Thursday, August 07, 2008

That Canadian Health Care

Barbara asked how our insurance works here, since we are American citizens living in Canada. Here's her question:
How does the insurance work with being in Canada? As Americans do you have to get your own insurance coverage, or are you covered at all under Canada's health care system?

As residents of British Columbia, we are entitled to health care coverage in this province. One of the myths of Canadian health care is that it is free; it is not free! We pay a monthly premium, based on the size of our family, and we pay very high taxes in this country which help to pay for that "free" health care that Americans hear about in the news. That basic insurance covers checkups and any illnesses that arise, including hospitalization and surgeries and treatments, which is very good. However, it does not cover prescription drugs, diabetes testing supplies, vision, or dental care. Any visits to the eye doctor or dentist are out of our own pocket.

We have an added coverage through the province, free to use, that covers prescriptions and testing supplies. This extra coverage works like a regular insurance plan, in that we pay an annual deductible based on our income, after which the insurance pays 70% of the cost up to a yearly cap, then pays 100% for the rest of that calendar year. At the beginning of each new year, we start over on our deductible and spending cap. So each year, we pay several hundred dollars out of our own pocket for my prescriptions and testing supplies. This is August, and I haven't yet met our deductible. So much for free health care!

This extra coverage is the one that we are having to get authorization from to get my medication approved for coverage. The two medications I take are very expensive - we'll meet the deductible pretty quick at this pace - and my testing supplies are very expensive also.

So yes, we are able to use the health care here, but it is far from being free. I just wanted to explain a little about the system so that when I say "we are covered through the health care system" people will understand that we are not living the high life, getting missionary support from American churches while getting free medical care! LOL


  1. I have to assume that each province is different. I don't know how the other provinces work it,but in Manitoba, we pay NO monthy premium for regular health care; doctor visits, emergency room, hospital stay, surgeries, prenatal care and delivery etc.
    We have one eye exam a year free...after that we pay. Dental we pay for.
    My husband has extra coverage through his work, so we don't pay for prescriptions, but as you said, for those who don't have that, prescriptions are covered after you pay the deductible.
    Yes, supplies for a diabetic would NOT be covered here either. My parents pay for theirs.
    In recent years, Manitoba has done a booming business, supplying prescription meds to Americans, through online pharmacies, because many of our prescription drugs are much less expensive.
    During camp meeting, we had a couple from Montana stay with us. She said her last baby, age 15 cost $10,000 in the hospital there. We just take it for granted here, that we don't pay for having a baby. Many complain about our system, but last year when my Dad needed open heart surgery, and a valve replaced, he spent alot of time in hospital, recieving mega doses of IV antibiotic to clear up the infection before surgery. He has had a multitude of tests before and since surgery, and follow up appointments with various doctors. He also has weekly lab work. He is turning 81 in October, and ALL of this healthcare is FREE.
    On the other hand, I believe that we should have the choice of using private facilities. If someone is willing and able to pay for something rather than wait for a free service, they should have that right.
    Sorry, didn't mean to write a book...just wanted to present a balnced view to the subject.

  2. We had supper last week at the home of a Canadian family that is now living in the States. One of the main reasons they moved was to get away from the 51% tax rate they were paying. They said that Americans should think twice about socialized medicine. The man's mother had cancer. It went undiagnosed for over a year because of the wait to get in to see a doctor. Very scary!

  3. Deborah, I'm pretty sure that each province is different, but I am a visitor in your country and don't know for sure! I just know how it is here in BC. I have a friend who lived in Ontario for a while, and I believe she told me that prenatal care is not covered in Ontario.

    Here in BC, the use of private facilities causes heated debate. From what I understand, people seem to see private health care as elitist - like you're a snob if you can afford to pay for your own private doctor. I see that as foolish, especially when the wait for elective surgery is 2 years, when you could pay to have it done next month. I couldn't afford it, but for those who can, why not?

    Thank you for writing so much. As I said, I'm a visitor in Canada, a newcomer, and I only know what I have learned here in BC. You're more than welcome to write all you would like to!

    Mrs. C, I can understand your friend's thinking. My experience here has been that I have no problem seeing my doctor, and when I need to see another doctor, he arranges it for me with no problems for me. Where there is a problem is in long waits for elective surgery, and the system decides what is elective. A man in our church had an aggressive form of cancer, and the wait time for his even beginning to have treatment was over 6 weeks - and he could feel the tumor growing every day. So he became a squeaky wheel, got his case reviewed and moved up, had his surgery and treatments and is fine now. His wife also had cancer 6 years ago, and from what we know of her experience, she was well taken care of. Again, it could be the difference in provincial systems between your friends' experience and ours. Even over here we don't pay 51% taxes! What province did he live in, if you know?

  4. I'm so glad you posted this. I have a friend who lives in Canada and had tumor that was cancerous. She wasn't scheduled to have the surgery for SIX months!! Everything is backed up there and so each and every day, that tumor was growing. It also wasn't free for her to get her medical care, as you stated. I really hope America wakes up and sees that there really isn't anything free. Your post just confirms that for me. Thank you for sharing!

    God bless you ~ Julie

  5. Great question and great comments. I learned a little more about the socialized medicine of Canada.

  6. I agree that the waits for some treatments are too long, that's why I think we should have the choice of private clinics.
    In Manitoba, cancer treatments are covered...the other comment didn't state a province, but it made me curious!
    It's also true that it can be a long wait for a regular check up,(up to 2 months for mine) as we do have a shortage of doctors in many places, especially small towns. For minor illness, we tend to use walk in clinics and go to our regular doctor if we need a follow up. Sometimes, you can find out when your own doctor is taking his/her turn at the walkin and go then! I also think that the wait is made longer by people who go to the doctor for every little thing...because it's free. If there was a small fee for service,(based on income, number of visits, or something like that)it would cut back on the frivilous use of doctors. (this wouldn't apply to those who need regularly scheduled checkups for a diagnosed illness.)
    My experience with emergency situations has been a very short wait.
    I forgot to mention too, that in Manitoba a midwife is covered, but in Alberta you have to pay for the service. But midwives have become very popular here, so there's a waiting list for them too!
    I think there are pros and cons to both of our systems. I think a mix of public and private health care would be the best system.
    As far as the tax rate goes...I'm clueless! We are not in a high tax bracket, and we have three kids, so we benefit from tax credits etc. Having gotten $5,000 and $6,000 refunds the past two years....I'm happy!
    Just out of the US, do you get a monthy check for each child? We used to call it Family it's the Child Tax Credit.

  7. Thanks for explaining! I have heard horror stories about socialized health care -- but then I have heard some horror stories about health care/insurance struggles here, too.

    My son was diagnosed with ulcerative colitis during his jr. year of high school, and though he has had no trouble since, now that he is no longer eligible for our insurance he can't get anyone to cover him. He has said many times he wishes we had socialized health care rather than insurance, but I am not so sure I like that idea, either.

    BTW, when I first asked the question, I wasn't thinking at all about what you said in your last line. :-) I was just curious at to how it worked.

  8. Julie, I'm glad this discussion has been a help to you. It's true that rarely is anything truly free; as I've said, we pay high taxes to pay for all the government programs.

    Pam, it really opens your eyes to live in another country, doesn't it? My focus living in America was so narrow. I feel like I see the world, as in the various nations and peoples, more clearly having lived outside of America.

    Deborah, I have more I want to say about your comment, but I want to make even another post! LOL I will say here that I have said many times in the four years we've lived here, that both countries could learn from each other and make both countries better. More later!

    Barbara, I wasn't thinking through well enough when answering your comment. I in no way felt that you were criticizing or questioning our honesty. I hope it didn't come across that way! If it did, please accept my apology. We have heard of missionaries moving to a nice country and living it up, and we've actually heard comments from pastors about those missionaries who move to a new country and just live the high life on churches' money. I just didn't want anyone to think we were like that, especially any of our supporting pastors or churches who might read here. Most people wouldn't think that, but sadly, some would have reason to think that way from personal experience.

  9. No, it didn't come across that way at all. I was in no way offended. I was just afraid I may have come across as implying the wrong thing in my question, but I figured you were directing those comments to general perceptions rather than to me personally.

    Although we haven't known personally of missionaries living the high life at churches' expense I have heard of that and I can see why you would want to be careful to be circumspect. What we have run into is that sometimes some folks don't understand what all goes into the missionaries' support levels, like higher living expenses in some countries, loss of the value of the dollar, and the fact that some of their support is going back into the ministry or into college funds, etc., and then they think the missionaries are getting quite a lot when they're really not. So I think these kinds of discussions help both perceptions.

  10. I'm not sure what part of Canada these folks are from. I'll have to check. I think he had a very well-paying job. :)

  11. I guess there are really a lot of flaws in both systems. I grew up in PA, but I have lived in Ontario for the past three years. From the way Deborah describes the healthcare in Manitoba, it sounds very very similar to the way it is here in Ontario. Pretty much everything is covered through OHIP -- I have never paid to visit a doctor or go to the emergency room, etc. Through my husband's work, we have additional coverage for prescriptions, eye exams, and 90% of dental coverage.

    It works well for us, since we are generally healthy people, but I have heard the stories of lengthy waiting periods or of people with diabetes such as yourself.

    It's always interesting to look at both sides -- the grass is always greener somewhere else, right? :)

  12. Barbara, you are so right that there is more to a missionary's expenses than just living expenses! I won't go into detail on my blog, because it's not meant to be a "this is what we need" thing, but you've hit the nail on the head.

    Mrs. C, Wes said that maybe the man did have a really high-paying job to be taxed so highly. We aren't taxed quite that much! ;)

    Melissa, being an American and being able to compare the two health systems, I've come to the conclusion that each country could learn from the other - each system has good and bad points. Do you feel the same way?

  13. Yes, I definitely feel the same way! My parents live in the USA, of course, and recently had problems with their health insurance and I saw what a huge problem that became since my mom has a chronic condition. So lately I've been focusing on the bad parts of the American system lol. But I'm sure something will happen in Canada to make me down on them too. Logically, Canada's way seems like the best way overall, but why are there still so many problems with it? Especially with all these "intelligent" people who take care of such things. :)


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