Post and video submitted by: Victoria Brewster, MSW
Healthcare for every American and Canadian is very important especially for those that are of lower income. Basics are covered here in Canada, but anything above? Everyone is entitled to a GP, but not everyone has one. Everyone is entitled to be referred to a specialist, but the wait can be a year. We have Medicare here in Canada or Universal Health Coverage, which is great overall and will cover routine GP visits and check-ups, many medications, surgery, tests, etc, but there might be a wait-list for any of the above. Overall, as a dual citizen of the U.S. and Canada and one who has accessed and used both healthcare systems, Canada’s is better.
Where else can a woman get pregnant, be followed by a physician or Ob/Gyn, obtain any needed tests or exams, ultrasounds, give birth to a baby and there are no additional fees attached? Yes, if one is working is is required that we obtain additional or supplemental health insurance, through our employer, but it is for things not covered by Medicare like, Dental, private Physical Therapy, private Occupational Therapy, Osteopath, Therapeutic Massage, Acupuncture, tests not covered by Medicare, glasses, or expensive hearing aids that are above what Medicare deems as necessary. Plus some of us have access to a Health Spending Account through our supplemental health insurance to cover orthodontics and the like. We also pay close to 15% tax on everything to help pay for all this.
I used HMO style health insurance in the states and because I was young and healthy I did not use it much so the few times I did, it was great. I do not think that is the case today after reading the various material that is available on the web, LinkedIn and other social media sites, blogs and such.
How do others feel about Obamacare or the Affordable Care Act?
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Waiting a year to see a specialist is a huge alarm bell for me. I’ve recently had to see two different specialists, and my wait was a week for the first appointment, a month after that. I can’t imagine having to wait a full year for proper treatment- it would have been a very difficult, painful year.
Michael,
For a basic check-up a year wait is really not so bad. If it was an emergency or something that needed swift action-the wait would NOT be a year. It often is first come first serve…but there are many specialists and hospitals one can access i the major cities anyway. Smaller towns this often is not the case.
Vikki
That would make more sense. My condition was not emergent, but it was painful and needed specialist for proper diagnosis and care. That is the big fear with a socialized system- wait times for specialized, non-emergent care. And being bound to dictates of primary care doc- how easy is it to change a primary doc if you do not like them or their office in Canada?
Michael, it honestly depends on the area one lives and how many GP’s there are. Here in Montreal, one can always go to a walk-in clinic to receive non-emergent medical attention. The issue is holidays and nights when there are no clinics open and the only choice is an emergency room. This is a separate problem. To me too many people go to the ER for non-emergent needs. Wait times can be 2-8 hours to be seen by a doctor. If one comes in by ambulance there are triaged right away.
Yes, you can change GP’s, but the issue will be finding one who is taking on new patients. Again, here in the Montreal area we have government clinics where one can call and place there name on a list for a GP and as soon as a GP has an opening…you get a GP.
I believe a solution would be a ‘hub’ or Primary Care Clinic that is Patient Centered; where GP’s, specialists, nurse practitioners, nurses, social workers, physiotherapists and occupational therapists all work in the same clinic. A case manager or care manager would oversee the more chronic/complex health related clients and organize all that needs to be done re: follow-up, scheduling appointments, advocating for needed tests, medications, exams, treatments and speak to any family or other professionals.
http://www.theglobeandmail.com/life/health-and-fitness/whos-fighting-for-private-health-insurance-in-canada/article4568340/
Worth a read to further describe private healthcare here in Quebec and others parts of Canada.
A casemanager for complex medical issues is an excellent idea, one that I wished for in helping clients and families with complex isssues. It exists in limited fashion in Maryland for disabled children, but could be greatly expanded. I would love to keep the freedom of private care choice with expanding access to all- as described above, my access to health care via my private plan is superior. I could pay less and have my access restricted, but I pay for top of the line insurance- and that’s an option I would not want taken away.
Michael,
As I have not lived in the states for 13 years and I have a feeling HMO has changed since then-how does your insurance work? Employer pays part and you pay part? What do you access with it? I would like to be able to compare U.S. to Canada insurance.
Thank you!
Yep, it’s split- I pay about 240 a month for top-of-line insurance, prescription, and dental for family of 3. I have a primary care, but I don’t need one- I can choose any provider or specialist in-network which, given it’s Blue Cross, is almost every doctor and hospital in the US. I have total freedom to see who I want when I want- if one doc can’t see me, I can call another without needing a referral. Co-pays are reasonable, too- 15 for primary, 30 for specialist, 50 for ER. Scripts are good, too- 10, 25, 30 depending on whether or not generic, approved named brand, or special brand, for 30 day supply.
Michael, $240 a month for a family of 3 is not bad, but this means your employer pays the balance correct?
I pay $150/mo. for supplemental health insurance and $45/mo. for dental for a family of 4 PLUS the 15% tax we pay on everything for socialized medicine. I still have my deductibles and co-pays as well for the supplemental health insurance.
In the U.S. how many have really good health insurance though? What about those that are above lower income limits so no Medicaid and their employer does not offer insurance? Is it truly know what the ACA is going to include? I believe each state has the power to control this, correct?
Here is a link re: generic medication here in Canada:
http://www.canadiangenerics.ca/en/news/oct_24_12.asp
and a link about stopping surgeries for a week due to a shortfall:
http://ochuleftwords.blogspot.ca/2012/10/funding-crisis-forces-hospital-to.html
http://www.kevinmd.com/blog/2012/10/understanding-patients-expensive-care.html
worth a read re: Patients who are the most expensive to care for the U.S.