"Get this thing off my back!" A Canuck Doper Universal Health Care case study

Miscellaneous and Personal Stuff I Must Share
1

From time to time, there have been threads and posts here on the SDMB from US Dopers asking how universal health care models work in other countries. See this recent thread, for instance: The Unbiased Truth About UHC, Single-Payer, Whatever.

As it happens, I’m going to be using the Canadian/Saskatchewan health-care system over the next little while (nothing too serious), and thought I’d post about it as a case-study. Anyone who’s interested can follow along and ask any questions about my experience and how the system works.

What I’m going to do is outline the issue, then give updates as things happen. At the bottom of my posts, I’ll keep a running tally of the following:

Wait Time: the time it takes to get in to see a doctor, wait for the next appointment, and so on.
Waiting Room Time: the time I spend in the doctors’ waiting rooms, waiting to get in.
Treatment Time: the time I actually spend with a doctor, nurse, etc.
Medical Fees & Co-Pays: charges paid to the doctor, hospital, etc.
Prescription and OTC Costs and Co-pays: amount spent for prescription and over-the-counter drug costs.
Parking and other incidental costs: because in some threads, parking fees has been identified as a contributing factor to health care costs. :confused:

(If I think of anything else I should include, I’ll add it; if anyone is curious about something that they’d like to see on the list, let me know.)

So, the background. About two years ago, Mrs Piper said to me, “What’s this bump on your back?” I said, “What bump?” She said “This one” and put her finger on a small soft bump, right in the middle of my back. Once she did that, I could reach behind and touch it. I said, “I dunno. I’ll ask the doc the next time.”

Our family doctor is Dr. M. We’ve been going to him for 20 years. The next time I was in for something (can’t remember what; probably some muscle stiffness issue, which I’m prone to), I said, “By the way, I’ve got a bump on my back.” Dr. M looked at it and said, “Looks like a sebaceous cyst. We’ll keep an eye on it, but if it’s not bothering you, we won’t bother it.” (Dr. M is a good, practical doctor who doesn’t believe in intervention for intervention’s sake.)

Update two years to the present. I gradually realised about a month ago that the bump is itchy a lot, that I’m reaching back to scratch it, and I’m noticing it if I sit in chairs with hard backs that press on it. Not really painful, but just a bit sore to the touch. I asked Mrs Piper, who said, “It’s getting bigger. You should see Dr. M about it.”

So, on July 4, I called Dr. M’s clinic and set up an appointment. That’s when the clock starts on this little case study. The receptionist booked me for an appointment on July 16.

July 4, 2012: Set up Appointment

Wait Time: 0 days.
Waiting Room Time: 0 hours.
Treatment Times: 0 hours.
Medical Fees & Co-Pays: 0 dollars.
Prescription and OTC Costs and Co-pays: 0 dollars
Parking and other incidental costs: 0 dollars.

2

I very much look forward to reading your experience as it progresses. Thanks for starting this thread.

3

Uh not to advocate for home surgery or anything but have you asked to squeeze it?

When my wife found a strange bump on my back it was the world’s largest blackhead lol.

4

July 16: Initial Appointment with Dr. M

Dr. M practises in a clinic with about four other doctors. It’s always busy. If you want to book an appointment with a particular doctor, it can take a while to find a spot on that doctor’s schedule. Or, if it’s something that needs immediate attention, you can just walk in and ask to see a doctor. Since I wanted Dr. M to look at it, the appointment took about 10 days; that’s a bit longer than usual (a week is more common), but it’s summer-time and people are on holidays.

Mrs Piper comes with me to the clinic. I go to the reception, show my Sask Health Card, and the receptionist confirms my address and contact info is current on their records, which are kept on the clinic’s computer system. We wait for about half an hour (the waiting room is full). Dr. M calls us in and I explain what’s up. He takes a look at it, and I and Mrs Piper explain what’s going on (she came in because she can actually see it and describe how it’s changed, which I can’t do). Dr. M listens (which he’s good at doing), and then says that he still thinks it’s a sebaceous cyst, which now is starting to show signs of infection - hence the itchiness and sensitivity to the touch. Best to have it removed, which is an out-patient procedure. However, he doesn’t do that type of thing himself - he’ll refer me to a specialist in that kind of thing.

He asks me if I have any preference or experience with specialists. I mention that about two years ago, he’d referred me to Dr. S, another doctor in the city, to have another cyst removed. He says, “Right - I’ll send him the referral.” He brings up my file on his computer (each of the consulting rooms in the clinic has a computer to access the patient’s information), does up a referral form, and submits it electronically to Dr. S. He advises that I’ll be contacted by Dr. S’s office sometime in the future.

Dr M also says that he’ll give me a prescription for an antibiotic, but suggests I don’t need to have it filled unless the cyst starts to get inflamed or really painful. He also uses the computer for the prescription, so that it is automatically entered on my file with the clinic. On previous occasions when Dr. M has given me a prescription, he transmits it electronically to the pharmacy of my choice in the city, so it will be ready by the time I get to the pharmacy. This time, he just gives me a computer print-out of the prescription, since I may not need it. (No hand-written, hard to read scrips, which reduces the chance of error in filling it.)

Mrs Piper and I go out into the blazing hot Saskatchewan day, and back to work. (No parking fee, since the clinic is part of a strip mall type complex, with free parking.) Overall, not surprised by the advice, and reassured that it doesn’t look like anything too serious.
Wait Time: 12 days.
Waiting Room Time: 30 minutes.
Treatment Times: 10 minutes.
Medical Fees & Co-Pays: 0 dollars.
Prescription and OTC Costs and Co-pays: 0 dollars
Parking and other incidental costs: 0 dollars.

5

We asked Dr. M that; he said that sometimes they will drain naturally, but this one looks fairly deep; doesn’t recommend trying to break it, because if it’s starting to get infected, that could just spread the infection. However, he said that if it does break naturally, hot compresses will help it to drain.

6

You’re welcome. I hope people find it interesting.

7

Definitely not the recommended course of action for a sebaceous cyst.

Middlebro got one the width and length of a thumb removed from his back last year (“since we’re going to be performing surgery on you, want us to take that thing out?”); I had a small one on a breast which dissolved by itself (almost gave me a heart attack when I found it :p).

8

I posted before that reveal.

9

Now there’s the difference between Canadian and American health care. In one, the sebaceous cycst is dealt with by a doctor. In the other, it is dealt with on youtube.

10

This mirrors my Australian experiences so far.

Question - I notice you have no co-pay for your doctor. Are there Canadian doctors who charge more than Sask (or other provinces) Health pays?

Here, we have docs who bulk bill - in other words, they charge only what Medicare pays for an office visit. We have other docs who charge more, and the difference is either out of pocket or picked up by private health care, if you have it. Some docs bulk bill sometimes and not others (I have one who bulk bills for kids under 18, people over 60, and on weekdays during business hours, and charges more for nights and weekends, but will waive bulk bills if you’re truly ill and need to see a doctor during those times.)

Does that happen?

Also, good luck with your icky cyst!

11

That was in the OP… passes coffee

12

So far Canada has resisted the temptation of two tier systems. We fear it’s the slippery slope that leads to better care for the wealthy, than the poor. So there are some small exceptions. Private hospitals for plastic surgery, for instance.

Also, with America on our doorstep, it’s actually pretty simple for someone, with lots of money, who wants to, ‘purchase’, access, to just cross the border to where the dollar is king. So the pressure to accommodate these types isn’t really there so much.

13

I’m impressed you only had to wait half an hour! Did you have a morning appointment?

That’s how (private) dental insurance works in Canada.

14

Oh yes! I’m sitting on the edge of my seat to read about a guy’s bump that may or may not drain at anytime. More please. :p;):smiley:

I’m really, really am joking.:slight_smile:

15

This would vary by province, of course; but right now, I don’t believe any province allows physicians to bill patients over and above the approved fee schedule. (We’d call this “extra-billing.”) I remember when Ontario outlawed extra-billing years ago (1980s?); banning it was somewhat controversial at the time, but “no extra-billing” has since become the accepted norm.

16

Spoons has it right - no extra-billing. I just put “co-pay” there because in my experience, that’s one of the questions US Dopers often ask in these discussions: “What about your co-pay?”

17

right after lunch, for just that reason - that’s usually the fastest.

18

Death Panel! Rationing health care! Socialism!

19

Not snarky, I promise:

Can you also do a rough tally of the taxes you’re paying? Sales, gas, etc.?

It’s an important part of the equation to me, and I’d like to get the whole picture.

20

This may not really give you a whole picture, since it would be pretty much impossible for anyone to attribute how much of the overall taxes paid by an individual go to the publicly funded healthcare system in a particular province.

Say Northern Piper pays 33% of their income in various taxes (pulling a number out of the air), while you only pay 27% of your income in various taxes. Does it follow that the “extra” 6% in taxes is directly because of universal health care in Saskatchewan. Obviously not.

So really, there is little to be gained in knowing the relative difference in tax burden between two individual people in the two countries; you’ll never be able to use the tax figures to parse out the actual differences in the cost of healthcare.