Yes and no. It’s not as straightforward as that, but yes, everybody gets treated and everybody pays more for it.
And yet, somehow, socialized health care is terrifying… just makes no sense- people are afraid of teh word socialist without any understanding of what it means.
Brilliant propaganda strategy by vested interests born in the wake of McCathyism, and hugely successful until pretty much now.
Makes the con of Big Tobacco look like a kids trick.
Yes, IIRC the provinces in Canada (who run the health plans) fund the hospitals. A hospital costs $X to run, the administration plan, budget and spend like the library, airport or any other public institution. The budget is provided by the government. Billable services paid to doctors and similar fee-earning professionals, i.e. for operations, are paid separately. Some doctors (emergency room physicians) are I believe paid a salary. There is no secretary for administrivia sitting in an office trying to track and allocate each bandage and aspirin to each patient.
I assume prescription drugs, just like doctor fees, would be tracked and billed since in some cases the patient has employment benefits that may pay for them?Don’t know, never been in hospital, let alone drugged in one. I do know from experience the emergency department will hand out aspirin, but I’m not sure how they bill for it.
In complete opposite to the USA, the dirty word(s) in Canada is “for-profit”. Since an institution (just like a doctor) cannot bill over and above the published medicare rate, the obvious question is - how do they plan to buy the owner a Porsche? There is occasionally a clinic in the news that will plan to offer to allow you to skip the queue for that MRI or ultrasound or hip replacement, for cash on the barrel. (a) Are there enough cash patients to keep it afloat, and (b) basically it amounts to paying cash to skip the queue. Fine when you have a few hundred and desperately don’t want to wait a month or two for that MRI (downside of our system).
But then they steal their techs and doctors from the public system (where else?), It creates wage inflation which adds to our taxes and shortage of techs (i.e. MRI and Xray techs) lengthens the queues and makes things worse. Employers don’t want to get into a system where they instead of the province pay for health care. People don’t want the US system where a medical emergency can completely bankrupt you. The downside of our system is, unless it’s an emergency, you will wait your turn. There’s a persistent debate, for example, that a hospital may budget and allocated only X hip replacements a year and hence the long waiting lists.
Whether you break your arm or your hip, or have a heart attack or need a new liver, if it’s an emergency, you get treated right away and the one thing nobody worries about is what it costs the system. It costs you nothing. One of the big grumblings in the news recently about our system is not their charge for aspirin, but how the parking costs at hospitals (part of their revenue stream) are too high.
:rolleyes: And yet somehow, they mange to dispense medications just as safely, for a tiny fraction of the cost, not only at every hospital pharmacy in every country in the developed world apart from America, but even in America itself, at the high-street pharmacy just across the road from the hospital.
Don’t you have private practitioners/clinics in Canada? There are in the UK and I thought the system was pretty similar in both countries.
Thanks for all the answers, by the way. So, if I understand correctly, the transplant isnt den ied because you can’t afford it, but because youn won’t be able to afford the drugs afterwards. A differencde without much substance, it seems to me.
Besides, it leaves me wondering : there are tons of medical procedures that require follow-ups and long term drug treatment. Would those be denied too? And if they are, doesn’t this mean, in practice, that you don’t receive even a life-saving treatment in the USA if you’re uninsured, as soon as the treatment is long-term?
What about necessary drug treatment when there’s no surgical procedure? For instance, AIDS patients : they won’t live without rather costly drugs. What do they do if they fall into the cracks by not having private insurance and not qualifying for Medicaid/Medicare? (especially since, I guess, private insurers won’t be very interested in offering them coverage with such a pre existing condition)
I forget the exact year it happened, but at one point the Federal government decreed active HIV automatically got you onto medicaid/medicare, which would then pay for treatment because, yes, people were dying for lack money to pay for care.
There’s difference between most transplants and other medical procedures, though. If you receive an organ transplant , and can’t afford the follow-up, have a history of being non-compliant with medication etc. and end up rejecting it , then that organ was essentially wasted. Someone else could have been given that organ. That’s not the case with long term drug treatment or other procedures that require follow-up.
If your country doesn’t have a high rate of medication errors, you need to improve your error-catching.
LOL
Yes, “Death Panels” exist, and we know who really runs them.
Exactly. The hospital cleared me for a transplant, but my insurance played games with them for two weeks before finally agreeing to allow it. Now, as far as the hospital goes, I’m just waiting. I see my nephrologist every few months, take my meds, all is good. My insurance continues to pester every office involved to make sure I still need a transplant. I’ve received letters / calls telling what lifestyle changes I could make to negate the need for a transplant. My type of kidney disease is not one where lifestyle changes would stop the progression.
The main difference is a simple one - the federal government provides a significant pile of funds for medical plans, and the provinces don’t get them if they don’t meet standards.
A while ago, it was found that a significant number of doctors were charging more than the published medicare rates for treatment - thus a visit to the doctor actually costed a (small?) amount. The worry was that eventually the extra billing would be a significant part of the medical costs for a family - so the federal standard is that no doctor may charge anything over the medicare fee list for a medicare fee. As I said before, if they do overbill, neither patient nor doctor get reimbursed - you’re either all in or all out, no moonlighting as a for-cash doctor on Mondays and Tuesdays, unless its vanity plastic surgery or other non-covered treatments. (Otherwise they would tell patients - come and see me when I’m charging extra…)
Since nobody gives US-style medical insurance as a benefit, this means the only “private” health system would be user pay, so essentially there is no such system. This is the BIG difference between the Canadian and UK systems. I’m sure there’s some system for millionaires but for 99% it’s the one system (per province). Unlike the UK, the middle and upper middle class use the same system as he poor - hence the incentive to make it work 100%.
Similarly, a private medical clinic would need to rely on cash customers. If you have $30,000 to blow and don’t want to wait 8 months for a free new hip or new knee, you could always go to the USA - so there is no great demand for local for-profit institutions. IIRC to prevent cross-border shoppers: you can get the provincial fee schedule for US treatment, which won’t really cover very much. Also , you can only get reimbursed for treatment if it was an emergency or the equivalent procedure is not available in your province.
So we’ve managed to avoid the worst of the UK and USA systems.
Death panels?
http://www.canada.com/cityguides/winnipeg/info/story.html?id=99aa7632-5e19-4cee-addc-bfb7e82d679a
http://www.cbc.ca/news/canada/manitoba/story/2011/03/28/mb-report-whitewash-golubchuk-manitoba.html
A case in the news a while ago, where doctors wanted to pull the plug and th family went to court to stop them. Some doctors refused to treat the guy. The real issue may not have been money, but quality of life - whether extraordinary measures were warranted in the face of the inevitable. I had thought the family had the final say on pulling the plug, but this article suggests doctors do, unless you have lawyers on retainer.
There are private pay-as-you-go clinics in Canada. I know because I needed to use one once. My wife needed a blood test for pregnancy on a very specific day as prescribed by our fertility doctor, and on that day we happened to be in Montreal. (We are Americans from California, by the way.) So we found a clinic where, for around $50 they would administer the test.
(It was negative, unfortunately, but we did have a child a few years later.)
Yes. It’s called “fly south to the US and pay cash”.
Yeah, if you can afford the US hospital bills - cash - then you can afford an air ambulance to the nearest US city once the local hospital has stabilized you.
Yes, some private clinics do pop up here and there. Usually, they do marginal things like small tests that people don’t want to wait forever to do. They will also do work for for-profit medicine, like elective cosmetic surgery, etc. (not covered by OHIP) Occasionally there seems to be a story about some clinic that wants to do tests like MRI privately. There aren’t a lot, because whatever the cost - hundreds of dollars, thousands - you have to be pretty desparate or pretty flush. Any clinic will do a test for cash for someone who is not part of the provincial system. IIRC that’s allowed.
The options, including who gets to decide, may depend on the specific protocol and/or specifics about the patient such as overall health, age, mental state of everybody involved, etc.; although I’m also wondering whether the doctors really could pull the plug without the family’s consent or it was a heavy recommendation on their part. Note that an individual doctor refusing to treat the patient, or to perform specific procedures, is not the same as pulling the plug.
LOL. Aren’t they ‘Socialized Death Panels’.
Better than a Python sketch.
Don’t recall all the details, but basically the doctors were complaining that extending life meant extending suffering and the kindest thing was to turn off the machines; as the article indicates, one even resigned rather than carry out the recommended protocol. Whether that was legit principle, or a snit fit over being told what to do? Who knows?
A side note, one of the provincial ministers mentioned on the radio yesterday that it costs about $1000 a day to keep a person in the hospital in Canada. (versus $150/day for “long term care” facilities.) I presume that’s not counting special treatment like operations, it’s just an accounting of the normal operating budget of the hospital.
I have a rare immune/blood disorder. Very few cases, so most treatments are considered “experimental” – something insurance companies tend to not want to pay for. Not a candidate for a bone marrow transplant (it didn’t work with others similarily diagnosed) so it’s monthly infusion therapy and weekly injections of all manner of proteins, enzymes, vitamins, etc. and, of course, blood tests, lots of blood tests! Just the infusion therapy has a ‘retail’ cost of $14,000 per treatment. Humana negotiates the price down to $4,500 and I pay 10% until I reach my $6,000 annual out-of-pocket max.
Just managing things is very complex. Primary care physician plus 3 specialists, labs and out-patient facilities, weekly blood work, 10 pills every morning and another 5 every night. No way someone without resources (not just financial, but family, social, etc.) could manage it all.
I cannot say for certain and have no way of proving it, but I suspect a poor, uninsured or homeless person in a similar situation would never even get the diagnostic testing, never mind the treatments. So they’d just die.