A question for Candadians and UK folks and the Universal Healthcare

[Dar]

What you need to remember is each province handles health care differently..

A friend of mine in Alberta.. she has to pay a monthly fee for her health care.. it is minimal but its still a fee

I am in Ontario and pay NO monthly fees, no deductible, no co-pays ect.... On the care I receive .. on meds when not in hospital are different.. meds in hospital are covered on our health plan.

If my doctor orders it, it gets done!... I was REALLY sick when I was pregnant with my daughter 8 years ago.. now I am having stomach issues and other bowel related issues. My doc ordered a whole battery of tests and scans and they are ALL covered. My wait time... I need an abdominal ultrasound with contrast .. wait time was 3 days, blood work was done the same day and results were the next day

another issue I am having is a sore foot... pulled all the muscles in my foot and it wont heal... Dr. Ordered an MRI... I had to wait 4 weeks.. but remember I was wayyyy down on the priority list too .. and no insurance company had to approve the cost of the MRI.. I need it I got it!

 

[eggbuster]

In Canada there is a chronic shortage of doctors which has become the limiting factor. 15 years ago, health care was absolutely unbelievable, great, but due to government mismanagement and robbing Peter to pay Paul ( who many suspect is a politician ) they have truly messed up a great institution. That being said I lived in Texas for 2 years a while back and I wouldn't trade our currant crappy state of affairs for what passes in the US. No one in Canada goes bankrupt or in debt because someone in the family has a booboo nor does anyone not get medical treatment because they are not one of the lucky to be insured, are unemployed or any number of other reasons. I have recently returned to Canada and am one of the ones that cannot find a family doctor. This means that should something occur, I must go to ER get triaged and wait my turn. Not nice but when something is seriously wrong its straight to the head of the line. This is also why you see people in ER that don't belong there. Simple solution; train more doctors but that is something they don't want to do because then they would have to pay them. Again your government at work; must keep money where it belongs; in their pocket. Fiscal responsibility died long before universal health care.

When a friend had a farm accident in Texas and broke the fingers on one hand, I took her to the hospital over her not dead body, and found out why she didn't want to go. She didn't have insurance and they pretended to look at her for legal purposes and then cut her loose without treatment. I ended up setting her fingers out in the parking lot and buying splints at the pharmacy because it wasn't classified as an emergency which is the only time they can't deny treatment. Totally ridiculous.

Some ex-pat friends of ours figured out that even with our high taxes they actually spent less money to live because they didn't have to factor in things like health insurance and drugs. No, our system is far from perfect and its getting worse every day, but a civilized society should not balk at helping those less fortunate even with the risk that some are frauds. Its only money and we place far too much value on it. I have a good life, I do not care to think of how easily that could change. If it does I know where I want to be.

 

[Dar]

Quote:
hey eggbuster... depending on where you are there are doctors referral services offered by the local health unit... its not very well publicized but when new doctors are coming to town the health unit usually knows a few weeks ahead of time.. this is how I found mine

 

[True Grit]

I'm a Cdn expat in the US.This is a little off topic and venting. I'll remove it if you wish. I've been employed with the same large corporation for 33 years. When I was in Canada I paid about $35 per month for just myself(16 yrs ago). Now I pay $260 for myself and step daughter with full coverage except for $20 copays, $150 for emergency if you don't stay overnight. DH has his own coverage. This enrollment period the company has taken the opportunity to put us on a $3000 deductible, 80% coverage capped at $4500. I really feel sorry for some of our employees who have chronic conditions as they have now just taken a $375 per month hit in the paycheck. We can contribute to an HSA on a b4 tax basis I believe but still, it is a car payment. I am ashamed of my employer for doing this. They are self insured and covering 26 year olds is gg to cost them next to nothing. Whenever they make these changes they say it is to help them remain competitive. They make BILLIONS of dollars. Sucks. If I had to pay more to help cover those who can't afford health care coverage I wouldn't mind; I plan on paying more in taxes to do so. I would like to see the P/L the company has on health coverage. Whoever came up with this scheme just got themselves a big fat promotion and bonus on the backs of a bunch of ee's that can't afford to quit. Diabolical too, as they will let people blame health care reform...

 

[PineappleMama]

EweSheep I've never seen a man, or non-preggers female, able to be on Medicaid... kids yes, preggers females (and for one month after delivery) yes... assuming you pass all the income criteria... but never seen a man on it... is that an Illinois Medicaid thing?

The latest person I know of to be on Medicaid is Sis... she was covered through her pregnancy, as were her kiddos (already here) and the baby is auto enrolled for the first month... then you have to update your stuff... baby is added, mom is taken off. But NEVER was Baby's Unemployed Daddy ever on the list...

I know there's got to be differences between states on this, there is on everything else so maybe that's that... or heck maybe they've changed things since Sis last applied, wouldn't surprise me.

But down here, as I understand it, Medicaid is in place to help CHILDREN (born or not)... adults are on their own... pay their own, have private, go to sliding scale clinics, and/or apply through systems like JPS... of course JPS is even harder to get into, they want tax returns and all sorts of stuff... years worth of income, not just a months' worth of pay stubs. Seems like maybe that would prevent people from cheating it in one way I've seen done... claiming your SO left, no income, etc when the guy is still totally living with you and working full time... easiest way I've ever seen of getting stamps, medicaid etc... meh, that's another topic... only mentioned to show how convoluted even the Medicaid system is...

And then there's CHIPS, a state children's insurance plan... obviously kids only... if you make a bit too much for Medicaid then they'll refer you to CHIPS... Last I Heard (some time ago) maximum premium is $18... you track co pays and such and once you hit... what maybe $200??? then you don't have to pay any more... they'll send you books for the 2-3 plans they offer and you pick one and a PCP from that plan book... then they tell you whether you actually get that doc or not, and if not they just assign you one... at one point we applied for this... that was June... finally got a card (HAVE to have to see a doc) Nov 20th or so, call the Doc (not the Arlington one we asked for, or any of the other 100's of Arl. ones, nope we had to go to Grand Prarie!) and the first Well Check Appointment that was available was Dec 19th or so "We'll Take It!"... Dec 1 get a notice that I must send in paystubs for renewal, did that. 7th get a notice saying they didn't get the stubs (mail) so I called and then FAXED them over... Dec 14th get a notice that our service is cancelled because I refused to send in renewal info. Had to call the Doc and cancel the appointment for next week. So, your application is valid for 6 months or less, and if you don't renew than they cancel what's left of that 6 months, and they delay sending you your card/Doc's name so long that you never do actually get to see the Doc before you are dumped. Wasting a LOT of time, gas money, and all you get in return is a giant dose of frustration. And THAT was our one and only experience with Texas CHIPS.

I haven't known anyone else locally who's messed with it... they either have regular insurance or medicaid for their kiddos... so if anyone has a tale of that one actually working I'd love to hear it.

 

[BlackBart]

Quote:
My Brother lived in Ontario and really liked the Medical and Car insurance there.
You probably pay extra in taxes. I would rather pay extra in taxes than per month. My Husband's company pays for the Medical and half the Dental plan. I think we pay $40 per month for Dental/Eye care/Extended.
A individual here in BC pays just under $40 per month. If you are on low income it is less, if you are on Welfare or at poverty level it is free. If you are a refugee, it is free. If you are poverty, low income, refugee, all meds are paid for.
No deductible, no co-pay etc. We do have to pay for a ambulance ride if it is non-life threatening

but it is cheap. We do not have to pay for life flight.
Delivery of babies is free. I think the Quebec Government was paying their residents to have children

We used to have to pay a fee per day for the hospital room but it was cheap too, but not anymore. Don't know why the scrapped that.

You do have to pay for elective non life threatening cosmetic surgery, face lifts etc..

My Mother pays $16 per day for homemakers to come to her home and assist her with personal care. Homemakers are paid by the government and a way for the elderly to remain in their home and maintain a quality of life. The fee is based on your taxable income (combined income if your spouse is alive) up to a maximum.

A friend of mine had AIDS. He was sent monthly to a mainland hospital for a special complicated, expensive, treatment. It was all free, even transportation to get there. Unfortunately he passed away from the illness.

 

[HeatherLynn]

Quote:
Many just wonder why we should HAVE to accept plain but excellent. I personally do not believe the excellent part. I have had 2 relatives die under state funded medicine in Austria. Needlessly died and I am not a forgiving person.

But again to the question why should we have to accept a change we do not want? I have excellent health care. I personally love my insurance. Do I trust them with my life. Heck no but I don't trust the government with it either. Heck I only trust them with my tax money because I have no choice. There are other alternatives that can make health care much more affordable and available.

If we were to make changes like limiting the cost of malpractice lawsuits, expanding the authority of nurses to relieve shortage situations, getting rid of limitations on states offering group health insurance ( yes currently there is so much regulation that an easy and much more affordable fix for most self employed is not available. I learned that one when I became licensed to sell insurance and had to take the health insurance course), making changes to life time limits and pre existing conditions requirements allowed to insurance companies. So many things we can do to make an already working system work so much better. Instead we choose to put together a mishmosh that no one understands, the government might not be able to afford, and most Americans do not want. There are some who would love insurance that cannot afford it and I understand that and we have systems for them to get the help they need, it may just need to be expanded a bit. We also have some who would rather save their money on health insurance premiums and then whine when they have to go. ( I have a relative like that much to my dismay) Those who can afford it I do not feel sorry for. They can be responsible like the rest of us have to be. There are simple fixes to those who are shut out that should be and can be dealt with.

How would you fund the needs of poorly paid people, the unemployed, the disabled and the chronically and terminally ill. They are all groups of people who probably cannot afford insurance and, if you were to make it easier for insurers to cancel and restrict cover, many would not be able to buy it at any price.

Here's my view on health care provision. I worked for 44 years in insurance and saw it all. Health care funding is such a vital right in a civiised society that it should not be left in the hands of private insurers, private hospitals or private doctors. I don't advocate State run businesses in general but I would rather my health care be in the hands of a body that is controlled by democratically elected representatives than some guy who has an eye on profit and bonus. Private insurers have to make profits for their shareholders and sympathy for the poor, sock and elderly is way down their list of priories.

There are already plans through most states that cover those who absolutely even with cheaper costs cannot afford health insurance. My entire family, including the hubby had to be on one of these for 6 months while both of us were back in school. If you look at group health insurance though you can see a really easy way to lower premiums for so many. There have been in the past there have been efforts to create a state group health insurance. All this means is that they get a group rate not that the state controls this or pays for it. It could go by region or state. The state does not pay for any of that unless there is a system to supplement those who have an income so low they cannot afford the entire premium and income so high they can not get on fully funded state or federal run plans. Its just a way to offer that same benefit to those who are not in a situation where they can benefit from the cost cuts being in a group plan can offer. Currently this is not possible because of regulation in the health insurance industry. Those regulations of course set up by the government. So instead of someone paying 800 for a private insurance plan if something like this were allowed they could join the " Kentucky State group insurance plan" ( for example) and pay $400 instead. Where 800 is hard from some to swallow just doing away with limitations on starting group plans could offer significant benefits to the public. These are not state or federally run. It is still private insurance but cheaper and it is unavailable right now because of regulations that do nothing to protect us but are keeping health care costs up. Its just a way to get the same benefits a business would for private insurance.

 

[PineappleMama]

Well, and also I have feelings on the whole insurance idea.... used to it was a "whole village to raise a child" sort of thing... everyone chipped in so anyone could have help if needed... but that's not really how it is now. Basically it's gambling... the people are betting that they WILL get sick, big expensive sick, and so they NEED insurance... and the Insurance company is betting that they won't, or if they do that it's a small enough percentage that they still make a huge profit overall. For those that do get cancer, AIDS, the biggies, then yeah you get (assuming the company actually shells out) your investment back... but those that don't just pay out the nose for a little card.

As I said before, for ME to be covered, it'd be $400/month... or 4800/yr...

If I don't get sick, just get an annual check up with a $20 or so Co Pay... than I've paid in $4820.00 for one checkup.

Last time I DID get sick, no insurance, I went to Care Now (described before)... I had an Upper Resp Infection, Ear Infection, Sinus Infection and my tonsils were the size of golf balls so couldn't really swallow... (went up to Arkansas without any allergy meds and sure enough those pine/cedars did me in) ANYWHO... the office fee was $90... They did NOT run a strep test, wasting money, instead they gave me a script for an antibiotic that would work whether I had strep or not... I had a shot of steroids (lower the tonsils so I could swallow) and antibiotics (to get started) and then I was given a script for pill antibiotics and liquid novacaine (again help with swallowing)... this was well before they started in with those $4-10 scripts at Wally, Kroger, etc... all told, Dr and Scripts cost me roughly $350... that was my total health care spending for the year $350.00

Had I had insurance then I'd have gone to my PCP, IF the office was open and they didn't send me to the ER... as sick as I was that's entirely possible. ER deductible I think was $50. That covers being seen, but doesn't cover treatments... those bring in the deductible... until I had paid for $2000 worth of stuff the insurance didn't pay for anything... so the bills for those shots would come to me, and there's the Co Pay for scripts... that does help... $10-20each... and that's on top of the $4800/yr I've already paid in to have health care...

Overall, for a normally healthy person, no catastrophes it's cheaper to just pay for your own... at least from my actual experiences it is. The only time it pays to have insurance is if you're in a wreck, cancer, etc... then you pay your 4800, and reach your 2000 deductible and THEN the insurance kicks in and pays... sometimes 100%, sometimes 90%... depends on the plan.

Health Insurance is just not run the same way as car or home insurance... in those it only kicks in in a catastrophe... flood, wreck, tornado... etc. You take care of the day to day... oil changes, light bulbs, lawn work... but IF you get smashed THEN insurance kicks in. That's why home and auto insurance is so much less than health, one reason anyways.

If we could find a plan of Health Insurance that did that, I'd buy it... we'd have the security of knowing if 'the worst' should happen then we'd be okay... but we'd also have our local doc/clinic for checkups, colds, immunizations at a reasonable rate WHEN WE NEED THEM... don't pay if you don't get sick...

Why can't a company step up and offer something like that? It seems like it'd make a WHOLE lot of sense. Heck even a government plan like that... that paid for cancer treatments for ANYONE... so that you don't lose your house... that would be great... peace of mind, for a LOT less.. maybe I'm missing something but it seems like that would be a logical and less costly solution to a lot of the problems.

Everyone thinks, and politicians and ins companies encourage that fear based thinking, that you HAVE to have insurance or you're dead, your babies are dead, your spouse is dead... scare the crap out of you and make you feel you HAVE to pay out the nose even when you don't get anything out of it... but I just don't think that's true. Not based on the numbers I've personally experienced. Again, that's regular healthy person, now and then sick, but nothing huge... for folks like that it just does NOT pay to have insurance... not how it's written now... for them that "Health Disaster Insurance" idea would be awesome.

Does that make ANY sense or did I just type a bunch of jibberish?

 

[Dunkopf]

Actually you make a lot of sense. If you are a healthy person and you have a good gene pool. If you are not healthy or there is a gene in your DNA that all the sudden jumps out and say "Honey I'm home then you can be in a world of hurt. My sister is 53 and takes great care of herself. She does a good cardio workout for 1 hr every day. Watches everything she eats. Stays away from processed foods, yada yada yada. When she was 47 she got breast cancer. It was in stage 2 if I have the terminology correct. She had quite a bit of muscle removed and part of her right breast. She did the chemo and was miserable for about 2 years. She has a nice house and about 150k in the bank plus a 401k. If she didn't have health insurance she would have been wiped out. She would have kept the house but the savings would have been gone. Her insurance paid out over 300k. No she would not have been able to negotiate a better price. Insurance companies already get the best prices out there.

If you don't really have much it's not a real big deal financially. The only thing you have to lose is your life or your health. Contrary to what a lot of people think, the hospital is not required to get you back to original specs. They stabilize you and if you need further care to stay alive they send you to the welfare hospital. So someone with cancer will be given some morphine for the pain and that's it. If you smash your hip they'll do the best they can to screw it back together and you will be crippled the rest of your life.

The people that are gambling are those that don't have health insurance. I sure can't blame anyone though. If you don't have it as a benefit where your employer pays at least 50% of the premium then it's something most people just can't afford. Personally I would rather see Uncle Sam spending money on health insurance for all than the billions they are wasting in the Mideast.

If everyone contributed to a national health plan the cost would be spread out and everyone would pay less. Yes people that feel they don't need it would also have to pay. Have you ever had a car accident? Quite often one accident will cost more than you paid in premiums for at least 3 years. That's just a fender bender.

If you end up with something that can be helped with a non generic prescription, you will pay out the nose. I used to take some expensive prescriptions. I still take Crestor to keep my cholesterol down. That stuff used to be 473.00 per month. I paid 40.00 copay. It is now available generic. Still cost the insurance company 275.00 a month. My copay is now 10.00 a month because it's generic. Prevacid was the same way and my stomach pumps gobs of acid for anything except baby food. Now it's available generic but is still in the 175.00 range.

In my opinion cradle to grace health coverage is the only way. That way it's fair for all. Nobody knows what cards nature dealt you when you're born. Some people eat bad food and smoke all their life and never get sick. You can do everything right and still get sick. I love America, but the social conscious in this country is very poor.

JMO

 

[eggbuster]

Dar

I live near Stirling Ontario. I know about the referral but they are wait listed in this area. About 350 people or so. I have been waiting 3 yrs. If I needed medical care I would have to go to the ER in Belleville or Campbellford. My son in Toronto has no problem getting fixed but in rural areas its different.