What’s health care really like in Canada?

This guest post is provided to you by Johnna Cornett, an Our Thoughts reader living in California. If you’d like to be a guest poster on Our Thoughts, email us at ourthoughts@gmail.com.

They’re talking about the Canadian health care system all day long on the radio down here in the United States.

frex: http://www.npr.org/templates/story/story.php?storyId=111084018

I’m hearing great anecdotes, like that one reason Canada works is that it has fewer people than California, and that someone couldn’t get health insurance in California because her injuries treated for free in Canada (hit by a car while she was on her bicycle) were considered a pre-existing condition in the States.

And I find, I’m really no closer to understanding what the Canadian health care system is really like. On one hand, I’m hearing a lot of stories about waiting four months to see a primary care physician, and long waits to have one’s cancer treated, hospital beds in halls, or 19th-century style 20 beds to a room. On the other hand, I’m hearing about the peace of mind of being able to see a doctor whether you’ve changed jobs, to get health care whether or not you have a pre-existing condition. I’m hearing it’s easier to start a business if healthcare is not one of the overheads.

I had a baby when my husband was between jobs. We lost our COBRA coverage though a paperwork error, and then I couldn’t be insured because I was pregnant. Pretty big consequence for paperwork. So I’ve had a baby on a cash basis, knowing I had no way to cover the expenses if my child was born with any complications. I don’t think I really got what it was like to be uninsured until it happened to me. I don’t think I understood the difficulty of getting insurance once you’re in that class of uninsured. And I thought the health insurance paperwork was bad enough when I was family-of-an-employee.

So, you LDS Canadian insiders, what is it really like getting health care in Canada?

Do you have to be clever at navigating bureaucracy to get care? To see a doctor you respect? It’s not atypical here to have to fight the paperwork fight when your insurance decides something wasn’t covered. What’s the analogy there?

And does the Canadian system have challenges when you’re LDS?

Do they give you a hard time about having lots of children? (Actually, that’s happened to me in California.) Do you worry about resources going to abortions? Is care being withheld from the elderly?

14 thoughts on “What’s health care really like in Canada?”

  1. Health care…well let’s see. It’s pretty normal! :) You would never have to take 4 months to see your primary care physician, maybe at the most a week? If s/he is that busy then it’s time to find a new one :) I have never had to wait that long and sometimes you can get an appointment as early as the next day or possibly even that day if there is a cancellation.

    It costs nothing to have a baby. If your doctor doesn’t cover births then s/he would refer you to someone who does, at some point during your pregnancy. In Alberta, BC, Ontario (and Manitoba soon I think?) Midwives are even covered by health care so you have that option too. A lay midwife (not registered) would cost out of pocket, but otherwise, all visits, birth included are covered in provincial health care.

    Nope, no need to go through bureaucracy for regular care. If you have to see a specialist you need a referral from your regular doctor. That appointment may take awhile, anywhere from a week up to a few months, depending on the seriousness of the need and how many specialists in that area there are. In some smaller centres there might not be specialists in certain areas and then you might have to travel to a larger centre to see someone. But this would be specialists who are not as in high demand. So say, Lethbridge doesn’t have cancer specialists, so one would need to travel to Calgary to see someone there and for treatment (though they are supposed to be getting radiology clinic here so that would eliminate that need for travel).

    I don’t think paperwork is a big issue. Of course I have never had a big need to figure things out. I remember many years ago when we were first married I went to walk in clinics oh every month of so to get a pregnancy test since I really wanted to be pregnant. So I saw a different doctor (didn’t have a Primary Care Physician since I had moved to a new city) um, almost each time and I got a letter from BC Medical suggesting I find myself a primary care physician since it was ridiculous to keep going to walk in clinics :) No hassle there, ha ha.

    I haven’t heard of paperwork being an issue. There is a main coverage through the government. Yes, I know that freaks a lot of Americans out. But as long as you know what they do, it’s not really an issue. No one is forced to do anything they don’t want to do, no one is denied care, especially basic or life saving care. You can even go in for something seemingly frivolous and you won’t be turned away. Many people have a tendency to use the ER as their medical clinic. This is a pain and slows up the service for people who really DO need emergency care (well to a degree. If someone comes in with a true emergency they get in immediately) but even they aren’t denied care.

    Well we only have 4 children and here in Southern Alberta I am sure they are used to lots of children. Some doctors might be critical, but the medical system itself has no opinion or at least they don’t get on anyone’s case.

    Resources going to abortions, well there isn’t much we can say or do, at least, there are doctors who won’t do them, so there is that, but I don’t know all the logistics with abortions so can’t comment on that.

    The elderly are well taken care of. Even the ones who are not well off are taken care of. With more money of course they can get into good care homes, but even so there are resources that are offered and the elderly are never denied needed care.

    We have primary coverage and then there can be other health care insurance coverage that would cover more (like dental, prescriptions, etc). Some things are paid for out of pocket, but again you can get coverage. Honestly, we have extra coverage (which helps with dental, optometry, massages, etc) and it has never been an issue claiming things. We know what it covered and what is not, but no one from the insurance company has ever tried to deny any coverage, querying the need of anything. It’s laid out what is covered, so we know and we claim for that. For everything else (the basics, whether a hospital visit, a doctor visit, tests, what have you) nothing has ever been questioned.

    I know that there seems to be some propaganda about the Canadian Health Care system and how awful it is, but really it’s not. It’s pretty darn good. Not PERFECT of course (it would be if Naturopaths and natural remedies were fully covered!!) but it’s good and you can really get any care you want.

  2. I think the four-month wait may have been to get a primary care physician.

    Canadians using the ER as a medical clinic–that’s a surprise. One of the arguments here is that if access to healthcare was more available, there would be fewer people presenting themselves at emergency rooms (required by law to treat all comers)

  3. Hi. Health care is pretty good. I live in Manitoba. I’m diabetic. I have a primary care physican and recently called another to see if I could get in. No problem. My regular physican might retire in a few years. When I was diagnosed with diabetes they sent me to classes to teach me about the disease and how to take care of myself ( eating healthier, etc. ). Even gave out free recipe books. I get a full physical every year, 2 full eye exams and have never had a problem getting a doctors appointment. I waited 2 weeks for an MRI. I’ve had CT scans, EKG’s, etc. without a long wait. I’ve never had to pay for anything or fill out any paperwork. The gov’t doesn’t decide what medical care you need, the doctors do. The doctors bill the gov’t. You just give them your medical card that identifies you as a resident. The elderly get excellent care. My MIL was getting dizzy and couldn’t think straight so she was taken to the emergency last week. She got in right away. They kept her for 2 days running tests every 2 hours. It turned out she had mixed up her medications and taken too much of one. The cost was nothing. They even provide your medications free when you’re in the hospital. It doesn’t cost anything to have a baby as far as I know. Even my friend who collasped of a brain hemorage was on the operating table within an hour ( a 12 hour operation ), in a comma for 3 weeks after with round the clock care, and then had to go for rehab. So even after 3 months of care his bill was nothing. They saved his life. He was in his late 30′s when it happened. My Mother who is 79 has had 2 hip operations,caterac surgery, breast cancer and needed surgery and crones disease. All was taken care of within reasonable times. There are wait times in Canada. If it’s life threatening there are no waits but if it isn’t you wait your turn. I think my Mother had to wait 6 months for her hip surgery.
    All in all I feel it’s a good system.

  4. My dad is currently going through cancer treatments. There’s been no waits. As a matter of fact, he’s had to put off dates of some treatments because they wanted to start and he wasn’t ready (ie. he lives in a small town and had to travel to where he would get radiation….he thought he was just coming up for a day’s appointment but they wanted to start a week’s worth of appointments that day….he had to ask to wait until the next day so he could go back and get stuff to stay overnight)

    I had a baby that was stillborn about 18 months ago. I never worried about whether or not we could afford an autopsy. The literature I received was actually American and it laid out all the costs that are incurred when a stillbirth occurs. It was stunning to see the list of things people are charged for. It just doesn’t seem right to me that at a time of loss like that one would have to make decisions based on money.

    I never hesitate to take my kids to the doctor if they’re not well. I don’t worry about whether or not I can plunk down the cash to pay for a bean stuck up their nose, or a cough that sounds especially bad, or a sprain or worse. I get annual paps and check ups as do my children (husband isn’t quite as consistent with that…..but I do nag him about it!)

    My dad’s cancer was found through routine tests that he probably wouldn’t have gone and done if he was in the US….at least that’s what our American relatives say.

    Our system isn’t perfect….but I wouldn’t trade it. That’s for sure.

  5. What I’m not hearing in the comments so far is HOW MUCH WE PAY for our system. Not having to worry about paying for a visit actually costs us more. Our health care system has made our level of taxation ridiculous. And we’re not exactly getting our money’s worth when compared to other systems. We’ve used our national health care as a point of Canadian identity for so long that it has become a sacred cow. Even the scandanavian countries that we think of as being borderline socialist aren’t nearly as “socialized” in their health care delivery. I’ve read about systems in that part of the world where everyone gets their own insurance for the regular, day to day stuff. Doctors visits, births without complications, etc. That’s all inddividually or employer funded and may be delivered either publicly or privately. But when things go really wrong, the public system kicks in and covers major surgeries, diseases, medications etc. And it works. It’s delivered more efficiently and it cost less.

    The thing I’ve never understood is why there has been so much resistance in Canada to private delivery. If it’s publicly funded, and that funding is available for everyone, who cares if an acceptable level of care is delivered by a private or public entity?

    That improvements could be made to the American system seems pretty obvious, but I wouldn’t be looking to Canada for solutions, because our system isn’t going to be working very well for us either unless we make some changes. Other nations, particularly in Western and Northern Europe seem to have pretty effective systems. What’s wrong with looking at them as models?

  6. Really, stop listening to the Republicans. There are some valid concerns with Canada’s health care system. They are not raising ANY of them. Instead their feeding you pure bull pucky.

    France is a good example to pull ideas from, as is Australia in some areas, but a good public/private partnership could massivly reduce the inefficencies built into the US system.

    Do you have to be clever at navigating bureaucracy to get care?

    OK, true story, I had to pay for some blood tests for an overseas work visa. The lab staff couldn’t figure out how to CHARGE me for the procedure

    To see a doctor you respect? It’s not atypical here to have to fight the paperwork fight when your insurance decides something wasn’t covered. What’s the analogy there?

    The closest analogy there would be if you have somthing very rare with a very expensive treatment. I’m a relativly healthy 30 year old. Neither I nor my family, which have run the gauntlet of the health care system have EVER run into having somthing denied that the reasoning wasn’t clear. Things like medical tests for work visas arn’t covered, some drugs are not covered, especially experimental ones. In Alberta we used to pay 33 bucks a month for drug coverage, but the poor an exemption and now we don’t even have that small payment.

    And does the Canadian system have challenges when you’re LDS?

    Do they give you a hard time about having lots of children? (Actually, that’s happened to me in California.)

    No, no hard time about having kids from the medical professionals.

    Do you worry about resources going to abortions?
    Yes, but you have the Hyde amendment down in the states. Your system couldn’t fund abortions without repealing that.

    Is care being withheld from the elderly?
    Absoloutly, positivly, categorically NO. Most provinces have a very solid drug coverage program for the elderly provided entirely for free, home visit nurses for those living in their own homes, hospital and nursing homes for those who need it, at the governments expense. Services of course vary in terms of where you are at, in a city you might have more access to specialsts, etc, just like rural areas in the US.

  7. Hi Jackson. What I’m hearing is the wait times. While everyone would like the costs of health care to be cheaper, the facts are that the U.S. spends about double per person on health care than Canada does. Rising health care costs are a concern in every country and some are more efficient than others. It’s a very good idea to look at other countries for ideas. The U.S. spends more on health care per person than any other industrialized nation in the world and right now it’s crippling them and making them less competitive.[1]

    Here are the statistics on health care. The cost per person in every country.

    1 United States: 4,271

    2 Switzerland: 3,857

    3 Norway: 3,182

    4 Denmark: 2,785

    5 Luxembourg: 2,731

    6 Iceland: 2,701

    7 Germany: 2,697

    8 France: 2,288

    9 Japan: 2,243

    10 Netherlands: 2,173

    11 Sweden: 2,145

    12 Belgium: 2,137

    13 Austria: 2,121

    14 Canada: 1,939

    15 Australia: 1,714

    16 Finland: 1,704

    17 Italy: 1,676

    18 United Kingdom: 1,675

    The entire list is here:

    http://www.nationmaster.com/graph/hea_spe_per_per-health-spending-per-person

    [1] http://www.cfr.org/publication/13325/

  8. The thing I’ve never understood is why there has been so much resistance in Canada to private delivery.

    We have private delivery. Dental care, chiropractic, massage therapists, and so on are privately covered.

  9. Someone in another group asked me to give an honest review of the Canadian health care system, with its pros and cons. So I’ll repeat it here. (FYI: I was born and raised in Ontario, Canada and lived there for 24 years. I now reside in Norway. Som things may have changed since I left Canada almost 7 years ago, but I think it’s basically the same, at least according to my family.)

    Here are the pros and cons that I observed in Canada:

    Pros:

    -Free health care without any deductible for all legal residents. Each Canadian province has its own health care system, which perhaps varies a bit, but is pretty much the same nation-wide. In Ontario, the province where I’m from, we called it OHIP (Ontario Health Insurance Plan). There may be certain fees that have begun since I left Canada, but I don’t think they’re common. My family still lives there and none of them have ever paid anything out of pocket to see a GP or specialist. Everyone has a card with their photo on it that they take to the doctor or hospital, so they are exempt from paying.

    -(Mostly) free immunizations for children and adults. Shots you would have to pay for are things like the immunizations you would need when going to another country.

    -Most people do have to pay for prescriptions, but many have a plan through work. Until I was finished college, I was covered under my dad’s plan and so I think we only paid the first $50 per year for our family.

    -So basically, for everyone — regardless of income or status — everything medically-related (doctor visits, hospital stays, surgeries, tests, treatments) are virtually all covered 100%, except for a few exceptions that I’ll list later.

    Cons:

    -Yes, there can be waiting lists, but it varies. I never personally experienced a long wait for treatment, but I never had any really serious problems. I would usually get an appointment with my GP the same day if I called early. A couple days tops. I had to see a cardiologist as a teenager for a heart murmur, which wasn’t serious, but I still got an appointment with one within days. I remember seeing a neurologist for headaches when I was a teenager and I think I perhaps waited a month or two. Once again, though, I would not have been a priority because the GP was not especially concerned. Right now, I have an uncle who lives in Toronto who is having heart trouble. He suddenly got an angina attack, even though he was in excellent health and physical condition, and it was discovered he had several blocked arteries. All of his tests were done within 1-2 days and his angioplasty was scheduled for within about 10 days. He developed complications after it, such as blood clots, and he was admitted to the hospital immediately and given an MRI and ultrasound immediately. He’s been extremely pleased with the care he has received, but no doubt he is lucky to be living in a large city where they have the best of care.

    I have heard of people having to wait for MRI’s and surgeries, sometimes for several weeks or even months. It depends on the area where you live, what your health problem is, and gov’t budget can also play a role because at times, there are cuts. Cuts in funding = waiting lists. I think, though, that some people assume that private health care eliminates waiting lists. This is not always necessarily true. The husband of a friend of mine in in the US had to wait 3 months to see a specialist about a lung ailment. As well, I’ve read stories about people in the US waiting for hours in the ER. Also, my sister-in-law in the US told me about one of her relatives who had a stroke and was denied treatment in the ER because he didn’t have insurance (even though it’s supposed to be illegal to deny emergency treatment) and he died while they were trying to figure out who should treat him.

    -Another con that some people like to point out is that generally, you have to see a GP before you can see a specialist. I couldn’t go to the cardiologist until I had a referral from my GP. In Japan, from what I’ve read, they have the right to go to a specialist without a GP referral.

    -In Canada, at the present time, there are no private health clinics to my knowledge. There has been talk of them, especially in the province of Alberta, but some feel it goes against Canadian law that health care should be equally accessible to all. In other words, it would be unfair to make private clinics available only to those who can afford it. On the other hand, though, allowing private clinics can alleviate waiting lists.

    -Some seem to think that public health care = bad service and bad bedside manner. I’ve had doctors that I really liked and some that I didn’t. I personally don’t have any horror stories to tell, but other people have had bad experiences. On the other hand, though, I think that this is potentially a problem anywhere. I’m sure that even private clinics in the US can have bad doctors with a poor bedside manner.

    -Some procedures and treatments may not be covered by the gov’t plan. Sometimes opponents of public health care seem to give the impression that your gov’t will leave you out in the cold if you get some disease and they refuse to pay for treatment, or that the treatment will not be performed in your home country, and then you have to go abroad to the US for private health care, at your own expense. I will try to give a fair description of this situation, based on personal accounts I have heard. First of all, although this CAN happen, I think that it’s quite rare. The only reason that I’m personally aware of that the gov’t will not pay for treatment is if it’s deemed experimental or illegal in your home country. Sadly, I have read of cases where, for example, someone gets a rare form of cancer and the doctors have given up hope, but the person is aware of a new treatment, in the US or somewhere else, but it’s deemed to be experimental or not yet approved in the home country. So sometimes these people are forced to pay out of pocket for treatment abroad that may be their only hope. Such cases often generate a lot of media attention, so hopefully things are changing. As far as common, recognized procedures are concerned, I haven’t heard of anyone being denied treatment. In fact, the Canadian gov’t will sometimes pay for a patient to get cross-border treatment. I am from a border town and a friend of my family needed a heart bypass. Apparently they gave him the choice of going to a private clinic in Michigan to get it done because it was close to home for him and he could get it done quicker than if he had to go to Toronto, for instance. As far as I know, he didn’t pay anything out of pocket.

    I’ve lived in Norway for 6 years and here are some of my observations:

    -The system here is very similar to the Canadian one. In other words, free health care for all, except for a small deductible (about $30-$40, to a maximum of about $300 USD per year. If you need surgery or chemo, you won’t pay any more than that roughly $300 per year. Pregnant women and children under 16(?) are exempt and pay nothing. Children under 18 also get free dental (not orthodontist, though).

    -If I don’t like my GP, I can go online and change doctors, for free, up to twice per year, I believe.

    -Prescriptions (that are approved) are subsidized. Patients in institutions, such as nursing homes (nursing homes are state-run as well) get free medical, dental, and medications.

    -You can take a taxi to medical appointments, if necessary, at low-cost. If you drive yourself, you can get reimbursed for the mileage. I work at a nursing home and have accompanied patients to the hospital several times in a taxi. The nursing home gives us a voucher, so the patient does not pay out of pocket.

    -Norway, unlike Canada, has some private clinics. Some companies that require medical evaluations for their employees will use a private clinic. My husband works for a bank and they did this. You can buy a membership in a private clinic (I think it’s around $300 USD per year, plus a fee for each visit) and then you can see a GP or specialist, usually within the week, even without a referral. The state system has a partnership with the private clinics in that if the waiting list at a private clinic is shorter, your GP can send you to a private clinic at the same cost as the public system. My first experience with this was last summer when I needed to see a cardiologist again. My GP referred me to a private clinic instead of the public hospital, probably due to availability. My case wasn’t exactly urgent or serious, so I had to wait about a month. Some people insist that the private clinics are better. I think it depends on what it’s for. For psychiatric help, you might be better off going the private route. I hear that there are long waiting lists in the public psychiatric sector.

    -The Norwegian health plan will pay for you to go abroad to get an approved procedure or treatment that isn’t available in Norway. I have a friend who works for one of the hospital archives. Part of her job is making arrangements for such people. She told of a couple who had a baby who needed some type of surgery (heart, I think) that wasn’t available in Norway, so the gov’t paid their airfare to the US, plus their lodging and the procedure, which I think cost over $200,000 USD.

    -In Sweden, from what I understand, dental care is part of the health care system, so they pay nothing or very little. There is a push to have the same in Norway. In Norway I pay a bit to go to the dentist, but it’s not much for routine work because it’s subsidized. If you have major dental problems, it can get very expensive. But if your dental problems are linked to a physical illness, you can get money back. For instance, my mother-in-law has bad rheumatoid arthritis. Some of the meds she has to take cause her teeth to be brittle. She’s had some pretty big dental bills because of it, so her dentist thought she should apply to get her money back since it was related to her illness. She was denied twice, but on the third try they finally approved her and she got a large sum reimbursed.

    There is talk of making dental treatment free like in Sweden, or with a small user fee, since oral health is so closely linked to overall general health.

    Both Canada and Norway offer the same coverage to refugees and those seeking political asylum.

    So that is a summary of my personal observations of the Canadian and Norwegian gov’t health plans. I’ve tried to give a realtistic view because although it would be false to say that single-payer or socialized medicine are perfect systems and that no one has bad experiences with either system, much of what I’ve read and heard from American opponents to the system is, in my opinion, either inaccurate or grossly exagerrated in order to scare Americans into believing that “socialized” medicine is a horribly ineffective system that takes away all your freedom and is doomed to fail.

  10. The biggest problem in the Canadian health care system is the terrible misuse of resources. The government required me to get a medical examination for my drivers license. The nearest clinic to my place told me that it would be three months before they could take me on as a patient. The next two nearest ones would not do what they call a “third party physical.” The next nearest clinic that would do a this did not have an opening for two month. Finally after going across town I found a clinic that had a wait time of “only” two weeks BUT required me to make a firtst appointment…I still don’t know why, just for the sake of making a “get to know you” appointment I suppose since I had never been to that clinic before. Long story short, two appointments over three weeks for a physician to ask me generic question about my health and test my eye sight with one of those letter charts. Oh and did I mention that this medical required by the government cost me 100$ and without it my drivers license would be suspended. This is the kind of unbelievable misuse of funds I’m talking about. The clinic/doctor billed the government for two “consultation” and charged me 100$ for doing…well, what I could have done =>fill out paperwork.

    The misuse is also on the part of the general public. People use the emergency room at the hospital for reasons like a caugh or a headache. The really silly ridiculous stuff so if you need to use the emergency room at the hospital you could easily have to wait upwards of 10hrs while they charge you a fortune for parking. A few years back I had a migraine and a fever for five straight days and your everyday aspirin or tylenol did nothing for the migraine and temporary relief for the fever so one night when my fever spiked I agreed to let my wife take me to the hospital. Long story short, I was there for 11hrs and they told me it was just a common bug. A few years later a doctor told me I had the symptoms of west nile virus at the peak wnvirus season. I would imagine that doctors see so many cases of common flu or cold that they just try and send people on their way instead of clogging up emergency rooms.

    I couldn’t imagine what I would do if I had to deal with a fraction of the problems I hear about with health care insurance in the US but that being said, health care in Canada could use some serious reform and it should also be nationalized…there nothing more frustrating that going to the doctor out of province and having to pay 60$ or so just to be seen by someone. You can claim this money from your home province but still, there always seems to be a catch.

  11. Many Canadians have a motherhood and apple pie view of Canadian health care. Our system has its charms and works well but is increasingly in crisis. This sacred cow perspective on public health care eliminates some opportunities for innovation and change.

    Sadly as greed and selfishness permeate our society they raise their ugly head even in such noble pursuits as public health. Doctors, insurance companies, drug companies, medical supply companies, huge executive salaries, ….

    Death of patients in the long run becomes very cost effective…..

  12. A good friend of mine lives in Canada and from what he has expressed he prefers the system insurance system there. He has also told me of some of the stories about needless waits for care. What I gather is that he’s lived in that system most of his life and is probably more comfortable with it.

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