I lived in Canada for 4.5 years and all my in-laws live there still.
Canada's health system is different than
ours. They have mandatory health insurance, but
the province administrates the health insurance
so it makes sure everyone can afford it. I do
not know how much it is but it is less expensive than ours is.
Much less expensive and offers universal access
Doctors get paid the same way they do down here,
fee per procedure. However the rate of
reimbursement is lower, and it is negotiated
between the Doctors and the Provincial health insurance authority.
Not much lower. Doctors are private,
that is, not employees of the system and the
canadians can choose them. A psychiatrist
makes a little less but he doesn´t have
to spend administrative costs that they spend in
America dealing with managed care.
The biggest difference is with the
Hospitals. Hospitals in Canada are flat
funded. They do not get paid by stay or
procedure. Plus each hospital may have one or
two big machines to use (CT Scans, MRI's
etc.) My father-in-law had tot ravel 200 mils
for his angioplasty as the only hospital in his
region to perform that procedure was 00 mile
way. He must travel 60 miles or 90 miles for an
MRI as those are the closest machines. He has a
local hospital that is quite large but it has no
MRI machine as it has not been funded or it.
Yes, Canandians sometimes have to travel
to get the examinations but this is not the rule.
Canada limits it health spending by Rationing
health care and procedures. This sounds
terrible to us, but they have made it work. If
you are sick you will get treated,but they do
not do hip replacements on 90 years olds.
In the USA things are also rationed.
When I was a psychiatrist working in America
managed care restricted a lot what I wanted to do
for my patients in termos of lenght and
frequency of sessions, hospitalizations, etc. It was terrible.
I know this first hand. My first child was born
in Canada. He was born with congenital heart
problems that necessitated his treatment both in
the local hospital and the Children's hospital
in Toronto. He never lacked for care. His
doctors were mainly US born and trained
Doctors. We never doubted that they did all
that they could for him. I also never saw a
bill!!! If I had been living in the states, I
would have been bankrupt with medical bills,
even though I had Med insurance. (I was in my
first placement after seminary making little or nothing.)
Many in the US go bankrupt. The US is
the only country or almost that doesn´t consider health care a right.
The biggest difference between many of these
countries and ours is that they have taken the
profit motive out of it, and made work, but
they also practice a form of rationing that we may not be comfortable with.
I am not sure. When you talk about
rationing it sounds like a bad thing. But in
terms of dollars and cents the Canadian System
has to make sure that the tax money is
well spent. In the US the private sector has a
lot of rationing by the insurance
companies. And then there is the case of
the ones who don´t have insurance and have to use the Emergency Rooms to have
care when things go out of hand. Isn´t
this a form of rationing? A perverse one?
We like our medical care when we want and it and
how we want it. That will not work in those type of systems.
Well this only applies to a portion of
the US population. Don´t forget that there are
45.000.000 uninsured Americans...
Regards
Marcio
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