Personal experiences with health care in US and Canada

I'd like to share with you some of my personal experiences with healthcare in both the US and Canada. I have lived in the US most of my life, but went to Canada for four years to attend a graduate program and was eligible to put myself and my family on the Canadian health insurance plans.

I had to go on COBRA in the US on two separate occasions, and the cost for my family and I were $1000 and $1300 a month, respectively. Of course, I had to pay this at a time that I did not have a job or any source of income. I had to choose COBRA becase pre-existing conditions made my wife and I ineligible for any private insurance. I had to cash in 401K plans to pay for health insurance.

On another occasion, when I was single, I was self employed, and tried to get private health insurance, and was turned down by every company. The reason? During one brief period (for a few months), a doctor had given me prozac to see if it would help with insomnia problems I was having at the time. He thought that mild depression might be causing my insomnia. Boom -- nobody would cover me later on, because I must be a psycho or something. And this was at a time when every 4th ad on TV was for some type of anti-depressant. I was able to finally land some ridiculously priced catastrophic coverage.

Immediately upon getting married to my wife, I tried putting her on my insurance plan. But the insurance company kept stalling stalling stalling for some weird reason. Finally, after two months, they reported that they had lost the paperwork and we had to start over again. But she had gotten pregnant in that period. No insurance company would cover her, for any reason, for any amount. I had to pay $20,000 for the birth of my son, due to some complications during pregnancy. I am sure, to this day, that it was the unwritten POLICY of insurance companies to stall on insuring newlyweds for the very reason that so many get pregnant right after marriage.

My wife gets migraine headaches. One insurance plan we were on would only allow her 8 Imitrex pills a month for migraines. So on a few occasions, she has run out of Imitrex, and has gone to the emergency room because the pain was so severe from a migraine. The cost for these visits (billed to insurance) has averaged around $1,000 a visit. They always do the same thing -- 5 minutes with a doctor, a shot if Imitrex, a shot of anti-nausea medication, let her sit for an hour, then send her home. $1,000.

Now -- move to Canada.

My wife suffers from rather severe pain due to a neck injury she received in an auto accident shortly before moving to Canada. She desparately needed a pain specialist. Well, there were very few pain specialists in the province of Alberta. She got put on a waiting list to see one, and stayed on that waiting list for 4 years, and never saw one. She never moved up on the waiting list. We were told when she first went on the list that she would have to wait 1 1/2 years. We were told at the end of 4 years that she was still 1 1/2 years away from seeing anyone.

To combat her pain, she had to take ever increasing dosages of pain meds. Then they refused to raise the dose anymore, and instead slapped her with the label of "drug addict". They forced her into a drug withdrawal program for a month where she basically sat in a hospital bed with almost no help for 30 days. She left on her own due to the excrutiating pain she was in. She eventually found a family doctor that was willing to put her back on pain meds, with an absolute ceiling on the amount prescribed.

Her neck injury involves a rare condition where there is a bubble of fluid in her spinal cord. She really needs MRIs and CT scans to monitor this situation. In the entire province of Alberta, there are exactly 2 CT machines -- one in Calgary, and one in Edmonton. It typically took MONTHS to get a CT scan, IF they decided that you should get one. Otherwise you were shit out of luck. In her case they allowed her ONE CT scan in 4 years. One. And it took 3 months to get.

While we were in Canada, the Liberal party started complaining about the ridiculous waiting lists for getting treatment, given that Alberta was awash in oil wealth at the time. Canada, or at least Alberta was mass generating "drug addicts" (like my wife) who had to wait 5 years for knee replacements and shoulder replacements and the like, and in the meanwhile, got hooked on oxycontin and other similar drugs. So the Conservative Party's response (they were in power) was to do nothing about the waiting lists but to, rather, crack down on the pain meds, making them more and more difficult to get, until these poor people (like my wife) were labeled drug addicts and forced into rehab when their only sin was massive pain. Doctors became absolutely paranoid about prescribing any pain meds because doctors were being prosecuted for this. The message to the liberals? Don't complain, or we will make things even harder on you.

In a one year period in Calgary, there were two deaths in hospital waiting rooms from pregnant women hemmoraging and bleeding to death -- right there in the waiting rooms. These were big scandals, indeed, but they happened.

Our entire family knew that you had better REALLY need to go to the hospital if you went due to the atrocious waiting times. One time I took my daughter in for an apparent allergic reaction to something (we weren't sure what, but she had red bumps all over). They DID see her pretty quickly (3 hours) because they considered it potentially life threatening. However, there was an 80 year old woman there with the flu who had been waiting 12 hours. Her family was taking 4 hour shifts staying with her. She still hadn't been seen when we left, and I have no idea how long she had to wait past the 12 hours I knew about. Our family finally realized that we would only go to the hospital if it was serious enough to be taken by ambulance, because then you were treated within a couple of hours or so. Otherwise -- forget it. And we also realized that this was conscious policy on the part of the health care system there -- constant pressure and intimidation NOT to seek help if possible.

I had some serious medical problems too that I don't want to go into. However, I continually ran into the situation that if something was life-threatening, it was taken care of. But if it wasn't -- forget it. I had an operation that saved my life, but then later on I needed a second operation to repair some significant damage caused by the first. That second operation never happened. Forget it. I was even lectured by a doctor that "how dare I insist on a non-critical operation that could take away medical services from someone needing the help to save his or her life". I am now seeking that second operation in the US, and the doctors are absolutely shocked that they would not do it in Canada.

These are just my direct experiences of both health care systems. Neither is in anyway satisfactory. The "for profit" situation in the US is absolutely brutal and inhumane. However, my experience of the Canadian system (at least in Alberta) was that it was completely neglegent in many ways. I do not know the answers for either system. Well, in both countries, people obviously must complain. Canada's system would work with one simple fix -- more resources being pumped into the system. (2 CT machines in all of Alberta is completely ridiculous). But my experience is that, for some reason, Canadians simply put up with this neglegent system for some reason. Canadians put a very high emphasis on cooperation and getting along with one another, but in this case I think this goodwill is misfounded.

but that's about it. A pain specialist would write a contract with her that includes counseling sessions along with a set amount of pain medication. Exceeding the dosage is not recommended and can result in referral to detox along with other nasty options.

Chronic pain patients aren't treated well here, either, in other words.

Acute problems are treated in a timely fashion, but even the Canadians admit that chronic problems are put on the back burner forever.

I have never met a Canadian who would trade their system for ours.

You might not like your treatment up there but it didn't bankrupt you, did it? It might have here.

Example: http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070914/belinda_Stronach_070914/20070914


Free and first-class--if you can wait: http://www.cbsnews.com/stories/2005/03/20/health/main681801.shtml?cmp=EM8705

"If the person named on this computer-generated letter is deceased, please accept our sincere apologies."

To make matters worse, Canadian doctors are bailing out of the Canadian system, and coming to the US where they can make a buck. They've been doing this for over a decade, and they're quite willing to work in US rural areas, which makes them a good recruitment bet: http://www.cmaj.ca/cgi/content/full/176/8/1083

And, thanks (?) to a conservative government, private health care is a thriving business in Canada nowadays. The Supreme Court there has ruled that it's "OK" ... and that could spell trouble in future: http://www.timelymedical.ca/

While recognizing that many Canadians believe that we have one of the best health care systems in the world, the founders of Timely Medical Alternatives Inc. also recognize that there are some 875,000 Canadians currently on the waiting list for referrals to specialists or for medical procedures.

Our organization was formed in 2003 to help Canadians from coast to coast, to "Leave the queue" and take personal responsibility for their own private medical services.. Since then we have helped hundreds of Canadians obtain second medical opinions, MRI's / CT scans / PET scans (within days) and surgery (within weeks). We have helped our clients to regain their mobility, to get relief from chronic pain, to get diagnoses of illnesses and we have, in some cases, helped to save the lives of a number of our fellow Canadians.

....Are you one of the 875,000 Canadians on a waiting list for medical care? Are you aware that private health care is thriving in Canada?

and quite a few people from South America coming for specialized care.

I don't think I ever saw a Canadian as a patient.

For some procedures they will, because it's close and the exchange rate is favorable right now. But sometimes, they'll go elsewhere as well, as will Americans--medical tourism is a growing enterprise. I know people who run to Brazil to get stuff done; they save a bundle.

Medical tourists have good cause to seek out care beyond the United States for many reasons. In some regions of the world, state-of-the-art medical facilities are hard to come by, if they exist at all; in other countries, the public health-care system is so overburdened that it can take years to get needed care. In Britain and Canada, for instance, the waiting period for a hip replacement can be a year or more, while in Bangkok or Bangalore, a patient can be in the operating room the morning after getting off a plane.

For many medical tourists, though, the real attraction is price. The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the U.S., for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa.

http://www.udel.edu/PR/UDaily/2005/mar/tourism072505.html

Here's a site that specializes in this stuff--I don't endorse it, I'm just pointing it out: http://www.medretreat.com/

Saudis and Kuwaitis come to Beantown because Boston has some of the best hospitals in the world. Sometimes, they'll just import the operating team. They've got some pretty sweet facilities over there, themselves. They just don't have the quality of sawbones.

And I do know all you medical professionals work your butts off, but fact is, only some of the people get some sort of care some of the time.

I am in debilitating pain most of the time. Have been for over 13 years. No, I don't know why because nobody will make an effort to get to the cuz. Several doctors have made extremely hostile remarks about me just wanting drugs. No, I can't take pain meds. I want an explanation and perhaps some real course of treatment.

Oh, they do complain about my blood pressure. And after 11 years of complaining, ONE of them wrote a script for something to lower it. What I notice is the blood pressure goes up the worse the pain is. When I don't hurt as much and can move around better, get sleep and enjoy one day or so, it goes down.

Pain is getting crippling. Still don't know what/why. No body orders tests beyond blood work. No x-rays, won't even look at the area that is chronic. Can't walk a block without being bed ridden next day. Getting to where I can't walk across the house and it is really a cottage.

My experience is that Americans are also neglected. When I reach a point, I will stop the pain myself. Only question is: will my ethics allow me to take insurers with.

and no predatory middle actors eg insurance companies for most people. This pays for the program.

Payment by consumers based upon ability to pay and avoid abuse of the system.

Cheap, merit-based admission medical and associated schools.

More research and infrastructure for the mentally ill.

Jobs for education expansion and more medical professionals now in short supply.

More research too from larger education institution.

Professional grads from the medical schools have a commitment for X time in the public sector but then can leave for profit-based health care to serve the economic elite (who can buy insurance or pay-as-go).

Massive amounts of new jobs, efficiency in administration, expanded research, readily available medical service for all, and more compassion.

The economic elite have their "freedom" and the rest have a basic human right of rational health care.

It really is that simple, isn't it? Just take the leeches out of medicine, and I don't mean those somewhat helpful critters from swamps.

Health care system that would pencil and have a multitude of social benefits and even that pursuit of happiness thing.

Politically difficult, and even if inacted in concept one has to factor in parties that in any case will act in poor faith to their own benefit.

IMO each American should be able to not only have health care but should be able to have the choice to build long term personal and trustful relations with medical professionals and para-professionals.

Part of this will require a chnage in mindset of medical professionals and para-professionals.

There is a self-selection process in the medical (and financial, military, etc) fields that is similar to what we too frequently see in our elected reps; specifically, working at odds with their own constituents because of inertia and social networks and $$$ making the rules.

I was in a remote area, in the military, and the US and UK had a deal where those of us working overseas had access to the NH care system--and on an expedited basis, too--faster than the average citizen.

I was pretty healthy and rarely needed them, but one time I did need the care of a doc. I still had to wait a couple of months for a specialist's appointment--on an expedited basis. It was absurd, but my neighbors (also on the service, but as civilians) were amazed at how "fast" I was seen. I ended up "self medicating" and took care of my complaint using herbal remedies. By the time I saw the specialist, I was "fixed," and the specialist had a short job of it. I only went to "make sure."

Both systems suck. One is a leech that sucks you dry of your money. The other gives shit service, spread out amongst too many patients with insufficient providers.

There needs to be a better way. I don't understand why we, as a nation, don't make better use of nurse and physician's assistants. You don't need to see a highly educated person with a specialty or ten to get a cream for a simple rash, or to get a boil lanced. We need more "medics" and a better system of triage so everyone doesn't end up at the ER, from the splinter in the thumb to the heart attacks and gunshot wounds, waiting for "the doctor" when the medic will do.

stepped on the plane in the states.

the same day i arrived in london, i walked into a clinic & was seen in 15 minutes.

a citizen of UK or on a State Department exchange of services/SOFA agreement.

health service itself.

have a card issued as a result of an intergovernmental agreement, you'll be charged--plenty-- for any care you get.

plan? A little of both (hopefully the better half)?

I haven't experienced that at all. Ive had little anecdotal experience in the ERs in BC, but I experienced similar waiting times to the US. As for private clinics, I normally get into those for general medicine purposes several times quicker than I would in the states. Different province, different problems.

But its also tough to comprehend that for family insurance for a month ($108), Ive spent over 10X that amount in the states for 15 minutes and two stitches. To each their own, I guess.

Do I mind waiting for a specialist and operation here in Canada? No. I didn't wait in the US. I couldn't afford it so I medicated myself with beer/naproxen/ibuprofen/pot

On the other hand, I think people are fooling themselves to think that rationaing/limiting services isn't a reason single payer is cheaper. The point is to help the public by keeping them from dying (or becoming an indentured servants as an alternative). But the goal doesn't always reach beyond that. I prefer this practical approach (life without chains) to the US alternatives of death or work detail for life.

I think the system is set up that way in hopes many will give up or die.

No system is perfect, but life without chains is worth everything.

convinced that no country has the answer to government sponsored health care that many people expect for the very reasons you describe.

Every country with government sponsored health care has some type of model to ration or allocate scarce medical resources based on a cost-benefit model, e.g. UK's NICE, and Obama recognizes that as a problem that has yet to be fully debated by congress.

See related DU thread, President Obama's Grandmother and the Ethics of Health Care Reform

Most Canadians who post on this site are happy with their medical care. My one experience involved the comparison of services provided to a Canadian and an uninsured American (me) for the same critical condition. Both illnesses were gall bladder attacks that resulted in pancreatitis and both happened within the U.S. I was sick for 3 weeks before finally seeking medical care after realizing it was a life-threatening event. I had to wait several days to see the gastroenterologist and, in the interim, began to improve. When he saw me he was prepared to admit me to the hospital and call a surgeon re the gallbladder . . . until I said the magic words "no insurance." Suddenly my treatment amounted to 2 blood tests and bed rest at home. The Canadian woman was visiting a neighbor when the exact same event happened to her. She was taken to the local hospital and later transferred to a major medical center about an hour away. The doctors there contacted the Canadian health authorities to have treatment authorized. The Canadians opted instead to fly a private jet with a medical team to this hospital, pick up the patient and return her to Ottawa for treatment. She recovered nicely. I recovered, too, but not without enduring much pain. If we ever get healthcare I'd love to find out how badly damaged my pancreas is as a result of being left out in the cold.

it simply must be funded adequately.

I am on a public funded health care plan now in the U.S. It is called Medicare. My mother was on Medicare, just Medicare with no supplemental plan, until she died 3 years ago at age 94. She always got her proper care...

I found that there was excellent care available in the US, as long as you have a great job with great benies. It costs, and I couldn't have imagined making a move to quit or contemplate some other career choice because I'd be either not covered at all, or stuck with an inferior benefits program. The system in the US encourages a corpie slave mentality. And then on the other end of the spectrum, there are those not covered at all. An aquaintence got hit by a car and beyond running to the ER for a quick "yes you'll live" diagnosis, she got no care for her banged up body. She lived with pain for years.

Canada has its problems, highlighted recently by the death of Natasha Richardson. There are waiting lists, but it's also luck of the draw. I've known people who were on lists for surgery, told they'd have to wait months, but then ended up getting in after a week or so. An elderly family member was diagnosed with cancer, and because of her age, we were encouraged to let the disease run its course while keeping her comfortable.

In the US maybe she'd have had a chance at a few extra months or a year. In Canada, the greater good rules, and so the cost of keeping a 75-year-old alive for 3 months extra is banked against all the others that could be helped. That being said, I was amazed at the great care she received in the palliative care unit. My God, her room was enormous, beautiful view, showers for family members, and the docs and nurses were true angels. She passed in peace. In the US well, that would have cost a fortune.

Some of the problems in Canada arise from abuse of the system and shortage of doctors. My GP announced she was going into psychiatry so she could make a better living (she was kind of wacky so I shudder to think how her patients fare :) ) and although I have no figures, it's common knowledge that doctors have their salaries capped. Many move to the States to make more money. Brain drain is an issue. As for abuse here's two: My wacky GP was constantly late and it wasn't unusual for her office to fill up on a Monday morning. When you come in, the nurse swipes your Medicare card. On one occasion, 12 of us were informed, after waiting for eons, that she wasn't coming in at all. Only one person thought to tell the nurse to "unswipe" us. That would've been 12 "free" visits billed.

It's also not uncommon for people, as in some orthodox religious communities, to intermarry with Americans. The woman will claim her parents' address and keep up her medicare card. Although living in the States, she'll visit Canada twice a year for check-ups, have her children there, etc... At one point, there was joke about the religious bus that carted people back and forth from NYC once a month for that reason. Also, illegal immigration has risen sharply, Canada has taken in many refugees in the past years, and this also puts a strain on the system.

Some of Canada is sparsely populated, with pockets of people here and there and so it's probably more difficult to get services in the middle provinces. People who live in Toronto, Vancouver or Montreal likely fare much better, and both Toronto and Montreal have world-renowned facilities, like Toronto Sick Kids for example.

I was in a car accident while traveling in Alberta (my home was in B.C. at the time), my car was totaled but I was not injured badly enough for the ambulance. I was taken to emergency by family members shortly after to ensure there was no serious damage done that was not immediately apparent. I waited in emergency for no more than 20 minutes, was seen by a doctor within a further 5 minute wait, had my left hand ex-rayed and a cast put on because a key bone in my hand may have been broken and it is crucial to immobilize the hand until the swelling goes down enough for the break to show up. As I was planning to return home in a few days, I was advised to make an appointment to see my own doctor within a few days of returning home. It cost me nothing, I only had to give my PIN (health insurance number).

I flew home to B.C. two days later and made an appointment to see my doctor and was given an appointment the next day. Another x-ray was taken but it was still unclear whether the bone in my hand was broken so the cast remained on and I was told to make another appointment for a week later. I did so, another x-ray was taken and it was now clear the bone was not broken. The cast was taken off and I was fine. Again, I incurred no costs for my visits.

At that time, I paid $56.00 a month for my healthcare. I now reside in Alberta and I do not pay anything for basic healthcare and 21.00 dollars a month for extended healthcare (vision, dental, etc).

My sister's personal experience with Canada's healthcare in Alberta. My sister was diagnosed with terminal cancer while living in British Columbia. She was able, for a time, to remain independent and receive care as needed but the time came where her health had deteriorated enough that she was in need of further care. Her daughter lived in Calgary and my sister moved in with her and her family. Within one week, she had an appointment to see a cancer specialist, was entered into an approved clinical testing program. For the first three months, her care was covered under her B.C. medical, after that she came under Alberta medical. This care sufficed for approximately 6 months but there came a time where home care was needed to help my niece. There was no problem receiving it in a timely manner. As a result of the care my sister received she lived approximately one year longer than she was given to expect. As her cancer was terminal, there came a time where hospice care was needed, she entered the hospice where she was lovingly cared for, where she died shortly after.
Her medical costs consisted of the cost of her prescriptions and those costs were subsidized by the government. There were no additional costs for her home care, doctor visits and her time in the hospice.

I can also detail the care my mother received, my in-laws, my children, etc, but they would be very similar to the two experiences I have described.

Our system is not perfect by any means but your experience, from all I know and have heard, seems to be an exception to the norm. There are waiting lists and one can go online to see how long they are.

Wait time for CT scan:

Actual Patient Wait Times for Persons served in the 90 Days preceding Sept. 30, 2008:

3 weeks 75.9
3-6 weeks 16.1
7 weeks - 3 months 07.0
4 - 6 months 00.8
7 - 12 months 00.1
13 - 18 months 00.0

http://www.ahw.gov.ab.ca/waitlist/CategorySummary.jsp?rcatID=19&levelOfCare=All

Here is the link to the Alberta Waitlist Registry where there is a drop menu to check on specific service categories:

http://www.ahw.gov.ab.ca/waitlist/WaitListPublicHome.jsp

I haven't had any problems with reasonable and timely medical services, and I don't know of many people who have.

I went to a symposium on pain control at the university here in Edmonton, Alberta, Canada a few years back. My take away from that was that chronic pain can be very difficult to deal with.

I think some medical conditions are so inherently difficult that people direct their frustration at the medical system, whatever it is where they live. I think that is the source of a lot of the complaints against Canadian health care. Like any human system, there are also errors, incompetent people, etc. - that is another source of complaints.

I know it is an unfair generalization, but the people I personally know who complain about their experiences with the Canadian healthcare system tend to be people who complain about things in general. They also harbour fantasies that their lives would be magically better if they had been born in the U.S. - they would make more money, have better health care, be happier, etc. It is hard to reason with such people. They have a lot of emotional energy invested in this delusion.

Too bad they will probably weaken it instead of expanding and strengthening it.

for the great discussions!

My whole family has used medical care in Asia. It's better quality care, facilities, efficiency, and costs. Hands down better and a lot faster.