Not so long ago, my half-brother, who lives in Toronto, suffered a twisted bowel. He was found collapsed in his basement apartment. The emergency responders arrived, stabilized him but needed additional help so they called the fire department to lift him up an outdoor flight of stairs. His case was quickly diagnosed and what followed was a several-hours-long operation followed by ICU care, a hospital stay of two weeks and finally, nursing home care. Daily, specialists visited. After the ordeal, all the family was required to pay was a TV rental fee.
There was never a question about money; his recovery was the sole concern. Pre-existing condition or not, did not matter.
Canadian health care is a single-payer system, which means that while the insurance is publicly financed and costs are controlled, both hospitals and doctors function privately. Canadian national health insurance ensures that all residents of Canada have access to medically necessary care on a pre-paid basis. (Those seeking tattoo removal or cosmetic surgery have to pay on their own.) Each province or territory determines its share of the cost; some provinces, like Alberta and British Columbia, finance premiums through sales and payroll tax, but no resident is denied coverage because of inability to pay insurance premiums. And the Canadian government regulates drug prices to ensure that its residents are not gouged when purchasing prescriptions.
Another advantage to this single payer system is that Canadians don’t require attorneys to deny health coverage, nor do they have to pay actuaries to set premiums. The result? According to the Canadian Institute of Health Information site, Canada spends around 11 percent of its Gross Domestic Product on health care, much lower than many countries. With a single payer system, suppliers aren’t able to charge as much, and the difference goes to services for patients, not administrative costs.
Canadians enjoy free choice of physicians; they are not restricted by specific health care plans. And all Canadians enjoy health care; no one goes without, no one is bankrupted by health-care bills.
No Canadian resident clings to a soul-denying job to ensure his or her family is insured. No Canadian resident frets that if she loses employment that she’ll be denied coverage because of a pre-existing condition. In Canada, a patient’s access to health care is based upon need, not upon one’s ability to pay, thus avoiding psychological trauma and worry.
My other brother, who also lives in Toronto, tells me he has never had a bad medical experience. On a couple of occasions when he ended up in emergency, he’s had to wait for a time, but says the doctors are very good at a quick assessment then treat the most urgent. Obviously, heart attack care precedes a broken toe.
In the province of Ontario, one’s general practitioner decides whether one needs to see a specialist; he or she becomes a referee, if you will, examining and ensuring that no one goes to a specialist unless such a visit is warranted. The reason for this is simple: the government does not want to pay for needless operations.
Last summer my brother contracted a pneumonia that did not go away. He was given referrals, had a battery of tests, saw two specialists, both of whom reviewed the results of the MRI with him; ultimately he was given a clean bill of health. In a non-emergency situation he had sophisticated testing, meetings in between, all with nary a worry about what it would cost.
In the rural provinces however, things can be quite different, primarily because there are too few doctors who are willing to live where the temperatures can drop to 30 below zero, and where hospitals are few and far between. But this is true of rural areas worldwide; fortunately, in Canada, residents can be treated in any city regardless of their home province.
Canadian health care is appealing, something I forsake to live in the United States. But grandchildren have a way of rooting family to place. Unless I can round them all up for a trek north, we’ll stay put, knowing that other family members are safe and in good hands in the country of my birth.
Date: January 30, 2017