This past Monday I posted “Straight Talk About Health Care.” I thought it also might be helpful to learn more about systems in other countries, especially those with public or nationalized healthcare. This post is submitted by George Shafer,* a Canadian friend, who lives in Almonte, Ontario, near Ottawa.
“Canada’s healthcare system is run by the province, in my case Ontario. Health care is provided by the OHIP (Ontario Health Insurance Plan). Most routine medical requirements are provided by OHIP such as doctor visits, lab tests and any required hospital procedures. By law, medical practitioners are not allowed to charge extra for their services. OHIP pays doctors and hospitals for each service that they provide. The money to fund the system is general revenue from taxes. Although managed by the provincial government, the federal government also funds the system through transfers to the province. All Canadians are enrolled in their provincial healthcare system. Patients are typically not billed for routine services. Prescriptions, eye care and dentists are not included in the OHIP system. A majority of working people and their families have additional insurance to cover these costs provided by their employers. People 24 and under and 65 and over have a majority of their drug costs paid by the healthcare system.
Throughout my life, I have been lucky and have not had any major medical issues. Routine doctor visits and tests have all been covered. In our town, we have a small hospital and a Family Health Unit with offices for most of the local doctors. Our family doctor works out of the Health Unit. Sometimes we need to go to Ottawa to see a specialist.
My experience with the medical system has largely been through family members. Recently, one of my relatives was not feeling well and went to the emergency room in Ottawa. As they suspected it to be heart related, she was quickly put on a monitor and saw a specialist the next day. After it was determined that she needed a pacemaker, she was sent to the Heart Institute for the procedure, spending one night in the hospital. Total time was less than 5 days. She has since had several follow-up visits with 2 different specialists and is doing well. The total cost to her was $0.
The complaint you hear most often from Canadians is the long wait for elective procedures. Covid-19 has definitely made the situation worse and it is generally believed it will take years to clear the backlog of elective surgeries that were cancelled or delayed due to the pandemic.
Canadians, however, are only covered when they are in Canada. While traveling outside the country, none of the provincial plans provide coverage. Most people purchase insurance to cover medical treatment on trips abroad.There are often horror stories about Canadians going to the US and having a major medical emergency running up $100,000 in medical bills. It can be expensive to get insurance if you have pre-existing medical conditions, but it can bankrupt you if you have a major issue while traveling.
Of course, as you age there are increased medical costs. A recent Ontario study showed that close to $5B is spent (10% of the overall health budget) on people in their last year of life. Although serious health problems can cause high levels of stress, paying for the medical costs is not one the worries Canadians have. Before universal healthcare, people would incur large debt or experience bankruptcy if they had serious medical problems. This is no longer the case.
It is not a perfect system. A relative of mine needed an MRI and waited months before finally getting one in the middle of the night due to a cancellation. If he had been in the US, he could have gotten one within days at a private clinic. However, that would have cost him about $2600; there was no cost in Canada.
I believe the key to our system is that everyone is required to have medical insurance. In that way, you don’t end up with an insurance pool of just sick people. This type of system also keeps down administrative costs—administrative costs in Canada are 50%of the US system. It is also somewhat of a cultural thing. Canadians are a more socialist thinking bunch. It is more about all of us rather than just about the individual.
Given that the US cost per person for medical care is five times that in Canada with Canadian’s having slightly better health outcome, the Canadian system works pretty well.”
*Mr. Shafer lives in Almonte, Ontario, with his wife Jean, an accomplished artist. He spent a career in satellite communications with Telesat Canada, Canada’s Domestic Satellite Operator. Of special note, Almonte, a picturesque town of about 5000, is located on the Mississippi River, a small mill stream with no relation to the Ol’ Man River by the same name.