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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Abby on June 5, 2000, at 9:30:39
Nikki's posts have gotten me thinking about Britain's NHS, and I had a couple of questions about Canada's health care financing.
My understanding is that in Canada, medical care is private but publicly funded. So, instead of being on salary, the doctors bill their time but are paid by the government.
I know, however, that some Canadians buy catastrophic insurance so that if they have a major illness they can be treated in the U.S. (Interestingly, there was a shortage of spaces for treating cancer in Quebec, so the provincial authority was paying to have people treated in Maine. They did it on an outpatient basis by getting people to act as hosts. Lewiston has a large French-speaking population, but I digress. My question is: does there exist a 'private' system the way there is one in the UK. Are there medical services which people have to pay for themselves?
Are there any provisions for prescription drug benefits? It's allover the news in the U.S. about how much lower drug prices are in Canada, but I bet that some are still pretty steep. In the UK everything costs 5 pounds, unless you're a child or 16-18 in full-time education.Thanks,
Abby
Posted by tina on June 5, 2000, at 9:51:01
In reply to Question for Canadians, posted by Abby on June 5, 2000, at 9:30:39
Hi abby--All I know is that some years back, my husbands grandmother had to come to Canada for cataract surgery because they wouldn't do it for her in the U.K. She was covered under her family's insurance over here. My own Nannie needs insurance to get any medications that she needs and the hospital always sends her home before she's ready because they say she can't afford a stay, her insurance isn't enough. I have this feeling that the system works much as the american system does but with more free clinic type places. I think Nikki is the best person to answer this question, not us canadians. I think our health care system is the best in the world.
We do have times when we have to pay for things ourselves though. Elective surgery is personally paid for like cosmetic surgery and unnecessary surgeries like varicose vein extraction etc. Psychiatrists aren't free either unless you see one affiliated with a hospital. Marriage councelling and some drug rehab programs are not government funded either. It's not like everything is completely free, our taxes are enormous in order to pay for all this medical care but I personally don't mind. The fact that I can walk into a hospital and stay there for an undetermined amount of time and not wonder where I'm going to get the money to pay for it is worth it to me. My husband does have a huge insurance policy through work that allows him a private room and extra days if a hospital stay is needed but that's about it. The policy is mostly for his out of the country trips in case he's injured while away. I'm not saying that there arent problems with the system, I just think it's a pretty good one in comparison with other countries in the world. Cam will probably have a more articulate and accurate response for you when he can get back here for a minute.
Nikki's posts have gotten me thinking about Britain's NHS, and I had a couple of questions about Canada's health care financing.
>
> My understanding is that in Canada, medical care is private but publicly funded. So, instead of being on salary, the doctors bill their time but are paid by the government.
>
> I know, however, that some Canadians buy catastrophic insurance so that if they have a major illness they can be treated in the U.S. (Interestingly, there was a shortage of spaces for treating cancer in Quebec, so the provincial authority was paying to have people treated in Maine. They did it on an outpatient basis by getting people to act as hosts. Lewiston has a large French-speaking population, but I digress. My question is: does there exist a 'private' system the way there is one in the UK. Are there medical services which people have to pay for themselves?
> Are there any provisions for prescription drug benefits? It's allover the news in the U.S. about how much lower drug prices are in Canada, but I bet that some are still pretty steep. In the UK everything costs 5 pounds, unless you're a child or 16-18 in full-time education.
>
> Thanks,
> Abby
Posted by NikkiT on June 5, 2000, at 10:28:56
In reply to Question for Canadians, posted by Abby on June 5, 2000, at 9:30:39
Thats an interesting though, even here in the UK.
I'll give a very quick synopsis of UK NHS...
General Practitioners (family doctors) are first point of call except in emergency) and you cannot be referred to any other specialist unless by your GP.
Any prescriptions then cost £6
You can also see your GP privately, thus paying, and the prescription cost will then be the actual cost, not the £6.
Once refferred, you can go private, and all prescriptions are done by cost.
If you go to see specialist on NHS, there are no fee's,a nd all prescriptions cost £6 again - BUT, waiting lists tend to be between 6 - 24 months.My mum (one example) was referred for an op... Waited 13 months to see the specialist, who then said yes, she needed an operation - she then joined the waiting list for the op - another 15 months!
As my employer gives private medical insurance, I always go private (except for my gp) as I believe in freeing up thre NHS places for people in more need than I - But it is generally still the same docs doing private and NHS! Mad!
Don't know why I've done all this.. I would be interested to know what actually goes on in Canada...
And, what about emergency care in the US if you ahve no insurance? Do they simply turn you away?
Posted by Abby on June 5, 2000, at 11:49:56
In reply to Re: Question for Canadians » Abby, posted by NikkiT on June 5, 2000, at 10:28:56
I know a bit about the UK. My sister goes to school there. Her medical care is fine, because the school has its own physician. She even managed to see a dentist! I've noticed that a lot of Oxbridge colleges have a similar set-up, an NHS funded doctor who acts almost like a private one. I know one old lady who is rather rich but is also a socialist and refuses to go private. She's convinced her husband didn't get as good care on BUPA. After her hip operations she made donations to the hospital.
There are public hospitals in the U.S. funded by state and local government. People who are poor get government insurance called Medicaid, a decidedly second-rate program with a real stigma, but there is a gap of working class people with many jobs who don't have any insurance, and they could be ruined financially if they got really sick. There are some efforts to provide free care, but it is getting harder all the time. Hospitals used to use insured patients to subsidize the care of the uninsured, but the insurance companies have clamped down on what they're willing to pay, and many times, hospitals lose money on insured patients.
I'm interested in health care policy. One of the candidates for president, Bill Bradley, had a health care proposal which I thought was superb, but instead of Bradley or McCain, we're getting the bozos Bush and Gore. I don't want to be flamed for saying that.
His plan was to have everybody on private insurance, and to allow everyone to buy it at the rates the federal government currently pays for its employees. Everyone could get the tax benefit which for a long time was only enjoyed by employers, and poorer people would have subsidized premiums.
A while ago some people posted information about a site of mental health care professionals www.nomanagedcare.org which I found very interesting. Their idea was as follows. Determine what a reasonable fee for a specific service is, say a physical or an appointment with a psychiatrist.
Let's say that (I'd do this in pounds for you, but I don't have the key on my keyboard) a reasonable fee in an area is $100. The insurance would then pay $80. Oftentimes traditional indemnity insurance paid a percentage, and consumers weren't sensitive to the price, and thought that somebody else was paying for it. If a patient was very poor, a doctor could waive the $20 or provide a sliding scale of fees. Likewise a really top specialist could charge more, say 120, 135 or 155. So let's say you wanted to go to a Harley Street shrink, because you didn't like your current one who costs you $20/visit. The Harley Street doctor still charges $135, and you might not be able to afford him, but it would cost you $55, only $35 more than you were already paying. Well, you get the idea.Abby
Posted by NikkiT on June 5, 2000, at 12:10:13
In reply to Question for Canadians, posted by Abby on June 5, 2000, at 9:30:39
Thanks for that Abby.. it is really interesting.. and do you really not have £ on your keyboard?? I have $.. infact I even have € (the Euro!!)
Sorry.. way off topic...
Your sister is at an Oxbridge college?? I think the example of that is not really agood one, as Oxbridge (Oxford and Cambridge Universities) are the TOP universities in the country, and are very very diferent to... well, anything else here! I bet she's having a wonderful time though, both Oxford and Canbridge are beautiful cities, and the universities pretty amazing.
Posted by tina on June 5, 2000, at 12:35:21
In reply to Re: Question for Canadians, posted by NikkiT on June 5, 2000, at 12:10:13
I can also vouch for Cambridge. It was one of my favorite places when I was in England. It's the most beautiful campus I've ever seen. Off topic I know but what the hey!!
> Thanks for that Abby.. it is really interesting.. and do you really not have £ on your keyboard?? I have $.. infact I even have € (the Euro!!)
>
> Sorry.. way off topic...
>
> Your sister is at an Oxbridge college?? I think the example of that is not really agood one, as Oxbridge (Oxford and Cambridge Universities) are the TOP universities in the country, and are very very diferent to... well, anything else here! I bet she's having a wonderful time though, both Oxford and Canbridge are beautiful cities, and the universities pretty amazing.
Posted by Janice on June 5, 2000, at 22:11:45
In reply to Question for Canadians, posted by Abby on June 5, 2000, at 9:30:39
Yes that's right Abby, medical care is private but publicly funded. Most doctors bill time (although some are on salary).
Our insurance, which most people get from work, usually covers a minimum of 70% (sometimes 98%) of the cost for the following: prescription drugs, dental care, vision care, assistive equipment and appliances (prostheses, wheelchairs, etc.) to independent living and services of allied health professionals such as podiatrists and chiropractors.
Seniors, children and people on welfare (vulnerable people) receive all of the above for free.
We buy travel insurance before we go to the States.
Prescription drugs seem alot less up here. My guess from comparing costs of medications that I know and have seen on pyschobabble is that our prescriptions are about 50% of US cost. The cost is covered by our insurance. Cam W would be the man to speak to about this.
Sometimes we send people to the States, I believe, if waiting for treatment could compromise their health and we don't have the facilities to treat them.
I can only think of the medical services above that I would have to pay for, and then wait for insurance to reimburse me. I have never heard of people paying to see psychiatrists - I have been seeing them for years for free. We see them for 1 hour here, not 15 minutes. But things are changing, so maybe this is a new policy in Ontario where Tina lives. I also had to pay to see a naturopath, but then again, insurance from work reimbursed me.
Many Canadian people are very concerned about maintaining our health care system, as it has served us so well (Cam would be your man here too). I have two doctor friends (one from Italie and the other from Ireland), who both told me they learnt in med school (in Italy and Ireland) that Canada had the best medical system in the world. I hope it lasts, Janice
Posted by Janice on June 6, 2000, at 22:51:20
In reply to I'm Canadian…, posted by Janice on June 5, 2000, at 22:11:45
he must of gotten his insurance and gone to the States.
Hi Abby,
funny right after I posted the above post, my friend, who works as a doctor, called. I almost feel embarrassed at how little I know about Canada's Health Care, so I was asking him some questions on it. He seemed to think our medications are, on average, about 65-70% the cost of US medications, but he is only a doctor. Cam is definately the man for that question.
Anyway, here is a web page describing Canada's Health System, complete with charts and graphics, if you're interested.
www.hc-sc.gc.ca/datapcb/datahesa/E_sys.htm
Posted by ChrisK on June 7, 2000, at 6:18:30
In reply to huh, no Cam yet…, posted by Janice on June 6, 2000, at 22:51:20
> he must of gotten his insurance and gone to the States.
>
Didn't Cam say he was going on vacation to Disneyworld sometime around now? I know he was worried about not getting there due to a health care strike but I think that was settled.
Posted by Abby on June 7, 2000, at 10:04:34
In reply to Re: huh, no Cam yet…, posted by ChrisK on June 7, 2000, at 6:18:30
Janice,
I know that prescription drugs, at least ones under patent protection, are much cheaper in Canada, because you have price controls imposed by the government. I asked about the insurance coverage, because I noticed that in the UK, there are no "official" price controls, but that the Health service bargains for its own drug purchases, and an NHS prescription costs only a nominal copayment. Thus two months (60 tablets) of 100mg Lustral (Zoloft) costs £6 on the NHS or £120--at Boots or £70 somewhere else. In other words, not particularly cheap. Canada, however, has much cheaper prices than the U.S. on most drugs. A lot of Medicare patients--who don't have a prescription drug benefit, have found it worth their while to travel to Canada, pay to see a doctor to get a prescription and buy their drugs in Canada. This made me think that perhaps Canadians were more concerned about the price of their drugs, because it wasn't included as a general benefit. Just my thoughts.
Abby
Posted by Kath on June 7, 2000, at 14:38:11
In reply to Janice---prescription prices in Canada, posted by Abby on June 7, 2000, at 10:04:34
I live in Ontario & as far as I know, psychistrists are free even if they aren't affiliated with a hospital. I've seen 2 over the past months & they've been covered by the government medical system. Psychologists & Social Workers aren't covered unless they're part of a government-funded program such as the substance-abuse program that my son attends.
Kath
> Janice,
>
> I know that prescription drugs, at least ones under patent protection, are much cheaper in Canada, because you have price controls imposed by the government. I asked about the insurance coverage, because I noticed that in the UK, there are no "official" price controls, but that the Health service bargains for its own drug purchases, and an NHS prescription costs only a nominal copayment. Thus two months (60 tablets) of 100mg Lustral (Zoloft) costs £6 on the NHS or £120--at Boots or £70 somewhere else. In other words, not particularly cheap. Canada, however, has much cheaper prices than the U.S. on most drugs. A lot of Medicare patients--who don't have a prescription drug benefit, have found it worth their while to travel to Canada, pay to see a doctor to get a prescription and buy their drugs in Canada. This made me think that perhaps Canadians were more concerned about the price of their drugs, because it wasn't included as a general benefit. Just my thoughts.
>
> Abby
Posted by Greg on June 7, 2000, at 17:15:32
In reply to Re: huh, no Cam yet…, posted by ChrisK on June 7, 2000, at 6:18:30
> > he must of gotten his insurance and gone to the States.
> >
> Didn't Cam say he was going on vacation to Disneyworld sometime around now? I know he was worried about not getting there due to a health care strike but I think that was settled.I just hope he remembers the tee-shirts and keychains for everyone...
Posted by Janice on June 7, 2000, at 23:49:45
In reply to Re: huh, no Cam yet…, posted by Greg on June 7, 2000, at 17:15:32
Abby,
I couldn't even give you an uneducated guess that I would feel comfortable with. Hopefully someone who actually knows something will come along.
Yes, Greg a trinket would be lovely.
Who said he could take a holiday anyway? (thanks for the laugh)
This is the end of the thread.
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