Post by * amanda on Aug 12, 2009 22:41:34 GMT -5
As promised, a few thoughts on "socialized" health care from an American (one of 250,000 or so living full-time in Canada) who has willingly given herself up to the socialized Canadian health care system.
So what is it like, you ask, living in a country where the health care system is completely government controlled?
Well, here's what happens. When I get sick, I usually just stay home from work til I get better.
If I am really sick, or suspect I have a problem that a health care professional should see me for, I walk on over to my friendly neighborhood health clinic. Like anywhere, the earlier you get there, the better. The one time I had to go to the clinic I think I waited about 20 minutes (I was not very sick; had I been, say, sick with strep throat, they would have put me through to the doc right away). After presenting my government-issued health ID card, I saw a doctor. (The nice thing is that when they call you out of the waiting room, you don't have to go and wait again in a little room til the doctor feels like meandering over to see you, he or she usually is right there and gets you going.) The doctor had graduated from Med school, lest there be any confusion. She asked me some questions then told me what was wrong and gave me a prescription. She also told me that if I wanted to make a follow-up appointment with a physician at the upstairs office in a month I could. I walked right out of the clinic without paying a cent. I went over to the pharmacy and my friendly pharmacienne filled it. And, quel surprise , my private health insurance provided by my employer, paid for the medicine! How shocking. I went home and slept.
And that, my friends, has been my experience with the Canadian health care system.
Let's review.
1. When you are sick, you go to a clinic (kind of like going to a prime care in a hospital but with much less drama - the clinics are for people with mild issues, like a bizarre rash, or strep, or something non-life threatening.)
---a) If your finger is cut off or your eyeball popped out, you go to the hospital. An ambulance will pick you up if you can't drive yourself.
---b) At the hospital, patients are questioned and then queued according to level of emergency. If you have a ingrown toe nail, you'll probably have to wait 12 hours. If you are suffering a heart attack, you will be seen immediately. Example: My father-in-law-to-be at one point had a rash in his face (it turned out to be some sort of strep virus) and when they saw him arrive at the hospital they put him right through, no wait, because when he arrived at the hospital he was in pretty bad shape (swollen, fever, etc.) He stayed the night in the hospital. Without paying a cent, of course.
2. At the clinic you see a real doctor, get a prescription, and walk out without paying a cent.
3. If you have to get medicine, usually the government will pay part of the prescription depending on what it is. If you have virtually any full time job, however, just like in the U.S. your employer will offer you some sort of health and drug insurance. My employer pays 90% of prescriptions; my former employer paid 100%. Oh, and drugs are WAY cheaper in Canada, because the government has to subsidize for the unemployed or under-employed, they pretty much keep the drug companies under control in terms of pricing. A medicine that might cost $30 a refill in the U.S. is probably 1/2 here.
4. If you want to schedule an appointment with a doctor, you can.
---Note: Usually I find that wait times here for an appointment are a bit longer in the U.S. - about 1-2 months wait time for an appointment for a GP. But if you are going for a routine checkup, it's not a big deal, you just have to plan in advance. If you're sick, that's what the clinic is for. Although I have heard rumours that if you have a good relationship with your family doctor, they will usually "know you" and wait times for you will be less than for Joe Schmo. I've also heard that if you have private insurance (from an employer) the doctor will slip you in sooner since they'll get paid more by you (your company's insurance). Which is pretty much what the U.S. system is like right now. Only the U.S. system is, quite frankly, more corrupt.
5. This system - just like the U.S. system does, and will - favors people with private insurance. Like me. You pretty much want to have it, and most people do unless you are unemployed or only work part time, in which case you can take advantage of the socialized plan. If you have the private plan, you have the upper hand. For example. A good friend of mine sadly has MS. She was diagnosed about 2 years ago. She suspected she had a problem about 3 years ago. She made an appointment with a private doctor to get a CAT scan. She was told she could get the CAT scan in about 3-4 weeks. (It wasn't an emergency, obviously... she hadn't been diagnosed yet. In an emergency you could get one the next hour if you had to, but only with the private insurance.) Unfortunately she was let go of her job about a week later. She then had to switch to the "socialized" CAT scan doctor, no longer having her private insurance, and was told the wait time for a CAT scan was 6 months. In that period of time, she found a new job, got new health insurance, and ended up getting a CAT scan at the private clinic once again.
So, in other words, you get faster treatment with private health insurance.
But that's about it. SO if you ever lost your job, you might have to wait, but you'd still get decent health care.
One of the major questions I keep getting asked by American friends and relatives is about that ad currently running in the states with the lady who said that she couldn't get treatment in Canada and had to go to the U.S. to seek treatment otherwise she would have died. That case doesn't make a lot of sense to me. In major Canadian cities, you have health specialists of all shapes and sizes at your disposal, both in the "socialized" system and those who accept private insurance. You may not get fast enough treatment or get to have the wide choice of doctors with your "socialized" health care, but you certainly would if you want to pay for it or use your private health insurance for the treatment. If that lady sought treatment in the U.S., I don't see how it would be any different from seeking treatment in Toronto, Vancouver or Montreal, except maybe way more expensive.
Also, it's worth noting there are a lot of specialists and supreme heath care providers in the U.S. simply because it's a big country with lots of money and research and universities. That isn't going to change with a socialized health care system; the Mayo Clinic and Johns Hopkins University and all of those great resources are still going to be around. The U.S. will still be a place where patients from all over the world, including Canada, will want to visit simply because of the sheer range and numbers of resources.
So I have been slightly sarcastic in most of this post. But I will share one major problem I have with the Canadian system. And that is... there is a major shortage of doctors and nurses, and those doctors and nurses we do have are overworked and underpaid. Canada has some fantastic medical schools, mainly my alma mater McGill, and produces respected medical professionals and cutting-edge research every year. Unfortunately, most of those professionals (doctors, nurses) flee at the end of the day to the U.S. to seek better hours, better perks, and above all, BETTER PAY. The socialized system does not pay as well, there is heavy demand on it, and there are simply too few doctors here to go around. I HOPE that the U.S. system becomes "socialized" because selfishly I am hoping Canadian doctors living and working in the U.S. will at that point decide to come back to Canada, since there may no longer be such a great appeal/incentive to be a doctor in the U.S. (i.e. they won't be paid quite as well anymore. However worth noting that with so many unemployed people right now they aren't being paid as well at the moment anyways.)
Most of the doctors that do stay in Canada stay for personal reasons or ideological reasons. I used to teach violin to a doctor. She was paid well enough to buy a nice house in a nice part of town, but other than that she lived a rough life... she basically worked 6 days a week, all hours of day and night, she was overworked, overtired. When I asked why she never went to the U.S. to work, she told me she had worked in Vermont for a while. But she had to come back to Montreal because despite all of the downsides of working as a doctor here, she couldn't bear to turn patients away because they didn't have health insurance or the means to pay for their treatment.
I believe that is really the issue that Obama is tackling here. He's not trying to take the good health care away from those who have private insurance; he is simply making it so certain members of our population, who may be "down and out", are not turned away from receiving proper care.
I am not a fan of either health care system. Canada has some major problems - mainly, how to keep qualified doctors in the country in order to prevent doctors who are here from getting overworked - and the U.S. has some major problems, mainly, telling people that if they don't have a job they don't deserve proper health treatment.
I don't think the system in either country is working now. Both are overburdened and both are fraught with corruption and scandal.
However, I do believe that by changing we will, hopefully, progress, and eventually, someday, I hope that either or both our countries will figure out a happy balance and a happy remedy to the ills of our health systems.
Hopefully, before I get old. So I can figure out where to retire.
So what is it like, you ask, living in a country where the health care system is completely government controlled?
Well, here's what happens. When I get sick, I usually just stay home from work til I get better.
If I am really sick, or suspect I have a problem that a health care professional should see me for, I walk on over to my friendly neighborhood health clinic. Like anywhere, the earlier you get there, the better. The one time I had to go to the clinic I think I waited about 20 minutes (I was not very sick; had I been, say, sick with strep throat, they would have put me through to the doc right away). After presenting my government-issued health ID card, I saw a doctor. (The nice thing is that when they call you out of the waiting room, you don't have to go and wait again in a little room til the doctor feels like meandering over to see you, he or she usually is right there and gets you going.) The doctor had graduated from Med school, lest there be any confusion. She asked me some questions then told me what was wrong and gave me a prescription. She also told me that if I wanted to make a follow-up appointment with a physician at the upstairs office in a month I could. I walked right out of the clinic without paying a cent. I went over to the pharmacy and my friendly pharmacienne filled it. And, quel surprise , my private health insurance provided by my employer, paid for the medicine! How shocking. I went home and slept.
And that, my friends, has been my experience with the Canadian health care system.
Let's review.
1. When you are sick, you go to a clinic (kind of like going to a prime care in a hospital but with much less drama - the clinics are for people with mild issues, like a bizarre rash, or strep, or something non-life threatening.)
---a) If your finger is cut off or your eyeball popped out, you go to the hospital. An ambulance will pick you up if you can't drive yourself.
---b) At the hospital, patients are questioned and then queued according to level of emergency. If you have a ingrown toe nail, you'll probably have to wait 12 hours. If you are suffering a heart attack, you will be seen immediately. Example: My father-in-law-to-be at one point had a rash in his face (it turned out to be some sort of strep virus) and when they saw him arrive at the hospital they put him right through, no wait, because when he arrived at the hospital he was in pretty bad shape (swollen, fever, etc.) He stayed the night in the hospital. Without paying a cent, of course.
2. At the clinic you see a real doctor, get a prescription, and walk out without paying a cent.
3. If you have to get medicine, usually the government will pay part of the prescription depending on what it is. If you have virtually any full time job, however, just like in the U.S. your employer will offer you some sort of health and drug insurance. My employer pays 90% of prescriptions; my former employer paid 100%. Oh, and drugs are WAY cheaper in Canada, because the government has to subsidize for the unemployed or under-employed, they pretty much keep the drug companies under control in terms of pricing. A medicine that might cost $30 a refill in the U.S. is probably 1/2 here.
4. If you want to schedule an appointment with a doctor, you can.
---Note: Usually I find that wait times here for an appointment are a bit longer in the U.S. - about 1-2 months wait time for an appointment for a GP. But if you are going for a routine checkup, it's not a big deal, you just have to plan in advance. If you're sick, that's what the clinic is for. Although I have heard rumours that if you have a good relationship with your family doctor, they will usually "know you" and wait times for you will be less than for Joe Schmo. I've also heard that if you have private insurance (from an employer) the doctor will slip you in sooner since they'll get paid more by you (your company's insurance). Which is pretty much what the U.S. system is like right now. Only the U.S. system is, quite frankly, more corrupt.
5. This system - just like the U.S. system does, and will - favors people with private insurance. Like me. You pretty much want to have it, and most people do unless you are unemployed or only work part time, in which case you can take advantage of the socialized plan. If you have the private plan, you have the upper hand. For example. A good friend of mine sadly has MS. She was diagnosed about 2 years ago. She suspected she had a problem about 3 years ago. She made an appointment with a private doctor to get a CAT scan. She was told she could get the CAT scan in about 3-4 weeks. (It wasn't an emergency, obviously... she hadn't been diagnosed yet. In an emergency you could get one the next hour if you had to, but only with the private insurance.) Unfortunately she was let go of her job about a week later. She then had to switch to the "socialized" CAT scan doctor, no longer having her private insurance, and was told the wait time for a CAT scan was 6 months. In that period of time, she found a new job, got new health insurance, and ended up getting a CAT scan at the private clinic once again.
So, in other words, you get faster treatment with private health insurance.
But that's about it. SO if you ever lost your job, you might have to wait, but you'd still get decent health care.
One of the major questions I keep getting asked by American friends and relatives is about that ad currently running in the states with the lady who said that she couldn't get treatment in Canada and had to go to the U.S. to seek treatment otherwise she would have died. That case doesn't make a lot of sense to me. In major Canadian cities, you have health specialists of all shapes and sizes at your disposal, both in the "socialized" system and those who accept private insurance. You may not get fast enough treatment or get to have the wide choice of doctors with your "socialized" health care, but you certainly would if you want to pay for it or use your private health insurance for the treatment. If that lady sought treatment in the U.S., I don't see how it would be any different from seeking treatment in Toronto, Vancouver or Montreal, except maybe way more expensive.
Also, it's worth noting there are a lot of specialists and supreme heath care providers in the U.S. simply because it's a big country with lots of money and research and universities. That isn't going to change with a socialized health care system; the Mayo Clinic and Johns Hopkins University and all of those great resources are still going to be around. The U.S. will still be a place where patients from all over the world, including Canada, will want to visit simply because of the sheer range and numbers of resources.
So I have been slightly sarcastic in most of this post. But I will share one major problem I have with the Canadian system. And that is... there is a major shortage of doctors and nurses, and those doctors and nurses we do have are overworked and underpaid. Canada has some fantastic medical schools, mainly my alma mater McGill, and produces respected medical professionals and cutting-edge research every year. Unfortunately, most of those professionals (doctors, nurses) flee at the end of the day to the U.S. to seek better hours, better perks, and above all, BETTER PAY. The socialized system does not pay as well, there is heavy demand on it, and there are simply too few doctors here to go around. I HOPE that the U.S. system becomes "socialized" because selfishly I am hoping Canadian doctors living and working in the U.S. will at that point decide to come back to Canada, since there may no longer be such a great appeal/incentive to be a doctor in the U.S. (i.e. they won't be paid quite as well anymore. However worth noting that with so many unemployed people right now they aren't being paid as well at the moment anyways.)
Most of the doctors that do stay in Canada stay for personal reasons or ideological reasons. I used to teach violin to a doctor. She was paid well enough to buy a nice house in a nice part of town, but other than that she lived a rough life... she basically worked 6 days a week, all hours of day and night, she was overworked, overtired. When I asked why she never went to the U.S. to work, she told me she had worked in Vermont for a while. But she had to come back to Montreal because despite all of the downsides of working as a doctor here, she couldn't bear to turn patients away because they didn't have health insurance or the means to pay for their treatment.
I believe that is really the issue that Obama is tackling here. He's not trying to take the good health care away from those who have private insurance; he is simply making it so certain members of our population, who may be "down and out", are not turned away from receiving proper care.
I am not a fan of either health care system. Canada has some major problems - mainly, how to keep qualified doctors in the country in order to prevent doctors who are here from getting overworked - and the U.S. has some major problems, mainly, telling people that if they don't have a job they don't deserve proper health treatment.
I don't think the system in either country is working now. Both are overburdened and both are fraught with corruption and scandal.
However, I do believe that by changing we will, hopefully, progress, and eventually, someday, I hope that either or both our countries will figure out a happy balance and a happy remedy to the ills of our health systems.
Hopefully, before I get old. So I can figure out where to retire.
I think the priority in the U.S. would be to first set up preventative/general care clinics. This will help ease the current burden on hospitals (I've heard that in Michigan hospitals are running out of money because those without health insurance are going straight to the emergency room whenever their kid has a sniffle.) This would provide fast support to the most common reasons people run out to the doctor and help ease unnecessary strain on ERs that have more important things to worry about than little Johnny's flu.
