Single-Payer Healthcare – Painful or Painless? A Firsthand Comparison of American and Canadian Healthcare
There are few topics in America today that garner as much controversy as healthcare. With the President’s promise to repeal and replace Obamacare or ACA (Affordable Care Act), individuals relying on this insurance are in a constant state of instability.
Yes, I realize that’s an oxymoron, but it’s true.
Early retirees should be especially worried about this instability, as changes to ACA could greatly impact the amount of money necessary to retire.
American politicians often use Canada’s healthcare system as an example of what happens when the government becomes the sole provider of a nation’s healthcare. Some politicians use the Canadian healthcare system to instill fear because they believe the system is terrible. While others tout the wonderful benefits of the Canadian healthcare system. In this debate, it’s often very difficult to cut through the noise. So, today I thought I would post about what it’s like to go from privatized healthcare in the US to the single-payer healthcare system in Canada.
There seems to be a lot of misinformation about healthcare on both sides of the border. We have found most Americans believe that Canadians are dying in droves while waiting to obtain medical care. Likewise, we have found that most Canadians believe that Americans are dying in droves because no one can afford medical care (due to lack of insurance).
The bottom line is that both assumptions are grossly inaccurate.
Before we moved to Canada, everyone in the US (and I mean everyone) who found out we were moving would give us their unsolicited opinion of socialized medicine. BTW, Canada’s healthcare system does not meet the literal definition of socialized medicine, but more on that later.
I’ll never forget my dentist in the US, who gave me a very dire warning about Canada’s healthcare system. He said, “I just hope you don’t need your gallbladder removed while you’re there, because people are actually dying waiting to have their gallbladders removed.” I can assure you that the death toll from delayed gallbladder removal is not a major concern in Canada.
I just hope you don’t need your gallbladder removed, because people are actually dying waiting to have their gallbladders removed.
On the contrary, we have found the medical care in Canada to be quite good. We are an active family of five, so we have had plenty of experience with the Canadian healthcare system. All of our kids are involved in sports, and among the three, we have experienced 6 fractures. Two of the fractures (same kid reinjured the same bone) were quite serious and involved surgery. My husband has also seen a specialist (neurologist) for the treatment of migraines. In addition, my husband and I have had the recommended preventive care exams. One of my mammograms came back suspect and there was no delay in getting me in for another check.
The Canadian healthcare system is often mislabeled as socialized medicine; however, most doctors are not employees of the government. The Canada Health Act guarantees that every resident is entitled to essential physician and hospital services which are paid for by the government.
Canadians do not receive a bill when they visit a doctor or receive treatment at a hospital, instead, physicians in Canada bill their provincial government for the care they provide to patients.
Contrary to popular belief, Canada’s healthcare system is not free. The cost is billed to Canadian residents through much higher income taxes than the US. In our province of Ontario, the highest income tax rate is 46.2% (federal and provincial), for incomes over $220K. Contrast that with the US, where the highest income tax rate is 39.6% (federal), for incomes over $418K. In other words, you hit a much higher tax rate at a much lower threshold in Canada than in the US.
It is an easy process to obtain a health card in Canada.
This health card is THE ticket to all your medical needs.
The services covered by healthcare plans vary from province to province. In Ontario, the healthcare plan is called OHIP (Ontario Health Insurance Plan) and residents obtain a health card through a Service Ontario Center (located throughout the province). Anytime you visit a doctor, clinic or hospital, you only need to show your health card. After your appointment, you walk out. No muss, no fuss. And a visit to a doctor in Canada is a lot less hassle than a visit to a doctor in the US (dealing with the paperwork, deductible or co-pay).
OHIP requires you to register (or roster as they say in Canada) with a primary care provider or family clinic. The primary care provider is the first level of care (other than emergency) for all health care needs. In Ontario, you cannot see a specialist without a referral from a primary care physician.
And getting in to see a specialist sometimes requires a long wait. For example, I asked my primary care doctor for a referral to see a dermatologist. No problem. In fact, the primary care doctor makes the appointment for you. The only issue is that my dermatological appointment was scheduled 9 months away. Granted, I did not have an immediate need, this was just for a routine dermatological check-up, however 9 months is a long time to wait.
Another issue we encountered was finding a family clinic who was accepting new patients. Canada has a serious shortage of family care practitioners. When we moved into the area (of about 350,000 residents), the only family clinic accepting new patients was 45 minutes away. Since there was no other option, we registered there. And every time any of us needed to see the doctor, we would have to make a long drive, which is not ideal when dealing with sick kids. Fortunately, another family clinic in our area began to accept new patients and we have since been rostered there.
Another issue has been dealing with fractures, you know – broken bones. And we’ve had several fractures in total (6 to be exact). In our area, the only place to go if you suspect a fracture is the Fracture Clinic. This clinic is located next to the emergency room of one of our area hospitals. If you show up at another hospital with a suspected fracture, you will be diverted to the One and Only Fracture Clinic. Let’s just say that a visit to the Fracture Clinic is never a good time.
Since there is only one clinic in the area, the wait is usually long, very long. And no one is happy there. Fractures can be quite painful, especially in a waiting room filled with of lots of injured people. In our multiple visits to the fracture clinic, we have never seen less than 40 people waiting to be seen by a doctor. Our typical wait has been 2 to 3 hours. Needless to say, I’ve spent lots of time in the Fracture Clinic. However, once you get in to see the doctor (an orthopedic surgeon), the care is excellent. We have had the same doctor each time and he has also performed both surgeries.
We have been very pleased with the skill of the doctor, the follow-up care and the rehabilitation. In our case, the rehab was performed at the doctor’s private office by his on-staff physiotherapist. Both surgeries were performed at an area hospital, where the orthopedic surgeon was also on staff. The care at the hospital was excellent.
While the healthcare system provides basic medical care, many services are not covered by OHIP, such as physiotherapy, acupuncture, massage, prescriptions, private or semi-private hospital rooms, etc. Many residents have private insurance to cover these types of services. Most large employers offer this insurance. In Canada, vision care and dental care are privatized (except for children and seniors). We have found absolutely no difference in the vision and dental care in Canada and the US.
The number one question we get from acquaintances and even strangers about life in Canada involves socialized medicine. We are happy to share our experiences and let everyone in the US know that people in Canada are not actually dying waiting for quality medical care, even medical care involving gallbladder removal.