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03/28/2008 10:23:45 AM · #26 |
Originally posted by karmat:
I also have a question. Most of the incidences I see mentioned here seem to be "emergency" situations where we would go to the emergency room or urgent care.
What about "maintenance" or "preventative" health care? I ask because one of my Canadian friends mentioned that she has waited over a year (and is still waiting) to get an appointment with a doctor for an exam. Apparently, if you are not an "established" patient it is difficult? How easy is it to schedule children's "well-baby/child" check-ups, OB/GYN visits, etc.? What about specialists for a non-emergency situation? |
Currently, my waiting period is about 2 months for a regular appointement. Well-baby is organized in advance with my nurse. I don't do Ob/Gyn, but the family MDs that do here schedule their patients for regular follow-up.
Even though the waiting period is about 2 months, when the patients call for an appointement, they can always leave a message with the secretary, and if he has to be seen faster, we fit him in.
Specialst appointements is often another story. A routine consultation can take some time to be done, sometimes many months, but whenever a patient needs to see , say a surgeon in a semi-urgent manner, it is done fairly quickly. If we need to have a patient seen in an urgent way, most of the time a simple phone call to the specialist gets him in the same week, often the same day. Same thing goes for investigations, like blood tests and radiology. Of course there are exceptions, but mainly that's the way it works out here at home.
It is true that when we are paid "per-service", the more we see patients, the more we get paid. Sometimes we get Docs who are "high rollers", and tend to do the easy work...Only seeing "healthy patients". (NOT the way I like to work). The reverse is also true where we get salaried MDs, and often these guys have no detailed contracts and get to see just a few patients per day with the same pay---I feel this slows down the system more often than not. |
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03/28/2008 10:28:28 AM · #27 |
| I can only say I am glad it exists. I would be dead if it didn't. Dead from suicide because I cannot believe the price it would have cost me 5 years ago after having a major health problem. I simply would not have been able to pay. What then? |
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03/28/2008 10:28:29 AM · #28 |
Sounds like those in the medical profession, i.e. Doctors, specialists, etc... are paid directly by the Canadian government, yes? Are they well compensated? In other words, are they rewarded for the extra skills and education required for their chosen profession?
I ask because I'm having a hard time envisioning such an environment here in the U.S., and the obstacles to overcome to make the transition to a universal healthcare system. |
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03/28/2008 10:32:20 AM · #29 |
| After my somewhat recent experiences being outside the "Employer-provided healthcare" system here in the U.S., I can tell you that a wait to see a Dr. would be a blessing over simply being refused coverage which essentially translates into being denied access. I don't want to digress too much, but one of the greatest shortcomings of the U.S. Government is their repeated failure to ensure access to affordable health care for all people who live here. |
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03/28/2008 10:36:03 AM · #30 |
Originally posted by BMacD:
BUT, there are areas that do not have enough family doctors. Then you rely on clinics or the emerg. Department. Usually first come first serve unless it̢۪s an emergency. |
Usually, all ERs work with a triage system and it is NOT on a first come first serve. The sickest patients are seen first, and the least sick are seen last, thus the long wait times.For example, when a patient comes in and the triage nurse finds symptoms compatible with, say, angina or oncomming heart attack, that patient should be evaluated by the ER doc within 30 minutes.
I often see patients that tell me they waited all day in the ER. After checking out their story, I find out the patient was evaluated in a timely manner, had testing done (Here, the lab gives out results for ER tests in 60 min), has treatments done (often served lunch while waiting for the results) and then is discharged at home. True the patient spent the day at Emerg, but not waiting for the Doc! |
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03/28/2008 10:41:31 AM · #31 |
I'm CDN, saw Sicko and gawd am so glad I live up here. Yes it sucks that we now have to pay a premium for health care, but better that than having to pay up bazillions of dollars for healthcare. There are more private clinics springing up now but they seem to be quite specialized. If you go to a walk-in clinic you can expect to wait a while, but will be seen. I've had a few trips to the ER and have waited from 45 min to 2 hours to get seen (after being checked out by a triage nurse).
My dad was an MD so growing up had no problems getting referrals to specialists when needed, but even so it was on average a 2-mth wait. Still was when I had to see a specialist recently. Getting a GP esp in rural areas can be tough; fortunately my then-neighbour worked at the medical clinic where the GP was setting up her practice, so I was able to get in easily. Generally I've had to wait no more than 1-2 weeks for an appointment with her.
Hope this helps. |
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03/28/2008 10:42:00 AM · #32 |
Originally posted by glad2badad:
Sounds like those in the medical profession, i.e. Doctors, specialists, etc... are paid directly by the Canadian government, yes? Are they well compensated? In other words, are they rewarded for the extra skills and education required for their chosen profession?
I ask because I'm having a hard time envisioning such an environment here in the U.S., and the obstacles to overcome to make the transition to a universal healthcare system. |
Yes we are paid by the (Provincial) Governement. We are relatively well paid (I can afford to buy a Sigma 70-200, 2.8 without my SO freaking out), and the specialists are paid more. The negotiations are done, in New Brunswick, by the New Brunswick Medical Society, which is more or less our "Union". We do however, for most of us, have pretty high overhead costs, paying for our office and supplies, secretaries, nurses... |
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03/28/2008 10:56:35 AM · #33 |
Speaking from the inside...I wouldn't have it any other way. It's not a perfect system (I don't think there is such an animal anyways!) but it works and everyone is covered, no one has to worry about not getting that cancer treatment because they can't afford it, no one has to be afraid of going bankrupt because they got into a car accident and have to spend the next month in an ICU. Are we well compensated, I'd say we make a pretty decent living. Could we make more in the USA? Maybe, maybe not...I have a few classmates who went to the US for a few years and came back home because they just could not cope with dealing with the insurance companies and the various bureaucracies involved. Here we all get paid by the government with fees negotiated by our association. We deal with ONE bureaucracy instead of the various insurance companies in the US. When you hear about long waiting times in the ER...well if you need really urgent care (heart attack, asthma attack, or any other life or limb threatening emergency there is no wait. People who end up waiting for hours are those who come in with a sore throat or constipation...even then, if the ER is not busy they get seen fast.
So in conclusion I'd say we have a pretty good system.
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03/28/2008 11:00:56 AM · #34 |
| Just FTR, the ER can be a nightmare experience here in the U.S. also regarding wait times. |
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03/28/2008 11:26:48 AM · #35 |
Not meant to Hi-jack in anyway. Last Thursday I got really bad stomach cramps (lower-right), I don't have insurance (US), and have no money to pay for appendicitis surgery, I was scared. I had no-choice but to try and wait it out, which meant the weekend, and an emergency visit if necessary, or a possible rupture.
In the US, this is considered S.O.L. or Up S. Creek. I prayed to the blue in the sky. It helped, and I healed.
The funny part of the story is in hindsight, I think it was an injury sustained during hyper intense intimacy. (lesson-learned) if not insured, go at it slow and easy. LOL.
I still have mild-cramps, and am now considering maybe hernia, or maybe somekind of pulled muscle.
Message edited by author 2008-03-28 11:28:31. |
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03/28/2008 01:33:16 PM · #36 |
| I wanted to ask the Americans -- Alex and I were talking about this on the way to work today. We were wondering if, say, somebody with no health insurance broke their arm with a compound fracture and had to be rushed to emergency. If they are not covered, and cannot pay, are they simply out of luck? Will the hospital refuse treatment? |
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03/28/2008 01:36:39 PM · #37 |
long waiting lines are in the states too.
I took a senior that i was supervising into ER as he was disoriented and making no sense and his face was drooping on one side. We sat and waited 3 hours... the senior laid across a bench.. ended up shivering and cold and wetting himself and the bench several times before they took him back and found out he had pneumonia.
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03/28/2008 01:48:01 PM · #38 |
Supposedly nobody is refused urgent treatment, as there are charities and write-offs that "cover" those that can't pay. I've seen this first hand, as my son broke his wrist, bad, while we were not covered. There was paperwork to fill out and calls to make, but while all that was going on, he was in surgery. You don't hear of anybody being "refused", although I imagine it happens sometimes.
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03/28/2008 01:48:39 PM · #39 |
| Yeah, I kind of thought that was the case. Glad to hear it. |
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03/28/2008 01:51:30 PM · #40 |
I wanted to ask the Americans -- Alex and I were talking about this on the way to work today. We were wondering if, say, somebody with no health insurance broke their arm with a compound fracture and had to be rushed to emergency. If they are not covered, and cannot pay, are they simply out of luck? Will the hospital refuse treatment?
Louis, I did just that, or similar anyway. I broke my hand in two places, and had to go to the emergency without insurance.
The nurse took an x-ray, and the doc came in the room looked at the x-ray and told me it was broke twice. The nurse came back in to put a bandage around it, and told me the doctor gave her this card to give to me, it was a business card for a "supposed" hand specialist. Done. And then charged me $600 for what I could of got at Wal-mart for 5.50.
My hand has since grown into whatever, I mean I still don't have a knuckle. 600 bucks. |
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03/28/2008 01:52:05 PM · #41 |
covering the situation with my local hospital for our newspaper, i have to say a lot of hospitals in ontario, canada are getting passed over. long waits, shortage of emergency staff, etc is all we hear. we started paying this health premium a few years back, which is a minimum of $300 a year for taxpayers, and i haven't seen any improvement myself. mind you, i haven't (knock on wood) needed to visit the hospital, only a walk-in clinic in the last couple of years.
but family doctor service is hard to find and when you do find one, they don't spend much time with you because they have so many patients to see.
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03/28/2008 01:57:13 PM · #42 |
True story.
My cuz broadsided a woman running a stop sign. She (insured) Him (not).
His head smoked the windshield, and busted him wide open. Huge trauma on the one side of his head. After 2 hours he was released to the authorities to serve time on a speeding ticket 4yrs prior. The lady stayed...for I'm kidding you none...a hurt foot. |
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03/28/2008 01:58:36 PM · #43 |
Originally posted by Louis:
I wanted to ask the Americans -- Alex and I were talking about this on the way to work today. We were wondering if, say, somebody with no health insurance broke their arm with a compound fracture and had to be rushed to emergency. If they are not covered, and cannot pay, are they simply out of luck? Will the hospital refuse treatment? |
It depends on the hospital. A certain number of them are required to take you whether you can pay or not. Some will refuse you. I went to a hospital with chest pains at the age of 36, with no insurance. I was told to go to a different hospital because a) they didn't feel I could be having a heart attack at that age and b)they didn't take people without insurance. I went to another hospital where I had angioplasty to clear a main artery that was blocked 95%, had 2 stents put in and a bill looming over my head of almost $35,000. Because of the hospital I ended up in, I didn't have a heart attack. I did manage to get most of the bill (the hospital part) waved, but still owed close to $10,000 for the doctors portion, which no matter how little money you have you are responsible for. Thank god when I had the two heart attacks that I had, I was covered. That was a total of 9 days in CCU, at a staggering cost. I can tell you that during the first episode 8 years ago, I waited days until the pain was so severe I really did think I was dying before going to a hospital because of lack of insurance. And I can also tell you that it is so hard to get out from under those staggering medical bills that sometimes you wonder if it was worth it to have your life saved in the first place. |
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03/28/2008 02:14:05 PM · #44 |
| I live in Canada and I've never had a problem with the health care system. The waits are long, but that is usually due to the severity of the case. I've never had to pay for anything except a few prescriptions. I was in the hospital for two weeks as a kid for osteomyelitis and I was sent home with a wheelchair, IV machine, everything paid for and my parents didn't have to worry about anything. It has its downs, but it is sure a lot better than having to pay for being sick. |
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03/28/2008 02:19:09 PM · #45 |
what are the taxes actually like in canada?? i know they are higher, and comparing the american tax system to the canadian tax system is a bit like apples to oranges, but what does the average candian pay in taxes on the dollar?
i know for my parents and their tax bracket they are at about 30 cents of every dollar goes to the government in some form, for me i get just about everything back in my tax return (between school/pro write-offs). |
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03/28/2008 02:34:12 PM · #46 |
From google search
Today (June 20th, 2007), is Tax Freedom Day, according to the Fraser Institute. For those who are keeping track, that's four days earlier than last year. The cut in the GST from 7% to 6% is the main reason for this "break."
This means that today is the last day families will be "working" to pay taxes at three levels of Government. As of Wednesday, we start working for ourselves.
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03/28/2008 02:53:53 PM · #47 |
The good, the bad and the ugly (IMO) of our health care system.
The good - nope, we do not have to put a dollar figure on our wellness. We are undeniably blessed for this. I can't imagine how terrifying it would be ill or to have a sick child and not know if I will be able to pay for medical care/treatment. Knowing that we will never be denied treatment for medical concerns (and we will not have to pay $600 to have a bandage put on our broken hand) alleviates what could end up being a horrible burden.
The bad - wait times can be horrible. Canada is a huge country, and some areas are better than others. I have lived in two prairie provinces and in both there seems to be a shortage of medical professionals across the board (doctors, nurses, specialists). A couple of examples:
We had to go to the ER with my daughter when she was about two. She had an extremely high fever, was severly dehydrated and was beginning to be non-responsive. We waited almost 2 hours in the waiting room. Thankfully, everything ended up okay. Another time, a close relative with heart disease went in at 2am with chest pain and difficulty breathing. She ended up waiting over an hour before she was seen by a medical professional (they took her info at the desk and she sat in the waiting room for the rest of the time). I have had a number of other experiences like this. That being said though, there have also been times where there was a very minimal wait.
Apart from the ER, it can be extremely difficult to find a doctor. We have been in Winnipeg since the beginning of 2006, we finally found a family doctor in the fall of 2007. There are a few others taking patients however many of them have malpractice suits/claims against them or they are located on the opposite side of the city from us (or both!). Finally, the majority of our walk-in clinics require an appointment. In the few that do not, a typical wait is 3 hours. This is 'a typical' wait. I don't believe, in the time we did not have a family doctor, that we ever were able to get in faster than that, even when we arrived first thing in the morning.
The ugly - there have been many times in which the medical professionals make severe errors. Prior to my daughter's diagnosis of lymphomatoid papulosis, we were told she had fleas, excema, as well as a few other conditions that I can't recall, and gave us treatments accordingly. We were applying topical steriods for a condition she did not have. She was 3 at the time. One of our family friends went to his doctor with severe abdominal pain and was told he had a bladder infection. He was prescribed antibiotics and sent home. When the pain continued to get worse despite the fact that he was taking the medication, he went to the ER. He had appendicitis and had to be admitted for emergency surgery. My husband had a skin condition on his face a couple of years ago. After numerous appointments and various different treatments, I found the diagnosis online, he went to the doctor and told him what he had and how to treat it. With no questions, the doctor wrote a prescription for what my husband told him he needed. I am not a medical professional, but I cured my hubby. In all cases it seemed to be more a case of the doctor simply not bothering to apply his/herself to the situation than a lack of knowledge. They just simply didn't take or have the time needed to properly treat the conditions. Again, these are not my only experiences like this.
So long story short, it is a wonderful thing to a universal health care system - we do not have to worry about paying for our health care. On the other hand, the shortage of medical professionals is definitely having a negative effect on the quality of the health care we are receiving.
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03/28/2008 03:08:20 PM · #48 |
| Phew, that was a little more long winded than I intended! Lol, stepping off my soapbox now.... |
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03/28/2008 03:31:03 PM · #49 |
| There is bad medical service, diagnosis, and practice in all systems, not just socialized ones. |
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03/28/2008 03:37:00 PM · #50 |
Originally posted by chris48083:
what are the taxes actually like in canada?? |
Here are the official federal tax rates from the CRA for 2008. In addition to federal tax, there is provincial tax. In the province I live, Ontario, there is also a health care surtax that can be as much as $700 per year, as little as $300, or nothing for low-income workers.
The health care surtax was introduced by the Liberal government in their first majority term (they're in their second) to ensure Ontario's health care system didn't collapse, due to the severe mismanagement it received at the hands of the previous Conservative government (which also lied about the province's multi-million dollar deficit during the election campaign in which they were soundly trounced).
Edit: the above-referenced URL also includes the provincial tax rates lower down. In Ontario, the rates are well less than half of the federal rates. Also consider that RRSP contributions lower individuals' tax burden -- this year I got a healthy refund due to my contribution.
Message edited by author 2008-03-28 15:41:37. |
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