Canada's health system is as good or better than the US new research suggests

CHATSDALE · Apr 21, 2007

i am in favor of broader health care benefits but i, too, have heard of people who had difficulty in getting basic things like a tonsillectomy, md decided that it wasn't necessary child was brought to us and has been healthy since surgery

i don't see why the preventive care can't be implemented. surely would be great

my ex was in military and we had to go to base for health care...the waits were horrible however the care if you were admitted was as good as i have ever received in a private pay hospital

just a question if anyone knows the answer

1] how much is the tax rate there as compared in usa?

2] does this coover all meds?

3] do you have a choice of doctors/hospitals?

4] how does does nurses pay compare in the two countries?

Multicollinearity, BSN, RN · Apr 21, 2007

i am in favor of broader health care benefits but i, too, have heard of people who had difficulty in getting basic things like a tonsillectomy, md decided that it wasn't necessary child was brought to us and has been healthy since surgery
i don't see why the preventive care can't be implemented. surely would be great
my ex was in military and we had to go to base for health care...the waits were horrible however the care if you were admitted was as good as i have ever received in a private pay hospital
just a question if anyone knows the answer
1] how much is the tax rate there as compared in usa?
I don't think we can compare the tax rates because Canadians have many differences in social funding besides healthcare. For example, I have two poor elderly Canadian relatives and they receive nice, cheery government subsidized housing that would make poor elderly Americans envious. They also receive government pensions that are a bit better than our social security. These are just a couple of examples. In addition, Canada is rapidly paying down its federal debt. What are we doing in the US? Hmm?
2] does this coover all meds?
No. Canadian coverage does not cover medications. Most get supplemental coverage through their employers. If you are low income then you pay a percentage of the cost. Example, one of my poor elderly relatives tells me she pays 15% of the cost. Thing is - Canadian medications sell for much less than the identical meds in the US.
3] do you have a choice of doctors/hospitals?
Any doctor any hospital in your province from what I've heard.
4] how does does nurses pay compare in the two countries?

From my research, it appears that Canadian RNs earn a bit less than US RNs. However, I know of Canadian RNs who earn almost six figures by working in Native Indian facilities.

I know two Canadians, one a physician, the other a psychologist who are working in the US to make more money. What I find interesting is that they both say if they got sick - really sick - they would high-tail it back to Canada in a hurry.

CHATSDALE · Apr 21, 2007

thanks for update

HM2VikingRN, RN · Apr 23, 2007

http://www.prospect.org/web/page.ww?section=root&name=viewprint&articleid=12683

as described by the american press, canada's health-care system takes the form of one long queue. the line begins on the westernmost edge of vancouver, stretches all the way to ottawa, and the overflow are encouraged to wait in port huron, michigan, while sneering at the boorish habits of americans. nobody gets to sit.
sadly for those invested in this odd knock against the canadian system, the wait times are largely hype. a 2003 study found that the median wait time for elective surgeries in canada was a little more than four weeks, while diagnostic tests took about three (with no wait times to speak of for emergency surgeries). by contrast, organisation for economic co-operation and development data from 2001 found that 32 percent of american patients waited more than a month for elective surgery, and 5 percent waited more than four months. that, of course, doesn't count the millions of americans who never seek surgery, or even the basic care necessary for a diagnosis, because they lack health coverage. if you can't see a doctor in the first place, you never have to wait for treatment. canada's is a single-payer, rather than a socialized, system. that means the government is the primary purchaser of services, but the providers themselves are private. (in a socialized system, the physicians, nurses, and so forth are employed by the government.) the virtue of both the single-payer and the socialized systems, as compared with a largely private system, is that the government can wield its market share to bargain down prices -- which, in all of our model systems, including the vha, it does.
...
a 2003 study in the new england journal of medicine found that the united states spends 345 percent more per capita on health administration than our neighbors up north. this is largely because the canadian system doesn't have to employ insurance salespeople, or billing specialists in every doctor's office, or underwriters. physicians don't have to negotiate different prices with dozens of insurance plans or fight with insurers for payment. instead, they simply bill the government and are reimbursed.

sounds like a good basis for a system!

newyorknursey · Apr 23, 2007

wow. someone did their homework. informed discussion is sooo juicy.

345 percent more per capita on health administration in the U.S.!!!

Simplepleasures · Apr 24, 2007

Other advanced countries spend far less than us and have more to show for what they do spend as far as longer lifespan and better health.
My Canadian relatives think Americans are stupid regarding healthcare financing, quite honestly. Sure they have complaints here and there - but they wouldn't want to live in the US system for anything. I have several Canadian relatives who live half and half in each country. So they do in fact have knowledge of both systems.

Absolutely my own experience when talking to my German and Canadian reletives about their health care. They cannot understand how such a rich , intelligent country cannot set up a universal health care system. The German reletives seem to like their system and have less complaints than the Canadians, BUT the Canadian reletives have said they would not want to go with our brand of health insurance based care, they would prefer to keep their bank accounts solvent and not have to forclose on their home to pay medical bills. Even in this country there are surgeries and procedures that are either outrightly denied or there is a long wait to get the procedure OR to even see the MD in question.

Kabin · Apr 24, 2007

I know two Canadians, one a physician, the other a psychologist who are working in the US to make more money.

Related to that is the issue of Canadian taxes. A Canadian engineer I worked with was glad to work in the states.

pickledpepperRN · Jun 8, 2007

The Canadian Nurses association was well represented here.

Taming of the Queue
Not many conferences attended mostly by researchers and policy-makers
can boast having had the Prime Minister come for lunch. But Prime
Minister Stephen Harper made a lunchtime appearance at the 4th annual
Taming of the Queue conference in Ottawa on April 4, 2007 to
announce, along with federal Minister of Health Tony Clement,
agreements between the federal government and the 13 provinces and
territories with regard to meeting specific wait time targets in
exchange for targeted federal funds....
... In their closing comments, the conference co-chairs re-emphasized the
positive messages that were heard throughout the conference that real
progress was being made in terms of measuring, monitoring, managing
and, ultimately, reducing wait times in different parts of the system
in different parts of the country. But there also remained some very
hard work left to be done. ...
... The advantage of course is that work on reducing wait times for primary care, mental health and children's services will be greatly enhanced by the hard work already done in those areas that have benefited from so much research and political attention in recent years.
Finally, it is clear that the success stories related over the course
of the two days of the conference also very much reinforced an idea
that has been central to the work on wait times since the issue first
began to receive attention from researchers and politicians.
Successful wait time strategies require champions willing to take on
leadership roles and persevere in the face of sometimes strong
opposition. ...
Begins on page 21 of the paper, not the PDF:
http://www.cprn.org/documents/48031_en.pdf

The opponents of single-payer national health insurance

claim that intolerable waiting times for health care would be

inevitable. They use the experience in Canada as proof.

Canada has had problems with excessive queues, but, as this report

demonstrates, they are being addressed, and with considerable success.

While Canada moves forward with queue management and fine tuning of

capacity, we continue to hang our heads in shame over the financial

barriers we place in front of tens of millions of Americans, which

prevent access to the most generously funded health care system ever

known.

DarrenWright · Jun 9, 2007

This is going to be mildly enjoyable to address.

First, there is a remarkable failure to seperate primary care from acute care when making these comparisons. Countries with socialized systems tend to have more aggressive primary care systems primarily because they know once the patient's health trends beyond the capabilities of primary care, their outcome will not be as good as the acute care outcomes in places like...the US.

Second, the repetition that the majority of Canadians would refuse trade their system for one like the US is not a valid argument for two reasons; A. The majority of Americans don't want Canada's system (also not a valid argument, but just as relevant as the idea preceding it). B. 75% of Canadians live within driving distance of the 'US system' and have the unique ability to access both systems.

And Canada IS addressing their troubled system with it's unique flaws, and one of the keys to their success has been by RELAXING the laws on privatization (making it more Americanized), not by exacting more gov't control. And if the US went to a single-payer universal type system, you will see DRAMATIC changes in the outcomes of Canadian citizens, a large number of whom currently seek medical care in the US, but would now find it more difficult to access our system, or might not be able to access it at all. We'd see a shuffling of countries who are proud of their rankings, and a reluctant change in sentiment.

Finally, we do not place any financial barriers in front of "tens of millions" of Americans. The approximated round number of 45 million uninsured Americans is a myth. That number is calculated based over a one-year period, meaning, of that 45 million, many of them were uninsured for only a day, or a few days, or a few weeks of that fiscal year, possibly while they changed jobs or insurance companies (during which time they were eligible by federal law for COBRA coverage). Additionally, millions more are people who can afford health insurance, but exercise the great American past-time of CHOICE, and opt out, possibly saving that money for an HSA (those people technically are not insured, but still have money available for health care), or use that money to purchase a more expensive home, etc. Suddenly they are alleged victims when they have to sell the home to pay for health care, when the truth is that their home was really their insurance policy, a policy they were living in instead of buying from a broker.

Intellectual dishonesty may become one of my trademark statements, but much of this discussion is flavored with intellectual dishonesty.

HM2VikingRN, RN · Jun 9, 2007

Try paying for COBRA coverage......If an individual and their family cannot pay for the family coverage at the employer rate how will they pay for that coverage with a 2.5% surcharge?

see http://pnhp.org/facts/myths_memes.pdf

Recent years have seen the rapid growth of private think tanks within the
neoconservative movement that conduct “policy research” biased to their
own agenda. This article provides an evidence-based rebuttal to a 2002
report by one such think tank, the Dallas-based National Center for Policy
Analysis (NCPA), which was intended to discredit 20 alleged myths about
single-payer national health insurance as a policy option for the United
States. Eleven “myths” are rebutted under eight categories: access, cost
containment, quality, efficiency, single-payer as solution, control of drug
prices, ability to compete abroad (the “business case”), and public support
for a single-payer system. Six memes (self-replicating ideas that are promulgated
without regard to their merits) are identified in the NCPA report.
Myths and memes should have no place in the national debate now underway
over the future of a failing health care system, and need to be recognized as
such and countered by experience and unbiased evidence.

Most of what you have promulgated against single payer falls along these lines of being as you say "intellectually dishonest"

ZASHAGALKA, RN · Jun 9, 2007

Try paying for COBRA coverage......If an individual and their family cannot pay for the family coverage at the employer rate how will they pay for that coverage with a 2.5% surcharge?

Maybe you don't know how COBRA coverage works. You have a few months to purchase the coverage and once purchased, it backdates to the day you last had coverage.

So, if you are between jobs, and it takes 2 months to get insurance at your new job, then you don't have to buy the COBRA insurance UNLESS YOU HAVE A PROBLEM IN THE GAP. If you buy it at that point, even after the fact, it is still effective.

So, COBRA coverage can span the gap between jobs even if you never purchase it. In actuality, this is exactly why COBRA is worded the way that it is: and it is why it is so expensive - it is one of the only retroactive (after the fact) "insurance" policies you can buy.

Besides, most normal people get some type of separation package from their jobs when they leave them, even if it's just accumulated sick leave or a 401(k) plan (that could be used for an emergency). So, anybody that reasonably plans should be able to purchase COBRA, if needed. Or, maybe it's too much to ask people to reasonably plan for their lives?

2nd, that 45 million uninsured? It's a two yr rolling period of anybody uninsured for any period in that 2 yrs. For example, I changed jobs about 2 yrs ago. I was technically uninsured for a month (although COBRA would have backed me up, had I needed it). So, add 4 more people to the uninsured total (me and my 3 boys) even though that's not just a statistic, it's a danged lie.

But when you want the numbers to say what you want them to say, why, just manipulate them.

~faith,

Timothy.

DarrenWright · Jun 9, 2007

Try paying for COBRA coverage......If an individual and their family cannot pay for the family coverage at the employer rate how will they pay for that coverage with a 2.5% surcharge?

This overlooks the beauty of COBRA. Most people don't take quit their job until they have a new one in the bag. Then once they quit their job, they have 18-36 months of eligibility, but here's the cool part; they don't have to pay a dime for it during those 18 months if they don't want it. If, however, they decide to enroll, they are covered retroactively to the first day they were eligible. So the beauty of this is that someone in transition who chooses to take a 6 month break between jobs is eligible for coverage, but doesn't have to enroll unless they want to, or have a need for coverage. There is a good chance they won't need to enroll, but they are essentially covered by virtue of federally mandated eligibility, and don't have to pay a dime until they decide to take advantage of eligibility.

And while a 2% surcharge may be considered high, if the enrollee is either 10% or $50 dollars short for a payment, the employer is required to provide full coverage.

Bottom line is that if someone doesn't think they can afford to take advantage of COBRA for whatever period of time they decide to take between jobs, then they shouldn't take a very long break; I took a 6 week break between my last two jobs.