Good question.
Let me start with some basics:
Canada, like all the other industrialized nations, has a universal/single payer health care system. Systems vary by country and means of administration, but I know Canada's well and so I can speak with some reasonable authority here. Let me dispel some myths and get some groundwork so that someone might better understand...
Thanks to some scare mongering, I hear lots of repeated myths about Canadian health care.
1. We are "assigned" a doctor by the government and this can take years to get that letter.
NO. I can pick from ANY gp taking patients. I got lucky in Vancouver, and loved the first one I saw. In Alberta, I had to switch twice. In Toronto, I haven't looked yet because i'm busy but the walk in clinic doc was decent, and in Halifax, I tried a few, and found one to my liking shortly before we moved. But never was I told that I couldn't doctorshop to my heart's content. We are NOT assigned or restricted from GP access directly.
2. We can't pick specialists of our choosing.
Well. Yes and no. It would seem that in the US, based on what I've heard/seen/read, EVERYTHING short of a sniffle gets bumped up to specialists. Here, you'll see a GP for most things unless it looks like surgery's on the books or chronic illness, but even then as an asthmatic, I preferred my GP to the respirologist, so I never went the specialist route after one visit with one who was something of a disaster. Ditto an allergist. I was being treated just fine by my GP.
But if you do need a specialist, you'll have a range of picks if you're in a large metro area. You might even have a choice in a smaller city. You might find that you're taking the closest one, if you're in an underserviced area.
( note: Canada is MASSIVE. We have lots of splat sized towns that don't have the latest and greatest because it wouldn't make sense financially or logistically to have a 5mil state of the art cardiology surgical unit with mobile MRI unit for a town of 300. But it's also been pointed out most people are but a short flight from a major medical center, or a 2 day drive if you've not busted an artery or such.)
3. We have a massive wait list.
Yes, and no. Each province has their own provincial plan for health care, overseen by the federal government. But through BC, NS, and ONT, and AB, the treatment I've received is at a basic level very consistent, caring, and good. Overall, no complaints. Anyway. Each province has its own priorities above the basic service, and some services are covered in one province and not in another, above the basic, which is extensive, really. People in NS tend towards an elderly demographic so they won't have the same concerns as BC with a younger active demographic. Wait lists for procedures then vary depending on the nature of the procedure.
Orthopedics is somewhat backlogged as is minor cardiac surgery, if I recall right.
we're not given a number "you're 800 000 on the list" where there's a big line ala burgerking, of 800 000 in front of you. You're waitlisted for that specialty, not as a whole.
Just the same if your issue becomes, or is imminently life threatening or limb threatening, you get bumped up the list, if yours looks like it could use more urgent attention, you'll be moved ahead.( this has happened to me.)
Downside is sometimes, you bump in front of someone else. It happens. It's medicine. By it's nature it's triage, not first come first served.
4. We don't treat our elderly.
NO. We don't even send them off on ice floes when we've felt they outlived their usefulness. Nope.
5. We send patients to the US because our facilities are SO lacking that we can't deal with em, and we envy the superior US facility.
NO. Sometimes patients have been sent to US facilities because there IS some equipment or skill where it's simply one surgeon at one hospital doing what he does and none else. Ontario sends 2000 or so to the US, (buffalo, right across the border.) at our own expense. Sometimes because that hospital is closer. another 10k go down of their own volition. Now, with the population of the GTA being somewhere around 2.5 mil? 2k, 12k is a proverbial drop in the bucket.
This also doesn't consider the fact that americans come here for cheaper meds, and I've heard some vague stories of american women coming here to give birth because if they're uninsured, its cheaper than doing so in the US. So the traffic I think, goes both ways.
6.People die, suffer on our system.
Yes, sometimes the system doesn't work. But people die. People die in the US in waiting rooms, or as recently, when someone went into premature labor, the EMT's who happened to be on lunch at the same cafe did nothing but offer to call another rig.( in both instances, the people died.)
7. We pay for someone else's bad health/decisions/morality.
MAYBE. Maybe we do. But we're also not really in the business of getting all up in people's business either. And you can be perfectly healthy, saintly, moral, whatever, and still get mown down by a drunk driver, or have some catastrophic illness befall you.
But most of us pay in to the system. We ALL have equal access. We tend not not think of it as "so and so is getting MORE services than I". Though if you wanted to, I guess you could get extra colonoscopies to balance out your neighbor's use of the ER but that's petty and nonsensical.
8.I don't want any ol government beaurecrat telling ME what to do.
Hey. Neither do i. And guess what, in Canada, they don't interfere between the decisions my doctor and I make. They don't tell me what procedure I can have, or where, by whom. The government doesn't act like an HMO or insurer where claims must all go through a central authority.
The government does encourage healthy behaviors and responsible use of the system, but that's pretty much as far as it's ever been involved. My doctor ordered a medical workup for investigation of an issue, even though I didn't specifically meet the criteria, she felt it was warranted and lo, it's done. ( same with cancer screening. the general policy says X, but your doctor calls the shots, not some beancounter in an office.)
9. We're oppressively taxed.
No, not really. I know people in the US who are taxed much less than us, and a few who are hit much harder. Our household's tax burden is a moderate 24% or so. The Ontario government commits 3700 a year, per person out of that tax revenue to our health care expenditures. 10% of our GDP or so, compared to nearly twice that in the us, and 18% GDP.
That includes unemployment insurance, a year long mat leave, all access no cut offs/restrictions health care that goes cradle to grave. Heck of a deal. We could and maybe should spend more.
Some rightwing think tanks will state the numbers higher but most other studies don't concur.
10. The insurance companies! think of the insurance companies!
Well, we have private insurers here, that will sell you or your business a policy for all those extras that the basic plan doesn't cover. I've lived very well without it, it's nice to have and most jobs offer it as a benefit. ( well some.) policies are fairly easy to obtain, and relatively inexpensive.
It's been said that the health care system here has allowed people the freedom to live, and work. I can't see how the US system functions. I know a florida area podiatrist who has 6 people managing billing, for insurers that pay out after 6m, but medicare pays him around 9 days after billing.
I don't see how strapping massive premiums to people, and employers, makes any kind of financial sense ( we do work in canada, because we have rent and food.) People argue that if it's provided in the US, what next? well, when that carton of milk runs at 100 bucks and you have to submit to background investigations for previous milk purchases or use or you may be denied a purchase, and milk is as vital as air or medical care, then yeah, we'll look at socializing food. But so far no one denies you food on largely arbitrary criteria, and there's nourishment at virtually all the prices you wish, and free if you're in need.
7/10 people who declare medical bankruptcy had insurance, BTW.
People are being cut off, denied, mid treatment, and hit with userfees, copays, rising premiums.
The other benefit to our system is that you don't need to resort to being on disability for medical care. I know a few people who simply can't work because jobs won't put them on the coverage plan, or they can't earn enough to buy their own policy.
This has to cost an immense amount, having people locked to disability or dead end jobs. It stifles the very thing I think americans valued at one time, that Go get em spirit.
I'm watching friends in the US battle with insurers, cut offs, and expiring plans, or plans that refuse to cover reasonable claims, rising premiums for less and less service. No lie, I worry. I'm angry that people think health care is something people are not buying because they prefer hohos and big screen TVs.
I think a lot of these myths are things people tell themselves so they can sleep at night. That there's charity care and agencies and even go beg for a reduction in your bill. Just what you need after a medical crisis, right?
And what of all the people who are uninsured and go to the ER because you cant be turned away? That markup on supplies, drugs and services goes to cover them. The US is already paying but in the MOST INEFFICIENT WAY POSSIBLE.
If you're a fiscal conservative, on this alone I don't see how people could think this was a great system of use of resources.
So if someone's wondering why I'm vocal, and how we roll in Canada, there you go. I think single payer/universal is about the only option. It works everywhere else. Only some of the US seems to believe that it won't work there. I don't expect the change to be easy, but I don't see how a country can function when so many are in this mess and struggling.
Tags: facts, healthcare, madness, policy
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