Health Care question

26 posts / 0 new

Tue, 2009-04-28 18:32

TiradeFaction

Hi guys and Gals, I'm new to this forum, so I'm not entirely sure where to post this question, so to be safe, I'll post it here.

Someone recommended me this forum on questions regarding Canadian issues, so I'm going to ask my question here.

Does Canada have a full single payer health care system that covers primary, specialist, and hospital care? I'm told that a lot, but I've heard some differing information on it, some have said some provinces don't have universal health care, but only cover some things? I'm hoping you guys can clear this up for me.

Thanks in advance!

Tue, 2009-04-28 18:35

TiradeFaction

Oh, I forgot to add, I'm an American, trying to learn about various other nations, and their domestic policies, and such.

(For some reason I can't edit my previous post, is that not a feature on this forum?)

Tue, 2009-04-28 18:51

Bookish Agrarian

Hello and welcome

The overall answer is yes. We have a single over-arching system under the Canada Health Act.

However, since health care is a provincial area constitutionally they set the rules in the individual provinces. So best to think of it as a 13 piece quilt that makes the whole. That means there is some differences in what constitutes covered care in every province, especially around alternative care and non-life threatening care. However, if you show up at a hospital, or your doctor's office requiring medical care, regardless of what province you live in, you will get treatment covered by your health card.

The administrative side of it is very, very complicated as we never really see it, but as a Canadian citizen, your interaction with the health system is pretty straightforward and you have plenty of options and choices available to you despite Republican scare tactics in your last election.

Tue, 2009-04-28 19:00

TiradeFaction

Thanks for the answer!

Oh, to clarify, it's not just Republican scare tactics that try to keep single payer down, Democrats do a pretty good job at it as well. (Case in point, Nancy Pelosi, the speaker of the House, is a democrat, yet she has gone on record saying "There won't be any single payer health care", honestly, I think she should metaphorically be flayed alive for that comment). California however, *may* be close to implementing a single payer health care plan.

Tue, 2009-04-28 19:13

No Yards

I think the only popular knock on the Canadian health care system coming from the US right that is any where near being closr to the truth is the one were they claim that the US system has more resources and can provide the best care in the world ... this is indeed true, IF you are rich enough to be able to afford it. Generally speaking, on a scale of 1 to 10, with the top tier of the USA system being a 10, all Canadians in general recieve an 8 level of service, where in the USA you have a large porportion of the population that receive a 3 or 4, and a percentage or two that receiver the 9 and 10 service. It's fine if your country has the "best health care system in the world", but if you can't access it, then it might as well be a 0 ... the real measure is i outcomes, and in that area Canada has it all over the USA ... except for your US millioniares who receive the 10 service, Canadians outlive you, have better infant mortality rates, and over all better general health that US citizens.

As for you specific questions, yes, it covers primary, specialist, and hospital care .... I believe the only limitation is on specialists, which requires a referal from a heath care worker (but that may not be the case, but the only time I've ever seen a specialists is through a referal, so that's my best guess.) Other than that I can go see my doctor every day if I wish and not pay a cent, as it stands now in a normal year I got for my yearly physical, and 2 or 3 regular minor visits (a decision made by me and my doctor) where I get the "chit" for blood work at the lab (also covered) and to discuss any issues with the last blood work (a bit of high Chloresteral is all I have.) Over all this means I can address any health issues early when it is inexpensive to do so rather than putting it off because of money issues and then having it end up costing many times more than what it could have been if I acted sooner.

And I don't need a job in order to do this, so I' not stuck at some dead end job that I hate just because I don't want to lose my health insurance.

Tue, 2009-04-28 19:16

TiradeFaction

Thanks to the user above for another imformative response!

Can you in Canada, ever go bankrupt because of Medical fees? It seems like everything essential is covered, so I'm guessing that's not a possibility?

Tue, 2009-04-28 19:36

Bookish Agrarian

You could I suppose if you became ill and lost all income, but even then there is a backstop however inadequete.

Drug costs are certainly a problem for those without a drug plan through employment, or you are covered as a senior and so on.

Tue, 2009-04-28 19:40

TiradeFaction

What's the backstep? I'm guessing the possibility of medical bankruptcy is rather small (which is good!)

Tue, 2009-04-28 19:42

No Yards

The only ways I can imagine are:

1) Heading down south for treatment

2) Medical incidents while out of the country (even then I believe you can be reembursed by the provincial health care system.)

3) Requiring expensive drugs (but even then I'm not sure this is possible .... I have a company drug plan, which pays for my drugs, but I'm not sure what those without jobs, or jobs that don't have drug plans, and low wage earners do about drugs ... I believe there are means-tested ways to have your drugs covered by the province, but I'm not sure on that issue.

Other than that you can have a major medical incident that costs millions to address and not have to pay a cent unless you wanted to upgrade your hospital room.

Tue, 2009-04-28 19:48

#10

remind

Well to be technical, no you can't go bankrupt over medical fees.

You could go bankrupt as Bookish said if you become so ill you lose your job, but it would have nothing to with health care costs, just normal living costs. The back stop referred to is, income support by way of disability pensions which is about 1000/month here in BC, and your pharmaceuticals and dental are paid for.

Many provinces also have pharmacare, so once your drug costs reach a threshhold of some type, then there is no cost, or very little. Not sure which ones do though.

Tue, 2009-04-28 21:59

#11

Fidel

Quote:
"I challenged those advocating radical solutions for reforming health care - user fees, medical savings accounts, de-listing services, greater privatization, a parallel private system - to come forward with evidence that these approaches would improve and strengthen our health care system. The evidence has not been forthcoming." - Roy Ramanow

Tue, 2009-04-28 22:07

#12

Bookish Agrarian

remind as usual is more articulate in saying what I was trying to get at in my rather brutish fashion

Tue, 2009-04-28 22:22

#13

Sineed

Good quote, Fidel!

One of my uncles (American) went bankrupt when he was so irresponsible as to have 2 heart attacks close together, requiring interventions that maxed out his insurance.

So yes; single-payer rocks.

The provinces have a pharmacare of sorts, not for everybody like the British system, but for people on disability and social assistance, and seniors (+65). Some provinces also have an extended pharmacare that kicks in after you've paid a deductible for low income people who don't have a drug plan - this was brought in for people who couldn't afford to get off welfare because they or a family member required expensive prescription drugs, and they would lose the free drugs if they got off social assistance.

Tue, 2009-04-28 22:24

#14

Fidel

remind wrote:

Many provinces also have pharmacare, so once your drug costs reach a threshhold of some type, then there is no cost, or very little. Not sure which ones do though.

I know a person who has had a kidney transplant, and his benefit plan at the unionized mill he worked for has a limit on drug coverage. He's approaching the $180K cap on drugs - expensive drugs that he will continue to need to prevent his body from rejecting the kidney.

Canada is in the minority of capitalist countries without a national drug plan, national eyecare or dental plan or even a national dental officer. This is not Tommy Douglas' vision for medicare in Canada.

Tue, 2009-04-28 22:59

#15

Bookish Agrarian

You're right to suggest that it takes constant vigilance to keep public medicare. Even more so as we try to expand it to include pharma and home care.

Tue, 2009-04-28 22:59

#16

TiradeFaction

Thanks for the interesting post Spectrum, I'll read on.

Tue, 2009-04-28 23:03

#17

Unionist

Bookish Agrarian wrote:

You're right to suggest that it takes constant vigilance to keep public medicare. Even more so as we try to expand it to include pharma and home care.

Since 1997, all Quebeckers who are not part of an employer-run drug insurance plan must belong to the publicly run provincial plan. Thus, everyone is covered by pharmacare in one form or another.

Manitoba has had a universal home-care program since 1974.

Don't know about other provinces, but the first steps have definitely been taken.

Tue, 2009-04-28 23:03

#18

Spectrum

Everything is not as Peaches and cream as one would like to think TiradeFaction.

While the horror stories about getting sick could be enough to convince you that bankruptcy could wipe away a whole lifes savings,

Some of us continue to fight to keep this priviledge for everyone, while there is a "for profit scheme" that has been working hard to make it much like the American system. So you are headed in the right direction if you can stop what was set out in the following commetary in 1982.

Quote:
There's not any doubt at all that the present Medicare program in Canada is in serious danger of being sabotaged. One danger is extra-billing, which is growing and which has meant only one thing: that we are rapidly developing two types of people in the health care field: those who come under the general program and whose care is paid for out of government funds, and those who pay "a little extra" to doctors who want a little extra.

If that goes on, the percentage they will pay in extra billing will increase from year to year, so people will get to the place where they are saying, "I'm paying almost as much in extra billing as I pay through taxes."

Let's scrap this plan. Otherwise, you're going to have a situation in which some doctors will only want patients who accept extra billing, and they will be the most competent doctors and the most proficient surgeons. Thus, after a while, the people who will not accept (or cannot afford) extra billing will have to go to the less competent doctors and less competent surgeons, and you're right back where we started when we fought for Medicare. The well-to-do who can afford it will have one standard of health care, and those less fortunate will have to accept a lower standard of health care.

Surely we're not going back to a system in which the quality of care patients receive depends upon their financial capacity to pay. Any free country that talks about the democratic process and allows extra billing to become the general rule is denying the basic principles of the democratic process.On the State of the Medicare Program

See Also:

Susect Violations of the Canada Health Act-total=89

Eroding Public Medicare

Tue, 2009-04-28 23:06

#19

Bookish Agrarian

There is no national pharmacare program and many of the programs in provinces are no where near universal

Tue, 2009-04-28 23:07

#20

Fidel

And my 84 year-old mother can remember physicians making house calls in England when she was a child. Can anyone imagine their family doctor paying them a visit at home? And there are far too many Canadians don't even have a family physician. We have 33 million people not 60M, and Canada has unparalleled in the world natural resource wealth being siphoned off for a song for far too long.

Tue, 2009-04-28 23:10

#21

Spectrum

Fidel I could change my status "from colours"..... "to sick and tired," as well." Why is it people do not see what is going on?

Tue, 2009-04-28 23:10

#22

Bookish Agrarian

I was astounded when my father's cancer doctor came out to his small community and made a house call rather than require her patients to come to her.

If that woman had asked me to lift up her car and carry it on my back to her next call I would have done it I was so in awe of her committment.

Obviously that was unusual, but the difference is made for my parents was beyond compare.

Tue, 2009-04-28 23:31

#23

G. Muffin

I've actually wondered about that from time to time. When did house calls fall out of favour and why?

Wed, 2009-04-29 07:13

#24

abnormal

Fidel wrote:

.... Can anyone imagine their family doctor paying them a visit at home?

Actually yes - as a kid I remember the family doctor making house calls but I don't have to go back that far. My mother's GP visited her on a regular basis up until she died (that was about two years ago) - the only time she had to leave the house for a doctor's appointment was when she was refered to a specialist or had to go to the hospital for tests.

Quote:
And there are far too many Canadians don't even have a family physician.

True - while the extent of the problem varies from place to place within Canada there is definitely a shortage of doctors. This has been an issue for a very long time [as far back as the early seventies med-schools were automatically granting interviews to applicants from places like Northern Ontario whereas applicants from southern Ontario had to go through a very rigourous screening to get that far].

Quote:
We have 33 million people not 60M, and Canada has unparalleled in the world natural resource wealth being siphoned off for a song for far too long.

I don't see what this has to do with the question.

[/quote]

Wed, 2009-04-29 09:36

#25

remind

BC has had home care for a very long time, though under Gordo it was gutted, to remain as a shell of itself.

Wed, 2009-04-29 09:47

#26

abnormal

remind, the doctors visits I'm refering to were in addition to the various home care services both my parents received in Ontario. While some of them came through veterans' benefits of one form or another they received regular visits (at least weekly) by nurses and were provided with a number of aids - a chairlift for example so they could move between floors in the house, a power scooter so my father could get around outside the house (and a lift for the car so my parents could get it in and out of the car), and so forth).