A Personal Comparison of U.S. vs. Canadian Healthcare Coverage

My interest in the U.S. healthcare debate wanes by the day.  And because I no longer have skin [literally] in the game, I am not angry and desperate as are many of my friends who sign petition after petition, post links and videos of hope on social networking sites, and travel to see their senators and representatives in Congress.  I am just incredulous at the absurdity of the debate and the vilification of other systems that manage to cover ALL their citizens.

I would let this issue go without comment, except that I received the following message this morning from San Francisco via email: “You have received a bill from Anthem Blue Cross for $1014.00 – ouch!” And that number – US$ 1014 – triggered  momentary outrage.

My first reaction was:  how are they trying to screw me now?  Then I realized that the number looked like 2 months of my former insurance premium.  Was there some kind of penalty for cancellation?  As it turned out, it was a false alarm – a technical error from a not-very-sophisticated bureaucracy – when I canceled my policy, thereby discontinuing monthly deductions from my credit card, the Blue Cross system automatically sent out a paper bill (but why for 2 months?).

I canceled my health insurance coverage in the U.S. on 12 October 2009.  I should have done it in August (when I qualified for the Medical Service Plan (MSP) in British Columbia and received my Care Card), but as a victim of the American healthcare system for so many years, I was scared.  Irrational thoughts of: “I’ll never get coverage again in the U.S.;” or,” I’ll have to pay an enormous amount of money to get covered” crossed my mind.  But after using the MSP for a full physical examination, blood tests, and an EKG, I developed confidence in my new coverage and severed the old.

At the time I canceled my Blue Cross coverage, I was paying US$ 507 a month in premiums (the premiums went up in March, from US$ 378 – a 34% increase!).  I believe I had a US$200 deductible, 30% co-payment for medical services and US$10 co-pay for prescription drugs.  Just before I left California this year, I took care of some basics.  I got an annual checkup (which included a pap smear), for which I paid US$ 42.50.  The labs for the pap smear cost me US$31.90.  Blood tests cost me US$66.90.  And a mammogram cost me US$ 121.98.  I also paid US$ 18.21 out of pocket for three months of prescription vitamin D because it was cheaper to buy them without applying insurance coverage.  So, my medical costs from the beginning of the year until 12 October totaled US$ 5,093.49.

In comparison, I pay C$ 48 month (based on coverage for a couple) for medical care in British Columbia.  (BC provides premium assistance for those who cannot afford the C$ 48 – if your income is less than C$ 20,000, you receive 100% subsidy.) To be fair, this does not include prescription drug coverage.  So, if you add an enhanced drug coverage plan (covering both name brand and generic drugs, including birth control and fertility drugs), which pays for 90% of your first C$ 2,220 and 100% of your next C$6,000, you would add C$ 57.90, for a total of C$ 105.90.  (Fair PharmaCare is an income-based plan that helps with prescription drugs.)  However, for C$ 114.40, not only can you get the prescription drug coverage outlined above, but excellent dental, basic vision, and a host of other coverage including Chiropractor, Osteopath, Podiatrist, Naturopath, Registered Massage Therapist, Acupuncturist, Psychologist, Speech Pathologist, Physiotherapist, Homecare and Nursing, Ambulance, Hearing Aid, Emergency Travel Health Coverage, Accidental Death and Dismemberment… and more…  So a complete package (did I mention massage therapy?) would cost you C$ 162.40 (C$ 48 plus C$ 114.40).

As I indicated earlier, I got another complete physical examination, including a pap smear, full panel of blood tests and an EKG done recently to establish health records in Canada.  Co-pay?  None.  Paperwork?  None.  All you do is present your Care Card at the beginning of your visit, and walk out at the end.

What about the difficulty in finding a family practitioner?  (There is a structural shortage of doctors in Canada – with an estimated 4 million “orphan” patients.  However, there are numerous clinics, at least in urban areas, that will serve on a walk-in basis.)  After asking for recommendations from friends, I found a doctor to take me on as a new patient in two phone calls.  (Friends impressed upon me to make sure that my family practitioner was younger than I was so that you are not left as an “orphan” when s/he retires.  By sheer luck, I chose a woman who is substantially younger than I am.  How much younger?  Let’s put it this way… she’s a size 2.) How long did it take to get an appointment?  Around 2 weeks for the initial consultation and 2 weeks for the physical.  (In the U.S., it would take me about a month to get an appointment with my primary health care provider, who is a nurse practitioner – my doctor retired to spend more time with her kids.)  And in the interest of full disclosure (or does this fall in the too-much-information category?), it will take me two months and three weeks to get a consult for a colonoscopy.  Since this is an age-based procedure in my case and not based on need, time is not an issue.  In the U.S., I would have had to wait about a month and a half to two months.

What do I think about the Canadian health care system?  It gives me peace of mind.


4 Responses to “A Personal Comparison of U.S. vs. Canadian Healthcare Coverage”

  1. 1 rahul November 9, 2009 at 7:33 am

    What an awesome post!
    US health care is a scam for sure. For non-urgent care, an $1200 ticket to India beats anything south of the 49th parallel!

  2. 2 Heena November 22, 2009 at 7:29 pm

    Isn’t it great to be canadian? =)

  3. 3 Yoo-Mi November 23, 2009 at 2:00 am

    Rahul – wish we could get a $1200 ticket to India!

    Heena – Yup, enjoying the privileges!!!

  4. 4 FLGirl March 18, 2010 at 5:14 pm

    My most recent personal comparison of Canadian vs US health care are two men who were friends/family of two different in-laws who were both diagnosed with ALS in the past 7 or 8 years. The Canadian was just diagnosed in early 2009 and dead and in the ground in less than 10 months while the American survived more than 3 years. That may not sound like a huge difference of time to some, but for the American father of a very young child, every month counted for his friends and family.

    A family member of the Canadian happens to live in the States. She and her own husband both work in the medical field and they do no support government run health care. They are well aware of the nuances of the Canadian system. She knows the hell of what her sister went through trying to get adequate treatment for her ailing husband. His health care may have been free, but unfortunately he got what he paid for when he needed it most.

    After my own little MS scare in 2001, I did plenty of research on treatment and was shocked at the overwhelming dissatisfaction among MS patients in both the UK and Canadian health care systems. Ask an MS patient in the UK how they feel about the lottery system for determining who gets treated under their system. In my case, I called my family physician the day my symptoms became apparent, was told to come in first thing the next morning and was sent for blood work that day and scheduled for an MRI early the very next day. Test results were back within a few days and I began treatments for a severe vitamin B12 deficiency and screened for brain lesions every 6 months to a year since then. That is not the way it works in most government run health care systems anywhere.

    As for those of you who champion the Canadian OB/Gyn system, I will say that my own daughter would have likely strangled to death during child birth had I gone down the path of a home delivery. She turned to a breach position a few days before my due date. My OB/GYN presented me with 4 or 5 options to deal with the situation and I chose to have a c-section after discussing each option and the pros and cons of each. He pointed out that babies turning so late usually have a reason for making that turn… In my case her cord had wrapped around her neck and would have been a tremendous risk had that not been caught before starting down the birth canal particularly in light of her being 9lbs instead of the 7-1/2lbs she was estimated to be. She’s currently working on a degree in environmental engineering.

    One glaring difference between the US & Canada which everyone fails to recognize is the Canadian system is partially supported by their huge oil and gas revenues owned by the state. Norway also uses their oil and gas revenue in a similar fashion. I have plenty of Scandinavian friends (particularly the Danes in my circle) who still have family dealing with socialized medicine in their motherland who are all too happy to share their reasons for opposing a government run system.

    I agree our system needs help, but our government is a huge part of what’s wrong with it right now and will never be the answer to correcting it. Much of the increase in premiums in the US are a direct result of high price of liability insurance and keeping up with bureaucratic bs required by state and federal regulation.

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