Do medical costs in Canada push people into bankruptcy despite universal health care?

[Euphonious_Polemic]

@emacknight

I wish that was the case, but sadly it was gonzomax that brought it up in the first place:
“In Canada, you can have a major operation and not pay a dime.”

So I pointed out additional costs that go beyond simply the cost of surgery to highlight the fact that health care in Canada is not free.

While I’m sure Gonzomax can defend himself, I’m reasonably confident that when someone says “In Canada, you can have a major operation and not pay a dime.”, they don’t really think that the operation fairies pay for it. They know that tax dollars are collected from people and corporations, and these tax dollars are used to fund the Taxpayer funded health system. What they mean is that the operation itself - the surgery, hospital stay and meds and supplies while in hospital do not cost the person directly from their pocket. Rather, it is paid for by the TAXPAYER and their own USER funded provincial health insurance.

Give me a break - people are not that stupid.

They also realize that they may have to pay to take their car to the hospital, and they may have to pay for Timbits on the way. Most reasonable people do not consider these to be “medical expenses”, no matter how you twist it.

[Euphonious_Polemic]

@emacknight

How do you think people with transportation issues who are sick get their medications?

What if you don’t have a car? What if the pharmacy isn’t on your bus route? How hard do you expect seniors to work in order to get their meds?

You are surprisingly dismissive of Canadians living in poverty, particularly seniors with chronic illness. You are also remarkably quick to dismiss Canadians not living in BC. Life is hard in the have-not provinces.

Not cool man, not cool.

You’re surprisingly uninformed about the various programs available for seniors and those in poverty in the “have-not” provinces. Programs like The Newfoundland and Labrador Prescription Drug Program (NLPDP) that provides financial assistance for the purchase of eligible prescription medications for those who reside in the province. There are five main plans under the program: The Foundation Plan, The 65Plus Plan, The Access Plan, The Assurance Plan and The Select Needs Plan.

And yes, seniors may have difficulty getting their prescriptions if the pharmacy is not on their bus route. I’m very sorry if this drives them into bankruptcy.

I suggest we take the 62% number of Bankruptcies that are said to result from medical debt in the US, and subtract the 15% Canadian number to come up with a “true” figure of 47% for bankruptcies due to medical debt in the US. The Canadian number seems to be those who went bankrupt due to factors OTHER than direct hospital/surgery/medical costs.

This would also eliminate the folks who were on the edge to begin with, or who did not self-report the true primary cause of their bankruptcy.

[Muffin]

@emacknight

Where do people in your area go for Cancer treatment and/or major surgery?

And how is the public transit?

ETA

The Manitouwadge Cancer Assistance Group is a registered non-profit organization formed in 2002 to provide financial support to residents of Manitouwadge battling cancer. The MCAG is governed by an elected board of directors who generously give their time as volunteers. In the **years since our creation, we have disbursed over **$00,000.00 (sic) **to assist cancer patients and their families with travel costs, accomodation costs, treatment and test fees and other related expenses.

Guess people really don’t pay a dime for health care costs.

Manitouwadge only covers fairly minor surgeries. For major surgeries or specialized treatment, patients go to Thunder Bay, Toronto or Hamilton. If they are not up to driving, then they are flown by helicopter. The transportation costs are covered by the government.

Manitouwadge is so small that the senior’s home / assisted living residence is adjacent to the hospital, and a single taxi covers the entire town of a couple of thousand people. It is the sort of place where if you need anything, your neighbours and members throughout the community will take care of you. In general, people who are aging and ailing move there, for a nice three bedroom home goes for about $35,000 (and much better deals are to be had), and the hospital is a nice new facility with good staff. Quite honestly, when my time comes, if my friends are not able to put me in a canoe and launch me off above Niagara, I hope I get placed in the Manitouwadge hospital.

If a person has serious medical problems that require frequent specialized treatment beyond that which can be provided in Manitouwadge, then that person will usually move to Thunder Bay.

Here’s an example of how it works. A couple of modest means retires to a nice house in Manitouwadge. Their various complaints, chronic illnesses, and the occasional injury are taken care of at the Hospital there by the local doctors and by various specialists from Thunder Bay who visit regularly, and sometimes with the assistance of telemedicine or remote diagnostic imaging services from Thunder Bay or Sudbury. A mamogram bus that travels throughout Northern Ontario visits regularly, and determines that the women of the household has breast cancer. Her travel is covered for her visits to Thunder Bay, where there is a regional cancer centre, and she stays for free in Thunder Bay at Tamarack House, which is beside the new Thunder Bay Regional Health Sciences Centre (the regional hospital). It is determined that she requires surgery and chemotherapy, so since that will take her out of Manitouwadge for more than just a quick trip, both she and her husband temporarily move into Tamarack House, again for free. Following her treatment and recovery, she occasionally has to return to Thunder Bay for checkups, where again she stays at Tamarack House. While in Thunder Bay, she gets to know the women of the Thunder Bay Breast Cancer Survivor Group, who throughout the following years are available to her for information and support.

BTW, I am the lawyer who has regularly visited Manitouwadge for over a decade, so when folks run into difficulty, they usually meet with me. Of all the people whom I have referred to a trustee in bankruptcy, I can not recall one in which medical expenses were the determining factor. Similarly, when I have attended during hearings of the bankruptcy list at court in Thunder Bay, I have not come across anyone claiming medical expenses as being the determing factor in their bankruptcy. Lack of income due to illness, yes, but direct medical expenses or indirect expenses brought about by ill health, no. That being said, I don’t doubt that outpatient drug costs sink people into bankruptcy – obviously they do, as established by the government bankruptcy stats (although the frequency may be in doubt due to the vagueness of the data).

[Muffin]

@Euphonious_Polemic

And yes, seniors may have difficulty getting their prescriptions if the pharmacy is not on their bus route. I’m very sorry if this drives them into bankruptcy.

In Ontario, pharmacies often deliver medications for free, and most pharmacies handle prescriptions on-line, so the patient usually does not have to go to the pharmacy other than the first visit. And medications for folks who are 65 or over are free other than a nominal co-pay.

[gonzomax]

EMACK is a believer. No matter how many people who have a system like Canada’s tell him how they prefer it, he will not believe it.
To argue whether car fare is paid for is irrelevant. The fact is the operation is paid for. The hospital is paid for. The doctor is paid for. So you figure out in which country a person will be put under financial stress.
Even having insurance does not save you in America. The insurance company is an enemy trying to cheat you out of every dime they can. It is a disrespectful system that harms people who are most vulnerable. It puts crushing stress into the most emotional times of their lives.
Is it possible someone in Canada has gotten in financial stress because of prescription costs? i suppose it is. Does that make their system equivalent to ours? It it almost the same thing? Of course not.
Those who can not afford health insurance in America are screwed.
Yet our health care is rated 37th in the world by the World Health Organization. Is that why we pay double what any other country pays?

[Muffin]

@Euphonious_Polemic

And yes, seniors may have difficulty getting their prescriptions if the pharmacy is not on their bus route. I’m very sorry if this drives them into bankruptcy.

I had an intersting trip on the city bus this summer. The busses are wheelchair accessible. Half a dozen seniors with walkers were on one of them, sitting at the front as they should, but not folding their walkers, such that it was not possible for more people to enter the bus despite most of the seats being empty. The bus driver was unable to persuade the seniors to fold their walkers, so at every stop at which someone wanted to board the bus, he had the seniors get off the bus to let the new riders board, and then reboard the bus. It was a very slow trip. Too bad the bus designers assumed that seniors with walkers would be capable of folding their walkers – a bad assumption led to a bad design.

Oh, I forgot to mention that in Ontario the government is putting a lot of resources into making it possible for people to stay at home for a longer period of time before moving into an assisted care facility. Nurses, therapists, home care workers, counselors and the like deliver treatment to people in their homes. This approach is growing, so there are still delivery gaps, but so far it is making things one hell of a lot better for a lot of people, and saving the government money. http://www.homecareontario.ca/public/about/glossary.cfm

[Tom_Tildrum]

@emacknight

But this is where we get into the second issue of debate, that 62% of American bankruptcies are due to medical costs. To which I believe is a gross exaggeration done to push an agenda. And in doing so undermines the very real fact that health care in the US can destroy people financially. But it’s not enough to say that, people have to essentially lie in order to make the number really really big and really really scary.

Here is where the two issues collide: the study that presented that 62% included everything and anything as medically related costs. It wasn’t enough to focus on people that got hit with a $100,000 bill after insurance denied coverage. The study needed to fixate on the same bankruptcies that also affect Canadians.

The 62% basically consists of cases where 1) the debtor reported that medical bills were a reason for bankruptcy or 2) medical bills exceeded either $5000 or 10% of annual family income. (Here is the study and a fact sheet). So if Canadians can incur over $5000 or 10% of their income in medical expenses, they would be included in that same group.

[Muffin]

@emacknight

I spent years trying to educate conservatives about their misconceptions about Canadian health care.

@emacknight

Canada’s health care system is a million times better than the US, but that does not mean it’s perfect.

@emacknight

Canada’s system is so vastly superior to that of the US liberals shouldn’t have to lie to sell it.

@emacknight

The Canadian health care system rocks, not question about that.

@gonzomax

EMACK is a believer. No matter how many people who have a system like Canada’s tell him how they prefer it, he will not believe it.

How about a cite on that, gonzo.

[Muffin]

@Tom_Tildrum

The 62% basically consists of cases where 1) the debtor reported that medical bills were a reason for bankruptcy or 2) medical bills exceeded either $5000 or 10% of annual family income. (Here is the study and a fact sheet). So if Canadians can incur over $5000 or 10% of their income in medical expenses, they would be included in that same group.

Thanks for the info. In Kanukistan, the various provinces’ catastrophic drug cost coverage fromulas differ from each other. Here they are: http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0906-e.htm#table1a

In Ontario, a person who is not otherwise covered for outpatient drugs will have to pay the first 4% of net household income. So for example, if a husband and wife together have a net after tax income of $54,000, then the province would step up to the plate when either of them reaches $2,160, with that $2,160 and a further $2 charge per prescription being deductible as well. If a single person has an after tax income of $18,000 per year, then he would be covered for outpatient medications after paying the first $752, again with a $2 per prescription co-pay and all of his payments being tax deductible.

[Muffin]

Continues . . .

With the 4% cap, it would take something other than outpatient meds to make an Ontarien’s bankruptcy for medical reasons comparable to / in the same group as an American’s bankruptcy since the figure the Americans are using is 10%.

[Euphonious_Polemic]

I strongly suspect that when some people in Canada say they’ve gone bankrupt due to medical expenses, they are including loss of income due to an illness as a “medical expense”. No data or cite to back me up though.

[Muffin]

I have the same suspicion.

[kushiel]

@emacknight

How do you think people with transportation issues who are sick get their medications?

What if you don’t have a car? What if the pharmacy isn’t on your bus route? How hard do you expect seniors to work in order to get their meds?

You are surprisingly dismissive of Canadians living in poverty, particularly seniors with chronic illness. You are also remarkably quick to dismiss Canadians not living in BC. Life is hard in the have-not provinces.

Not cool man, not cool.

I don’t think anyone in this thread is saying no one has been bankrupted from health care related costs in Canada. But in the long run, our system still gets care to an amazing amount of people who wouldn’t get it in the US. I’d still much rather have a system with those costs than a system like the American one. And American seniors and poor still have cost issues like transportation, but the thing is, their treatment isn’t covered once they get to the doctor, unlike Canada.

I grew up in rural Saskatchewan before it turned into a ‘have’ province a few years ago. I know ‘have-not’ provinces have it tough. The solution to seniors transportation issues? Sell the farm and move into the city, preferably an apartment complex with other seniors.

I’m not sure where the debate is here now. Are we still debating the impact of additional health care related costs and bankruptcy? Are we debating an overhaul to the Canadian health care system?

[Really_Not_All_That_Bright]

@Euphonious_Polemic

I strongly suspect that when some people in Canada say they’ve gone bankrupt due to medical expenses, they are including loss of income due to an illness as a “medical expense”. No data or cite to back me up though.

The US figures include those people too, for the record.

[Euphonious_Polemic]

@Really_Not_All_That_Bright

The US figures include those people too, for the record.

Apparently - although I’m not sure the surveys in the two countries are identical
This is why I suggested taking the 62% US figure and subtracting the 15% Canadian figure, as that probably represents medical “related” expenses like donuts, or job loss that is self-reported as “medical expenses”. It can act as sort of a control for these sort of self-reported surveys.

This would give you an actual figure of 47% of bankruptcies in the US caused by direct expenses due to hospitalizations or doctor/specialist costs.

[emacknight]

To open an old wound, here is what the Canadian Medical Association Journal has to say on the issue of parking fees:Parking fees are a barrier to health care and add avoidable stress to patients who have enough to deal with. They can and
sometimes do interfere with a clinical consultation, reducing the quality of the interaction and therefore of care.

http://www.ctv.ca/CTVNews/Health/20111128/hospital-parking-fees-111128/#ixzz1knNMy2yC]From CTVClosson noted that in Ontario, the provincial government only covers about 74 per cent of the cost of running hospitals. The remainder is raised through a variety of revenue-generating schemes – things like rental of space in hospitals for coffee shops, charges for private and semi-private rooms and parking fees.

Coffee shops? What they’re saying is that the Tim Horten’s franchises in the hospitals are helping to fund health care.

And a rather chilling account of how poverty affects the health of Canadian seniors:
"There are months when Andrew can’t afford the $50-a-month dispensing fees on his Parkinson’s drugs, so he goes without."Contest uncovers hidden tragedy of impoverished seniors