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…..

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.

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.

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.

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/

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.

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?