Health care Canada vs US - Experiences, Truths, Myths (crime, credit card)

[Vagus]

Originally Posted by evlevo

The Canadian system is set up to make people healthy,

The US system is set up to make $$$.

Speaking of making money, anyone know what physician salaries are like in Canada? I've always heard about a big "physician exodus" from Canada to the US because of the salary difference.

[Cornerguy1]

Vagus

Again, there is no set rate across Canada. Each province runs its own individual health care plan, so each province establishes different fee schedules.

On a related issue, doctors and hospitals are not allowed to set their own prices for procedures. Each provincial plan pays the doctor or hospital an established rate for a particular procedure.

Rest assured, few Canadian doctors are visiting food banks to make ends meet.

[taigagirl]

I just joined and this looks a really cool site. I live in rural Manitoba (which is
a province north of North Dakota. I live about one hour from the capitol city
(Winnipeg, MB). It is impossible to get in to see the doctors---everyone just goes to the walk-in, and they won't send you to Winnipeg...unless you are practically dead. It can take months to see a specialist, and lots of people who have cash do go across the border for surgery, etc., because they don't feel like waiting. There are also some private clinics allowed...for example my Dad had cataract surgery in Winnipeg and he just paid for it because he didn't feel like waiting in the queue.

Canadian medicare is definitely not cheap. On a trip to Mexico, I met some really nice people from Nebraska, and we were comparing notes. Our taxes are much higher, we don't write off any of our mortgage interest, and the general cost of any taxation seemed to be much higher. Our salaries were similiar. We are taxed to the max. Also, if you get certain illnesses the government may not cover the cost of the medication, so you can definitely go broke here as well, if you get sick.

Many employers do not offer health care packages anymore, and believe it or not Walmart just got named one of Canada's 50 top employers! Go figure.

Most doctors are overworked, but not underpaid. I know a couple who worked in the States and came back because the paperwork for the insurance companies drove them crazy, also the cost for malpractice insurance was insane. Canadians are not very litigious, and usually Court rewards for malpractice here are small.

The walk-in clinics are abused lots by people who just have colds or very minor ailments, you can wait for hours to get in. The doctors where I live opened a huge walk-in because so many people were clogging the emergency ward and just wasting hospital staff's time. The last time I went to the walk-in for a throat infection there were 20+ people there and 1 doctor. I waited almost three hours. I think chronic abusers of the system (and there are lots of them) should be dealt with. No one has quite figured that one out yet. Some "experts" have argued about a point system for smokers, alcoholics, etc., basically anything that could be traced to self-abuse...but that's a whole different story and who wants to go there!!!

[StuckPA]

[quote=taigagirl;514328]The walk-in clinics are abused lots by people who just have colds or very minor ailments, you can wait for hours to get in. The doctors where I live opened a huge walk-in because so many people were clogging the emergency ward and just wasting hospital staff's time. The last time I went to the walk-in for a throat infection there were 20+ people there and 1 doctor. I waited almost three hours. I think chronic abusers of the system (and there are lots of them) should be dealt with.QUOTE]

After I discovered self-healing,home remedies etc years ago it occured to me that people should be taught self-care. I mean,it's our bodies and no one should know more about that than us right? In this generation of 'do-it-yourselfers' I think that should be at the top of the list. There are simple things we could do for constipation etc(which I've heard of people in emergency rooms for) thereby reducing the wait times in hospitals and also less of a burden on the medical financial/insurance system.

[postman1745]

3 years ago my father had open heart surgery. One year later he had brain surgery. His total cost... nothing. The quality of healthcare was unbelivable. His recovery was labor intensive. Cost of rehabilitation.... nothing. We are not a wealthy family so I cannot imagine what we would have done. Socialized haealth care is unbeatable. Especially for lower income. Obviously if you are wealthy you can find better coverage.

[kitty71]

I have to agree... although I posted earlier about my own negative experience, my dad needed a quadruple bypass operation...bang, he got it - no waiting, great care, no charge.

8 years later he needed an esophagectomy (a very serious surgery where they basically replace your esophagus with part of your stomach) to remove a small tumor. BANG - again, in the hospital, got the surgery, and he's still doing great 5 years later.

My theory about Canada is that if you REALLY NEED SOMETHING CRITICAL done, you will get it ASAP. I needed an emergency c-section during my second delivery, and got the best surgeon etc. within an hour. The follow-up care was amazing, and I got to pick if I felt well enough to go home (I didn't) so got to stay 2 extra days in the hospital (which shows how badly I felt - I hate hospitals). My daughter received exemplary care in the NICU for 3 days... and at the end of it.... no $ - not a cent.

For not-so-critical care the US definitely outshines Canada, but wow, will you be out of pocket for it! I was extremely shocked to receive my first medical bill here... and we have a good benefits plan - what would someone who doesn't do to pay????

[sunsprit]

kitty71 .... Someone who can't pay?

that's the crux of the problem in US medical care right now. They get the same services and quality of care by government policy as that you who do pay receive .

The medical care providers have no alternative left but to extract the service costs from those who have the money, "cost shifting". You get to pay for your services and that of several others, too.

I have seen several people with adquate resources defraud the system by claiming they were indigent. Their income was substantially all cash, and they live a very low apparent lifestyle ... out of their camper, on the road as transient labor or equine clinicians.

They defraud the tax system as well as the medical system ... one had colon cancer, needed a lot of treatment and surgeries. He told the hospital and the doctor he didn't have any money, and they just set him up on a modified repayment plan, voluntary to pay $50 month (which would take the rest of his life to partially pay off the whole bill). If he doesn't pay each month, they just assume he's not able to work or make the payment and don't pursue him.

Last time I saw him, he was planning a riding clinic with 6 folks paying $1,200 each for three days of riding lessons, and that was in between a number of private lessons for weeks around that time. He's driving a new Corvette when not in his beat up pickup w/camper.

[DocGSD]

Originally Posted by ColdCanadian

I still can't wrap my head around the fact that you can make an appointment to see a doctor within a day or two. Why? How?

(The Canadian health system is obviously the only one I've ever known. )
Sometimes I've been lucky enough to get an appointment within a week and a half.

In Canada, if you need to see any kind specialist, you must go to your family doctor to get a "referal."
Actually, I think you have to see your family doctor before you're allowed to see any other doctor, period.
(except in the case of what we call "walk-in clinics")

This involves making an appointment often weeks in advance to see your family doctor. If and when you get the referal, you start the waiting game all over again, only this time it's waiting weeks or months to see your specialist. If you need a surgery, it's usually another few weeks or months again after that.

Basically if you need something like a non-life threatening surgery, you can expect it to be dealt with within a total of 6-8 months. However sometimes it takes longer than that.

THey through DR license around here like baseballs!.. J/k. THe medical profession in the US is booming. ME, having never been to Canada, can only speculate. I would say that from the rumor mill, insurance companies do not pay medical facilities in the canada like they do in the us. A doctor here in private practice can start out making around $500,000 per year proffit. In Canada its much much lower due to governmental payouts. The Medicade/Medicare health programs in U.S. is fair to doctors and unfair to patients. I have heard the medical expenses are much lower in Canada (is this true to your standards?). I would say that medical treatment in the us is easier to come by because more doctors are here and thats because of MONEY. What are your opinions to that?
If I just rambled on, Im sorry. I am half asleep!

[Cornerguy1]

You have indicated several times a dissatisfaction with US government regulations which require medical services to be provided to those without resources.

This is because you feel those policies are causing the medical costs of the resourceful society to be elevated?


You also give the impression that you feel US government rules requiring the provision of medical services are not only costly, but also unnecessary.

Should these rules be rescinded?

How should the system be restructured so as to be able to function in a sustainable manner?

[taigagirl]

There seems to be alot of people in both Canada and the U.S. who are taking advantage of whatever system they can. That is partially why the walk-in clinics in my community are so full. The physicians set up their own walk-in clinic so that these "daily patients" would not be clogging up the emergency room--and they have signs everywhere outside the e.r. telling people to go the the walk-ins for everything but real emergencies. They also hired a few doctors for the emergency. Before they got the emergency Doctors in the e.r. you only saw nurses. This is very common in rural Canada.
There are tremendous physician shortages in these areas. Now, if you spun the wheel and didn't get really good nurses in the e.r., you didn't get to see a physician. That happened to me when I was pregnant with my first child.
I went to e.r. feeling really ill at 11:30 p:m (they didn't call the Dr.); I went back at 4:30 a:m (they still didn't call the Dr.), and sent me home with antibiotics for an infection?? No exam, etc. And we didn't have an ultrasound machine either. (Which they probably would not have called a tech in for, because they only work from 8-5). At 7:30 a:m I started to bleed heavily and went back. By then there was a Doctor in, and he sent me into a teaching hospital 90 minutes by ambulance with 2 nurses. Baby died (I was full term), I got DIC (dessiminated intravascular coagulation) and had to have a hysterectomy. To add insult to injury "the nursing care" I received was "private" so I had to pay for that and also for 2 ambulance trips. This was not many years ago. The reason I had to pay for the nurses and ambulance? Because the Manitoba government only covered costs when the patient could be returned to the original rural facility the same day--and because obviously I was in the hospital more than 24 hours I got to pay. I think with nurses, ambulances, and prescriptions I came home with a bill for at least $7,000. And guess what? No payment plans. That was a real surprise. So I don't really have much faith in rural facilities, but at least now they have physicians in the e.r. which has made a huge difference in terms of initial assessment. The cost of my care was probably horrendous and could have easily been prevented if I had received the emergency care I needed in the first place. My rural hospital almost killed me. And no I didn't sue them, but I did complain and I did get a personal apology from the nursing director who acknowledged I should have received care at 11:30 on my initial visit. Any therapy I needed afterwards (and I did), I had to pay for myself. So much for a "free system".

My mom had cancer and received wonderful care in the same teaching hospital. It was also emergent but her physician managed to get her into see a specialist within a couple of days and she had her surgery about two weeks later so she didn't have much of a wait. But again, the follow-up care in a rural community is not available so she sees a specialized nurse once per month.
I don't think we are atypical of rural communities in most parts of Canada. While Canadians do get good emergency care, I think some of it could be prevented if there was a better preventative care management system in place instead of band-aid medicare.

Doctors here are basically paid on a per office patient visit, and that is set by the provincial government in each province. Doctors overhead costs will vary from location to location. Hospitals are funded by the government. The
government "helps" with the budgetting process to ensure that hospitals try to stay in line with spending. Doctors do not pay for any of the equipment in hospitals. There are all kinds of fundraising mechanisms to buy whatever a hospital might need (Bequests, lotteries, dinners, basically anything legal goes).

There is no way here that a physician in a general practice can net $500,000 early in their career.