Canada vs. U.S.

Several days ago the U.S. women's water polo team defeated the Canadian women's water polo team by one point in a very exciting and obviously close game. Imagine the chit-chat at Danielle's water polo practice after that game. We hear daily chatter about Canada vs the U.S., including the usual sports competitions, daily dollar comparison and of course....health care. It's interesting to be on this side of the border during the U.S. health care debate and other U.S. news like the government spending. We do get all the U.S. news stations by the way -- unfortunately, oops, we mean, including Fox News -- so we're up to speed on the debate on television from the fair and balanced U.S. media. However, we also enjoy the news perspective from some of the Canadian comedy shows like This Hour has 22 Minutes on CBC.

In talking with several Canadians and Europeans, they don't understand why the U.S. does not have a universal health care plan. Kish was recently at a doctor's office for a routine visit and he summed it up..."the Canadian system is great if you are healthy, not the best of you are a little sick, but very good if you are really sick. You're not going to lose your home if you can't pay your medical bills, because you don't have to worry about that."

A neighbor's daughter recently had an emergency surgery. The daughter has a seven week old baby at home and had some non-birth related complications. After a day of testing, surgery and a night of post-op in hospital (Canadians don't add "the" before hospital, it's just "hospital"), she was released and sent home to focus on healing and taking care of her baby. She won't be getting EOBs, co-pay notices, deductible calculations, bills, calls and collection notices for her procedure, because she won't be getting any bills. Everything is covered under her Medicare.

Yes, most Canadians do have an additional coverage plan through an employer. And yes, you can also talk to Canadians with horror stories about medical care in Canada. As with any issue, not everyone is going to be happy. Everyone knows that non-emergency procedures may take longer and there may be waiting lists. That's where the "little sick" part comes in. Canadians who can afford it can pay for a procedure to take place sooner, yes. So in that respect, it's still a two-tier system in Canada, despite what the media and Michael Moore may portray.

Our experience in the last almost 11 months has been fine. No complaints here. In fact, it's been the easiest medical experience our our married/child raising years. Before finding doctors we did make a trip or to to the "clinic" with our Medicare cards in hand. Did we wait? Yes, one time for four hours. Was it acceptable? Yes, there were people in the clinic with more severe illnesses and they did warrant getting to see the doctor sooner. We accept that, and we've waited that long in a U.S. emergency room in the past. This winter, Kish took Louis into the clinic for a sinus infection and casually mentioned that he also has asthma and was complaining that his chest hurt. He was seen in the clinic within minutes.

We do have peace of mind and far less paperwork. We simply hand over our Medicare card at each visit and don't pay anything unless a procedure is not covered by Medicare. Yes, there are things not covered -- like local anesthetic if you have a skin sample removed at the dermatologist. If you want it numbed, you pay the $20 or use private insurance. In our case, because we have the extra insurance, we simply pay the bill, submit it to the insurance company and get reimbursed. It's so much easier and cuts down on the piles of EOBs and bills. There are no co-pays or deductibles. Oh, vaccinations are free if you go to the clinic or have them done at school like we used to do as kids. If you don't want to go to the clinic, simply pay extra at the doctor's office. There's talk of vaccinating everyone in Canada for H1N1 this fall --all covered by the government. That said, we do understand it's easier to manage government health care for the 33 million people in Canada as opposed to the population (documented) in the U.S. We also admit that thankfully, we have not had to endure a catastrophic illness in Canada so we don't have any personal experience and hopefully will not be able to elaborate on that topic. We only know what we know from talking to the Canadians we have met along the way. As Kish's doctor brother recently said, "comparing the U.S. and Canadian medical systems is like comparing apples and kiwis." He's right, there are millions less people in Canada. Canadians are used to higher taxes. And the medical system, while it has gone through revisions, has been around for a while. No system is perfect. We're just saying that for now, we're happy with our universal health care system in Canada.

Do we pay higher taxes even though we are Americans in Canada? Yup. A lot more. We pay the same rate as any other Canadian family. But we are finding at the end of the year it all balances out. We do get a lot in return from a medical perspective. Plus, if we live here long enough Danielle could go to a top-notch university for about $3,000 a year. We're finding Canadians tolerate high taxes and for the most part admit that they do get a lot more in return. The roads and highways may not be the best, but most health care is covered, college is affordable and we have yet to mention the family benefits like child fitness tax credits, one year maternity leave for moms, several months for dads, paid leave for taking care of an elderly parent -- and $7 a day daycare.

Following is an interesting article appeared in the Montreal Gazette on August 3 on the Canada vs. U.S. health care debate -- from a Canadian perspective.

The Bluffer's Guide

Everything you need to know for a dinner conversation about ... Public health care: Canada vs. United States

COMPILED BY STEVE FAGUY, CANWEST NEWS SERVICE; THE WHITE HOUSE; ORGANIZATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT; CATO INSTITUTEAUGUST 3, 2009


So, what's going on? Canada is denying health care to its elderly and sending them out on ice floes to die because they're too expensive to treat.

Seriously? No, but that's what some Americans are starting to believe after the scare tactics in TV ads.

Why on Earth would they spread such awful stories about Canada? Because they don't want our health care system in the United States.

Why not? Because such a system would disrupt the profits of the giant health insurance industry. So their lobbyists are launching television campaigns and meeting with lawmakers to get proposed health care reform law changed.

So it's all about greed? Not entirely. One worry is that in a government-run system, eventual cost-cutting will reduce the quality of care, without leaving people the choice of going to another provider. This argument has some logic behind it, looking at cuts to health care in Canada in the 1990s.

So Americans don't really want Canadian-style health care. That's not even what they're proposing. What President Barack Obama and the Democratic Party have put forward is a health reform package that has the following major points: preventing health insurance companies from denying coverage to people who have pre-existing medical conditions; forcing all Americans to be insured (which prevents them from gaming the system by only getting insurance after they get sick); saving money through preventive care and by digitizing medical files, among other things; allowing people to keep their employer's health insurance plans even after they lose their jobs; and creating a government-run insurance provider to compete with private providers. It's still a big step from that to Canadian-style single-payer plan, where it's illegal to have private insurance for health care covered under the public plan.

Well, it was illegal, anyway. That's true. Jacques Chaoulli got the Supreme Court of Canada to rule that preventing a private insurance system violated the rights of patients to receive proper medical care without excessive delays.

So what does the industry have against the Obama plan? Conservative think tanks like the Cato Institute say a government-run health insurance system would compete unfairly with private health insurers because it would be funded by taxpayers. They agree that reforms are needed, but want ones that push for individual health insurance instead of employer-provided insurance, and that provide more tax incentives for people to get health insurance plans.

What do ordinary Americans think? A recent poll from CBS and the New York Times showed that 72 per cent of Americans support a public health care plan alongside the private health insurance system.

And doctors? Physicians for a National Health Program represents 14,000 health workers and supports universal health care.

That's a lot. What has the industry been saying about us to change their minds? More like what have we been saying about us. A group called Patients United Now uses Shona Holmes of Waterdown, Ont., in a television ad. Holmes remortgaged her home so she could spend $100,000 to get a growth near her pituitary gland treated at the Mayo Clinic. The alternative would have been months on a waiting list in Canada.

Is this kind of thing common? Common enough that they've given it a name: medical tourism. But it actually happens in both directions. Americans come across to Canada mainly to save money (they still have to pay for care here, but in many cases it's less than what they'd pay at home without insurance), while Canadians with money to spare travel to the U.S. to avoid long waits for surgery.

Sounds like Canadian health care isn't as good as in the U.S. Depends on how you look at it. Proponents of universal health care point to statistics like average life expectancy and infant mortality, which show Canada and other Western countries slightly ahead of the United States.

But that's because we spend more on health care than they do. Actually, it's the opposite. The United States spends almost twice per capita on health care than Canada, and more than any other Western country.

So how is the U.S. system better than ours? Well, they have more stuff. The U.S. has more expensive MRI and CT scanning machines, and they pay their doctors more, which has resulted in a brain drain from Canada to the U.S., and chronic labour shortages north of the border.

Is that why they say we can't choose our own doctor? It's a common claim, but nothing prevents Canadians from getting a second opinion or choosing their family doctor, assuming they can find one. A lack of general practitioners is a big problem here.

So they don't ration care here? Well, we certainly don't leave our seniors to die. But you could argue that long waiting lists for non-urgent treatment constitute a form of care rationing.

Open-ended discussion question: If you took the best of both worlds, what kind of health care system would you have?
© Copyright (c) The Montreal Gazette