Canada - Health Care

Tell me if you like the health care system in Canada.
It has been in place for 50 years now. I have friends in the country who tell me it is a lifesaver and they support it
I also hear about Canadians coming to the USA for surgery or other treatment. These people must be well off.
If you live in Canada please tell me the strengths and weaknesses of your system as the USA is debating this now.

The good side: I go to my doctor or to a hospital and get treated with no money changing hands. I know that if I get cancer, say, they will what is necessary and there is no discussion of costs. This has been the case for nearly 50 years. I do have supplementary health insurance but hardly ever collect anything. I keep it because it insures when I visit the US. This the main reason I don’t move to the US, where my 3 children live (although in different places). I could buy in to medicare but then I get into the game of what does it cover, does Dr. X accept it, what about all the added expenses a hospital adds on, e.g. $25 for an aspirin or $1000 for a specialist to glance in through the door (article in the NY Times a couple days ago).

The bad side: Of course taxes are high to pay for all this. Worth every cent IMHO. Long wait times for “optional” procedures. A friend had to wait about 6 months for a hip replacement during which time she experienced considerable pain whenever she walked. I had an audiologist exam and the conclusion was that I have some loss, but not enough that the province will pay for a hearing aid. My doctor is no longer allowed to give me a half hour checkup once a year. Fifteen minutes only. That’s new.

This applies to Quebec. Each province has its own plan and makes its own rules.

Hari Seldon has summed up my experience and take on things. The system does need an overhaul, as does the tax system, which is less progressive than it used to be.

I’ll second Hari, though I’m from Ontario.

I’ve had numerous medical issues, the most serious involving 2 weeks in hospital, 6 weeks in a rehab hospital, and another 4 months as an out patient. My supplementary insurance through work paid for the difference between a ward and a semi-private room, I had to pay out of pocket for the difference between semi-private and private. The total cost was probably about $600. On top of this I had to pay for TV rental and parking.

I’m currently dealing with a frozen shoulder. Physiotherapy is not covered by public health care, although I can get reimbursed under supplemental insurance. I needed to see my GP for a referral to a medical imaging Dr who injected cortisone into my shoulder. That took a total of about 5 days waiting between the two appointments, cost was $11 for the cortisone.

Just to clarify for any American, Canadians don’t pay more in taxes for health care than we do because their health care system is better run.

Pretty much every western nation spends about 8% of GDP on public health plans. But most only spend another 2-3% privately on health care while the US spends an additional 10% privately.

Isn’t the system funded through taxes on (among other things) cigarettes and gasoline?

Funding is from a combination of general revenue, employer taxes (EHT in Ontario), and secondary funding like lotteries for hospital capital funding. As an employer, I pay 1.95% in EHT on my payroll.

All taxes charged by the federal or a provincial government go into a Consolidated Revenue Fund for each government. provincial tobacco and gas taxes go into that fund, along with income taxes, royalty revenue, and any other revenues, and then government programmers are paid from that fund. We don’t have taxes dedicated to particular purposes, as a general rule.

And it’s not generally true that Canadians pay more in taxes than Americans. Both countries’ tax rates hover around the OECD average.

Here’s three articles which discuss the differences between the tax systems in the two countries. All three conclude, using different types of analysis, that the tax systems are similar; that sometimes Canadians pay slightly more taxes and sometimes Americans do; and that personal circumstances are the most important factor (e.g. A two parent family in the US tends to pay a considerably higher percentage of taxes than the same family in Canada, because of the federal Child Tax Credit in Canada).

The articles conclude that even if Canadians are being taxed at a slightly higher rate, Canadians tend to get more in return: not just health care, but a generally stronger social support net.

Americans, of course, get the benefit of knowing they have the single largest military in the world.

It works the other way, too. There are Americans who come to Canada for health care, because it’s cheaper here and they have trouble affording it in the US.

Here’s a short blog post from a few years ago, suggesting that it’s about the same percentage of the US and Canadian populations who travel for health care. In both cases, it’s under 1.0% of the total population.

However the profile is different. Canadians who go south for healthcare tend to be wealthier and are paying out of pocket for their own care, rather than taking the public option.

Americans who go north tend to be less wealthy, and need to go north for cheaper health care than they can get in the US.

Americans Flee America For Overseas Health Care Just Like Canadians – Mother Jones

Not Canadian, but married to a Canadian (who is still, after decades in the the US, horrified by the US system), and a frequent visitor to Canada.

My wife is from Newfoundland. Her family has been through medical misfortunes that would have bankrupted a middle-class family in the US. In particular, an automobile accident that rendered the victim a quadriplegic, required a helicopter ambulance, and required something like a year of in-patient treatment, and then lifelong skilled care and home aides.

It was all covered, with no financial burden to the family. Obviously they faced great difficulties, but worrying about the cost of treatment wasn’t one of them.

And comparing the cost and paperwork burden of the birth of our three children with the cost and paperwork burden of the births of their Canadian cousins is, well, eye-opening.

On the down side, as Hari Seldon points out above, one elderly relative had to wait some months for a hip replacement. The family is from a fairly remote rural area, without the facilities you’d find in, say, Toronto, and so there’s a wait for non-essential procedures.

I know which sysem looks better to me.

I know which system is objectively better, by any measure that means anything or has any moral validity.

It was a lifesaver / financesaver for my niece, whose daughter was born with massive birth defects requiring massive reconstructive surgery and extensive on-going medical care for at least the first ten years of her life. They are in British Columbia.

Here’s the thing: I’ve paid way, way, way more into the system than I’ve taken out. But, I’m supporting other people by doing so. Some day I may require a substantial surgery or life-saving procedure: and I don’t need to even consider the costs.

Hypothetically there’s some kid in Alberta who is being treated thanks to my tax contributions. Eventually I’ll be requiring an MRI thanks to contributions from New Brunswick. (Hypothetically!)

Of course that’s very simplistic, but we don’t need to go there now.

Socialism: Terrible concept, right?

Remember, though, Leaffan, that it’s not socialist at all. “Socialism” implies that the government, in the name of the workers, owns the means of production, but our doctors and hospitals are not government-or worker-owned or run. Doctors tend to be self-employed (or they organize themselves into private professional corporations), and hospitals are typically non-profit corporations or run by religious organizations, also non-profits. There are no “death panels” made up of government bureaucrats looking to deny care to one’s 89-year-old grandmother in order to save money; necessary care is determined by the patient’s doctor, and the claim is always paid, no questions asked.

Our system is better described as single-payer insurance, but even then, it’s not really insurance. There are no actuaries determining rates based on a person’s lifestyle, no adjusters determining whether to deny a claim, and no premiums (i.e. taxes) being raised based on the fact that one has made a claim.

That’s why you’re a lawyer and I’m not.

Thank you. :smiley:

Long in the tooth data, but folks are welcome to update to see if anything has changed significantly.

It’s worth noting that although overall health care in Canada is better overall than health care in the USA, what people in both Canada and the USA should take note of is that there are other countries that do significantly better from whom we could learn a lot (see the WHO cite supra).

I’m not Canadian, but my daughter now has Canadian citizenship and her husband was born in Ontario. When he had a traumatic brain injury not long ago, requiring evacuation from a mountaintop and transport to a high tech neuro ICU along with prolonged hospitalization and intense rehab afterwards, their total bill was about $50 Canadian. Which was covered by their supplementary insurance.

Fortunately my SIL has made a full recovery, and this event did not beggar them, as it very well could have in the US. They love the the system.

Given my own experience as an MD in the US (currently working the public sector, but with over 15 years practice previously in the private sector), I wish the US had a similar system to Canada’s.

I have no first-hand knowledge - just one data point from a guy I know who is Canadian.

About 20 years ago during a visit to the US he was involved in a crash that resulted in very serious injuries to both his legs. He was in hospital for a couple of months, and had something like 10 surgeries to reconstruct his feet & legs (many pins, screws, etc.). The cost of all this was something a bit north of $250k, which he (with difficulty) paid.

When at last able to leave hospital he returned to Canada, where commenced a long wrangle over the possibility of reimbursement for his US medical care. All medical records were carefully examined. After months of this, the final decision was that very little of what care he’d received was covered.

During the process of the medical wrangle he spoke with one of the doctors who’d examined his case in detail, who told him: “If this had happened in Canada, you’d have been fully covered. And I can tell you for certain that your hospital stay would have been much shorter - because without question one leg would have been amputated above the knee, the other just below.”

So he’s out around a quarter million, but has two whole legs - a bit scarred, but close to fully functional.

This cite, with 2016 data for the U.S., and 2015 data for Canada, shows that the gap has grown. Life expectancy is now:

  • 81.9 years in Canada
  • 78.6 years in the U.S.