This is the fourth post in my series on universal health care. The first was a description of the health care system in Germany, the second was my experiences in the German and the US systems, the third was reader submitted experienced with universal health care in Germany, and the fifth takes on some of the myths surrounding the universal health care debate. Here are some more experiences from people around the world that have either been submitted to me or that I’ve gathered from the web.
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Kerry O’Malley, Holland (and previously the UK)
Your ingrown nail reminded me of 3 stitches I got in my finger, $1400 in California. I had to pay cash at the time, was a student, or my bill would be handed over to a collection agency and my credit would be marred.
My experiences (as a US citizen) of universal medical care was with the British NHS. When I first became involved in having to use the system, I was a little shocked. Things were different. But in the long run, I had peace of mind that I would not lose my home due to medical bills I couldn’t pay, if god forbid something did happen. There was NO paperwork to be filed. I could see my doctor as often as I wanted with no co-pay. I didn’t have to wait for hours and hours to be seen.
I now live in Holland. Holland did away with their socialized meds program a few years ago now because they deemed it too expensive, however, people can still get basic care here. My insurance is much like that of the US. I pay quite a bit monthly 175Euros ($250) and get very good care. Still, I have quite a high deductible.
I am cheering for the NHS. It may not be perfect but it is the peace of mind it brings that I think is most valuable.
NHS really saved my life financially. Auto accident when I was 31. Everything ‘paid for / handled’ without me having to worry. In the US, I had to pay $14,000 for emergency surgery once due to not being insured.
I choose universal healthcare no matter what tax I have to pay. It’s benefitted me so many times. Not perfect but good care.
I am pessimistic that America will move away from it’s current model. Too many scared people who are reluctant to change. That is too bad and one of the reasons I will not move back there. Ever.
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Rhona of The Real Tragedy in Death is a Life not Lived!!!, Ontario, Canada
Health care in Canada – The Canadian health care system is very good if you ask me. For all citizens, we have access to universal health care no matter what. The Canadian government used to pay for basically everything in the past but over the years they have slimmed a bit and consumers have to pay for “non-essentials”, but it is usually a marginal fee.
My experience with health care has always been positive aside from going to emergency rooms. In Ontario (where I live, was born and will concentrate on), the taxes we pay go toward a myriad of things including health care. The taxes are GST (5%) and PST (8%), totally 13%. In other provinces, they may pay HST and different rates of PST. Note that the PST is not paid on all services we buy. For Ontario, the PST is broken down:
- For housing, the rate is 5%
- Alcohol and forms of entertainment, at restaurants, is billed at 10%
- Alcohol purchased at government only appointed distributors, is 12%
In Canada, our government pays about 71% of the heath care costs. This is called Medicare or OHIP. The rest is paid for by private and public insurers. All citizens are provided with a Health Card which is scanned by the doctors office upon each and every visit. This ensures that you can actually see a Dr. and he/she will be paid by OHIP for their services provided. For medications, the government has implemented controls, global median, to ensure costs are kept neutral and fare by the drug companies. Depending on your plan (private or public insurance coverage), pharmacy dispensing fees are usually covered.
For myself, as I said, the experience has overall been very positive and consider myself lucky to have been born in a country where health care is not a privilege but a right. When I see my Dr., I never have to think about money. Upon arrival, I hand over my health card which is scanned by the receptionist and then handed back to me. This process takes about 3 seconds. The wait times to see my Dr. (booked appointments) vary. Sometimes I see my Dr. as soon as I walk in or other times I have to wait. The longest I have ever waited to see my doctor was 45 minutes. It is important to note that there is a drastic shortage of physicians in Ontario. The population has exploded over the last ten years and there is too much demand for the limited supply.
I, personally, have never had to pay for any appointments to date. When my doctor refers me to a specialist, I only have to call the office (or they call me) and go in with my health card. This is the same for GYN visits. Being referred to a hospital or clinic for a specific treatment (such as CT scans, MRI’s) are always paid for. Citizens do not pay for these services unless it is not covered under OHIP’s regulations.
I have never had a baby so I cannot comment on the services but I have friends and family that have and the scenario is the same. Most hospitals have separate wings for births, infant care etc. When a woman goes in to have a baby, she never has to wait in the emergency room. She is immediately escorted to the birthing wing to be cared for. If she wants a private room, instead of the government appointed and paid for multiple rooms, she will have to pay a fee. I cannot comment on this as I have never known anyone who paid for a private room. When a woman leaves the hospital, even if there were medical emergencies or the baby has to stay longer due to illness, there is no bill to be paid. It is all covered by OHIP. Every woman I do know, who has given birth, does comment on the short length of stay after said birth. As long as the mother is fine (as in no medical complications) she is literally kicked out of the hospital within 24-48 hours of delivery.
Insurance: With my insurance coverage at work, I pay a small percentage per pay to receive services. The deductible is based on the amount of dependents the employee has and if their spouse (or partner) also has insurance. For myself, who is spouse and dependent free, I pay approximately $7.00/pay toward health and dental. For this, all my prescriptions are covered and so are my pharmaceutical dispensing fees. I shopped around for a pharmacy with a relatively low fee for drug dispensing so I pay $0.00 total for my prescriptions. However, if I was to go to Shoppers Drug Mart, for example, I would have to pay a fee. This charge would be the balance owed after my insurance companies cap. For my insurer, the dispensing fee maximum is $10.99. Shoppers has a dispensing fee of $13-14.99 so I avoid them.
With my private insurer, I am also covered for other services. Optometry, orthopedics, message service and dental are the ones I am familiar with. I know people at work use other other services that the insurer pays for but since I have no use for them, I don’t pay attention. For my eye care, OHIP covers the optometry charges every two years for all citizens, paid in full. Once again, your health card is needed. OHIP does not cover any fees associated with glasses or contacts. Canadians have to pay for this out of pocket, unless they have an insurance plan. For me, my insurer pays $200.00 every 2 years for my glasses prescriptions. I do not use any orthopedic services so I cannot comment on this. However, as for messages, my insurer pays $750.00 or 10 visits at $75.00/visit per year. I do take advantage of this but it is only a matter of me remembering I have this available to me. It is mainly a luxury than anything else in my case.
The government does not pay for all health services however. Dental, ambulance, cosmetic and non-essentials are not paid for. Dental is covered by my insurer. I have a yearly co-pay of $25.00 which I gladly pay. I get to visit the dentist every 6 months for routine cleanings and not have to pay for the other services. I am also allowed to visit my dentist and get treatments up to $1500.00/year. Anything exceeding, I will have to pay or send in a separate claim (to see if they might by chance accept the charges). So far, this has worked out perfect for me.
OHIP: If one is going overseas, OHIP will pay for Canadians if some medical emergency was to occur. In these cases, I believe that the patient would have to pay the bill however will be reimbursed once back on Canadian soil. However, having private coverage might eliminate all this. While I was in Germany for three months, I was covered 100% by my company’s private insurer however this is valid for 90 days only. Anything longer requires a lot more paperwork and approval.
However, anything cosmetic is not covered by OHIP. Cosmetic and non-essential services (such as mole and wart removal, certain travel vaccinations or shots , Dr.’s notes for work etc) are not covered by OHIP. The full costs will have to be paid by the patient as I don’t think that anything is covered by the government in these cases. Ambulance services is something that is not fully paid for by OHIP. When an ambulance is called to a home, the owners will receive a bill of $50.00 in the mail later on. This is obviously supplemented by the government.
The main issue Canadians are concerned with now is the waiting time to receive services for medical treatment. Hospital waiting room times are horrible and cause many issues. This has been in the media a lot lately. Due to the costs to run a hospital, many hospitals have the room to accommodate patients but numerous beds and floors are closed due to lack of funds. This is also true of doctors and nurses. Right now, Ontario is going through a nursing shortage and has been for a number of years now. Another issue involving waiting time is getting an appointment to see a specialist. Personally, I have never had this issue but I know many people who have waited months to see a specialist to further treatment.
In order to resolve some of these emergency issues, the government has increased the amount of walk-in clinics with after-hour services. This obviously is designed to alleviate the problem with long waiting times at hospitals. Also, within hospitals, new features have been set up to avoid longer wait times. When my sister broker her Achilles tendon 2 years ago, we went to the hospital as she could not walk on the foot. The attending nurse directed us to a special section in emergency that deals solely with broken bones, burns and muscle issues. A doctor saw her, took care of her foot for the night, set up an emergency operation for two days later, wrote her a prescription for heavy pain meds, gave her samples for that night (it was after 10pm when we went in) and sent us on our way in under 3 hours. It may seem long but that is fast for the services we were provided. My sister was invoiced for the crutches she has to use and I think the cost was about $75.00 which she claimed and was reimbursed for by her employers private insurance. Two days later she had the surgery, in a hospital out of town, spent 2 nights (she had a fever), was discharged and had follow up appointments all paid for by OHIP.
My sister also had surgery this year for a typically cosmetic issue but this was affecting her health so it was covered by health care. Although the surgery date took a while to be booked, she was sent to a specialist, had numerous consultations, blood tests etc. and finally the surgery with no cost to her. The follow ups were also fee free. She received the services of a non-profit health care organization, supplemented by the Canadian government, that sent a nurse to our home once a day for 2 weeks to assist her with her bandages and drainage bags. They also would have helped her bath but our family helped her with so the extra help was not needed. I cannot comment on how much the total cost of this is as we never see the amounts billed. That is just not part of the OHIP process.
My personal experience has so far (and I hope continues to be) been limited to doctors visits and few specialists referrals, GYN, a few operations and a hand full of emergency walk ins. I have not had to pay for any of these services.
My part time job is in the health care system and I am exposed to issues revolving health on a daily basis. One of my client’s daughter was telling me a few weeks ago her experience with the health care system. Her mother (my client) suffered a brain issue in June 2009. After being rushed to one of the best hospitals in the area, in Mississauga, they assessed her situation and noted the severity of it. She was flown by medi-helicopter to a Buffalo hospital that specializes in these issues. She was in the hospital for a total of 99 days and her daughter was set up in a hotel (not luxury but just enough) for that time period. The patient received optimal care and as a result, has sustained very little of the normal lasting symptoms that a disease like this can affect a person. At the end of the conversation, I asked the daughter if she had to pay for anything and she looked at me, with blatant shock in her eyes, with a resounding, “No!”. OHIP covered every single cost associated with this medical emergency. I am sure however that they did received a $50.00 ambulance fee.
There are many people that argue that our health care is not very good due to the long waits. I would argue that yes, this is correct but Canadians are damn lucky overall. We can have a baby, see doctors, have an emergency etc. and not be broke for the rest of our lives if we don’t have private insurance.
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Quickroute of Paddy in Buenos Asia, an Irish expat in Hong Kong via Buenos Aires
I was lucky that my company covered 50% of my medical insurance costs in New York but even then it was expensive. The quality of service was pretty bad – long waits for my GP even though an appointment had been made and the support staff were rude beyond belief.
When I lived in UK the healthcare was free but long waiting times were frequent and you were shifted out the door in 5 minutes for a GP visit.
I remember the healthcare in Australia was pretty good but you had to pay as you go although not too expensive.
There is free healthcare in Argentina but most expats avail of private care which is as expensive as USA but better.
Still figuring out how it all works in Hong Kong!
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Marilena in the US
I just wish to point out that Germany’s health system is very different from the “socialized” system of the UK or Italy because from my understanding Hospitals and Doctors are not employed directly by the government. Also you actually know how much money goes into the health care system. In Italy and the UK, you pay taxes but then the government decides how much to put into the health care system and it is true that they are not always investing enough. That said my aunt just had to have a 12 hour surgery, performed by the best surgeon in the best hospital in Italy and didn’t have to get permission from anyone. Her 15 day hospital stay was $0.
Still if I had to choose I would rather go with a German type system, I think there is more competition and so doctors and hospitals works better. This is what I heard from a friend who moved from Italy to Germany. I only lived in Italy and now the US so I can’t compare directly.
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Korie of Lilac Colored Glasses, Belgium
Belgian healthcare, from what I know if it (which isn’t a ton, but certainly enough to know the basics) is set up very similar to German healthcare.
I was going to write about it for you but I really don’t know enough of the ins and outs to put together a comprehensive summary. All I know is that for both Hans and I we pay a fraction of what I used to pay in the U.S. just for myself and more things are covered here.
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Further reading:
- Tanya at Parisian Spring – French Health Care, a good review of the French system
- Reuters – Q+A: Views from expats on healthcare systems, views from a German in London, a Brit in Paris, an American in Munich, and an American in London
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Read more of my health care series:
- Health Care in Germany
- Health Care in the US and Germany: My Personal Experiences
- Health Care in Germany: Reader Experiences
- To my German readers: What do you think of your healthcare?
- The Takeaway’s Health Care Roundtables
- Universal Health Care: Taking on the Myths
Do you have an experience with universal health care that you’d like to share?
{ 9 comments… read them below or add one }
I really wanted to write in about my experiences on this subject. I didn’t have the time to sit down and write everything out though… I am a huge supporter of Universal Health Care. I have been a resident of Israel for 9 years, 5 of which I have paid taxes and been a part of their health care system. My experience has been nothing but good. We have two children and another one on the way. I am glad that when my son developed Pertusis at 2 months old, we could stay in the hospital where he received oxygen and medical support when he needed it, without going into debt to save his life. I’m happy that when my daughter developed a horrible eye infection, it was treated right away because I am part of this society that takes care of it’s citizens when they need it. I am glad that I have access to good health care whenever I need it without having to decide whether I can afford it or not. I would never want to live in a country without a universal health care system again.
I have to comment on Rhona ’s comment on health care. Two things stand out immediately one of them is that she has private insurance (which pays for drugs, dental, semi private hospital bed, eyeglasses, etc.) and two, she lives in Mississauga which has a fairly good if not superior hospital to most Toronto hospitals. Her insurance however won’t buy her an MRI.
There is NO public drug coverage unless you are over the age of 65 or on welfare/social assistance and not all drugs are covered. For example the drug Tamiflu for H1N1 is not covered for seniors. Some of the newer cancer drugs are also not covered.
Private insurance is not obtainable if one has a pre existing condition or you reach a certain age. Example, my husband had private covered with similar benefits as Rhona but being self employed it cost him $145. per month and he’s healthy. I was denied the same insurance and was offered a plan that covered $300 drugs and $300 dental per year with 25% co pay at a cost of $95. per month. It wasn’t worth it..
She is lucky that she has a family physician. Many physicians are close to retirement, my own included. He has already cut back on his patient load and I live in fear that he will cut me from his roster. There are currently 1.1 MILLION people in Ontario who do not have a family physician and I will soon be one of them.
Wait times, the bane of our existence. Sure we don’t have to pay out of pocket but when you wait 18 months for a life changing hip or knee replacement, 16 months for heart surgery, 5 months for retinal surgery, more than a year for foot surgery and one year for gallbladder surgery you really have to wonder if there isn’t a better way. The above times are not pulled out of a hat, they are my life. We pay, by the way, it ain’t free. We just don’t see it out of pocket but our tax load is immense. Rhona just touched the basics, there is more.
Elder care, it’s a joke. My mother wasn’t in the ER more than an hour when they discussed “letting her die with dignity”. She did die but not with dignity and totally at the fault of the hospital and doctors there. She was a robust woman who needed a pacemaker. She waited, waited and waited some more. Meanwhile they diapered here (didn’t have time to toilet her), she lost all muscle tone and mobility, never did get the promised MRI and SIX weeks later they finally did the pacemaker surgery which took all of 40 minutes. One week later she died which begs the question, had she got the pacemaker the first couple of days would she still be alive and at home with me.
So there you have it, Germans are lucky and Americans can be if they model their proposed system on Germany but never on Canada. Ours is broken. Oh yes, almost forgot, I’m on a long wait list for hip number two. Maybe next year some time…ciao
.-= rositta´s last blog ..Were We’ve Been =-.
You can keep these blog entries coming on this topic because they are really great! Again, thanks for taking the time to put this together
Rositta, thanks for the comments on my post however as I said, repeatedly, this is from my experience alone and some people I know. I did not say and know the services are not perfect however.,I think Canadians are lucky. There is too much to point out and I would be writing a 20 page post. That piece was written purely on my stance.
.-= Rhona´s last blog ..Things for sale and packing =-.
@Sherah: Thanks for commenting. I didn’t know anything about the Israeli system, so it’s nice to learn about it.
@rositta: I’m wondering what you think of the American system. Would you choose it over the current Canadian system?
@Isabella: Thanks, I put a ton of work into these. I’m working on ideas to keep this series going. Gotta see what I can scrape together.
@rhona: Thanks for writing in your experiences. It’s difficult to make a post covering a large country, especially if health care differs from state to state.
Christina, no I wouldn’t choose the American system over the Canadian one with one exception. Private insurance ought to be available to all and if I have the money I should be allowed to pay for an MRI without traveling to the U.S. A purely socialist system doesn’t work since the very rich travel elsewhere for care anyway…ciao
.-= rositta´s last blog ..Were We’ve Been =-.
Well that was really nice. I will wait for the fifth one.
.-= natural gas´s last blog ..A walkthrough on the CNG’s compressor =-.
I’ve read all your post on universal health care and they are all very great and informative.Hope to read read the fifth one soon.
Health is always a great wealth for all. Why we will not achieve this? In this consideration everyone wants to have good health. Let us build our healthier life with controlled food habit, discipline, keep pace with work, rest and or exercise. While Health is the root of happiness let us build a happier life.
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