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Old 03-09-2009, 09:17 PM
3,060 posts, read 7,937,840 times
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Yeah me either umtiki - I've lived in three provinces and had excellent care across the country - two babies born, one breast lump removed, a routine colonoscopy, a routine mammogram, son with broken leg, daughter hospitalised twice with croup, vasectomy for ex-husband (and he broke his leg skiing), dad had a double bypass, and much more that I am not going to bother mentioning.

I have been on this earth (and in this country) for 45 years and nary a complaint have I heard from anyone in my family, or amongst co-workers or friends regarding our healthcare. Most significant for me is the complete lack of stress that the vast majority of Canadians have when it comes to healthcare and the knowledge that they will be taken care of. I would say that overall we feel blessed.
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Old 06-18-2009, 08:41 AM
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Originally Posted by ZX14TJ View Post
This is a great point. There are many Canadians that go to the US and pay for medical services out of pocket. That is the worst of both worlds. Pay very high taxes here in Canada and then pay out of pocket for services in the US.

While quality of care has an impact on life expectancy, there are many other factors outside of healthcare. Life expectancy is not an appropriate metric to measure the effectiveness of any health system.
I agree that it's not an appropriate single metric, but it does seem to me that it would be one significant metric. What other metrics are there? (I don't mean this as a challenge. I'm really curious.) Is there an overriding one?
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Old 06-18-2009, 08:54 AM
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Originally Posted by Acajack View Post
This is true, but these are only the federal income tax rates. Provincial income tax levels vary from province to province, but all in all, someone who makes 75K would generally pay an average of about 40% income tax (this includes both federal and provincial) in Canada.

Also, although it is impossible to tell how much of your income tax money goes to health care, most provinces say that about a third of all the tax money they collect goes to health care, and the federal government estimates that around 8% of all its tax money goes to health care (almost all of it transferred to the provinces, who are responsible for health care).
Do you mean that someone making $75,000 would pay 40% X 75,000 = $30,000? Or do you mean that the 40% is the marginal tax rate?

I ask this because from the table that was given, the federal amount would be about $13,781.76, which, if it really was 40%, would mean that the Provincial income tax would be 30,000 - 13, 782 = 16,218. Seems awful high, but, then, I wouldn't know, which is why I'm asking.

Hope this makes sense. And it is an important question because if the 40% is the marginal tax rate, then it's pretty comparable to what we pay in the States (in most states, that is; it certainly varies widely from state to state).


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Old 06-18-2009, 08:57 AM
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Originally Posted by Acajack View Post
The 40% figure is an estimate of effective *income* tax rates across Canada. Since provincial income tax varies, a 75K earner might see a variation between 5% and 7% on that from some provinces to others.

If you are wondering about an effective tax rate that includes all taxes (including sales taxes, which are quite high in most of Canada), then you’re probably looking at between 45% and 50% for most Canadians in this income category.

A good comparison between Canada and the U.S. is tax freedom day, which is usually estimated at some time in April for Americans, whereas in Canada it occurs sometime in June, which gives additional credence to the 45% to 50% numbers.
I'm very sorry for reasking the same question. I should have read further. I'm not sure from the answer, however, that the question was really understood. Hope I'm not jumping to conclusions.


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Old 06-18-2009, 09:10 AM
5 posts, read 12,097 times
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Originally Posted by Aery View Post
Hi. I am new here and just stumbled on this thread. I hope no one minds if I add my 2cents too.

I am both American and Canadian, currently living in the US, old enough to have lived in both countries for many years and used the medical facilities in both in various states and provinces, and I have relatives in both countries currently. I also go back and forth between the US and Canada frequently, primarily to see my father who, at 92, lives in Canada and gets what I would still call better health care than I do in the States where I pay a fortune.

The cost of healthcare in Canada is fairly stable for a citizen in that, though taxes can and do rise, they usually do not change astronomically from year to year. The cost of healthcare in the US more than amounts to the differences between tax rates, etc. and it is much more volatile. Today I may spend x percent of my income for healthcare .. but tomorrow it could cost me 4x (at the whim of insurance companies and uncovered add-on service costs, etc.). It is not anything I can control at all, other than by lowering my own coverage and/or dispensing with coverage entirely.

In the US, over the past 3 years, I have seen my services fall and my effective healthcare 'insurance' rate rise rapidly - more than 100 percent change in that time period, while my deductible also went up, co-pays went up, and at well over a $1000 per month for myself and my husband (with really NO health problems though we are 59 and 57 years old) we are scared to go to the doctor because, once there, even if nothing is wrong, any test, any bloodwork ordered, or even just walking in the door .. costs more. If we ever have to go to the hospital, I am petrified we will be gouged to the point of homelessness - even with our coverage, each visit could still cost us tens of thousands of dollars. And this fear is not good for my health!

I was in Canada a year ago and twisted my ankle. I called my US insurance company for 'approval' to go to the hospital for an assessment. They refused to give it .. told me to drive to the US for assessment and treatment or they would not say if they would pay (ummm ouch, and ummm, dangerous to drive with a very swollen gas pedal ankle for well over 140 miles to the nearest facility that would see me with the insurance company I use). I went to the local (Canadian) hospital where I was seen immediately, had x-rays taken, saw a doctor in no time (the lines in the ER were less than the last time I had to use a similar facility in the States btw). The only thing that was a problem was the cost - which my insurance company decided not to cover at all - and that cost was for 'administration'. The rest of the bill .. for the doctor and x-ray, etc. was incredibly inexpensive (all for less than $100). Taking my name and credit card however .. apparently costs $600!

During the Y2K era, I did a lot of work in the US with HMOs getting their facilities, people and machines ready for what was expected to be a problem if 'compliance' was not ascertained. That was right after I arrived in the US and I was astounded at what I learned about American healthcare practices, costs, responsibilities, organization, etc. I think that if Americans really truly understood their own healthcare system (something that government and healthcare insurance agencies do not want them to do), they would be very annoyed and would (one hopes) demand that things be fixed so that costs could be lowered .. and care would be better for everyone! The legal system here, which allows litigation for just about anything that 'might' have happened adds to the costs of healthcare and for doctors, to the cost of malpractice insurance. The 'coding system' is proprietary and allows insurance companies to deny payment for many things even if they are covered, or at the very least, delay payments to doctors which, in turn, forces doctors to live precariously without knowing if they will be paid in time to pay their own rent and salaries, to spend an inordinate amount of time and energy learning all the different insurance codes/systems/interfaces/billing methodologies etc. (instead of practicing medicine), and/or to lie to get paid and treatment for patients they care about. This system turns honest people into liars and thieves. Americans should be outraged and should march to stop this. I would hazard a guess that most doctors hate this system - except perhaps if they are in the kind of healthcare that is more cosmetic where they don't have to deal with insurance companies very much. However, the way they intend to 'implement' a new system down here will not work either because the people suggesting how to do that are not 'normal, ordinary, regular' people .. they are removed from reality and are way too political in nature.

On the other hand, we have a number of doctor friends in Canada too and I agree, doctors in Canada are not paid as highly as they should be. In the US, doctors can often afford glitzy digs and fancy equipment .. because they 'advertise' and/or are in, as I mentioned, the 'business' of making money through providing either costly services where the patient pays extra such as 'cosmetic surgery' .. or .. colonoscopies .. do you have a clue how much the latter costs even if you have the very best insurance? the last one I had cost me well over 6k and that was 8 years ago. It was a 15 minute procedure and not performed in a hospital. They nickel and dime'd me to death! People I didn't even know were involved in the procedure sent me bills .. and none of their supposed 'services' were ever covered it seems. None of this was told to me in advance and it surely is NOT in the ads on tv that constantly tell you to have these procedures and imply it is somehow inexpensive enough for everyone to have done.

Meanwhile, back at the ranch as they say .. in Canada .. my father, at age 87, talked to his doctor about not being able to keep his food down too well .. the next day he was taken in for a colonoscopy and when they discovered colon cancer .. he was rushed into full surgery and had half his bowel removed, was kept in hospital over a week and cared for well there .. then moved to another medical facility for further recovery. At 92, he is as well as I am .. just a little slower moving around. No charge. And no one gave him lesser service because he was older. But, of course, he paid into the Canadian tax system for years and years and still does .. to help support everyone getting that type of response and care.

Sorry for the length of this 'note'. There are good and bad things in both countries when it comes to healthcare but my considerable experience in both countries tells me .. you will pay the same amount if you don't get sick in either country (but have insurance) and a LOT more if you do get sick in the US .. and you cannot be guaranteed better or faster service here in the US, or worse/slower service in Canada either. A lot of doctors here (US) also have waiting lists or are not taking new patients. To get a first appointment with any doctor I have been to in the US has taken a minimum of 6 weeks .. how is that faster, better service?

Having lived in both countries, I can also tell you that it may sound as though the taxes are lower in the US .. but I have found that, making more down here, I had less disposable income at the end of the day than I did living in Canada making less. I wonder why that might be? Oh, and the food is better in Canada .. and surprisingly, I have found, often fresher and cheaper (for many types of things such as vegetables and cheese and lamb .. though not for chicken, butter, or ice cream).

As for having better stats in Canada .. for life expectancy .. folks, cold is better for you than heat is! More of the US is 'warmer' year round than most of Canada is - the stats for places like Wyoming, Minnesota vs those of across the border provinces would probably be comparable in terms of longevity, all else being equal. I think also that the fact that there are more poor and illegals in the US who don't go for proper prenatal care (something that I think more Canadian women do do because there is no reason not to when all are insured!) probably accounts for better stats in terms of birth survival, etc.

Luxury - you don't get that in Canada when speaking of medical services however competence I do think you get .. doctors who do stay and work in Canada even given the low pay do the best job they can because they love being doctors, not because they want to get rich. That is true of some US doctors too but not as many as in Canada (percentage-wise). Canadian doctors who cannot deal with the low pay (which, I DO believe should be higher but not because Canadians would get better care if it was .. but because the fee schedule really does force some doctors out of business - overhead is not easy to pay at the current rates even though Canadian doctors don't have the malpractice costs they would in the States) .. those doctors leave Canada and go to the US to make their fortunes. So do Canadian musicians and actors, etc. The grass is always greener, eh? Well .. not really .. but it often looks that way from the other side of the fence.

Anyway, in my opinion, there is no utopia on either side of the border. I don't think however that Canadians are told daily about America and its healthcare system what I do know Americans are told about Canada's healthcare system (when the American media even acknowledges there is a country past the end of the weather map!) and I know that, for the most part, what Americans believe about Canada and Canadian healthcare is often either wrong or grossly exaggerated. Hyperbole is a national sport in the US.

I have found being in the US one of the hardest things I have ever done in my life because everything here tends to be done or suggested to the 'extreme'. I will go back to Canada when I can but unfortunately the greed, politics and bad management of those in positions of power down here .. who have brought on this current depression ... are going to make that move more difficult for a while yet. I do know I will feel much more secure on many fronts back in Canada. Until I can afford to move again though .. I will continue to pay a fortune for healthcare I don't really need (but, if I quit paying and I DID need it in a hurry? ... well, all would from then on be completely out of my own pocket - I would not be able to ever get healthcare coverage again or if I could .. it would cost me the same as the national debt .. which is not funny right now!).

Rifleman .. sorry you are so grumpy. I agree with the others .. you do seem to be. That attitude of yours jumped right out at me, and it didn't sound very Canadian-like in spirit.

Oh .. and .. Canada is spelled Canada .. not Kanada, sir.
While I'd disagree with a few things you said (mostly unimportant things), yours was a very good response. Thank you for it.

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Old 06-18-2009, 12:52 PM
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There are both positives and negatives to both systems. Overall I like the Canadian system although it can be frustrating. I like it because at least everyone have access although in some instances quality might be an issue.

I have lived in both Canada and the U.S. and have also live in the US while having good insurance and without insurance. Essentially what I have found is that a lot depends on where you are and who you meet i.e. who is your doctor.
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Old 06-19-2009, 11:18 PM
Location: Canada
6,754 posts, read 8,266,028 times
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I won't pretend to be an expert on US health care but simply relate my experiences with Canadian health care. In the first place health care in Canada varies from province to province. There are procedures that are covered in some provinces that are not covered in others.

I had the usual experiences with hospitals for someone in their 40s: tonsils out, appendix out, tore a ligament in a knee a few years ago and had laparoscopic surgery on it. Didn't cost a dime. (I'm assuming it is already agreed and understood that we have higher taxes than Americans, and universal health care is one of the things that those higher taxes cover.)

However, my husband and I weren't able to conceive children and those particular costs are not covered by provincial health care here. Maybe it shouldn't be, but given how much I wanted children, I can't help being human and selfish enough to wish that in vitro had been an option for us. It's not a subject I can be objective about. There is now some debate going on about that and perhaps it will be covered in the future.

I see the doctor no more than I have to since I'm one of those people who feel they will stay healthy only as long as they don't see a doctor.

My husband is somewhat older than I am and has had a spinal tumor in the last eight years, as well as a quadruple by-pass and other heart-related issues. There is no cost to us. There were no long waiting periods, which is not to say that it another province might have longer waiting periods.

I consider it well worth it to have the peace of mind knowing that I, and my husband can receive appropriate care without having to worry about how we are going to pay for it. I can't imagine how we would have done it if we had had to pay for it.

Last year I became the aunt to extremely premature twins who spent the better part of 6 months in the hospital. Due to the prematurity, one of the twins is profoundly deaf (other devvelopmental isses may show up yet) and I don't see how all that treatment wouldn't have bankrupted the family if they had had to pay for it.

Prescription costs used to be covered with a one hundred dollar deductible. Everything above that was returned to you. Some companies offer separate insurance to cover those extra costs now, but in Manitoba at least, what your deductible is is governed by your annual income.

I certainly wouldn't say that our system couldn't do with improvements. If I were the boss, I'd implement a user fee - it could be as small as $5 - but there are an awful lot of Canadians who abuse the system through unnecessary visits that they would not make if they had to pay something tangible, and on the spot.

I do not mind at all paying higher taxes so that everyone, from the least to the greatest is afforded health care any more than I mind paying school taxes on my property even though we were unable to have children. It is an investment in the future of my country on the one hand, and for the other, it is basic human decency - that "love thy neighbour as thyself" thing that no one should be turned away or denied treatment due to inability to pay.

There are doctors and nurses who do leave Canada for the opportunity of making more money in other countries but since I'm a socialist through and through, I believe firmly that the good of a society ought to take precedence over an individual's desire - not need - for more money. I would hope that a desire to heal would be what would attract people to the medical profession, not the desire to "be somebody" in a social or monetary sense.

I think part of what skews the wait times in ERs is the number of people who are there for non-urgent care. The times I've been in the ER for my husband's heart issues, there has never been any wait time at all. All in all I am satisfied with the Canadian health care system although there is always room for improvement. There is no perfect system anywhere.

We lived in Germany for a year when my husband taught at a university there, and there was a 300 DM (at the time, D-marks) monthly deduction from his salary for health care but I never did understand quite how the system worked there. I know my husband saw the doctor without having to pay anything, and that I saw the dentist and also had to pay nothing.

When I lived in France, I never needed health care so I don't know how the system works on a practical level there. But I would be interested if anyone out there could explain the German or French systems to me.
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Old 06-21-2009, 10:21 AM
Location: Ottawa, Canada
609 posts, read 1,129,649 times
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Originally Posted by Galloway View Post
In toronto hospitals, the wait times are extremely long, and the services afterwards are very poor. you will literaly die while waiting to see a doctor.

If i was rich then i would choose American healthcare in a second, if i was poor then i would stick with Canadian healthcare.
I'm from Ottawa and this literally never happens. I'm not saying it hasn't happened, however I have never ever once heard of it happening.

wait times are long, but the services themselves are good. A lack of healthcare just shows the rich control the country. i feel its a basic human right and no one should ever be worried about being in massive debt or unable to pay for thier health. its a crime
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Old 06-22-2009, 01:43 PM
Location: Longueuil, Quebec/Brooklyn, NY
59 posts, read 148,821 times
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Originally Posted by leangk View Post
I'm from Ottawa and this literally never happens. I'm not saying it hasn't happened, however I have never ever once heard of it happening.

wait times are long, but the services themselves are good. A lack of healthcare just shows the rich control the country. i feel its a basic human right and no one should ever be worried about being in massive debt or unable to pay for thier health. its a crime
When I lived in Ottawa I never heard of this happening either.

Now I live in New York and I work for a company where I get excellent health insurance (though this company is slowly cutting back on what is covered and raising premiums each year.)

Still, even with this great coverage, I still have to pay co-pays to see a doctor and then several weeks later I have often received bills in the mail for tests and treatments I thought were covered. Then I have had to waste time fighting with the insurance company over who actually pays for them. I even ended up with a negative on my credit report because a bill was sent to my old address and never got paid.

When I injured my knee, I had to wait several weeks for treatment because my insurance company required it. Wait times are part of the American experience as well, but you don't hear about it as much because it is privately managed. However it's a known fact that people in the States have died waiting for healthcare treatment too. The only difference is that you can get around the wait in the States if you have money. In my case, I didn't have $5,000 lying around to pay for a procedure that would mostly have been covered anyway (though I still had to pay for part of it out-of-pocket) so I had to wait, just like at home.

While my taxes may be lower (though I think NYC taxes are about the same as Ottawa's because of the city income tax), I still pay out more in insurance premiums than I would in taxes for Canadian medicare. Healthcare is much more expensive here than at home, so my take home pay in the States isn't better than it was in Ottawa, if you include all taxes and the health and benefit costs.

The American system is definitely more responsive if you can pay for everything out of pocket. But most of us can't, particularly over the long run. American facilities are often cleaner and newer and the procedures are more cutting edge than in Canada, but it's hard to say whether that means that they are more effective.

And again, I am one of the lucky ones. Many Americans are underinsured or uninsured and as an HR Manager I can say that nearly every company is cutting back on what is being covered and raising premiums, so in a few years if current trends continue, the middle class will be priced out of healthcare too.

Last edited by toujoursdan; 06-22-2009 at 01:59 PM..
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Old 06-22-2009, 02:49 PM
Location: St. Louis, Missouri
9,353 posts, read 19,258,020 times
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not to discount the terrible time rifleman's father endured, i will add my 2 cents here......

my mother endured much the same wait time and treatment at a couple of different hospitalizations ..... and she was covered by private insurance AND medicare......... those ER visits were some of the worst days of my life.....

and i contracted mrsa in my hip after a major surgery at a hospital here in the states...... the infection was WAY tougher to deal with and recover from then the initial surgery........

and now..... i am self-employed and uninsured..... and that is very stressful.....

i am happy for you that you have such excellent insurance coverage provided by your employer...... you are rapidly becoming a minority here.....

my one brush with canadian health care came over 25 years ago in toronto..... tore all of the ligaments in my right ankle..... hardly a life threatening injury (although EXTREMELY painful) ..... the care I received was excellent and FAST...... and they agreed to send the $25 or so bill to me at my home in the states.......
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