"pre-existing condition" and other words you'll never hear in canada

From "Canuckistan" at Democratic Underground, thanks to Nick at Life Without Borders.
Words you'll never hear in the Canadian health care system

As a Canadian I marvel at all of these terms that are so common to Americans, but are virtually unknown to us.

Here's a partial list off the top of my head:

1. "Out of network"
There are no "networks" in Canada. Doctors and hospitals are not affiliated with private insurance companies. Doctors are private business entities and hospitals are usually run by non-profit boards or regional health associations.

2. "COBRA"
Health coverage is NOT tied to your place of employment in any way. So any COBRA-like scheme is unnecessary.

3. "Co-Pay"
The government pays 100% of basic care, 100% of the time. Drugs are not covered, but are subsidized by government to a point. And because of mass buys, discounts are obtained from the drug companies. That's why our prices are so much lower. Most employers offer a drug plan that pays for 100% of drug cost coverage.

4. "monthly premium\deductible"
Wazzat? We don't consider our health to be the same as our possessions.

5. "waiting for approval"
Doctors are the sole decision makers for health care. NOBODY influences or delays their decisions, warns them of costs or prevents them from giving treatment for any reason.

6. "Government interference"
The provincial government in each province PAYS for whatever services doctors provide. No questions asked. Unless the procedure is experimental, not medically necessary or unwarranted, doctors cannot deny basic care - by law.

7. "Health insurance lobby"
There are NO insurance companies for basic care, only companies for providing insurance for travelers. No money to be made here.

8. "bureaucracy"
When we visit a hospital or doctor's office, we walk in, get treated, walk out. No "applications", "registrations" or any other kind of paperwork is required. We NEVER have to talk to a single "government official" or wait for a "judgment".

This is such a foreign concept to us. A Canadian's usual reaction to the explanation of this term is astonishment.

Our US-to-Canada community owes a lot to Democratic Underground: that's how Nick found me. He was the first USian to contact me about moving to Canada through wmtc, and the first to follow through.

After quoting Canuckistan, Nick continues:
As an American living in Canada and as a legal permanent resident I am entitled to the same health care as everyone else in Ontario (the program is called OHIP). I can honestly tell you that I have had BETTER service in Toronto then I ever had in the 12 years I lived in Colorado. I have NEVER had to wait for a doctor's appointment, and the longest I ever had to wait for a specialist was one month when I had to get scheduled for my sleep study (which is covered 100% by OHIP and my CPAP will be covered up to 80% with the rest coming from my employer's insurance company.) By the way, my doctor was not chosen by the government of Ontario, I picked her myself.

No one EVER files for bankruptcy due to medical bills in Canada, and when I explain to my fellow Canadians that Medical Bills are the number one reason for Bankruptcy Filings in the United States they are in shock.

Everyone is covered by the same plan (each run individually by province or territory) so the Prime Minister to the homeless guy on the street both have the same type of medical coverage. 50 MILLION Americans have NOTHING. No one ever gets turned away from a Hospital Emergency Room, whereas I can't tell you how many clients in Denver I had being "diverted" to Denver General from rich, posh, private hospitals in the suburbs.

Also, when it comes down to decision making, the ultimate decision is left to Doctor and patient, not the HMO or insurance company. If my Doctor says I need a surgery and I agree it happens, no questions asked; but if i disagree it does not happen and I can go get a second opinion for FREE. I am not sure what Ms. Shona Holmes' doctor told her, but she made her own choice to go to the United States for treatment.

I am not taxed to death for the medical system up here; while taxes are higher to pay for health care, they also pay for higher welfare cheques, daycare subsidies, mental health services, employment insurance, and a host of other "social programs" that actually benefit people....in other words, helping them. The truth is when I look at my paycheque here and my paycheck in the States, when I add in my health care premiums and co-pays in Colorado....there is very little difference in my net pay.

I am not saying the Canadian system is perfect, and that every Canadian is happy with their province's health care plans; there are plenty of opportunities for improvement in Ontario and other provinces, but it is also not the fallacy that Ms. Shona Holmes precipitates in her fear-mongering Republican funded commercials while she sets up house in Washington DC. A recent study showed that over 85% of Canadians are happy with their health care system....Ms. Shona Holmes is obviously not one of them.

Note: Shona Holmes is a liar and a fraud.

Don't forget to keep circulating this!


James said...

Shona Holmes was the divorce consultant for the parents of a friend of mine. The friend is currently quite active on Facebook in getting the word out about Holmes's falsehoods.

Jennifer Smith said...

One minor point: some provinces do have yearly premiums, but generally in the order of a few hundred dollars per year, not per month.

BTW, after wading into this mess on DailyKos, I ran across a woman whose medical condition so closely parallels my own that I feel particularly horrible that I'm doing just fine while she's currently waiting for her husband's insurance to cap out so she can go into hospice to wait to DIE.

She had investigated the option of moving to Canada and decided that it would be impossible given her condition (kidney failure, dialysis, etc.), but I told her I'd check into it. Any thoughts or suggestions? Let me know - thanks!

L-girl said...

One minor point: some provinces do have yearly premiums, but generally in the order of a few hundred dollars per year, not per month.

Right. In Ontario, we pay annually through our tax returns on a sliding scale. Depending on your income, the fee can be anywhere from zero to $1200 per person. For an entire year, for everything you need. And you cannot be denied coverage.

Regarding the woman you asked about, her condition alone would not bar her from emigrating to Canada. However, she and her husband would have to meet all the other criteria - employment opportunities, "proof of funds" (savings), etc. - and it takes around two years or so. So she may not qualify in other respects.

I'm not sure what she found when she investigated it - there's a lot of misinformation out there, and she may have a lot of other factors that prevent her from qualifying. Lack of money is a big one.

I saw your "If I were American I'd be dead" post, through RossK's blog. Excellent stuff.

richard said...

Good post. The amount of misinformation out there is staggering. One small caveat:

Most employers offer a drug plan that pays for 100% of drug cost coverage.

While things are pretty good on that front I'm pretty sure that this is not quite accurate. I would hazard a guess that 100% drug cost coverage is quite rare. 80% is more common, up to a certain annual maximum after which costs are covered by a Provincial drug plan (at least it is in BC. Not sure about other provinces). It's still pretty good!

L-girl said...

Yes, the private coverage varies a lot. Increasing numbers of Canadians have jobs that don't offer drug or dental coverage - and of course unemployed people have none.

If you're in a household or couple where you both have benefits, chances are between the two plans, you get 100% drug coverage.

There's definitely a wide spectrum - and room for improvement.

richard said...

btw, why is dental coverage not part of the whole package. It seems arbitrary to single one (very important) part of the body as not covered. It always strikes me as odd. I'm thankful for my excellent plan but I feel for those who don't have that advantage

L-girl said...

You're absolutely right. People mistakenly think of good dental health as a luxury or an extra, rather than the necessity that it is.

We were without dental insurance in the US for a long time (though we also had coverage for some years), and now have some basic coverage. I know a lot of people who don't have dental insurance simply don't see dentists. Not good.

There should definitely be publicly funded dental care.

Jennifer Smith said...

I remember a few years ago there was an article in The Star about why dental coverage should be covered. The opened with a story about a fellow who started out with a toothache and ended up dying of a brain infection caused by an abscess because he couldn't afford to see a dentist.

L-girl said...

That's exactly what I was thinking of when I wrote that comment.

There was a follow-up story about a young man who was smart and energetic - and unemployed, largely because of his rotted teeth. As soon as he opened his mouth, no one would hire him.

Colin Heacock said...

Canadians can hear the term 'pre-existing condition'. If you buy travel insurance and travel to the United States on holiday and require emergency medical care you could foot a bill for thousands (or in some cases millions) of dollars. Private insurance companies like Blue Cross are just as unscrupulous. A Saskatchewan who recently travelled to Hawaii had to have an emergency birth. The woman got a bladder infection which led to bleeding which led to a pre-mature birth. The bill was 1 million dollars. Blue Cross denied their claim saying they had a pre-existing condition. The doctor in Hawaii wrote a letter to Blue Cross saying that the cause of the pre-mature birth was due to a bladder infection which led to bleeding and could have happened to anyone. It was NOT a pre-existing condition. Blue Cross still denied their claim. They will have to go to court to fight it. I hope they do. I can't see a Canadian jury tolerating that type of BS.

Colin Heacock said...

Also on another note I would like to say Canadian health care isn't that good. It only appears to be good because we compare ourselves to a country (USA) that has no health care. When compared to European and even Asian countries we perform poorly in many or some areas. First we don't have national health care in Canada, we have provincial health care with Federal guidelines. Most other countries actually have national health care that is the same across the entire country. Second most countries subsidy their medication. In South Korea a prescription would cost you around $3 as opposed to $30-$50 we get charged here. I can't think of a European country that doesn't subsidy prescription drugs. We need to stop comparing ourselves to a country (USA) that doesn't give a shit about its citizens and start comparing ourselves to countries that do so we can make our health care better.

laura k said...

Canadians can hear the term 'pre-existing condition'.

But not in Canada. I hope Canadians know better than to pay that bill! Trash it and forget it.

We need to stop comparing ourselves to a country (USA) that doesn't give a shit about its citizens and start comparing ourselves to countries that do so we can make our health care better.

I agree completely. It's a very, very low bar.

Although why you are commenting on a post from five years ago is anybody's guess.

laura k said...

Also Colin, the original post that this quotes, from "Nick" and "Life Without Borders", is written by an American who was emigrating to Canada. Thus the comparison. Perhaps you didn't understand that.