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Health care, Canadian-style

Unless you live under a rock, you’ll be at least vaguely aware that there is much debate these days (mostly heated, it seems) centred around health care reform in the U.S. I’ve been thinking… with increasing gratitude, I might add… of the health care on offer to me as a Canadian, and thought I’d take the time to write out some of my own reflections on the situation up here.

I can’t speak about the specifics in other provinces, but I can definitely talk about health care in British Columbia, the province in which I’ve lived for my whole life.

At this point in time (and for the past number of years), my husband and I pay a premium of $96 per month (total) to the Medical Services Plan of B.C. (MSP), which covers us as a family of two at our current level of income. If our income were to significantly reduce, however, we would be eligible for premium assistance (which is available to all British Columbians based on net income). Just for the sake of interest, the current adjusted net income thresholds are as follows:

$20,000 – 100 percent subsidy
$22,000 – 80 percent subsidy
$24,000 – 60 percent subsidy
$26,000 – 40 percent subsidy
$28,000 – 20 percent subsidy

(For complete details on MSP premiums and premium assistance, see this page on the MSP web site.)

MSP “insures medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures,” which covers pretty well anything that could happen to us (e.g., illness, accident, etc.) or anything medical we might require (e.g., surgery, hospitalization, etc.), apart from prescriptions (though prescriptions are reimbursed after a deductible is reached under Fair Pharmacare).

As an aside… unfortunately, dental care isn’t covered as part of our provincial plan, and neither is vision care; however, most extended care plans (provided through employers) cover one or both to some extent. Extended plans differ from employer to employer based on who provides the insurance, options chosen, etc. In my case, our company’s plan (paid for completely by my employer for all full-time and qualifying part-time staff members) provides such things as 100% reimbursement for prescriptions, full dental care (including twice-yearly checkups/cleaning), annual eye exams, chiropractic treatments, massage, acupuncture, naturopath, psychologist, and so on. (Unfortunately, apart from the annual eye exam, vision care is NOT covered under our particular plan, so we’re on our own for glasses and/or contacts.)

Back to the provincial plan, though, as that’s what is available to every British Columbian regardless of employment or income level.

From a personal standpoint, I could go on and on about how my extended family has benefitted from our MSP coverage. At risk of sounding like a bunch of invalids (!), a few things come to mind right off the top of my head… treatments received for no charge beyond our regular monthly premiums:

  • Hip replacement surgery and hospitalization (two people).
  • Breast reduction surgery and hospitalization (two people).
  • Skin cancer removal (several occurrences).
  • Extensive treatment for multiple sclerosis over nearly thirty years.
  • Treatment after heart attacks.
  • Surgery and week-long hospitalization after infection.

We don’t receive any bills, ever, so I have no idea what any of the above would cost if we had to pay out-of-pocket, but I doubt any of it comes cheap.

We are free to choose any doctor in any part of the province, and have the peace of mind of knowing that we can see them any time, without having to worry about whether or not we can afford it. Phone the office, book an appointment, and show up – that’s all there is to it. No additional cost, no co-pay, nothing.

In my (relatively small) city we have two major hospitals and plenty of drop-in clinics. In the case of an emergency one is free to go to either hospital (of course, whichever is closest would be the smart thing to do!), or for problems that need less immediate attention a drop-in clinic is probably the better choice. In terms of scheduled procedures, what type of treatment you are having normally dictates which hospital treats you, as each of them specializes in different areas. Doctors can work in both facilities.

As I said earlier, I can’t offer any personal insight into coverage in other parts of my country, but I can write about the care a member of my extended family (now in her 30s) has received while living in a different Canadian province. She was diagnosed with juvenile diabetes very early on, and in addition to being hospitalized multiple times throughout her life, as an adult she has had two kidney transplants. All of her care has been covered by her provincial medical plan, and, harsh or not, it’s safe to say that she would be bankrupt and/or dead today if she had lived just a few miles south, over the border.

It drives me absolutely crazy when I read some of the lies floating around – in some cases, planted – about the Canadian health care system. And it breaks my heart when I hear the personal stories of my friends in the U.S. who have lost (or are at risk of losing) their insurance coverage, who have insurance but pay exorbitant premiums plus co-pays, or who have policies with such large deductibles that the only way the “coverage” is really of use is if something catastrophic happens. Nice.

My country’s health care coverage isn’t perfect by any stretch. I’m sure other countries (even other provinces within my country) have better systems. But let me tell you – it’s pretty darn good, and I become more and more grateful every day for what we have. Dear friends in the U.S., don’t believe the lies spread by people who have a vested interest in keeping things exactly the way they are. Listen to someone who knows what’s what because she, her family, and her friends live it, every day of their lives.

UPDATE: New post (part 2!) with a link to a great video well worth watching.

UPDATE: New post – “A personal example of Canadian health care”

Laurel Storey, CZT – Certified Zentangle Teacher. Writer, reader, tangler, iPhoneographer, cat herder, learner of French and Italian, crocheter, needle felter, on-and-off politics junkie, 80s music trivia freak, ongoing work in progress.

{ 15 comments… add one }
  • Anonymous August 22, 2009

    Interesting article you've written. 🙂

    I didn't realize until a short time ago that you have to pay premiums in British Columbia for your health care. Here in New Brunswick, we pay nothing but get the same care. Of course, our taxes must pay for it but we don't actually make the payment so don't notice it.

    The health care system in Canada is one of the best things about living here IMO.

    My mother had a hip replacement, was later hospitalized for five months (in rehab) after she had a stroke, my father had surgery to remove lung cancer and skin cancer, etc. I could go on and on. No bills were ever sent for those things. They're all included.

    The only thing I've paid out of pocket lately is $10 for an endometrial biopsy done by my ob/gyn. That's nothing.

    As in BC, our health care doesn't provide dental coverage or eye glasses but we have insurance that pays most of that.

  • Dawn August 22, 2009

    Thank you for your comment! I'm really interested to know how other provinces handle health care, as my only experience has been in BC. I guess they all have to follow the Canada Health Act, but handle payments for the services in different ways (i.e., premiums or taxes). I'm pretty sure (but not 100% positive) my husband said that there are no monthly premiums in Ontario (where he's from), either.

  • Elaine August 22, 2009

    Dawn I was going to post a comment to this entry but then decided it was too long and that I'd just post my own blog entry. If you want to read it, it's at http://elaine.cat-holics.com/wordpress/?p=655 if you'd like to read it.

  • Dawn August 22, 2009

    Thanks, Elaine! I've added a link to your blog in my blogroll, so will check it out regularly. 🙂

  • Tabby August 24, 2009

    The greatest threat to healthcare in Canada are conservatives who are bound and determined to get it privatized. Here in Alberta, the government slashes funding, complains that it's broken, slashes more funding, complains that it's broken and is going to run out of funds, and so on.
    I really wish I was making this up. Yet for over 40 years, people who would not be able to afford American-style healthcare keep voting them back into office because… I don't know. I really don't know why so many people vote against their own best interests time and time again.

  • BAllanJ August 24, 2009

    Here in Ontario there's a Health Care (OHIP) line on the provincial page of the annual tax return, so at least part of the premiums come from there but I don't see that's a lot different from taking it from the provinces general revenues. I can't remember the numbers. There used to be a premium thing that you could get assistance on way back in the 80s, I seem to remember. It dissappeared long before the tax form line item appeared, I think.

  • Elaine August 24, 2009

    In response to what Tabby wrote, there was one thing came to mind. I find it ironic that they're slashing funding and claiming they're broke when (last I heard) Alberta is a rich province. When I say rich, I mean that unless things have changed since I last heard, Alberta didn't have a provincial sales tax because they didn't require it. Maybe if they're health care is in such bad shape, they could get a sales tax system and use the funds for health care in the province. Just an idea…

  • Elaine August 24, 2009

    Dawn, close to 5 years ago or so, the Ontario government had employers withhold additional tax (I don't know if it's a set amount or if it's a percentage of your income – mine I think is about $50 per month or pay, I don't remember which) which would go to Ontario's health care. This was a little disconcerting since I live in Quebec. Since it's a tax that's withheld at source, I get to claim it for income tax purposes. What bothers me about it is that the someone else gets to collect interest on it when they shouldn't have it to begin with.

  • Dawn August 24, 2009

    Tabby, BAllanJ, and Elaine, thank you so much for your comments! Having lived in BC for my entire life, I really do find it interesting to be educated as to how things are handled throughout the whole of Canada, so thanks for taking the time to give your input.

    The thought that we have the potential to lose what we have is a frightening one. I'll never understand why people seem to have a pattern of voting against their best interests. 🙁

  • Paula Plays August 25, 2009

    D. I don't know if you saw my recent facebook post about my current illness and being turned away for care (here in the USA). I wish everyone could read your blog entry. Very informative about your experiences with the health-care system in Canada!

    *deleted and re-posted due to typos*

  • Dawn August 25, 2009

    I did see your FB post, Paula, and it broke my heart. 🙁 It's hard to accept that things are so different when you're physically located so close to us!

    Thank you for your compliment, and for linking to this post on FB… I really appreciate it! 🙂

  • Anonymous September 5, 2009

    Thank you for a very interesting post.
    As someone who lives in the US, I can only warn all Canadians to BE CAREFUL!!!
    Tabby's story is scary and one that may be spread to the other provinces. Please don't let it happen. The conservatives in this country are very dangerous. They go to church, they talk about God, and then they say they that all those not as well off are lazy and deserve it. They won't even provide healthcare to the poor. SCHIP, the law that provides assistance to poor CHILDREN was aggressively fought by conservatives and passed mostly by Dems and only a few Repubs. And Bush didn't want to expand SCHIP saying private insurance good take care of them. Which they unsurprisingly didn't. Bush and conservatives consider themselves as "compassionate" conservatives, but they didn't want to provide assistance to poor CHILDREN!!! So be careful of what conservatives say. What they do is not compassionate.
    Also, be wary of private insurers. Especially the US private insurers. They deny coverage, ration care, and dump you when you get really sick, ex. cancer, in a process called rescission. Even if you paid premiums for years, they are allowed to dump you immediately without paying a dime. Good luck with treating your cancer. Don't expect the "compassionalte" conservatives to help you.
    In the US, 22000 die each year because they can't afford health insurance. EACH YEAR! Millions have gone bankrupt due to medical bills and they HAVE insurance. THEY HAVE INSURANCE! premiums have DOUBLED since 1999 and will DOUBLE in the next 10 years.
    And all this can be googled.
    So please, please be careful. Be careful of those who espouse how private insurance can save the healthcare industry. Because they will make profit from people's pain and suffering and the "compassionate" conservatives will applaud throughout and look the other way as people die and go bankrupt, just like they do in the US.

  • Laurel Regan September 5, 2009

    That is frightening indeed. I hope beyond hope that we never lose what we have here in Canada.

  • john September 6, 2009

    Our system in Nova Scotia is very much like the New Bruswick comment. In fact some of the more complex procedures for New Brunswick people are done at the bigger hospital here in Halifax. We have no monthly or yearly payment in addition to our regular taxes.

    Nova Scotia has drug plan for seniors, 65 and over, as well as a drug plan for people who don't have drug plans from employment. I'm retired and have a decent pension but it means that once I pay 3% of my net income on prescriptions, I only pay 20% on my prescriptions after that. It's not that I have a really low income, it's that my four blood pressure meds are REALLY expensive. So the drug plan sounds pretty good to me.

    I've had several procedures over my almost 60 years.

    I had a football injury as a 20 year old and had kidney surgery(serious but not urgent). I saw my GP the same day as the injury. He sent me to a a urologist in the city (I lived in a small town) who I saw within 3 days of the injury. He put me in hospital the 4th day, did testing and Xrays and stuff the 5th day and I had a hemi-nephrectomy the 6th day. Not bad in my opinion.

    I took my Mother, at age 72, to the emergency department (by then I was living in Halifax) with severe angina. From the ER they hospitalized her and took a day to stabilize her medically, so she would be more likely to survive the surgery, and she had bypass surgery the next day. Basically within 48 hours. I might have been sooner, but it was the cardiologist's opinion that it was necessary to stabilize her further for that day before the surgery.

    My mother at age 77 had cataract surgery. From diagnosis of the cataract to surgery took only 14 days. Cataracts are not urgent. To me and to her, 14 days was really not long at all.

    Three months ago I went to my GP with vocal hoarseness. He referred me to an otolarygologist and saw him a week later. He removed a lesion from my larynyx and surgically reconstructed my vocal cords within 5 days of that specialist visit. Having surgery from one of the top otolarygologists in eastern Canada within 12 days is miraculous as far as I'm concerned. Incidentally, the pathology report showed the lesion to be benign, but I've been referred by him to a speech language pathologist to assist in getting my voice back in shape, so every two weeks since the June 12 surgery, I've been going to voice rehab, of course covered by the health care system.

    Since I was 45, I've been on medication for hypertension, so I see my GP maybe four times a year for consultation about my blood pressure and to have my meds adjusted, if necessary. This attention to it drives my heart attack risk way down. At age almost 60, I have a less than 10% chance of having a heart attack within the next 10 years, based on testing. That sounds much lower that I would have expected based on family history.

    Anyway, that's my story. 🙂

  • Laurel Regan September 6, 2009

    John, thank you so much for taking the time to share your story! As time passes, everything I hear from my fellow Canadians is consistent (not that I'm surprised) – I hope that, somehow, the people in the U.S. who need to hear the truth from average, everyday Canadians finally understand that we are doing this the right way.


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