This sort of a post – discussing health care reform, socialized medicine, and the health care bill – requires a clear introduction. In this post I hope to compare my family’s medical experiences in Canada and the United States. So let me be clear by emphasizing that this post is not intended to be political in nature. Second, this post is intended to serve as my reflections on actual medical experiences from nine years of living in Canada and nine years living in the United States. I do hope this post will clarify some gross misconceptions about the Canadian health care system. Photo by Rodrigo Basaure
Over the last few months my family has been in the United States. During that time we have been asked essentially the same question over and over – What is the health care like in Canada? How bad is socialized medicine? What is your true experience with health care in Canada?
All along I never thought of addressing the question on this blog until I was forwarded an email asking me to share my thoughts in an email discussion. Here is an excerpt of the email I was forwarded:
I was considering a move up into Canada (_____ to be exact). My employer has a manufacturing facility up there. With all of the debate going on now here in the States with regard to health care, I thought it may be a good idea to get an objective opinion about health care in Canada. How do you feel about it? What would you advise as far as the quality of the health care in Canada? There has been so much talk about how terrible the quality of care is up there with a government run system, that it gives me pause about moving to Canada. Any thoughts on the matter would be greatly appreciated.
The original recipient included some of his thoughts on the topic
From my point of view, Ontario has a good health system. I’m certainly not saying it’s perfect, and I suspect from recent experiences of friends, you wouldn’t claim perfection for the US system either.
I think our doctors would perform well when put up against anyone anywhere. I would say this is generally true of those who work throughout the system. Our problems come into play for what are normally thought of as non emergency procedures. Wait lists are too long in my mind for knee replacements and similar surgeries. Also for other serious surgeries. Although, if you have a heart attack or similar incident that needs treatment immediately, you receive it in a timely manner. There are also wait times for MRI and similar scans when it is non-emergency. One difficulty is that things can be emergencies when they don’t appear to be.
It can be difficult to find a family doctor, so we do have people who end up going to walk-in clinics and seeing whatever doctor is on duty rather than having one to whom they always go. Some areas are better than others. …
Of course improvements are needed. The new head of the Canadian Medical Association-representing our doctors recently made some statements about the need for change. …
I personally wouldn’t hesitate moving here because of the health system. Interestingly though, if I were offered a position in the States health care there would be one of my biggest concerns.
As the conversation continued, the original sender (the one inquiring about the Canadian health care system) asked if the recipient could suggest someone who had lived both Canada and the US to attest to the true differences – I was that person suggested.
“there has been so much talk about the quality of care”
This is where I want to focus my energy – the quality of care and the medical experiences between the two countries. Remember, this is only the experience of one person and might not be true of others. Remember, also, in my comments I am really only comparing my experiences in 4 or 5 US and Canadian medical facilities.
First, my conclusion. If someone were to blindfold you, spin you around three times, move you to an undisclosed location, and in the process break your leg and you were forced to get medical services, you would not know if you ended up in Canada or the United States. When US media and well known individuals speak of the Canadian health care system I believe they grossly misrepresent Canadian medical services. If there is a difference in the care my family has received in the two countries (which undoubtedly there is) those differences would be subtle and refined. More like talking and about blue and teal. However, when US citizens (often many who have never been to a Canadian medical facility) speak of the differences, they talk about it like there is a canyon of differences. They think the discussion is more like comparing blue and red.
In fact, to be completely honest, my greatest medical frustrations have been experiences in the United States and not Canada.
Photo by Martin Kingsley
NEGATIVE U.S. MEDICAL EXPERIENCES
- In 2003, my wife was having some serious symptoms and it was my first time to use our health insurance in a brand new city. It took me 45 minutes – 1 hour to find the right hospital in our network and to find out how to get to the hospital. I had been given conflicting information by my insurance company.
- While living in Houston, in a two year period my wife had to see three different OB doctors because each time a doctor left our network. The process of finding another doctor was frustrating.
- In 2006, my wife had a two hour visit to the emergency room. Unfortunately, we had no idea that our insurance (which we paid dearly for) did not cover emergency room visits if you are not admitted. She was not admitted, and as a result we had close to a $2,500 hospital bill for a short emergency room visit in which she didn’t even get a bed.
- On four occasions I have had to purchase health insurance in the US. Reading through the fine print and trying to understand what is and is not covered is a pain in the neck. On one occasion we had to extend our health insurance using COBRA while my wife was pregnant. Those short three months burned through a good $2,400 in health insurance premiums alone.
Functionally, the United States does not have a perfect health care system. There are good options like a health savings account, but this is still not a perfect solution. This is not just my perception, but it is the opinion of many Americans. Does it need to be reformed? You can decide. How drastic do the reforms need to be? Your votes will determine that (or have). Should it be socialized? Not my political agenda. All I can say is I know many others who have experienced different levels of frustration with the current health care system.
NEGATIVE CANADIAN EXPERIENCES
- During the birth of our third child my wife was induced. She was called to come in one morning and almost immediately sent home because they were already too full in the maternity ward. That was a frustrating experience as we had called right before we left the house. A family member observed that this was because of our poor socialized system in Canada. That evening we had an email from a friend who said that the exact same thing happened to her in Austin, Texas.
- After the baby was born, the private rooms at the small rural hospital were full. As a result my wife stayed in a ward room with another mother. That kind of thing would likely not happen in the States. Interestingly, she quite liked the experience of having company.
- I recently tried to set a doctor’s appointment in a small town and was told that I would need to go to another clinic as they were no longer accepting new patients. I had to go to a walk in clinic instead.
Is the US system better? Perhaps.
Is the US system more efficient? Possibly.
Is the US system more costly? Undoubtedly.
Are there Canadians who want a better system? Absolutely.
Are there Americans who want a better system? Absolutely.
Will there be a solution that leaves everyone happy? Unfortunately – no.
Is the government’s involvement in health care likely to result in worse medical services in the US? I suspect.
Nevertheless, pragmatically, our experiences once in the doors of a doctors office or hospital has been essentially no different. If you are going to talk about the medical care offered in Canada, I only have one kind request – talk about what you know, not what you have heard. Chances are what you have heard is not close to the real experiences of everyday Canadians.
By the way, to our friend who is wondering if he should move to Canada - I would say don’t let the health care system be a stumbling block. The beauty is that where you are thinking about moving to is only an hour drive from the US border, so if I’m wrong about my impressions you can still drive across the border and get American treatment :).
My wife and I have had three children – one in the States and two in Canada. We have made the choice to have our children in Canada because we found the care to be good, medical service exceptional, and the cost difference unbelievable (If you want to know the difference between the cost of having a baby in the US and Canada read this post).
What does any of this have to do with personal finance?
My wife and I have had an emergency fund in place for probably just over eight years. In that time period we have only had to dip into our emergency funds twice. Both were because of medical costs experienced in the USA. Many families are struggling with the burden of increased health insurance costs and premiums. Whatever decision is made by the Obama administration in the USA will impact your personal finances – either for better or for worse.
And now I open the door to your feedback …