life. The insurance companies take vicious advantage of that. I also believe that as bad as the system is now, many Americans fear that any change could only be for the worse.

    You do realize that the socialist NDP mobilized an online campaign to stuff the ballot box in Douglas’s favour back when this contest happened.

    I too recently had an excellent experience with the Montreal Children’s Hospital. They spared no expense for my son, ordering all the tests that the doctors felt he needed. In the US I’m sure each x-ray, bone scan, ultrasound, would have cost thousands of dollars and I would have had to decide which ones we could afford, after which the doctor would have had to guess.

    Where they do seem to save money is in rooms and food. They were not hotel or gourmet standard by any means. But that doesn’t affect the health of the patient so it’s fine.

    You do hear stories about long waits. These are very annoying for those involved, but they are not usually life threatening. The life-threatening procedures all get first priority. I do think that Canadian health care can be improved dramatically. I really am disappointed at how some regimes basically force the patient to use an expensive form of healthcare like an emergency room for non-emergency or easy-to-solve issues. i.e., in the above fever example the patients could have easily been monitored by nurses and told to come back if the fever persisted or worsened. Then if it did the follow-up could be scheduled or something.

    Regardless, I’ve never had more than a 4 hour wait myself, probably because I don’t go in for anything other than real emergencies.

    by: Dave Harvey | August 27th, 2009 (6:43 pm)

    The thing that I like most about the Canadian Health Care system is that the only bill that I have to pay for a hospital or doctor visit is a parking fee.

    And isn’t that parking bill a little steep? For goodness sakes, if they can give me a free blood transfusion why do they cheap out on the parking!

    I guess our system is pretty good when it comes down to life threatening emergency. They will take care of you regardless if you have money/insurance or not.

    However, when you have other problems (we have to see an orthophonist for my son), you can wait for several years. I presently have 2 options:
    #1 wait 1-2 years on a waiting list
    #2 pay $200/hour in a private clinic and wait 2-3 months…

    I let you guess what is my choice 😉

    Do you have insurance for the orthophonist?

    by: The Financial Blogger | August 30th, 2009 (7:33 pm)

    I do but I don’t know if they will accept to pay for it since it is “technically” free if I wait… I’ll let you know in 3 months from now!

    Things aren’t all puppies and roses across Canada. I recently moved to Nova Scotia and have been horrified.

    My wife went in for dizzy spells that were making it dangerous for her to navigate the stairs in our house. The walk-in doctor informed her that she needed to see a specialist, but without a personal physician to follow her, there was no real point. When asked if he knew of any personal physicians accepting patients, he said “There are none”, and sent her home. We are doing our best.

    To add to the danger, she has also diagnosed with arthritis in her knees and has been referred to physio. After 18 months, we are still waiting for her to get in to physio.

    The craziest statement I have heard was, “we may not be able to get healthcare, but at least its free, and we don’t have to mortgage our houses for it like in the US”.