It is very interesting (as someone living in the US) to hear from real people what aspects of the Health Care system in Canada is actually like.
At least from my perspective, other than in this TUD forum, I don’t hear anything real. It is always sound bites from people here in the US who are trying to spin something and compare our healthcare system to another country to make a political point in this direction or that direction.
I enjoy hearing the facts from real people who actually live in Canada.
Yes, Medicare is socialized medicine for people over 65, people on disability, and people with end-stage renal disease.
However, people on Medicare in the U.S. generally have access to the same hospitals/facilities as people on private insurance (even if these hospitals receive federal funding, they’re not run by the government). Some doctors won’t take Medicare patients because they’re generally paid less for those appointments, but most doctors will. I think this may be one significant difference between socialized medicine in Canada and Medicare in the U.S… Is that true?
It’s a single payer system, which means everyone has access to the same hospitals and doctors. All hospitals are publically funded. Neither hospitals nor doctors can bill for services privately if they are covered by Medicare, so no one has access to better doctors or hospitals than anyone else generally. It’s not as comprehensive as the NHS or other countries though, and private insurance fills in the gaps for services that aren’t covered such as dental, vision (except for diabetics) and drugs. What is covered is up to each province. Hospitals still have their own administrations and doctors operate as entrepreneurs who bill the government instead of insurance companies or the patient. Patients (mostly) have freedom of choice over which hospital to go to, doctors, etc. so it’s similar to how Medicare works in the States if it covered everyone and there was no private insurance.
Medicare coverage in the US does not prevent us from getting Timely tests and treatment unlike other countries’ socialized medicine programs. So please don’t try to compare socialist countries such as the UK to Medicare in the US
They’re both socialized medicine. Period. There’s no debating this. It is a fact.
Each country will encounter different problems while providing healthcare. Some countries handle the wait time issue much better than others. However, those countries may have other issues. There are tons of issues in the U.S. healthcare system. People on Medicare are much better situated than people trying to pay for healthcare through their employer or the exchange. We ration healthcare through cost rather than wait times. This enhances already existing inequality within our country.
Wait times in other countries (those with socialized medicine such as NHS) can kill you, or limit your quality of life.
Heck, Medicare paid for an expensive bit of titanium hardware (over $10k) that Blue Cross (my wife’s employee insurance plan–NOT an HMO–it was a PPO) refused to pay for. Therefore she had to wait until she went onto Medicare.
I cringe when I read about the lengthy times folks wait in other countries for things such as an MRI, or a procedure. In the US, when I need an MRI I can get one in a couple of days, no problem. Doesn’t matter if I’m on Medicare or not.
Yes, it does. It matters because it will be covered if you’re under Medicare.
Hospitals are only required to provide treatment in emergency situations. If you’re covered by private insurance and don’t have the money to pay your deductible or copay, the hospital can refuse to give you an MRI if it’s not an emergency.
I’m not saying U.S. Medicare is a bad system. It’s a great system, but the U.S. has so many problems with the rest of our system (e.g. Medicaid). It’s not appropriate to compare only one of the best aspects of our healthcare system to other countries’ systems. If everyone in the U.S. was on Medicare, we’d likely have different problems with our healthcare system.
I think this is basically the point I’m trying to make.
Anyway, I’m sorry it got political. I’m glad you have access to excellent care!!! So excellent that you want to defend it. That’s good.
One difference it seems from what I read on these and other forums is that you need referrals to access specialists. You can’t just call up an endocrinologist and make an appointment, you get a referral to an endocrinologist through a GP (or walk-in clinic, or hospital, or whatever). I hear about many people in the US who go from specialist to specialist until they find one they like, and it sounds like one can just call up a specialist and make an appointment without a referral.
Wait times are based on urgency. Those with more life-threatening conditions get bumped ahead of those who don’t. One issue we have is a lack of doctors/nurses (particularly in more rural areas) and a population which is MUCH more spread out than even the most sparesly populated areas of the US, which I think exacerbates the wait-time issue. I, personally, have never had problems with wait times (having only lived in cities). I have waited four to six months to see a specialist, but I’ve talked to people in the US who have had that same experience. I’ve also gotten to see specialists and procedures within the week, so it’s really quite variable.
I’ve lived in Germany, Austria, the United Kingdom, Canada, and the United States, so I’ve experienced a variety of healthcare systems first-hand. Generally, in the socialized medicine systems, you have the security of knowing that getting some catastrophic illness is never going to bankrupt you, your friends, or your family, and you will never have to make a choice between getting the healthcare you need or not depending on your finances. However, the availability of specialist care and services is slower in socialized countries.
Socialized medicine works much better than privatized medicine where the country spends 10% or more of its GDP on healthcare, such as in Canada, but works poorly where the country spends less, such as in Britain, which spends only 7% of GDP on healthcare. But generally, as a type 1 diabetic I would not feel safe in any country without socialized medicine, since I am prone to so many catastrophic diseases in addition to the diabetes I already have that I would be ruined under privatized medicine.
For example, if I were to develop endstage diabetic nephropathy in the U.S., I would have to spend down all my resources to get Medicare to fund my treatments, which would cost around $60,000 a year, and I would have to receive those treatments in a private facility, which would shortchange my care in order to maximize profit within the basic per-treatment allowance that Medicare grants. This cost-cutting produces a death rate on dialysis in the U.S. which is about double that in the rest of the developed world.
In the US and with regard to employer sponsored health insurance, there are both approaches. Some employer provided health insurance does require referrals for specialists from a primary care physician (PCP). These are often times Health Maintenance Organization (HMO) plans which require referrals. There are also Preferred Provider Organization (PPO) plans which typically do not require referrals from the PCP. There are other types of plans as well: EPO, POS probably others. In many cases, a given plan really needs to be read in order to understand the details of how it works. It can get confusing when comparing employer sponsored plans to each other particularly if you are only studying and do not actually have that plan. IMHO, what an employer offers for a health plan is just as critical (if not more so) than what they are willing to pay for a salary or wage. An employer who wants to attract the highest quality employees has a very strong incentive to offer top notch health insurance.
Very close to 50% of the US population is covered under employer sponsored health insurance.
There are a number of US Government health care programs. Certainly anybody not living under a rock has heard of Medicare. There is also Medicaid, CHIP, Tricare, VA and IHS. Wouldn’t surprise me if there some additional ones. About 35% of the US Population is covered under some sort of US Government (federal or state or combination thereof) sponsored health care program.
That leaves about 15% of the US Population that is covered under individual non-group non-employer sponsored health insurance or uninsured. This is typically the segment which you hear the most about on talking points involving US Health Insurance. It can be hard to get real facts in this category as IMHO a great of what gets publicized is spin and political posturing.
There is and probably always will be a great deal of misinformation floating around as there likely is with most things.
Unfortunately for both the prospective employee and potentially the employer, it can be really difficult to determine the coverage of a plan before you join it. I wish there was more transparency.
You provided a lot of stats in your write-up. I’d be interested to know how you determined the % of people on employer-sponsored plans and government health care programs. Not second-guessing… truly interested.
I’m one of the population that doesn’t have any insurance or government assistance, I did have SSI when I was a kid but some bureaucrat wrote down that I was cured and I wasn’t ever able to get it reinstated. I pay full price for all of my medication minus what the manufacturers will discount on their savings cards. In the case of Dr.s I can and do just call up the offices and get an appointment, although this depends on whether or not the Dr. is taking new patients.
One interesting thing with paying up front for all of my care is that many clinics and all blood tests are half price for self-pay patients. I think it is really weird that CGMs need a prescription since they are not medicines and I can’t think of a way to hurt yourself using one. The problem with making these devices and diabetes care products in general prescription only is that for people like me who are self-pay, every new prescription requires a Dr.s visit which then costs money that I could have been spending on my expensive medicine.
I know that in most countries diabetes supplies are over the counter and I wish it was the same in the US even for newer insulins not just a couple of really old ones. I know it would simplify my life if I didn’t have to wrangle getting new refills several times a year and then I wouldn’t be tied to one pharmacy, unless I get the pharmacies to talk to each other to get my prescriptions changed over or in case of an emergency away from home.
@Firenza … that’s pretty much my point, to order Dexcom’s here it’s hard to believe you have to pay to go to the Dr first. It might be helpful if you could buy them directly if you DON’T have coverage. Then those that have insurance that requires a prescription could go and get a script, but that same insurance would cover you dr’s app’t!
Take insulin in Canada, yes I can buy it over the counter, but I would rather get a dr’s prescription so that our heathcare pays for it, but since they also pay for the dr’s visit it’s no problem.
But clearly there are pros and cons to both systems. My mother in law had to wait for 3 years to get a knee replacement which is totally awful and I’m sure if you had good coverage in the US you could get one much much sooner. But then when I had a baby that required open heart surgery and stayed in the hospital for 6 months I never saw a single bill and I’m sure the hospital spent a small fortune on her.
Oh and to clear up a question, @katers87 our hospitals are run by non-profits, but the government does supply up to 95% of their funding. Each provincial government acts like the insurer, they have rules set out for which drugs dr’s should prescribe first and they sometimes will limit operating room time for surgeons which creates troubles like delaying knee replacements and such. The up side to the government acting like an insurer is that we seem to have much tougher safety laws because keeping us all safe and out of the hospital is cheaper for the government! All people over 18 are required to wear helmets on bicycles and motorbikes and everyone has to wear seatbelts… that sort of thing.