Canadian/UK Citizen Healthcare Poll

Another canuck here. I’ve never had any serious medical issues, but for the routine stuff (broken arm, minor surgery) and the GP maintenance I’ve never had a bad experience in the system.

My ex-wife recently contracted meningitis very seriously about 3 years ago and underwent significant long term medical care (hospitalization of about 8 months, much after care). She would be bankrupt in the US.

I’ve never had any complaints with Canadian healthcare, and I would absolutely NOT want the US “system” instead. However, I’m only 29, in good health, and haven’t really needed any complicated care beyond routine check-ups from my GP.

Since we’re trading anecdotes, here are my two:

Last summer, my uncle from the UK was visiting my parents in New Brunswick. One afternoon, he fell down while going for a walk. A few hours later he started complaining about extreme abdominal pain and vomited a few times. We took him to the Saint John Regional Hospital, and the triage nurse in the emergency room suspected he might have a kidney stone. Within four hours of checking in, he had undergone two MRI scans, and the doctors confirmed that it was a ruptured cyst on his kidney causing internal bleeding. For all the horror stories you hear about 6+ month waiting lists for MRIs, we certainly didn’t see it.

My sister-in-law moved from Vancouver to Indiana three years ago to accept a faculty position at Purdue University. Despite being in excellent health and having a really good insurance plan from the college, she’s already complained to us several times about health care in the US compared to Canada.

I’ve heard complaints about not having a two-tier system but of course that was coming from the rich who can afford it.

I remember several years ago listening to a radio commercial where the owner of a large jewelry chain in Toronto was complaining about the lack of a two-tier system in Canada. And of course, the former premier of Alberta, Ralph Klein wanted a two-tier system as well.

Here in Canada, the Canada Health Act does not allow private for-profit clinics that provide the same service that the publicly funded hospitals provide and charge patients for those services. There are private clinics that skirt the federal and provincial health acts by charging a “members only” annual membership fee of $3000 to $4000. This upsets a lot of people because it creates a bigger problem of finding a family doctor when more and more GPs are attracted to these private clinics.

I’ve got a couple of interesting stories to tell about Canadian health care, from two different, yet personal perspectives:

First, my mother, who’s currently battling cancer, has had an extremely positive experience with the Canadian health care system. Diagnosis was made quickly, with all necessary diagnostic appointments booked in a timely fashion (Ultrasound, CT, MRI, blood work). Treatment, at the cutting edge of the research for her type of cancer, was equally rapid with no waiting period.

Her oncologist is at the forefront of her field and is considered a world-renowned expert in this area (so much for the brain-drain!). The hospital, one of the oldest in Montreal (and slated for replacement in the near future), has a recently renovated oncology wing so the accommodations post-surgery and during chemo were clean, bright, and warm. The staff has been uniformly supportive and skilled, with a full team including oncological nurses and psychologists in place to attend to her needs. And, of course, at no time was there any question of treatment options being denied due to cost concerns.

Then there is my brother, the Emergency Medicine physician. He just returned to Montreal after completing his three year Emergency residency in Atlanta, at the Emory University hospitals. Most of the time he was working at Grady Memorial, which any of the Atlanta residents here will tell you is as busy, battered and financially bruised a US public hospital as any out there. Now he’s stationed at various McGill University hospitals, and still a resident (as here in Canada, the College of Emergency Physicians requires 5 years of residency). He’s just finished his first month of Canadian health care, and he’s seriously concerned about the system here, specifically as an ER doc. His primary beef is that a lack of nursing staff and rooms in Internal Medicine means that a lot more people end up in stretchers lining the hallways of the Emergency Room. In the US, even at the worst of public hospitals, apparently there has been more of a focus on getting people out of the ER and into the wards. He also complains about the facilities being dirty, and aged, but that’s because he’s working in the same hospital where my mother was treated, and as I mentioned, it’s due to be replaced by a new McGill “Superhospital”. I don’t think renovations are very common there, and are focused on the more critical areas.

All that to say that I don’t think I’d be as happy in an Emergency Room in Montreal as I would be in the US, but I’d get over it quickly when realizing that there’s no big bill heading my way once they get me out of my hallway stretcher. With serious illness, though, even backwards Quebec seems to be able to take care of its residents.

I personally would not trade my current health care coverage for anything offered in the US.

Canadian here, I’ve been to the ER 3 times so far. First time was a long time ago, tobogganing accident (we were doing ti somewhere we weren’t supposed to and it ended poorly). Broken ankle, I had to wait in the ER for about 8 hours before I got my X-ray and cast, I don’t remember what day it was. The second time I went was for cutting my hand open on a knife on a Friday night. I had to wait for about 6 hours, luckily the nurse disinfected and dressed it when I registered, and I got it stitched shut. The third time was for getting a large, heavy door slammed and held shut on my hand, I only had to wait an hour that time, it was also a Friday night.

I’d say the system works incredibly well, sure I was in pain while I was waiting but it’s not like my injuries were life threatening, and I got the medical help I required at no cost to myself.

I’ve always thought the anti-government-healthcare argument that Canadians have to wait so long to be seen by their Socialist doctors was pretty dumb. I mean, I’ve waited 8 hours in an airport because the airline screwed up my reservation. If I have a non-life-threatening injury and it’s a choice between being seen quickly for several thousand dollars and having to wait a while for free care, well, I’ll just bring a book.


Pain Management Advice

A few years back my dad’s wife had an aneurism and had to be taken to the ER. She ended up being in intensive care for over a week, had brain surgery and eventually died. The staff were very supportive and caring, and of course none of it cost anything.

Conversely, I have had to deal with a private insurance company for things like orthodics, that were prescribed by a doctor, should be covered by the insurance but not by medicare. First of all you have to pay up front and then try to get reimbursed, and it was a huge fight and I only ever got my money back about half the time. I can’t imagine going through that for something like my dad’s wife. It was a difficult enough time even with all the expenses paid for transparently.

When I lived in northern Vermont, there were regular, organized bus trips for people (mostly senior citizens) to go up to Canada to buy prescription medication, because it was just that much cheaper up there.

My experience with Canadian medicare in Quebec has been good across the board. I am glad to pay taxes to support it, though I would say especially Quebec it could be managed better. Still seems more efficient than the American system which at least from afar seems like a bureaucratic quagmire.

Moved the family up to Vancouver BC from Seattle 4 years ago, so we’ve seen it from both sides.

I can honestly say that I’ve NEVER missed the US system. My older daughter shattered an arm on the monkey bars and had surgery to insert various rods and pins to put it all back together. She got absolutely stunning care from the ER to the operating room to recovery. All for the bargain price of absolutely free.

Just before we moved here, my wife was hospitalized for a month with Guillain-Barré syndrome. Almost two weeks on a respirator and another two in recovery and physical therapy. I’d just switched jobs and our new health insurance kicked in 48 hours before she got sick. Two days earlier and we would have been bankrupt.

The US insurance industry is one of the worst health care provisioning systems ever invented. Somebody somewhere controls your access to care. I for one, prefer an elected government to a faceless corporate entity when it comes to those kind of decisions.

You bastards left NZ (and Aus) out!

NZ care is all pretty much in line with what the UK and Canukians have beensaying. Only difference is I think we have the best antenatal arrangements/system in the world. Private health insurance is available but isn’t really required for most things.

Live north of Toronto and have always been to the same hospital.

Been to the ER five times. Longest wait was around two hours (Friday afternoon which a fractured wrist), shortest wait was about ten minutes on a Monday morning at 9am for some hormone test (I think it was an ACTH test?). Okay, technically the shortest was zero wait time, but I arrived by ambulance. On that occasion I saw a doctor right away, and a specialist was there within the hour. Spent one week in hospital on two of those visits, only bills were the ambulance and the TV.

Just had my septoplasty done recently, as well. Saw an ENT and although I could have scheduled it much sooner, I postponed it due to school. Normally when you have a septoplasty, you wake up in post-op and then they take you right back to before and after care for a couple of hours and then send you home. There was a lot of bleeding after I had mine done, so the ENT/surgeon decided to admit me around 4pm. I didn’t get a bed/room until 8pm. Apparently there was one available, but there was a communication error. I was so out of it I didn’t really care where I was. The after-care nurses were awesome, and one stayed with me I’m sure way past the end of her shift to make sure I got to a room okay. Again, no charge for any of this, not even for the delightful opiates they gave me.

UK here, health care seems pretty good. Lets be honest if you are ill, the last thing you need is additional money worries while you get better.
The lack of a national health system is one of the major things preventing me emigrating to the US.

As an American, this is an extremely depressing thread to read.

It should be, your health care system is absolutely terrible, unfortunately most Americans simply don’t know it.

Bill Moyers recently interviewed Wendell Potter a former executive in the health insurance industry.

Wendell Potter on Profits Before Patients

UK. I love the NHS and it has many fine people working in it.

However it has suffered greatly from government interference. It would be far better if it were an independent organisation rather than a government department victim to the political whims of whoever is in power. Much of the money poured into it has been wasted on rip-off contracts with private firms or meaningless bureaucracy whilst key services have been pared down to a bare minimum.

Couple of examples:

I know a medic who works at a mid sized district hospital which has been turned into a factory for hip and knee replacements. It’s very good at doing those. However if you have a cardiac arrest or are in a car accident and smash your face in you’ll get taken to their A&E department. The staff at that A&E will assess you then transfer you to the big hospital in a city 15 miles away because the district hospital no longer has an on call cardiac surgeon or ENT specialist. This can delay urgent care by up to 2 hours. It would make much more sense to take such cases straight to the big hospital where they can actually be treated, but the district hospital still officially has a “full” A&E department so the paramedics aren’t allowed to do that. It would cause too many problems for local politicans if the reality of the situation were accepted and they closed the A&E.

One of the hospitals in the city I refer to above recently built a new wing. It’s state of the art and very nice. However they funded it by selling the land and buildings of the hospital to a private company and renting them back. The private company will clear a profit after 10 years but the rental contract continues for a further 20 years. The annal rent is much more than the interest on a loan to build the new wing would have cost yet the payments will carry on indefinitely. The private company has increased the rent each year above the rate of inflation because the contract allows them to do this. This way millions of pounds that could have been spent on healthcare are funneled straight back out of the NHS into the hands of private investors. At the end of the contract the private company may decide that the land the hospital stands on is more valuable as offices or housing so (though unlikely) a major teaching hospital in the centre of the city may have to move!

HK and UK here. HK is like the UK system, but better (small urban area, so coverage is easy/ efficient) and has a small co-pay (to ensure no “frivolous” use, but if you are low income, it is waived)

Anecdotes - friend cut his arm badly on glass on an outlying island. Helicoptered to A&E, operated on, kept overnight. Cost 250HKD (about 35 USD) Food was good…

Another friend’s child has leukemia. Again, no complaints, dedicated childrens’ oncology unit.

In UK, my father has good and bad. Ten years ago, a cataract op went wrong, and he lost his sight in one eye. He refused compensation and waived his right to sue, saying it was just one of those things…

He just had another eye op, which was fine. He now has vascular dementia, and has had MRIs, home visits by specialist, as well as nurses and also the NHS is giving my mother support (training in how to care for him, making sure she isn’t too stressed etc)

HK is better, because of the geography, but both work. AFAIK they both deliver longer lives & better health than US, and are much cheaper (both in absolute, and % of income)

Doctors are solidly middle class, but not rich in both places. There’s also an strong element of socially approved rationing in both (sick kids get almost unlimited resources, but a 65 year old smoker who has a kidney problem will get dialysis, not a transplant) and a hospice culture - i.e. asking/ telling terminally ill patients to forget about treatment, and focus on pain management/ death with dignity. This also keeps overall costs down.

The health-care sector has long ranked with financial services and energy interests as one of the most powerful political forces in Washington, and it spent nearly $1 billion on lobbying in the past two years alone. As momentum moves toward overhauling health care, major medical groups have stepped up their lobbying and campaign activities while shifting money and attention to newly empowered Democrats, according to federal records and industry experts.

I’m sure it’s got nothing to do with bipartisan campaign donations. (WaPo March 2009) This stuff is annoying because it’s the larger theme of politically-connected entities obtaining special preference in law.

Free speech should be free of charge grumble. /tinfoil

Canadian here.

As I have said before I have had numerous cases in my family of cancer and each one has been treated promptly, the staff were generally pleasant, and the care overall was good. In particular my family had nothing but good things to say about the hospice care of one on my uncles. Also unlike everything I had read in the press there was generally very small wait times for imaging (although it was difficult to get a PET scan in one case).

Also there have been a good number of heart attacks within my family and they have all been treated very well, IIRC, 3 bypasses, 1 stent, and 1 heart transplant. All were huge successes (especially the heart transplant).

There have been one or two problems however, one aunt was misdiagnosed at the emergency room, IIRC, she had gallstones (I could be very wrong on this one, however it was something like that) and she was told she had a stomach ache and told to take some over the counter medication. The result was that a few days later she had to have the organ removed. Quebec, what do you expect? Clearly malpractice but in the Canada there is little recourse.

Overall for my family I would say that Canadian health care has been a hugely positive. Only one of my relatives (maybe two) could have afforded the care they got in Canada in the US. I don’t know what would have happened. I would guess that they would have gone bankrupt in the US. Maybe they would not have gotten the care. Maybe I would have been footed with the bill. Good times.

I personally got screwed by the Canadian system, but that is probably my own damn fault. While it worked great for me in the biking accidents I got into (three, maybe four visits to the ER, two ambulance rides to the ER, perhaps I should not ride a bicycle), I got screwed by getting PRK in Canada. My doctor was a useless turd who turned off the safety protocols on the laser and this resulted in my correction being entirely screwed up. At least in the US I would be able to sue and perhaps put the bastard out of business but in Canada I had (essentially) no recourse.

Anyway, if I had to compare the two systems (I have lived in the US for over 10 years), I would have to say if you work at Microsoft (or are quite wealthy) the US system is better. By better I mean that the hospitals are prettier to look at, the number of tests ordered is quite larger, and the number of hours that doctors are willing to spend with you (when you are not clearly sick) is far greater. Does that yield better results? I don’t know, the stats seem to suggest that overall no (although to be truthful it does give me piece of mind, but were I paying for it the costs benefit seems out of wack). However for vast majority of the population (90+ %) the Canadian system is better.