Wednesday, August 5, 2009

Loulou's Anatomy (My take on Health Care)



No, this post has nothing to do with Grey's Anatomy, except I will be talking about doctors, and also? Aren't you excited for the season premiere? I am. I totally am.

This post is about health care. It's on all our minds. It's the most important thing I care about when it comes to who I vote for. And reading Pauline's recent posts about her views on health care, it got me thinking I should finally write about my views on this topic, too. (If you haven't read her posts yet, you should - she covers the latest developments from a US perspective.)

I feel blessed to be living in a country as great as Canada for many reasons - one being our health care system. While it is far from perfect, I think it is pretty darn good. And I've had lots of first-hand experience, which I'll talk about later on.

If you don't know much about Canada's health care system, let me summarize for you: basically, everyone gets free health care.

"Canada's national health insurance program, often referred to as "Medicare", is designed to ensure that all residents have reasonable access to medically necessary hospital and physician services, on a prepaid basis. Instead of having a single national plan, we have a national program that is composed of 13 interlocking provincial and territorial health insurance plans, all of which share certain common features and basic standards of coverage. Framed by the Canada Health Act, the principles governing our health care system are symbols of the underlying Canadian values of equity and solidarity."

Canada's universal health care system covers about 70% of expenditures. Ophthalmology and dental services account for a lot of the private expenditures in Canada. So, basically, you have to pay to to go to the dentist - if you are not insured. I have insurance through my job in the Federal Government - which pays my dental fees, massage therapy, eyeglasses, etc. The benefits and pension plan that Federal Government employees receive are excellent - not to mention the one year maternity leave we get which includes, basically, our FULL salary for the year we're off - but that's another post!

Back to health care. A recent study I read said there are approximately 45 million Americans who are uninsured at any one time. I think this number is depressing, if it is in fact accurate. That means that these people do not have access to proper health care. (Studies show that 40% of US citizens and only 5% of Canadian citizens lack adequate access to health care). That is just wrong!

I think Canada's system where everyone in entitled to health care is fair and right. Can you imagine what it must be like to be a poor mother living in the United States with a sick child who requires hospitalization, only to realize she can't receive the proper care for her child because she can't afford it? I feel terrible for people in these situations. Something should be done to allow everyone - ESPECIALLY children - access to the same care as those who can afford health care.

At the same time, I should point out that I am also a huge supporter of private health care. I think in a perfect world, in a perfect country, a two-tiered system would be allowed. Many countries already have two-tiered systems. Canada does not - yet. (Just certain provinces in Canada do.) In a two-tiered system, there would be private clinics and hospitals for people to go to if they wanted to pay. And there would still be quality hospitals for people who cannot afford to go to the private hospitals, or those who don't want to pay. There would still be 'free' hospitals and clinics, so everyone would receive the same quality care they so deserve if they are sick.

I absolutely think that there should be clinics and hospitals where a person can go to and pay to be seen faster, or to get an MRI done quicker. Many people do not agree with this concept. And I get that. But... when it comes to my health - or my children's - I want nothing but the best. Even if I have to pay for it.

Having a two-tiered health care system in place across Canada would be ideal, I think. I'd like to have a choice. If I want to pay for a certain test, I should be able to. It's my health, after all. Instead of waiting 2 months for, say, an MRI - I'd only have to wait two days. This, in turn, would actually reduce the wait times for people waiting in the public system for the same test. See? Win-win situation.

Some say Canada already has a two-tiered system - the second tier being "The USA" which is where people go if they have money and need urgent care - again, I don't see a problem with this. If need be, I'd go to my friendly neighbours for health care, too. As I am sure most of you would, as well! Of course it is not fair to those who cannot afford to do this - but if it comes down to your health, or your child's health, wouldn't you do whatever you could to make sure they are receiving the best care possible? Even it meant having to pay?

Now, the experience I have had with hospitals in Canada has been nothing but excellent, although I'm sure at the time I had a few complaints. However, when my oldest son was 12 weeks old, he had a high fever, so we rushed him to CHEO, where he was seen RIGHT AWAY, and after determining he had a kidney infection, was in a room on the 4th floor with an IV getting better. No waiting, no worries, no forms to fill out. No bill. Despite the many ultrasounds he had. Just good quality care by some excellent doctors and urologists. He was sick again when he was 6 months old, with another kindey infection, and he was in a room being treated shortly after we arrived.

This past winter, he got a bad case of pneumonia. While we did have to wait in the emergency room for a few hours to be seen, once we were seen, an x-ray was performed and he was admitted - for two weeks. He even needed surgery to drain fluid from his lung and a chest tube was in him for 4 days. He had countless x-rays, ultrasounds and a C/T scan. It was all free. (Let's not talk about the horror of seeing my child so sick - something I'll never forget.) His doctors were all brilliant and deserve all the money they make.

Sure, we are taxed super high in Canada, but holy hell, it is worth it if my child is treated so well in the hospital! I have nothing but the best things to say about our experience with CHEO and the fabulous doctors and nurses. Especially the nurses. They deserve an entire post, too. Am I too understand that there are children in the United States who get pneumonia but are not treated because their parents can't afford the insurance? Please tell me this is not the case!

What it comes down to is this - free health care = excellent. Everyone should have access to free health care, with quality doctors taking care of them, and no child should be left untreated. Every child deserves the same care. Absolutely.

It would not be harming anyone if we allowed a two-tiered health care system across Canada. I know there are private clinics in bordering provinces, and I'm thankful for that. We should be allowed to pay for a test if we want to. As long as the quality of care were to remain the same in our public hospitals.

Now, I'm not one to usually talk politics here on my blog, and please forgive me if I have any information wrong in this post. Feel free to correct me. I like to keep things light and happy on my blog, but this is an issue that weighs heavily on my mind, and I wanted to discuss it. I would love to hear your thoughts on health care, whether you live in Canada, the United States, or Europe. I am hoping everyone can be civilized with their comments, and although I have no problem with a heated debate, let's try to remember that everyone is entitled to their own opinions, okay?

Thanks!

35 comments:

OHmommy said...

Yay. I was patiently waiting for your response. It's fascinating to read an account of health care from across the border.

Very cool Loukia!

BTW. 40 million people are un-insured. Number is deceiving because nearly half of those are illegal citizens (like I was) and a small percentage of those are people whom qualify for Medicare but do not take advantage of it. So the number is actually lower. But people really like the ring of 40 million people are uninsured.

Does Canada insure illegal citizens w/o proper IDs? And I thought EVERYONE was insured. Why is there 5 percent that is not?

McMommy said...

I feel like I can have a tough heart on ALOT of things/subjects....but innocent children make my knees buckle...no matter what the cause or situation. Our children deserve every opportunity our country can afford to give them.

Nap Warden said...

In our state, one of the things our former Governor did was pass All Kids. This is a plan that insured "all kids". So, even though there are many adults without healthcare...at least their children have acess to quality medical care. No, it is not an answer...but it is certainly a start:)

Tiffany @ Lattes And Life said...

Just another reason I wish I was Canadian. One of many....

My experience when I was a Social Worker were the people on the fringe. They made too much to qualify for Medicaid for their kids (free healthcare, based on income). Yet they didn't make enough to be able to afford private insurance through their employers. So those families do indeed suffer. America really stinks at taking care of the Middle Class.

Lady Mama said...

I agree, I like the Canadian healthcare system a lot. I'm not sure I agree with you on the two-tiered system. I'm from England where that exact set up exists, and what happens is you end up having lots of wealthy people who can afford to get things done a lot sooner, and lots of doctors want to move into private practices, and eventually the public healthcare system begins to suffer.

What we have in Canada is a great system where everyone gets good attention in a reasonable timeframe. I guess I'm just not sure how the two-tiered system would really benefit Canadians.

Great post Loukia!

Annie @ PhD in Parenting said...

In general I agree with you Loukia. I think our health care system is great, I think there is some room for improvement, and I think there is room for a two-tiered system (I like the German system).

To answer OHmommy's question, all Canadian citizens have health coverage. Period. But that doesn't mean that they have adequate access to healthcare. There are some remote communities, for example, where the level of care may not be adequate. It is constantly a challenge to encourage doctors to settle in small communities. I imagine that same problem would exist in a private system too though.

With regards to immigrants...If someone is an illegal immigrant, then they probably don't have coverage. If someone is a legal immigrant, they get access to our universal healthcare. If someone is a temporary immigrant (student, temporary worker, etc.) I believe they need to make their own arrangements for private insurance.

Scattered Mom said...

Every year when we vacation to the USA we noticed that there is one question everyone asks us. This year it was about health care.

I had planned to write about it too-mind if I link to you?

Great Post! :)

Chandra said...

I sooo agree with you!

I don't know the numbers nor do I care..I just know that it's staggering the amount of people without health care int he US, even the ones who do have it such as my family...pay a hefty price for our premiums AND are still left with fairly big bills after we have met all our deductibles...that is if you are treated and not denied by BIG INSURANCE COMPANIES!
I am all for health care reform and wish on many levels I lived in Candada for that reason alone!

Amy said...

I'm not sure about the two-tiered system. Say you have 'X' amount of doctors all working in the public system, then you take 1/3-1/2 away to the private system (likely all of the BEST doctors), then you now have that many FEWER doctors in the public system. The private system would only be servicing a very small portion of the population (ie. those who can afford it), thus leaving a shortage of doctors in the public system.

Implementing another tier of healthcare would absolutely affect the public system. How could it not? Where will those extra doctors come from? Who will pick up the slack? There's ALREADY a shortage of medical professionals in most areas of Canada.

We need to find a way to fix/improve the system we already have -to EVERYONE'S benefit- rather than create a system that will only benefit a select few.

Sorry Lou. Love ya, but don't agree on this one.

Kami's Khlopchyk said...

This is a great post! Your take on the two tiered system is exactly how my FIL feels but I have always wondered about what Lady Mama said...would we be able to keep good doctors in the public system?

I love Canada and it's health care system (though not always) but it's far from perfect but I am quite happy to pay our taxes to keep it.

familytiesandgrowingpains said...

We live in New York and have to pay for healthcare through my hubby's job. And gosh it really puts a dent in his check.

cruncchy said...

yeah not happy about the two tier idea..it is not working in the UK.

And here it wouldn't either..we see already the lure of specialty medicine for gen practice for the glamour and cash...we need to encourage more docs to be gp's..and in less 'cool`' areas..we need country docs and better care in rural areas.

However..I have never had to wait or be denied a special test for anything..cancer scares, pregnancy, etc....but I live in a big city.

I love our system..flawed as it is...I can't imagine being faced with huge hosp bills insured or not..or being turned away or turned down.

How does that take care of your people.

I don't get the bitching about paying for others or the worry about illegals...it seems to miserly and greedy and I don't see how that mindset goes with national pride...

Neil said...

I think it was wonderful that you spoke politics on your blog. And at this point, health care is not really politics anymore. I think everyone -- no matter what political party or view -- agrees that something is wrong, and that there are good and bad points about being TOO public and being TOO private. The most important first step is making sure everyone gets some sort of basic care.

ModernMom said...

Oh Hot Topic. Always has been. I'm always thankful that as a Canadian I don't have to think twice about taking my babe to the peditrician, or that I will not be charged for an ER visit. Down side, many of our talented Doctors are going to the US to work, wait time for minor things like ultrasounds can be months, even surgery waiting lists are ridiculous. Scary even. My Dad waited 6 months for prostate cancer surgery. No system is perfect, but at least here in Canada we are all treated equally. (Unless you are realted to a Doctor...then you are gold lol)

Maria @BOREDmommy said...
This comment has been removed by a blog administrator.
Wendy@RuensOnTheRun said...

Great post - I find it very interesting to read your viewpoint as a Canadian on health care.

Krystyn said...

I think we do need a change. Is nationalized health care the answer? I don't know. However, the current plan? I don't think it will work.

CaraBee said...

Just to clarify, as OHmommy did, the number of people who are actually uninsured, counting out the illegals and those that can get it but opt not to (like I did in my twenties), the number is actually estimated to be more in the range of 10-12 million. Which is still a lot of people but that is only 3% of our population. You say 5% of yours don't get care, so how is that different?

IMO, we need to fix the programs we already have in place, like Medicare (which Obama and Co just cut funding for, does that make sense to you?) and Medicaid, not to mention SCHIP (that's the children's program). Fix and expand what we already have. Cut back on the BILLIONS of dollars in fraud and waste with those programs and we could afford to cover more people with it.

Remember that we are 10 times the size of Canada and you guys can't even get it right. We already pay for medical care for more people (approx. 50 mil) than your entire population and then some. I just haven't seen any evidence that our gov't, that is mired in bureaucracy and inefficiency, can possibly run a program of this scale.

Elisa said...

Switzerland has a two-tiered health care system. There is no free healthcare, but insurance is mandatory. It is, however, taken into account in one's salary. And there are many different types of insurance, for different budgets. The quality of health care, however, is excellent no matter which insurance you have. With th lowest one you simply don't have access to private clinics unless you pay out of pocket.

Every single experience I have had here has been excellent, and it is my beliefs that Switzerland has the best health care in the world, at least compared to the placed I've lived in: Italy, Scandinavia, the US. And every other expats I've met (who is a Swiss resident) said the same.

I don't think the health bill for the US is quite the same as what is already in place in Canada or Italy. The proposed US bill is NOT good. It violates privacy, it violates freedom of choice and it is unfair, because congress gets a different treatment.

It is possibly one of the worst ideas ever IMO.

Anonymous said...

Don't agree with 2 tiered healthcare but do agree with some sort of user fee for patients in Canada. I work in a Dr's office and can't believe the number of calls we get for ridiculous things. Today a family had lice and wanted to see the DR!!You can be damn sure that if they had to pay a small user fee for this appt they would think twice about coming in to see him for something so ridiculous.

Canada also has A LOT of fraud in relation to their healthcards. It is quite sad.

Grant said...

CaraBee:

You're a little (ok, a LOT) off in much of what you said.

First, a lot of those people you're talking about that "opt" not to get insurance in the US are "opting" to be able to feed and cloth their families and pay their rent and make their car payments instead. This gets called a "choice" not to have insurance based on some right wing policy analyst declaring that they could technically afford insurance if they really really wanted it, as an excuse not to count them as *really* being uninsured (even though they are) and make the statistics look less horrible and justify their obstruction of reform.

On top of that, there are tens of millions more people on top of the uninsured in the US who have what is frankly totally inadequate health insurance that will leave them financially ruined in the event of any serious, expensive illness. And many of them don't even know it because that little fact is buried in the fine print on page 47, paragraph 6, sub-section 13a of their insurance policies. Which is why something like 75% of people in the US who reported that medical bills contributed to their bankruptcy filings last year HAD insurance but went bankrupt anyway. That simply does not happen in Canada.

That's how it's different.

And the US being ten times the size of Canada is a *good* thing when it comes to insurance. Insurance works *better* in large populations where it is able to more efficiently pool and mitigate risk. But instead of taking advantage of this by creating a very large single payer insurance entity that could do something with that the US instead carves their population into thousands of penny packet segments serviced by hundreds of private for profit insurers gouging each and every one of them with ridiculous premium payments for mostly sub-par coverage.

That's assuming you haven't been rendered effectively uninsurable for having committed the heinous crime of getting seriously sick before you bought insurance ("a.k.a, possess a "pre-existing condition")... or having gotten sick when you HAD insurance but then lost it (good luck getting a new plan). Not to mention that would also make you highly unemployable to any employer with a company provided health insurance group plan since their insurance provider would jack up the rate for the entire company if they hired a known sick person.

That's also how it's different.

Oh, and the bankrupting the nation with completely out of control costs thing. That's a difference too.

Clear things up?

Crystal D said...

Excellent Post! I agree with you, America needs to follow in the footsteps of Canada.
Sure it is less then 40 million if you don't count everyone.... but hello... EVERYONE should be covered who is here.

BeachMama said...

Great post Loukia.

I am not sure how I stand on the two-tiered part only because I fear that the good Doctors will all be too expensive, and the not so good ones will be left in the public system. But, if it worked well, then I would be happy because like you, I would be willing to pay to avoid waiting a long time.

As for health care being 'free', I just want to clarify for the US readers that it isn't technically 'free' we do pay for it through our taxes. And it isn't cheap, at one time you had to pay for it up front and get reimbursed for it with your taxes, but they just rolled it all together now. I'd still take that any day over what is available in the US, I would not want to have to pay to go to Emerg.

Lesley said...

You know, so many people are only focusing on uninsured. I personally am more interested in the under-insured issues. Most of my family (and in-laws) are self-employed and can never obtain (AT ANY COST) good coverage. They have insurance and pay dearly for it, but they are always scared to death of losing it.

Also, I cannot get a private insurance policy for my son because he had a stroke when he was born. My husband would love to start up his own private practice, but we can't do it.

I recently learned when talking with my professional friend (architect) and she cannot get private insurance AT ANY COST that will cover any sort of maternity coverage.

Lastly, I know a lot of people are worried about the big taxes on businesses, etc. But, I think we're already paying through the nose, but it's not as transparent. Our family policy costs about $18000 a year (family of 3) through our employer policy. Fortunately, the employer picks up about $15K for that (and I did not even pick the most expensive policy). The coverage is great, but I just don't think it's sustainable for employers to operate that way.

I do have several primary medicine doc friends. They are working themselves to the bones because of the insurance payment structures. They are getting the short end of the stick, also. So much of their practice is devoted to haggling with insurance companies instead of treating patients.

Sorry for the long comment, but I wish their was a bit more discussion on the barely insured, underinsured & scared of losing insured populations.

Sara @ Domestically Challenged said...

Very well said. I don't know much about Canada's health care, but I do know it can be bad here in the US. I see a sign EVERY.STINKIN.DAY for a person {or 3} who are having a benefit because they are injured, sick, ect, and can't afford their medical bills. It is sad, that we have to be responsible for helping them rather than everyone getting the care they deserve.

Loukia said...

Thank you all for your well-thought out comments. It's clearly an issue we all care about! I appreciate the feedback, and your thoughts, so much. If WE all worked together, I bet we'd eventually come up with a perfect plan, or close to it!

Anonymous said...

Do we need some changes in our healthcare system? Yes. Does our government who has nearly bankrupted social security and any other program that is funded with our tax dollars need to run healthcare? No. Please name one thing our government has had a hand in that runs effeciently. By the way that's a trick question there isn't anything. Beleive me I worked a govt. job for 6 1/2 years and it was sickening to see the waste. And by the way nobody in this country goes without being seen by a doctor right now anyway. That's why our emergency rooms our full of people who have colds. And I don't understand how national pride has anything to do with letting people take advantage of you or your country. And if this plan and our social security is such a great plan, why are our congressmen not on the same plan.

Maria @BOREDmommy said...

I'm against the two-tier system too. I completely agree with Amy on this one - we need to work on the system we have to make it better. I believe introducing a two-tier system would only damage our current health care situation.

Shannon @ AnchorMommy said...

I just sat down with my husband and an insurance agent today to try to decide how my son and I should be insured now that we are no longer on my employer's insurance. Do we join my husband's company's plan, or go with individual insurance for half the monthly cost? Of course there's all the co-pays, deductibles, and co-pays AFTER the deductibles to consider....it makes a person's head spin.

It is a nightmare to try to budget for 'maybe' or 'what if.' In fact, it makes me angry. AMERICAN HEALTHCARE IS BROKEN and I am so jealous of countries like Canada that at least TRY to make things work for the majority of the population. Even if it's not perfect, at least most people don't have to choose between paying for food and paying for medicine.

Thank you for this post, Loukia. It is nice, as an American, to hear a Canadian perspective on the issue as the U.S. tries to muddle through some type of national health care agreement. I should get back to co-pay comparisons now. :-(

truemommy said...

I haven't completely decided how I feel about Obama's choice for a government run healthcare system. I would like to think that it would be great to give everyone access to a medical doctor without any fees (especially children) but it also worries me about the speed to get into the doctor as well as the quality of the care.

I personally wouldn't want to go to school for 10+ years and not get paid enough to repay my loans.

You are the first (as well as your commentors) Canadian I know who hasn't complained about the healthcare system there. Many of my friends have come from Canada and one of the main reasons was because they were not satisfied with their healthcare.

I do not work, and we were originally going to pay for me to be a part of my husband's company's plan. We ended up setting my daughter and myself onto a Health Savings Account and an Individual Healthcare Plan. It was WAY cheaper (only about $100/month for both of us) and we had saved enough in our bank account that if something tragic were to come along, we wouldn't be bankrupt. In fact, we contributed the maximum amount to our HSA last year and it has almost completely met what our maximum out of pocket would be if we had a disaster happen.

With that said, I do believe something needs to be done, I am just very unsure of the style of healthcare that is in Canada.

daddy bookins said...

I am completely for a Nationalized Health Care system, in addition to the option of having private insurance. Here in the states, it is brutal, insurance bruhhaha, we have what is pretty much fantastic insurance....quite frankly it sucks! It is a constant battle, dealing with the insurance companies. I have my rants, beginning back when lil boo was born...I'll stop there.

Here is what I want to know....You have massage therapy coverage????? That is freakin' awesome!!! :o)

Cheers!
~daddy b

Elaine A. said...

I don't know what the solution is (boy do I wish I did!) but I definitely think a plan closer to what you all have in Canada would work better for us. At least that's what my gut tells me.

We (meaning my family) do fine because my husband has a good job and good insurance so we are "sitting pretty" so to speak. And, there are parts of the plan that is being proposed that I DO NOT like or agree with. However, I cannot imagine not having the money to make sure my sick children were taken care of and like you, I hate to see other people's children (and them for that matter) have to suffer because they cannot afford it.

Again, I SO wish I had the answer and I pray that as a country, we can come to a conclusion that will work for all.

andrea from the fishbowl said...

I think we have a good system here in Canada. I've heard a lot of scary stories about the US health care system. Have you seen the Sicko by Michael Moore? If you haven't you should!

As someone mentioned before, I do worry about two-tier health care. What's to prevent the best doctors going after the money and migrating out of the "regular" health care system? I don't trust that that won't happen.

Jenn said...

Great post Loulou, lots of interesting opinions.

I agree with some of the other posters in that I don't think a two tiered system is the best. I don't think that just because you have the money your healthcare should be any different.

I also work in healthcare and like the idea of having a fee to go to your doctor and to go to the emergency room. There could be something in place for people who can't afford it. But a doctors visit costs the Healthcare system 50 dollars and a visit to the emergency room costs approx. 500$. I see many people who visit the emergency when it's not really an emergency. I wonder if a fee would help to avoid that.

Jenn

Anonymous said...

yoo... good thoughts ))

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