As I understand, the National Health Care system in Canada is copied after the British one, right? I.e., everyone is covered, from birth to death. How inclusive is the coverage? For instance, is cosmetic care covered and to what extend? Is dental care covered? Root canal or just extractions? Oral surgery? Non-pressing lipomas? (in GS) I gave just a few examples, I can’t think of all eventualities, nor you can provide the entire code (if it exists), but, perhaps, you can give us basic ideas.
I’d also like to know how intrusive the system is, i.e. if private insurance is permitted or out-of-pocket payments are legal/accepted by doctors?
Our health care system used to be everything that you described. It used to make sense and make health care available to all people, regradless of stature or bank acount statement.
This is ALL changing. I will be very surprised if anyone, doctor, nurse or polition, can possibly explain this to you. Sorry, ask in a few years and we might have something worked out.
Or write to a polition and get a lot of crap about how they won’t touch health care and how it is great and a lot of other useless propoganda.
Sorry about the rant, but it is sad to see one of the best things of our society falling apart.
Most things are covered in Canada. Cosmetic care, ie., plastic surgery, having your child circumsized, etc. are not because they are decisions of choice, not medical.
We also have started having private clinics open up here. An example of how they are somewhat helpful, if you have money…I booked an mri for my son, somewhat urgently and its taking eight months to get the appointment. If I happen to have an extra thousand dollars lying around, I can just go get one tomorrow.
Dental care is covered, not by health care but by private plans mostly. Depending on where you work, and if you are lucky, you have a dental plan. In my case, my ex and myself both have a dental plan so all my son’s dental care is virtually free as we can claim twice.
Hope this was the info you were looking for?
Yes and no, Sue. I am not looking for the info because I am about to move to Canada. I know about the U.K. system, but it is in Europe. The American one is not bad, but it is not universal (and as I said, not bad, but less than perfect).
So, it looks like a Good Health Care system does not exist. As soon as the government takes over (or even before) it becomes slow and inefficient. If it’s more or less private, it is efficient but leaves many people uncovered. In Canada, everyone is covered, at least on paper, but to get good care and on time is almost impossible. Besides, the prices rise faster than in other areas because “somebody else” is paying.
I hope that Dr. Paprica or somebody else could give a pro viewpoint. Tx.
I’m sure there was a thread on canadian health care in IMHO or GD if someone wants to actually take the time to do a search.
This being MPSIMS, however, I feel perfectly justified in asking something a bit less relevant.
Why are you moving to Canada? And if so, are you moving to the party city Montreal like me? 
this is not the case at all.
if you know all about it, then why are you asking?
Now, I’m confused. I’m quite sure (though I’m too lazy to look it up) that one of the Canadian posters in last month’s GD thread on the subject stated that private care was illegal in Canada? 
It’s not illegal in Alberta for private clinics. They are opening all the time. Check out this article. http://www.edmontonjournal.com/news/alberta/110797ab2.html
Right now our doctors across the Province are staging slow downs and/or closures because of money issues.
They are asking for 50 percent more and are being offered 29 percent. All the hospitals here are on alert (so says the paper today) with extra staff because alot of the medi clinics, and regular doctors offices are not open. Last weekend the rural areas shut down.
http://www.edmontonjournal.com/
I think peace meant he was not moving to Canada, just curious.
Canada is divided into ten provinces and three northern territories. Provinces have a lot of power; power is more decentralized in Canada then in any country with the probable exception of Switzerland.
I could review the history of health care legislation in Canada, but it is boring. The jist of the situation now is that the federal governments provide a lump sum to the provinces which they divide at their discretion between health, education and other things.
This money is provided under certain conditions. All procedures needed for a valid medical (not elective or cosmetic) reason are covered, Canadians have the right to move from one province to another and stay covered, care must be accessible, etc. The federal government strongly supports a system of health care where no private clinics exist. They have the right to penalize or withhold money from provinces which allow them.
Doctors are paid on a fee-for-service basis which is pretty outdated. They lost the right the right to charge extra money beyond that prescribed by Medicare about twenty years ago, with the exception of filling out insurance forms, doing company physicals and so on. Doctors can opt out of the medicare system and form private clinics, but they generally cannot charge more for their services than they would recieve from medicare. There are other penalties for doing this, few doctors do.
Since provinces are in charge of health care spending, the existence of private clinics depends on where you are. Alberta is the strongest advocate of private clinics and has repeatedly been threatened with federal penalties. The number of private clinics depends on the province, but in general there are few private clinics, indeed. These are still heavily regulated and/or experimental. They can’t be compared to the American ones with the possible exception of laser eye surgery or cosmetic surgery which are permitted since the government would not pay for these anyway (not essential).
I think the country with the best overall medical system might be France. I do think very highly of our system – its flaws are very apparent but the problems have more to do with government mismanagement of the system rather than its philosophy and structure. America pays much more per capita, covers far fewer people and has lamentable results in a few categories such as child mortality, etc. In health it often makes sense to use more inexpensive imaging and more diagnostic skills. American patients prefer expensive imaging and medicines without knowing any details. American doctors get a percentage and like the more expensive things too. American HMOs don’t like to pay for anything. It is a system where no one does not have a vested interest. In Canada, the doctor orders the most economical thing that does the job; usually doesn’t get a benefit from doing otherwise.
The reality is, sick patients get the urgent treatment they need, including quick MRIs and surgery. The people who suffer are those who have serious bu not life threatening conditions such as needing hip replacements or breast cancer suggestive of benign disease. If you were in that position and suffering, you would also want quick treatment even if you don’t need it.
The other problem is that our system relies on referral by a declining and aging number of family doctors. Governments dramatically reduced med school enrollments ten years ago. The fewer students graduating today choose specialties other than family medicine (which really is a specialty of its own) because they have high student debt loads and make less money in family (unless they work much harder than many specialists). Only 29% of students chose family residencies this year… usually it is closer to 50%. If you don’t have a family doctor (and most family doctors are not accepting new patients), you need to access the system by going to the emergency room. This is a big waste of money since treating things in the ER is expensive (resource intensive). The ERs tend to be pretty busy, dangerously so in large cities. Hospitals are hiring family doctors to work in the emergency and to deal with less serious hospital cases… hence many family doctors are choosing to do this exclusively since this can be very lucrative, and is less taxing than a traditional practice.
The government is continuing to mismanage the system and it is spinning out of control. But the system has worked very well in the past and would do so again if the government had the public interest at heart.
Dental insurance is much less comprehensive; I’m no expert but I don’t think much more than basic dental care is covered, and for the needy only.
It is illegal for doctors to accept money to allow someone to skip the queue. On the other hand, urgent cases should be treated first. Relationships with other doctors are important in medicine, a personal call from the family doctor can result in very quick service if it is needed. It is illegal to accept payment or favours for this, though. I have heard a few stories about doctor offered money to allow this, though. Private insurance is not like in the US; many people do carry some to allow a wider selection of drug coverage, dental work and problems while travelling. (Canadians in Florida with problems often take a private helicopter back to Canada for treatment, it is still a lot chaper!).
It’s Saturday night, but I ain’t drunk. I can’t believe that it happened: I missed NOT! I am NOT crazy and I am NOT moving to Canada. Or elsewhere. Anyway, my sincerest apologies.
In my opinion, the health care (HC) is the biggest problem of our time. We can negotiate deals with Cuba or Iraq, Israel will settle with Palestinians, but I see no solution to the HC problem. I know that only universal HC can deliver HC to all, but I also know that universal HC is very mediocre: long waits for minimal care. I am a firm beliver in the capitalism and free markets, but I understand that HC can not exist as a free market entity, that human health is above that. I am the first one to blame a government for anything they mismanage but I do not blame them for the failures in HC. HC is bigger than they are. They can (somehow!) manage large systems (mail) and big military, but it still 3 million people, not 270 million. And the human body (and mind) is more complicated. So I am down. We all can scorn Canadian or American systems (do not confuse medicine and HC, though, American medicine is among the best), but I wonder, guys, do you have any positive ideas?
In case I missed NOTs again, I put a spare one here: NOT.
awww cmon Peace, Canada’s a great place to live 
Actually some plastic surgery is covered. Otoplasty is usually covered as is any kind of corrective surgery eg. correction of asymetrical breasts (which many insurance companies would never cover). All plastic surgery is tax deductible.
Peace: I was actually about to start a “What’s wrong with health care in America?” topic in GD.
See you there.
Oops, my mistake, thanks Renton_lvr for pointing that out.
We New Democrats have been fighting a pitched battle on the streets and in the House for health care, which the Liberals have been massacring for seven years. They’ve cut some $25 billion to transfers to the provinces for health care and they’ve failed to enforce the Canada Health Act. Result: waiting lists, overcrowded emergency rooms, nurses’ strikes, even some deaths.
We still have a good medicare system. But that’s in spite of the current national government, not thanks to it.
Credit-where-credit-is-due department: Tommy Douglas, the founder of the NDP, installed the first public health care system in North America when he was premier of Saskatchewan, and he was instrumental in getting it done on the national level as well.
Sue, I’d move to Quebec city if it were a San Diego suburb.
Tomorrow.
I had to go to an emergency room on Saturday night. It was slow (I spent 4 hours there, mostly waiting), all workers, except security guards, looked busy and overworked, but I had my MRI in no time. I was not dying, would survive without MRI, but I was relieved when it came back negative and doctors were relieved that they could let me go home.
I understand that my case does not describe the whole system, but, on the other hand, it was just a random case and I see it as typical.
Hey Peace. It’s nice that you got your scan so quickly, but what if by doing so you harmed another person who had a greater need for health care resources? I’m not just yanking your chain, so please bear with me for a minute.
Any nation will have a limit on resources, and will have to decide where to spend its resources. Fly to the moon, feed a child, build a road, run a university. You get the picture. Similarly, there is an upper cap on what a nation will spend on health care. The US is number one in the world on per capita health care spending, doling out quite a bit more per capita than any other nation. Canada is back in the pack of first world nations at number 10. But for overall level of health, the US is 24th while Canada is 12th. When looking at infant mortality, children under 5 in Canada have a better chance at survival that those in the US. Why is this?
Both countries spend a great deal on health care out of the public purse, but in addition, folks in the US spend a great whack more through private insurance, which of course is consumer driven. Because it is consumer driven, people who are more well off financially have a much greater say in how the money is spent. Thus resources are put toward MRIs and the like, rather than into basic health for low income persons. It becomes a two tiered system, with amazingly good health care available to those with the cash, but not nearly as good health care for those without the cash. The two tiered system also becomes a self-consuming dragon, for administration of large scale insurance puts an additional level of cost onto the system, which drives health insurance out of the reach of even more people. Because many health facilities handle a mix of public and private patients, the procedures offered and the personnel and equipment devoted to these procedures, tend to be skewed toward the private patients, which means that a chunk of the taxes paid by the public patients goes to provide procedures to which the public patient will have limited access. (You’ve probably heard all this before – for example, potential transplant patients who can not afford anti-rejection drugs.) What it all comes down to is that in the US the wealthy tend to use a disproportionate share of health resources as compared to the poor, so despite what should be an adequate inflow of public funding, the results simply are not there.
By comparison, Canada has a structurally sound universal health care system, but due to some heavy budget cuts in the last decade there has been growing frustration by the populace. As seen in our recent election, Canadians are pretty solidly behind the system, and want to have resources put toward it again. This takes time, for cuts in education and cuts in physical infrastructure can not be made up quickly. There are also some oddities, such as fee for service rather than salary, the under-funding of family and rural doctors, and the over use of emergency facilities for non-emergencies, which have all resulted in administrative inefficiencies, though it remains to be seen how such issues will be satisfactorily addressed. The result of all this is that necessary procedures are being preformed, but non-necessary procedures sometimes get put on the back burner. The delays for non-necessary procedures has led to a push by the political right toward a two tiered system such as in the US, and a push by the left and centre to restore funding.
So I am far from convinced that privatization of the administration of health care is the route to efficient health care. I see it much to the contrary. I am also far from convinced that universal health care equates with mediocre health care. I suggest that privatization of the administration leads to an inequitable distribution of resources, which in turn sacrifices the health of the poor for the health of the rich. The outcome of such a system is more and more money being poured in, with negative results to show for it. I also suggest that with universal health care, excessive cuts are no more than false savings, and eventually will drag down the overall level of health. But if adequately funded, universal health care can provide a higher standard of national health at a lower per capita cost than a two tiered system.
If you are interested in this sort of thing, check out the World Health Organization’s basic indicators stats. They can help zero in on which countries get the best bang for their health care buck.
This one’s off to General Questions, eh.