Reality of Canadian health care

With the flubbed registration website for Obamacare front and center, I've been reading many discussions about health care and in some of those, the subject of Canadian health care often comes up. So I thought it might be helpful to review how Canadian health care actually works and what it's like compared to American health care.

First of all, it's important to realize that health care in Canada is a provincial matter, the federal government plays only a minor role (in sharing funding of research, mostly). The enabling legislation for subsidized health care was passed by the federal government in the 1960s but delivery and funding are provincial responsibilities.

Where I live (British Columbia) we are billed directly for participation in the plan. The highest monthly premiums for people of middle-income or higher means would be in the order of $121 a month or $1450 a year. You can get reduced premiums tied to lower incomes.

In all the other provinces, health care premiums were abolished where they ever existed and the revenues come directly out of provincial income taxes.

The typical Canadian tax rates for middle income earners would be around 25% for federal income taxes and 10% for provincial (it's lower in my province because we are paying medical premiums directly). I think that it's fair to say that the average Canadian pays about 3-5 per cent of their taxes towards medical care services.

This only pays for basic health care. Various other services are billed directly by specialists, for example, most physiotherapy, vision care, anything complicated that can't be provided in a clinic, doctor's office or hospital setting is usually an extra cost. Most working Canadians have a health care plan (in many cases not optional) that takes another 50-100 dollar a month payment and then pays out a percentage after a deductible. This is probably similar to your basic health care plan but it only covers some (not all) of what the existing provincial plan does not cover. Something like an ambulance visit and transport to hospital is not fully covered either, and if you don't have supplementary coverage that can cost about $80. On the other hand, some fairly complex hospital visits are fully paid and you could spend a week in hospital here without paying anything. We have had a rash of problems with super-virus outbreaks, and some hospitals have rather bad reputations for that sort of problem.

On the positive side financially we can claim medical expenses and receive about one-fifth of them back in the form of tax refunds through a tax credit scheme, but to get that you have to have reportable income high enough to generate the tax credits.

The basic weakness of the system compared to the U.S. system is that voluntary or one-time medical procedures, which may not really be "voluntary" but just not urgent enough to require a hospital visit, are often dispensed quite slowly compared to a pay-for-service model. This has led to calls for a two-tier system and some moves towards one, but the reality is that the wealthiest elites have access through their ability to travel and pay elsewhere, while the average person in terms of income has to wait. When these services are provided eventually (such as hip replacement, for example) they are largely paid for by the program, but there are not enough specialists or facilities available and the main reason for that is the economics of scale, the plans mandate payment levels that are no doubt lower than a private enterprise system would generate.

Hope this brief discussion helps place things in a more realistic framework. Essentially, our "free health care" is a rather bureaucratic $2,000 a year imposed health care program that, if you choose to remain outside in the one province where that's even possible, you would have to pay very high rates for all services.

Any comparison of the two countries would have to take into account that, for better or worse, we made this transition in the 1960s when things were nowhere near as expensive or complicated as they are nowadays. I am sure we would be having all the same problems as the U.S.A. if we were trying to deal with all this change given today's much larger medical budgets and welfare rolls (and we don't have nearly the amount of illegal immigration to factor in, nor the Obama urban demographic factors say no more).

“Countries like Canada with relatively low minority populations can still pull off a socialized health care system to a degree.”

ONLY because the desperate, impatient, disgusted by waiting times and restrictions can cross to their southern neighbor for the best, most up-to-date and technologically sophisticated medical care in the world.

Take that country away and in 5 years take a good look at the shambles called Canadian Health care

Yeah, but they don’t emigrate from Canada...that’s my point. I’m well aware that people from other countries take advantage of our services or even purchase private health insurance while bragging about their socialized health care systems. I have Brit in-laws who do that. I’m simply saying whatever the faults of the Canadian health care system, most Canadians stay Canadians.

Well the Canadian health care system sure works well for...US border cities.

The waits for various labs, specialists, scanning equipment is so long in Ontario that on any day you can drive around Buffalo, NY and look at the various facilities and see many Canadian license plates.

In the Buffalo area alone we have more CAT scan and MRI installations than all of Ontario.

We love our Canadian neighbors but we sure don’t need their rationed health care system.

but a bookkeepers and an entrepreneur are two different things.

Ain't that the truth! The one builds a company, the other manages its costs. One grows by innovation, the other by acquisition. <

There is that not-so-magic moment in every company's life -- when the entrepreneur sells out (or dies) and the accountants take over. The former has seen the company through its youth and adolescence, into its productive adulthood. The latter will manage it thru its maturity and old age.

It's a palpable difference.

Countries like Canada with relatively low minority populations can still pull off a socialized health care system to a degree. Most Canadians must approve because I didn’t see masses of Canadians trying to cross the border to get away from socialized medicine the times I’ve visited The Great White North. But I wonder how they’d like it if they had the amount of parasites we have. There’s about 15-20% of the American population who do little or no work and are basically leeches. And of course, we have millions of illegals who receive health care on the tax-payer dime. Canada’s leech population is probably less than 5%.

Thank you!
I recently went to the Maritime Provinces for a visit. They were, by the way, fabulous. Ann of Green Gables, who could forget?
My impression of Canada: white, white, white.
Nothing wrong with that; I just wasn't prepared for it. Lol. GREAT place!
I am from California.

When my husband worked for ARAMCO (Saudi Arabia) we paid NO FEDERAL INCOME TAX...a carrot to sweeten the pot for Americans to go to that God-forsaken place.
And, since we lived OUT of California for 1 year+--no state income taxes.

We made so much money that, after two years, we bought a home in San Francisco, California, paying cash. The house was paid for in nine short years.
After five years though, we KNEW that it was time to come home. Money isn't important as people. Lesson learned.

There were a substantial amount of Canadians over there too. I learned a lot about (aboot) Canada too.

Thanks for posting this, Peter.

I have had a few occasions to go to the emergency room over the past number of years, and I can say that the service I received was very good (at hospitals in more than one city). The downside, as was noted by someone above, was that since my injuries were painful (broken bones, torn ligaments) but not in any way life-threatening, I did spend a number of hours in each case unattended. Fortunately, the pain was bearable, and I had brought something to read.

Our system is neither the cure-all (no pun intended) that its most ardent supporters think it is, nor is it the living hell that free-market-medicine proponents mischaracterize it as. We receive excellent medical care, albeit attended by the inefficiencies that any economist will tell you to expect.

Unfortunately, we’ve been conditioned to recoil in horror at the mention of “two-tier” medical care, where the public system and a user-pay system exist side-by-side. I would be all for it; I can’t think of a single moral reason why any Canadian shouldn’t be allowed to buy medical care from private facilities on a cash-and-carry basis. Wouldn’t that just free up resources for the rest of us?

It’s not the fact that places have minorities or non-whites, like everybody else it’s the crime. My wife and I love to visit the southwest where there are large populations of non-”white” people. We’ve never felt unsafe. We’ve been in the El Paso marketplace close to the international bridge and didn’t feel a bit worried. And there were only a few other anglo-looking people out of a large crowd of shoppers.

Gotcha.
It's odd, isn't it, where we feel safe and where we don't. It doesn't seem to matter where or when, but our own opinions.

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