How do you feel about the Canadian health care system?

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11/17/2009 Eric B. says:

I'm from the US. We are in the process of reforming our health care system.

Our media and elected government law makers try to claim that your single payer health system is terrible. I'm skeptical of anything our elected officials and media say. How do you feel about your health care system? Is it really so horrible?

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11/17/2009 Ramanan "Funkaoshi" S. says:
I love the shit out of OHIP. It's fucking awesome. America would be lucky to have a health care system half as good as ours. For starters, I don't know anyone who has gone broke from getting cancer, or having a heart attack.
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11/17/2009 John "underpaid civil servant" F. says:
I am a US expatriate. The Canadian system does have some flaws and issues, but it beats the US by 100%. With a health care card here, I can walk into any hospital and be assured of free treatment in an emergency.

The problem with the US is that when government funding comes up, Republicans and "Blue Dog" Democrats have trained all of the stupid rednecks there to have panic attacks, including poorer people who would actually benefit from guaranteed health care. If the US did not have a population with the brains of the sheep in Orwell's "Animal Farm" it might be able to get something done.
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11/17/2009 Kat "don't get me started!" F. says:
I'm a fan. There are long wait times for some tests and services but that's my only gripe.
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11/17/2009 Katrina "foot" L. says:
I LOVE our healthcare system. For the past few months I've been visiting different medical facilities like hospitals, doctors offices, xray scans, ultrasounds etc... Every time I do one of these things, I just think to myself "THANK GOD I live in Canada where I can just show my ghetto red stripe card and go right in, leave the checkbook at home!" I probably would have gone broke just trying to diagnose what was wrong with me.

But I agree with Kat that long wait times are "my only gripe"*. And of course because of these long wait times, some things may not be caught early enough but this is something that can happen anywhere.

______________________________ ___________________
*quote from Kat F's previous post
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11/17/2009 Kelly "Swagger Coach" O. says:
I love our system. As someone who does not have health care through work, I cannot even imagine having to make the decision to get groceries this week or buy antibiotics. It is morally wrong that people all over the US are driven into bankruptcy because of poor health, and parents must make the choice to feed their kids or take them to the doctor. In an affluent Western country, that is criminal. Often, the people that suffer most are single women, and children.

I think the only people who are worried about the public option, are people who have 1) excellent care through their jobs (as tenuous as this can be), or B) Never had to deal with a serious illness, or known someone who has.
Yes, our system has problems, but I would take it any day of the week!

The transition for the US will be bumpy for sure, and probably confusing, but in the end it will make the whole country a better place to live.
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11/17/2009 Sam G. says:
I would definitely take this system over the US system. I agree the wait times can be bad, though I'd like to think that its due to the fact that I've never had a truly terrible illness and if something was urgent/really wrong I'd be prioritized. While I'll admit that I don't follow the issue closely, it seems to me that we don't truly vigorously debate how the system could change, be improved, or made more efficient. Particularly through the election process. Because if any politician touches it the wrong way, even with a ten foot pole, they'll get shot.
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11/17/2009 Karl "Kid Don Cornelius" R. says:
It's a bit like blind men feeling the elephant. Depending on which part you examine, you get a different story. End of the day it can be summarized thusly:

- In Canada you die waiting for something.
- In the USA you die because you can't afford it.

We can't possibly mine enough MRIs and fabled machines that go PING out of the earth so we have to ration healthcare via waiting lists or the price system.

My only major experience with anything beyond my family doc was in Seattle. I had great insurance and from discovering a lump in my lung to a CT guided biopsy that determined it was not cancer was about 3 weeks tops. Cost: zero. Free socks: 2.

But then my friend had some pain and she was only allowed to spend x amount of dollars a year trying to diagnose it. After that, she had to wait another year.

The American system works GREAT when you have GREAT insurance or a lot of money. The Canadian system works great when you don't. But conversely, if you do have a lot of money, well, try to get an MRI at a private clinic. You can, of course, always go to the USA and pay rack rates.

End of the day, everyone has to decide which kind of nation and health care system you want. One that takes care of rich and poor the same but rations via wait times and government oversight. Or one that opens access based on your efforts in life and theoretically doesn't shift the cost burden.
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11/17/2009 Mike "STUNT" P. says:
Honestly, in my opinion the health care system is great.

I have never been been sick nor do I use any of the services offered by OHIP. But I know others who use the service frequently and have only good things to say. How can anyone attack a service that provides "free" health care for those suffering from cancer, or other terminal illnesses?

Mike
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11/17/2009 Kat "Kitty" T. says:
As a US-Passport-holding, cross-border-licensed health care worker, I have to agree with all the Canadians! I love government-run Canadian Health Care. As a patient, I didn't find anything good about the US system. I never had to be hospitalized, but visiting the doctor's office as a patient is like night and day. Here in Canada, I walk in, show them my provincial health card (OHIP) and wait mere minutes to see the MD. I can often get same-day appointments if I am not feeling well.
On the other hand, In the US, I worked at a job with no benefits. I had to seek out a Blue shield provider, purchase insurance including filling out a 10 page medical history form. If I wanted to see the doctor, I actually was sent to a clinic where a computer screen asked me a list of questions and a prescription came out the other end! This cost me $30 and the bill took 4 months to find me.

I can totally see where that "gotcha" denial of coverage can come into play. If I got hit by a car, they could go rooting through my history and find out that I was once treated for an ear infection that I didn't report and deny all further claims. That's why I personally like it that the decisions my doctor makes are not dictated by an insurance company. The crazies in the US think their system is better because the government isn't telling doctors what to do.

In Canada, health policy does mandate certain things, but it is evidence-based medicine and these are things doctors should or should not be doing anyway. Sometimes, the government actually recommends MORE than the US doctor's would think to do. In the Me! Me! Me! system of US health care, not everyone needs an MRI annually. But many are happy to get one, if their insurance covers it, not realizing this makes the entire health care system exponentially more expensive!
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11/17/2009 Neil "indefinite review hiatus" T. says:
Kat T. -- you are awesome. That is all.
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11/17/2009 Eric B. says:
Thank you all for contributing. I find it very interesting to hear from regular people who think your system works fine. In the US, the media and elected officials try to spread fear about how horrible your system is. If only there was a way to get ordinary Canadians to talk to us ordinary Americans about how your health care system is A-OK.

BTW, what percentage of your income do you pay in taxes? Do you have to pay more in taxes than we do because of your system?
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11/17/2009 from Yelp for iPhone Kat "don't get me started!" F. says:
I believe income tax is is about 20-25% or something like it, depending on the bracket. Yeah?
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11/17/2009 Karl "Kid Don Cornelius" R. says:
In Canada you pay a federal tax and a provincial tax. Unlike the USA there are no city taxes. Other major deductions include Government Pension Plan and Employment Insurance. As well, many employers have you co-pay for a company health insurance plan which covers drugs, dental, etc. (mostly stuff that government health care doesn't cover). My take home pay is 70% of my gross income. That's actually a lot better compared to 10 years ago when it would have been closer to 60%. Taxes have come down a lot in Canada.

Of course income tax is not everything. There's a provincial and federal sales tax which tacks on 14% to goods and most services (groceries are not taxed). I spend about $1200 a month of my net income on stuff that is ultimately taxed via federal and provincial sales tax (cable tv, starbucks, clothing, insurance, gas, starbucks).

So doing a quick calc, I'd say income tax (federal and provincial) plus sales taxes means I'm left with 66% of my take home pay.

Now when I say taxes have come down a lot, it also means they've downloaded services. License fees have gone up, the city of Toronto has started its own parallel fee structure for things like a plate tab/land transfer tax. Garbage they're starting to charge for. I actually don't mind that stuff so much as one has more control over it. I'd rather have the income tax cut and then fee for services and let me pick and choose and pay for the services I use.
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11/17/2009 Karl "Kid Don Cornelius" R. says:
continued ...

In the USA, depending where you live, your take home % can be wildly different. Now if you're living in California or New York, I'd bet you Canada/Ontario taxes don't look 100% bad. If you're living in Washington state which has no state tax or Oregon which has no sales tax, maybe it doesn't look totally great.
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11/17/2009 Eric B. says:
Interesting. About 28% of my paycheck is withheld. ADDITIONALLY, I pay $100 per month out of pocket for health insurance PLUS my employer pays $250 more per month.

Then, if I want to see a doctor, I have to pay a co-pay around $30 per visit. PLUS, I have an annual deductible of $1,000. Furthermore, I've never been really sick and I'm sure my insurance company would come up with some way to deny my claim if I ever got really sick.

Overall, your system sounds much better to me.
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11/17/2009 Deanna "mongoose extraordinaire" W. says:
@Kat T extremely well put!

Having moved and now piggy-backing off my husband's benefits I have to agree with the above. If you can afford the insurance down here great but then you have to ALSO worry about the added hassle of finding the right approved doctor, making sure your claims go in appropriately and god knows what I haven't found out yet. I miss the days when I could just flash my OHIP and wait two weeks or what not for an appointment, tests etc.
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11/17/2009 Carmen "They Call Me Mellow Yellow" M. says:
I'm an American living in Canada. I don't usually talk about my opinion of the two healthcare systems because I'm usually not very popular with my Canadian friends when I do. But I know that my Yelp friends won't attack me, so I'll stop lurking around this thread and contribute.

I agree with Karl R -- if you have good healthcare in the US, it's far better than the Canadian care I've personally received. I worked for the same company in the States (I was transferred to Canada with that company) and I can say without a second of hesitation that the actual care I received in the States was far better, and far quicker, than that which I've received in Canada. I paid $20 a month for a single person with my company in the states for a PPO which is the best you can get in the States (not HMO like what you get in Canada where you have to get referrals from your GP) and families at my company paid $40 a month. I could go to any doctor I wanted and have personally had two MRIs which happened the same day they were recommended. A very close friend of mine who's also American and a physician (she went to a top medical school in the States), but who married a Canadian and now works here, is moving back to the States with her husband -- her reasoning is that the Ontario government does not fund medical research or technology improvements like in the States, which, for obvious reasons, is sort of important. Sure, the pharmaceutical industry is funding a lot of that research, but at least it's happening. From what I understand, that just isn't happening in Canada, probably from lack of public funds.

I've never done a cost comparison between the two, although I'd imagine via Canadian taxes, I'm paying far, far more for less care than I received in the States, but that's just anecdotally (I'm from Texas who does not have a state tax). I've experienced both systems and, if I had to get sick somewhere, I'd want to get sick in the States. If you have insurance there, the care and facilities (from my personal experience) is far better.
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11/17/2009 Eric B. says:
Carmen, that's an interesting perspective. However, I know a number of people who have become seriously ill, and then their insurance company does not accept claims or drops them completely citing pre-existing conditions or non-disclosure on the application.

Plus, I personally would rather make sacrifices and wait longer if it meant that everyone had coverage. I personally think it's unethical that 50 million people don't have access to basic health care. Then, people who think they do have good insurance get dropped the minute they get sick.
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11/17/2009 Neil "indefinite review hiatus" T. says:
That makes sense Carmen. I guess the big issue is if you don't have coverage or have a pre-existing condition that excludes you from coverage.

I've been hospitalized in Canada for eight days exactly 10 years ago (great 20th bday!) and can say that the care I got was great. I was admitted immediately after some results and was operated on within hours. At the end of the eight days my bill was....$15 -- telephone charge. I don't hear similar stories like this coming out of the US.

Also, my father had a heart attack a few years back and was admitted right away. He was stabilized, but then had to wait a couple of days for surgery. They released him within 24 hours of that. All at no charge. Had his condition been more serious, I am sure they would have operated right away.
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11/17/2009 Dana S. says:
I think it's ridiculous for people to pay for health care so I don't really support the US system. Health care is not the same as other industries and it should not be capitalized on.
In a matter of life and death if someone cannot afford an operation, they have no place to go - and that is unfair. There are already enough internal system errors that can have detrimental effects on people's lives, we should not have to worry about costs eating away at our banks accounts too. There's obviously problems with people abusing the system in Canada, but that's a management issue that should and can be dealt with in other ways.

There's the argument that the care is better in the States and yeah, that may be true, but it increases a social gap between people and if you're a hardcore capitalist then it probably doesn't matter and you'd prefer the American system... for those who can afford it, that's great, but for those who can't it's a big problem... and let's just say that if I lived in the States I would probably be able to afford it no problem, but it's the principle that I have an issue with, health is not a commodity.

Generally speaking, the reality is that the US system is probably better in terms of care since of course people are paying for it... but neither is perfect and I'd rather take it free and spend some extra time looking for the care that is appropriate for me.
I think I'll stick with the Canadian system.
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11/17/2009 Rachel L. says:
Hey, I am an American living in Canada for school. I use health care sparingly so I have a pretty big grudge against the UofT health clinic for turning me away. They told me that I was not sick enough to be treated (compared to the other people waiting) and asked me to come back later. I felt like I was at a sports meeting and had to compete against other patients.

When filling out forms for an international trip, I had to pay $100 for a doctor's signature on one sheet of paper. Out of pocket. Had I been in the States, this would have been free.

I also think it is weird that dental care is not covered by OHIP. In the States it is a separate deal, I know, but if we are going to talk abut universal health, I'd like to point out that we all have teeth that need to be looked after. Maybe this is not universal thinking.

Fortunately for me (and I know it, really!), I have a good health care plan in the States and I am covered in Canada too. They both have their strong points but unfortunately, health care is also a business and it still has to deal with the eternal fight over time versus money.

Either way, I wish everyone the best of health.
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11/17/2009 from Yelp for iPhone paul a. says:
I consider myself to be extremely blessed to be able to have the use of OHIP. Sure you have to wait for a few things, but if it's lifethreatening you get seen pretty quick, and ya don't have to sell your house to pay for treatments.
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11/18/2009 Eric B. says:
In regards to Dana's point: "Health care is not the same as other industries and it should not be capitalized on."

I agree 100%. I'm very much a capitalist. However, health care is clearly an example where the free market system has failed us. Health insurance companies have become useless middlemen that add a layer of cost for doing nothing, and then increase their profits by finding unscrupulous ways to deny coverage that was paid for (i.e. pre-existing conditions, irrelevant errors on the application).

I'm not in favor of socializing any other industry in the US at this point, just health care. At the bare minimum, I am in favor of the public option to compete with private insurance.
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11/18/2009 Karl "Kid Don Cornelius" R. says:
In Canada, doctor's fees are capped. A doctor can't bill the state more than a prescribed level. An MD from a Canadian university allows one to sell your services anywhere in the world and Canada does lose a lot of doctors to the USA. One might consider if the USA adopted such a system, American doctors would head to Dubai or set up shop along the Mexican border and serve American patients. Capping salaries also might make it harder to get young people to become doctors. If you're a young smart guy, you might go "why be a doctor when I can be a dentist and make more? Why be a doctor when I can get a Phd and get rich in stock option working in biotech? Why not get a Phd in biology and then study law? Doctors might also move to specialties like plastic surgery where fees are not capped. Even in the USA, there's a shortage of some doctors, like pediatricians because the economics no longer make the field a financial go. Doctors respond to economic signals like any human and there's no quick 'n' easy solution.

Of course we don't mind if the other guy's salary is capped but what if the government mandated your salary is capped? That's it. You cannot make more than 50K a year plus COLA from age 40 until you retire. I don't care how talented of a web developer or graphic artist you are. Sorry. That does not strike me as a very fair world either.

The problem with economics is there are always consequences in the other direction. Nixon was famous for saying he wished he could find a one armed economist, because then the guy couldn't say "but on the other hand".
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11/18/2009 Ramanan "Funkaoshi" S. says:
"- In Canada you die waiting for something."

Do you know anyone who has died waiting for something? I don't. I find in Canada people generally get triaged to the tops of lines if their conditions are serious.
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11/18/2009 Karl "Kid Don Cornelius" R. says:
I don't know anyone personally, just as of my American friends I don't know anyone who died because they could not afford health care. My anecdotal experience doesn't really matter. The Ontario government has a 6 month wait time target for bypass surgery. Longer you wait, greater your chances of having a heart attack. I wouldn't mind getting in next week. Ontario has a wait of 51 days for a CT scan. I could get one in Seattle the next day. While some cancers might not grow in 2 months, I don't know if I'd enjoy waiting almost 2 months to find out if I have a cancerous tumor or something benign.
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11/18/2009 Kat "don't get me started!" F. says:
Only 51 days, Karl? I waited close to 8 months to get an MRI last year!
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11/18/2009 S. S. says:
Having worked in the U.S. and Canada, the two systems are different. The Health Care in Canada is actually funded by the corporations. Corporate taxes are higher in Canada, hence it is more expensive to run a business in Canada. And every citizen is treated the same when you walk into a hospital (wealthy or not).

In the U.S., many of the PPO's you have to pay a monthly premium, on top of a deductible and fee's when you visit the hospitals. I remember going to get a blood test at a Kaiser hospital, and had to shell out $20 for my appt, and $50 for my blood test. Everything costs money over there, and the funny thing is, the hospitals themselves make a killing! This is why the nurses can make over 100k a year easily in the U.S. The health insurance companies say this universal health care plan Obama is proposing is a bad idea, because they will become regulated and will not be able to claim the large profits that they do any longer.

But you guys bring in some great points. I have multiple relatives who've had cancer and were treated in hospitals in Canada problem free and cost free. Only thing they needed to pay for was if they wanted a semi-private room or private room. In the U.S., you can easily go broke just from one hospital visit without having the proper coverage.
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11/19/2009 Chris "5 secs. cranking = 20 mins. talk time" E. says:
I've never had any trouble or wait. When I needed rabies shots a few years ago, they were available within a day. Free. When I needed serious spinal surgery about 13 years ago, I was on the operating table in a week, with the best neurologist in the province at the control. Canadian health care has flaws, but what doesn't?
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11/19/2009 Karl "Kid Don Cornelius" R. says:
For sure Chris. I think there are three measures you can apply to your nation's health care system. How happy are the voters? The anti-public health care forces in the USA attempt to use some anecdotes to pretend like the Canadian public is really, really unhappy with public health care. Canadians seem pretty happy:

http://www.gallup.com/...

Then again, North Koreans will tell you how happy they are living in a communist paradise. Perception is not reality. Although it can help.

How much does Canada spend per person vs the USA? Figures I've seen indicate we spend less. How healthy are Canadians vs Americans? There's ways to measure that but it's not easy to say how much our actual health care system contributes. But these stats seem pretty compelling:

http://healthcare-econ...

All 'n' all, our system is not falling apart at the seams like the US right wing tries to portray. I for one would like a public/private system. If I can afford a level of private insurance that will send me to a private MRI clinic, for example, I might be interested in that kind of coverage. That is currently illegal in Canada although it's not illegal to get a nose job or breast implants at a private clinic. And that strikes me as bizarre.
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11/20/2009 John "underpaid civil servant" F. says:
@Karl - you must also remember that there are reasons besides health care for the lower taxes in the US. The US government does not subsidize tuition. Canadians can go to a top notch university for 7,000 or 8,000 a year. In the US, it might be more like 50,000 or 60,000. Canada also provide more assistance to the poor and to refugees. Topping it off, we must remember that Canada has more territory than the US and less than one tenth of its population - hence higher per taxpayer cost for territory-size dependent infrastructure.
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11/20/2009 Randy "200 by Dec. 31" G. says:
Karl, I think one of the reasons for avoiding the private / public system is poaching the public system for resources - specifically, talented and highly trained nurses and techs. I recall some private clinics opening a few years back, and there being a bit of an uproar over them hiring their staff away from the hospital, leaving the hospital with not enough staffing to run their equipment...

Keep in mind, this is a distant recollection, and almost surely distorted by the sands of time - but I think the point is still valid: at least in the short run, bringing parallel private services online will likely have a negative effect on the public ones. And long run thinking is so hard to come by these days.