Plus, I guess, any co-pay amounts. I have seen posts that suggest many Americans may end up out of pocket thousands of dollars over and above health care premiums. benefits don’t kick in until you have spent $X out of pocket, etc.
Again, no such thing in Canada.
But yes, costs for a simple accident are like costs for a service such as a lawyer. I have no idea what a broken arm or leg would cost if I had to pay for it, any more than I have any idea what a lawyer for say, UI or divorce would cost - never having to have to pay for any of those things.
(I did see an article once on some Polish lady who went into labour while visiting Canada and ended up with a bill for $20,000 - but I think that included complications… I hope it’s not routine.)
I think there are some on this side of the Atlantic who would argue that that doesn’t provide enough disincentive from you cracking your skull. Or getting cancer, for that matter.
There seems to be a punitive angle to some people’s view of the world and if you’re sick or addicted to pain killers it’s because of something you did and you shouldn’t be bailed out for free.
That’s my point, you know there won’t be one. Zero is easy to estimate.
The fun part is that if you have hours and hours free to read and understand the bill and your coverage, and fill out paperwork, and use the correct words on the phone, it’s often possible to adjust the bill…maybe by orders of magnitude again. But many people have zero familiarity with the system.
The obvious comeback to “diseases are lifestyle induced” is that childhood diseases, random cancers, dementia - strike everyone.
But what about being stupid and splitting your head open trying to do some clever trick involving the metal railing on a long concrete stairway and you skateboard? Should healthcare cover that? How about hang-gliding or dirt-bike racing? Some might say “you brought it on yourself!” But then, where does it stop? Do you deny claims because the person was skiing the black diamond hills? Skiing still has the reputation that you will inevitably break your leg or something (Thanks, Sonny Bono!) Crossing the road when you should have seen the car coming? Not tidying up your stairs at home? Not installing non-skid mats in your bathtub? Not drinking enough milk in old age? Eating too much of the wrong foods?
The simplest answer is nobody sets out to get unhealthy or injured on the theory “my insurance will handle the consequences”. The number of people who stupidly injure themselves is fairly low and ripping off insurance companies is low on their motivational totem pole. (Or Maslow pyramid) Ditto for poor lifestyle problems. Simplest process is to cover everyone for anything no questions asked. Otherwise, you likely tie up more resources adjudicating issues than you save by not treating the problem, and even more resources trying to figure out where to draw the line. Plus, those people will (like medical bankruptcies and poor people in the USA) still consume the resources and still end up with the general public probably footing the bill.
Healthcare is one of those things that are an absolute need. A for profit system puts all the incentives in the wrong place. I would much rather see all medical professionals on the payroll. They would have no incentive beyond keeping their job and treating patients effectively. Education is approaching the same status and we may have to deal with that in the near future.
Yes and no. Canada’s physicians are mainly on piecework - paid per patient visit. it has its flaws, but it does enforce a certain level of dedication to their job. “I get paid by the hour” is not a recipe for good care. (Some doctors, like IIRC emergency room physicians, do get a fixed wage)
Of course no system is perfect. Some provinces had to enact minimum times for procedures (you can’t do 30 annual checkups in an hour). But all physicians get the same government-mandated fee schedule per procedure. Plus, doctors run their own offices as private businesses, giving them a certain level of self-direction - they pick their own hours, manage their own appointments, etc. As a result, their self-directed office efficiency and willingness to work more hours contributes to their net pay - far more efficient than simple salary. (I know of several doctors including my own who are retiring gradually - at around age 65 they scale back to less than full days, less than 5 days a week, more frequent absences. Plus, by working in a clinic with several other doctors, they make the arrangements to share office staff, etc.
If all that were a civil service system, there’d be a highly paid manager to take care of that stuff and probably mandates as to office hours, and all the other fun things that come with a civil service job.
A friend of mine many years ago in medical school remarked that a factor that contributed to rising medical costs in Ontario when OHIP began was when the provincial health plan replaced administrative staff in Catholic hospitals, so nuns working for room an board was replaced by a highly paid administrators and supervisors. No need to do the same thing for GP’s. They already know how to run an office.
I’m sure there are better systems than the Canadian model - just haven’t heard of any yet. (Except the ST. Johns stations I ran across in New Zealand - if all you have is something like a bad cut, a paramedic or nurse can sew it up rather than waiting for a doctor…)