Canada health care commentary

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Subject: Canada health care commentary
  As a new immigrant to Canada, I was wondering what other new Canadian immigrants, or residents/citizens here think about a commentary just published in my prior U.S. local city newspaper. It´s by a Canadian university health academic who severly criticizes the Canadian health care model as compared to the U.S. I think the movie "Sicko" has triggered these debates.

In my recent experience with health care in Canada, I´ve found most if not all in the article not accurate.

Here´s the link:
http://www.suntimes.com/news/otherviews/440668,CST-EDT-REF23B.article

Text also copied here:

Hidden costs of Canadian health care system

June 23, 2007
BY BRETT SKINNER
In a pivotal scene in ´´Sicko,´´ filmmaker Michael Moore marvels at Canada´s single-payer health system, suggesting that it is a medical utopia. ´´It´s really a fabulous system,´´ explains one healthy Canadian, ´´for making sure that the least of us and the best of us are taken care of.´´

But healthy people don´t use much health care. If Moore had interviewed ill Canadians, he would have gotten a whole different story.

In reality, Canada´s health care system is not the paradise Moore presents.

I should know: I live there.

Consider Canada´s notorious waiting lists. In 1993, Canadians referred by their doctors to specialists waited an average of 9.3 weeks for treatment. By 2006, it was 17.8 weeks -- almost twice what´s considered clinically reasonable.

In the words of Canada´s Supreme Court, ´´Access to a waiting list is not the same thing as access to health care.´´ The court used that phrase when it struck down the single-payer system in one Canadian province in 2005. Yet somehow Moore missed this, the biggest story in Canadian health policy in the last 40 years.

Canada´s long waits are partially caused by a shortage of doctors. Whereas the United States had 2.4 practicing physicians per 1,000 residents in 2004, Canada had only 2.1. That´s a difference of 300 fewer doctors in a city of 1 million residents. New York´s population is more than 8 million. Imagine what health care would be like in the Big Apple with 2,400 fewer physicians and you have some idea what it´s like in Canada.

Over the last 10 years, about 10 percent of doctors trained in Canada decided to practice medicine in the United States. This is the result of low physician salaries, which are paid by the state. The average Canadian physician earns only 42 percent of what the average U.S. doctor takes home each year. Simply put, single-payer systems exploit medical labor. Any U.S. state that adopts a single-payer approach is going to lose doctors to other states.

Canada´s single-payer system is also letting its hospitals rot. While the average U.S. hospital is only nine years old, the average hospital in Ontario, Canada´s largest province, has been around for 40 years.

And Canada´s system limits the adoption of new technology. Among the 24 Western nations that guarantee access to health care, Canada ranks 13th in access to MRIs and 17th in access to CT scanners. The lack of access to medical technology contributes to longer waiting times for diagnostic tests.

The rationing of medical procedures and drugs is another harmful result of Canada´s system. In 2003, twice as many in-patient surgical procedures were performed in the United States per 1,000 residents compared to Canada.

And Canada´s ´´universal´´ healthcare system doesn´t offer universal drug coverage. Only about one-third of the population is eligible for government drug programs in Canada -- the rest pay cash or have private insurance.

Canada´s cost advantage is also an illusion. True, Canada spends less per GDP on medical care than America -- but so does Ethiopia. Such comparisons are meaningless without considering value for money. And compared to Americans, Canadians get relatively little in return for the money they spend. Canada´s single-payer system does not cover many of the advanced medical treatments and technologies that are commonplace in America, and Canadians have access to fewer doctors, fewer treatments and fewer new drugs.

Yet in Canada, public spending on health care is still growing faster than the ability of the government to pay for it. As of 2006, public health spending in six out of 10 Canadian provinces was on pace to consume more than half of total revenue from all sources by the year 2020 -- without even taking into account the added pressures from an aging population. As of 2003, the growing unfunded liabilities for health care reached 46 percent of Canada´s total economic output.

These are the hidden costs of Canada´s health system, and they´re far worse than the monetary price of U.S. medical care. But Michael Moore is not interested in such facts. He makes fictional films.

Brett Skinner is a Ph.D. candidate at the University of Western Ontario and director of Health, Pharmaceutical and Insurance Policy Research at the Fraser Institute in Toronto.

[25-06-2007,14:59]
[**.47.174.241]
Richard
(in reply to: Canada health care commentary)
Richard,

Some recent reportings found Canadian Healthcare system is inferior to the other publicly funded healthcare system despite spending the most. Though Canada claims some good points (at least free to all); however due to extensive waiting time, lack of technology availability...
http://www.fraserinstitute.ca/admin/books/files/HowGoodHealthCare2006.pdf (extensive one, go to the conclusion at page 79).

I read many similar reportings.

About US/Canadian system comparison;
http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

It has some good eye opening points contrarary to the popular theory. Specially, unavailability of healthcare for the poor men in the US which is a common belief.

Based on my experience in both country, I would prefer US system with less waiting, more time spending with my physician (in US I get almost as much as I wish compared to extremely limited time in Canada), readily available recent technology. Yes, I have to pay out of my pocket, but this is health isuue, I´m willing to pay rather than waiting for 6 months in agony and start looking for India as an alternative (many patients from Canada have to do this in reality).

[26-06-2007,10:12]
[***.254.208.242]
Shah
(in reply to: Canada health care commentary)
Thanks for your input, Shah. Apparantly other than us 2, this health care topic apparently didn´t interest others here on the board. What a shame, since it´s such an important factor in moving to Canada.

But I do have to disagree with you in preference on which system. I´ve seen the terror in people´s eyes in the U.S. when they thought they would lose their job, and with it their health insurance. I´ve persoanlly dealt with the endless forms and paperwork of filing claims, and also the unreasonable denial of helth care coverage for my wife by th e private insurance companies that control everything. My experience in Canada has been quite good and without worries. So no thanks for the American style profit system in my opinion.

[26-06-2007,23:41]
[**.47.174.241]
Anonymous
(in reply to: Canada health care commentary)
Richard,

I 100% agree with you that the Healthcare system of Canada is a single most system for which Canadian must be proud of. May be it is so much that nobody wants to discuss any flaws of this. I also feel greatly frustrated in it. If you don´t acknowledge the fault then it won´t take long to lose it, I´m afraid that is emminent, if not near. Free healthcare is the single most point that contributes Canada´s place as the best living place over years. For what immigrants feel interested to settle.

About your 2nd remarks; I agree with you partially. In fact, earlier I actually should´ve pointed that my opinion was totally for myself, I selfishly denied thinking for many low income people in the US. Even I felt frustrated to see few hundred´s $ bill last month for my wife´s mamogram test even after insurance coverage. I console myself that she got the best care with no delay. She also noticed the difference of care in US/Canada physicians. Definitely, If US would have something like Universal healtcare like Canada it would have been best. But, I also know in most of the state there is free medicare system for the poor men who even don´t have to pay a single buck. I´have few relatives in NY recently immigrated they are enjoying that. One even got eye glass free of any charge (which I´ve no coverage at all). So, in US the poor men are not fully denied too. I guess, the middle income class is the big victim for paying co-payment. Also, I should be thinking of a free system which can´t treat me in time. This is health issue, not byuing a new model car that I can wait for 6 months. Though I strongly think that Americans should stand against the health insurance providers rather than teaching democrary to others. To be honest, I´ve excellent health condition. If I have something chronic which needs frequent medical attention, then I would also choice Canada no doubt.

All countries have good/bad side. My opinion most probably was influenced by the other positive sides of US. The overall frustration that I passed in Canada sometimes force me to be biased.

[27-06-2007,12:12]
[***.254.208.242]
Shah
(in reply to: Canada health care commentary)
Shah,

In your response I agree with you 100%. The quality of care in the U.S. is the best, but only if you can afford it, and not for the poor. In Canada, everyone is considered equal from the health ministry´s point of view, regardless of how much money you have. This I like and think is the most fair system possible.

When I go to the clinic to visit the doctor in the U.S., I always notice the expensive Mercedes and BMW cars parked in the physicians´ parking places in back. I wonder if that kind of wealth for the doctors is worth the inequities in the system?

I agree with you that America should fix this problem instead of teaching the rest of the world how to behave. Perhaps Canada´s health system is something that America can learn. But yes, every country has pluses and minuses. I think on this subject, Canada´s solution is a big plus.

Thanks for the discussion here, as I notice your replies to others here, and always find them quite interesting.




[27-06-2007,18:39]
[**.47.174.241]
Anonymous
(in reply to: Canada health care commentary)
That was me writing the last post - my name was left out for some reason.
[27-06-2007,18:41]
[**.47.174.241]
Richard
(in reply to: Canada health care commentary)
Richard,

I also firmly believe that in any civilized country Healthcare must be free (or at least easily accessible) to all. Canada or other countries with such system must deserve big thanks. It mustn´t be a sellable product, it is a basic human need. Though I don´t mind physicians are earning a lot, I think they deserve that also. It is not very easy to be physican and they are supposed to next to the God. However, there must be a limit too. I feel bad to see how the insurance providers are sucking money from us.

Sometimes it comes to my mind that may be to distract Americans from their daily basic needs such democracy lessons are badly needed for the US Govt to continue over years. Otherwise I can´t justify spending billions for democracy teaching rather than spending for own country´s healthcare.

Though I respect Americans and wish the success of America in every phases, Americans should be more thoughtful and analytic.

It is a common popular theory that in Canada you have to pay more tax. True. Many people prefer US just because of that. But on the otherhand in US, we have to pay good amount for Health insurance which should balance this. Specially when even after paying so much we have to pay out of our pocket. This really frustrates me a lot.

I also read all of your posts always and find very intersting and different than typicals. I know you are an American and immigrated into Canada for some personal perspectives like the free universal healthcare. Few years back, I also did the same thing leaving a settled job in US for the more or less similar reasons. Rest of my family members are also in Canada. However, I had to return to the US right after getting the passport for some good reasons; mainly the over frustrating job situation and poor customer service. I gusess you are not in that bad shape and wish your success in Canada.

[28-06-2007,01:01]
[**.152.238.67]
Shah
(in reply to: Canada health care commentary)
I don´t know if you´ll see this reply since this thread is already so far down in the queue.

I, as you have, also returned to the U.S. from Canada, even though I also have Canadian permanent residence (PR card). I could not find a job in my field there, and the high taxes and cost of living was too much for me without employment. Can you imagine $300 monthly electric bills?

It is the prices of everything that is the most disappointing to me. I think you experienced similar in Canada. On the other hand, health care was free and on my last visit to the walk-in clinic, excellent quality. So as you say, there are pluses and minuses.

So no, I am not in such good shape in regard to my move to Canada. But I have not given up, since I think Canada´s social and political ideals are more in line with my thinking than the America´s.

It seeems we are in similar situation, with a little bitterness from our first experience in trying to move and live in Canada. (But we should not give up.)

[28-06-2007,13:01]
[**.47.174.241]
Richard
(in reply to: Canada health care commentary)
Richard,

I was actually waiting for your reply. Good that you didn´t forget. Thanks for that. Sorry to hear your similar frustrated job situation. I didn´t expect that at least for you. Can you believe with 2 Masters in Engineering (1 from US with 2+ years experience, another from the U of T, their best school) I couldn´t find an appropriate job in Canada? At the same time I see how some people are landing in good jobs just because of nepotism, which is the biggest qualification there. Competition is so acute that nepotism plays above all. I gave up and didn´t want to return there. I don´t want to be racist, but if you are not of white Canadian ethnicity then it is unthinkably hard to find a professional level job. My wife also tried there to find a min´m salary work, guess what? The same thing. On the other hadn when I started again in the US I literally have to disconnect my phone line/message sometimes to avoid emplyer´s calling.

I was ready to accept lower salary in Canada, which I thought to be the only down side aganist free healthcare/better social care, lower crime rate there. Never I could imagine that even with a Canadian University degree I´ve to struggle like this. I didn´t deserve that. Also, if I could manage in job there, I won´t move in Canada. I had work experience doing some technican level jobs (suppodedly for the High school drop outs, semi labor). The proffesional environment I find there with contrast to USA was extremely poor. Overall the quality of customer service in Canada was very disappointing. I still couldn´t think of waiting 30 min´s for the elevators in our Toronto Apt (1/1 high rise) (paying 200 $ more than our nice 2/2 FL apt.) and maintenance taken care of after 2 months with several written request. Auto Insurance? Started with 267/Mo. then ended with 302/mo for a 93 Tercel myself. Now paying 240/6 months for 2 cars for 2 of us.

Morever, you may be surprized to know that I don´t want to live in a immigrant flooded location. I don;t feel like I´m in a particular part of the world.

I can accept lower salary. But certainly not under jobs to my qualification. I also willing to pay and accept service for that. Yes, still there free healthcare system is better than US, but on the other hand I have to sacrifice so much that such free healthcare would mean nothing to me.

I wish your success there, Good Luck. My overall judgement about Canada is; it is one of the best place to live. No doubt. But not for all, particularly for the high educated professionals who are born outside with no personal circle.

[28-06-2007,14:02]
[***.254.208.242]
Shah
(in reply to: Canada health care commentary)
Thanks for your most interesting reply, Shah. Your experiences had profound impact on me and my thoughts about Canada.

I wonder if you will let your Canadian PR lapse and not return to Canada? After all the effort, waiting, and expense to get it? As you know, one must live there for 2 of every 5 years - did you manage 2 years at least?. Myself, I would hate to see my PR end, and will try to complete 2 years somehow (lived there 9 months, 15 months remaining).

Good luck to you as well.

[28-06-2007,15:28]
[**.47.174.241]
Richard
(in reply to: Canada health care commentary)
Richard,

I already got my CDN. citizenship; hence at least grateful for Canada for that. (though in reality that helpded me to enter US without any Visa, that´s it).

I heard that you may stay longer over that 2 years cumpulsary period upon recieving prior permission from CIC. You may do a little research on that. Similar thing also is valid in the US for the GC holders; you can stay longer than 6 months each time with permission.

USA is my dream land, not for money, I love dwelling with the Americans and doing excellent here. I feel it is hard to cross the US border, but once you go through that, life is way easier. May be that makes US still as the best choice for the professionals. If they would let their border like Canada I´m sure job situation would have been worse there too. Scenario is totally opposite for Canada, easy to enter, hard to survive. As an immigrant, it seems way easier for me to mingle with the main stream society in the US where I rarely have the uneasy feeling of being an univited guest in a party. Currently my biggest worry is to process the GC, that is just a matter of time, that´s it.

[28-06-2007,15:43]
[***.254.208.242]
Shah