General chatter - A question for Canadian and UK chickies




caryesings
08-03-2009, 04:53 PM
You may have heard that US is trying to revise it's health care system, and one of the arguments against reform repeated ad-naseum is that we'll end up with a system like Canada or the UK if we're not careful.

I've noted the Gall Bladder "adventures" of some of the Canadians here and while it sounds like you did have to wait for your surgeries so have 2 of my friends here whose insurance did not approve the need for the surgery for a number of years (both did not have visible stones so surgery deemed not necessary).

I had a GB full of stones so got immediate approval and because I had insurance, I had to pay "only" $2,000 of the $20,000 total. So for me, personally the current system worked. However growing up I had family in both Canada and UK and I remember listening to the grown-ups discuss the issue and one of their fears about emigrating to US was losing their health plans. However that was 30 years ago.

Realizing your knowledge of how American health insurance works is probably as limited as me knowing how your systems work, would you make the trade to American-style or continue with what you have?


ANOther
08-03-2009, 05:09 PM
From what I understand there is a difference between the UK and Canadian systems: in the UK you can opt out and get private coverage, in Canada you can't, public medicine covers everybody. I think if we get some kind of public health care system there should be an opt-out mechanism. ETA 08.08: another thought enters my mind, perhaps public health care funding should be reserved for people below a certain income threshold, lest employers think, oh now that Uncle Sam is paying for health care we don't have to provide health insurance as a benefit. Also, at least in the past I've heard the same complaints (from those who worship and bow down at the altar of the sacred free market) about US managed-care plans (at least some of them) that I hear about subsidized health care in the UK and Canada, rationing, long waits, have to go through your primary doc before you can see a specialist, and the worst of all CAN'T CHOOSE YOUR OWN DOCTOR. FWIW I've never had any complaints about getting timely care from the HMO I belong to, I can choose a doctor, and they dropped the obligatory primary-doc referral to specialists several years ago

Rosinante
08-03-2009, 05:24 PM
I'm kind of torn.

I really appreciate the UK emergency cover. We hear horror stories about people in the US having accidents or sudden illnesses and not being treated until or unless they can produce insurance documentation. That may not be true, it might just be Quincy ME or Diagnosis Murder.

I do have problems with the non-urgent NHS care. Actually, when I had my GB done, the response time was pretty quick - but it was months, with trips to A and E, like others here have posted.

Then, and forgive any offence I might be about to cause, I have problems with the sheer range of things people demand as a right from the NHS: things that are not about life and death or even about illness as such ... OK, I choose not to list some of the things I call elective, it's too emotive but what I'd like to see here is a 2 stage system: unquestioned emergency care but pay for yourself medical cover for everything else. I truly believe that those of who could pay for/pay for the cover for our medical care should do so, provided there is the safety net for those who cannot. and I do mean can not, not will not.

The only query I'd have, I was just thinking about it the other day ~ If your doctor/surgeon says you need procdure X, how do you know they're not just saying it to make money?

and yes, we can opt for private health coverage in the UK but you've got to be phenomenally rich to afford it on a pay as you go basis; and if you go for medical insurance cover, you've (obviously) got to take it out when you're well, you can't get taken on for medical insurance cover for pre-exsiting conditions.


lovesjm
08-03-2009, 06:34 PM
I am a canadian, and my husband is an american. He grew up in the states. He recently finished his undergrad and will be starting his masters degree. We were torn between a school in the states, and a school here in canada. We decided to stay in Canada. A large part of that decision for us was the health care that we get here. Coverage in the states is so much more expensive, and although sometimes the waits here are longer, I like knowing that I can walk into any doctors office, clinic, or hospital in the country and be treated, no matter what. No forms to fill out, no proof of insurance, no fees. Given the choice, my husband (who has lived in both systems) and I would agree that we would choose the system that we have in Canada.

caryesings
08-04-2009, 10:26 AM
Thank you for answering, sounds like my memory from 30 years ago on this issue still holds true.

kiramira
08-04-2009, 10:40 AM
Lots of negative media about the Canadian Health Care System. Here are some FACTS for you:
With respect to primary care:
http://www.theglobeandmail.com/life/health/canadians-happy-with-primary-health-care-study-says/article1229169/
In particular:
85 per cent of people aged 12 and older have a regular doctor, and two thirds have been seeing the same doctor for five years or more, according to the Canadian Institute for Health Information (CIHI) study, released yesterday.

“I feel darn good that 92 per cent of Canadians would recommend their family doctor to a friend. That is the litmus test,” said Sharon Johnston, a family physician and University of Ottawa professor.

Very few Canadians complained about not having a family doctor – despite the oft-repeated grievance about a shortage of physicians in some parts of the country.

For a balnced and comparative view:
http://boingboing.net/2009/06/27/myths-about-canadian.html
In particular:
The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

and http://www.denverpost.com/recommended/ci_12523427
in particular:
Myth: Canada's government decides who gets health care and when they get it.While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Most of the negativity around the system involve wait times. This usually comes up whenever funding issues are discussed -- you know, wait times are outrageous we need to improve the funding for X according to the lobby group for X...
The reality is that conditions are prioritized, so that if you have an elective concern that you would like a dermatologist to examine, such as unsightly age spots, of COURSE you aren't a priority. IF you have a melanoma, you are at the top of the list. If you need a hip replacement, you'll probably wait. If you have a bone sarcoma, you're at the top of the list. I have a pituitary microadenoma -- benign, non-threatening. I waited 6 months for a specialist appointment. I personally have no issue with taking a place in line behind someone with a more serious condition.

From personal experience, my dad pitched a heart attack at my brother's apartment in Montreal, MILES away from his home province of Alberta. He got to the hospital, was immediately assessed (in the ER, ahead of the drunks, the sprained wrists, and cold sufferers), immediately admitted into the cardiac unit, placed on 24-7 monitoring, and had quadruple bypass surgery 5 days later. Cost -- NIL. Thank GOD for Medicare. He didn't lose his house at the age of 68. Today, he is followed regularly by a cardiologist, has quarterly stress tests. Cost: NIL.

The system isn't perfect by any stretch of the imagination. But IMHO, it works well for the majority of people.

Kira

Stella
08-04-2009, 03:24 PM
I live in the UK and am very concerned about the state of the National Health Service. As someone else already said, there are things which are covered which should really not matter that much, and on the other hand people have to wait several weeks for chemotherapy, where the promptness of treatment can matter so much.

Of course, I do appreciate that I do not have to fund my medical care, but if my husband or I were gravely ill I would be extremely concerned.

BTW, if you want to jump the queue, you may do so by paying privately. You`ll be seen immediately, and this, to me, is two class-care.