Anchor Struck

So, regarding Linda’s inquiry about Canadian health care: Jude and I pay $117 a month each for both of our Provincial health care.  Some provinces don’t charge anything.   Prime Minister Trudeau says he wants to eliminate Provincial fees nation-wide.  Our federal taxes are supposed to pay for the single payer system. Prescriptions, eye care, PT, massage, dental, and some others services are not covered.  My primary care physician (whom I was allowed to choose) is on our island.  It usually takes no more than a few days to get an appointment. My doctor is first rate.  I was lucky, as most doctors are not taking new patients.

If I need a procedure or service not available on Quadra, our ferry fee is covered if I get the proper paperwork.  Waiting times can be lengthy.  In December of 2014 I had a hip replacement.  The average wait time for that in our region is a year.  I only had to wait six, as explained here and here.  Some 31 months later, the hip is working better than many of my original parts.

Any bureaucracy can be improved, but I’m quite pleased with my interaction with the program.  I certainly would take it over the spotty, expensive coverage we had in the states.  We are free from the fear of financial ruin from a catastrophic illness or injury.  And at age 71, that is an immense relief.

So that’s the take of a satisfied consumer.  Let’s hear from a former provider, my lovely wife Jude:

As you wisely supposed, Linda, the issue of access to care is a big problem for both US and Canadian systems for different reasons.  The Canadian system is meant to pay for essential services such as routine doctor visits, specialists, and hospital care.  Some care, such as nursing homes are subsidized if you qualify.  There are multiple “gate keepers” in the Canadian system even for care that is covered.  For example, if you need help at home for bathing, you need a nurse case manager to assess and approve your need and authorize the number of hours you can use.  Then a Home Support Supervisor will come to assess your home to be sure it is safe for the worker.  It can take weeks for this process and the actual care to begin.

The equipment such as MRIs, CTs and the like are not as plentiful as they are in the US so not as accessible and therefore, the wait.  Canada does have a shortage of physicians – again slowing down access to care.  Emergency rooms are some people’s main source of medical care (like the US).  The ERs are so busy and understaffed that the norm (at least in the hospital where I worked) was to do basic tests and get people out as quickly as possible.  People would return in a few hours because they felt sicker.  Usually the third visit would get the patient a closer look and admission to the hospital.  Fortunately, walk-in clinics are becoming more available.

Waiting in line (in queue) is a value here.  Jumping the queue is a big no – no.  You really need your doctor to advocate for you if you are in need of a test or procedure due to the severity of your condition.  If they don’t, you wait.   Specialists are generally in bigger cities and travel is required.  Expenses are tax deductible, but not the total cost.

Unfortunately, Allen’s belief that our health care coverage prevents financial ruin is not accurate.  There are seemingly arbitrary limits or conditions that are not covered that can only be available if you pay out of pocket.  You can not carry your coverage from province to province and there is usually a waiting period before you can receive coverage, so you need to buy private insurance if you want coverage while you wait.  They do have help for poor people similar to Medicare in the US and coverage for people with disabilities with the same type of bureaucratic paperwork and frustrations as the US.

While neither system is ideal, what is happening now in the US with the uncertainty of healthcare is worse than either could ever be.  The affordable care act forms a good base and there are models in the US that work well.  This idea that people will be able to put aside enough money to care for their needs and wade through all the confusing options will work as well as trickle down economics has.  Trickle down health care – the rich get care and the rest get what is left (if they can pay)?