Health Care In Canada

For our American readers, here is a primer on how health care works in Canada.  We’re going to use simple concepts and small words so the majority of you can understand the whole thing despite having voted for the Republican President and been distracted by shiny objects and blatant lies.

Canada, that big country in pink over top of your country on a map, has about 36 million people in it.  We have cradle to grave healthcare for everybody.  Let’s take a common, easy to understand scenario.  You have a clumsy moment on the street and trip over your own two feet.

If you trip over your own two feet and break an ankle a few things happen up here in Canada.  One, you get treated for a broken ankle by doctors and nurses at the hospital. That would mean an x-ray, reviewed by a real physician to determine a) is this ankle broken? b) is there anything else wrong/life threatening with this broken ankle?

Assuming yes, the ankle is broken, nothing complex and there are no other complications, a physician will write an order for a cast.  It could be plaster, it could be fibreglass, it could be one of those newfangled ‘boot’ casts that are attached with velcro straps, depending on the severity and complexity of the break.  In all likelihood you will get a prescription for Tylenol 3’s and some crutches.   You’ll be sent on your way from the hospital along with some advice to keep your ankle up, rest, ice it and see your own physician soon.

Upon seeing your own physician, most probably they will write you orders for physiotherapy once you’re healed up, some follow up x-rays to make sure your ankle is healing correctly and anything else you might need to have a good outcome.  If you don’t have your own physician, it could be a couple of outpatient visits at the hospital and outpatient physio, either at the hospital, or a physiotherapy clinic.

Cost to you?  Less than $50.  Hospitals do charge a nominal fee for crutches.  And the cost of your Tylenol 3’s, about $11 for the Rx to take the pills at home over the next few days.

Notice that during this entire process, there has been no mention of insurance, funding, co-pays, deductibles, asks for a credit card, or other money up front.  Nobody has measured your wallet.  The medical decisions have been made by medical people using common, accepted, scientific methods of treatment to get the best possible outcome for the patient.

If you have supplementary insurance usually through your employer, the whole thing might not have cost you anything other than parking at the hospital while you hobbled into Emergency.

I won’t guess how much a hospital in the US would charge you for the same treatment, but according to some rudimentary web queries the prices range from $2,500 to $11,000 not including doctors’ fees, which can be $1,000 to $2,000 plus the radiologist fees to read the x-rays.  Let’s go mid-way between the two and call it $6,000 to $9,000 for the same uncomplicated broken ankle, cast, physio, some Tylenol and crutches.

The first question that gets asked when you hobble into a US Emergency is “Do you have insurance and with what company?”  There is the essential difference.

Now, the hard question:  How do we pay for health care in Canada?  Taxes.  We pay more Federal and Provincial taxes than Americans pay in Federal and State taxes.  In reality, perhaps 7 to 10% more, so not really a great difference.  That extra money we pay in taxes goes for things like universal health care.  Canada made that decision as a country in 1966 because it was the right thing to do for all our citizens.

As a closer to home example, the beloved spousal unit wound up in hospital with an abscessed tooth.  She was sent, by her dentist to Emergency as things were not clearing up.  There was oral surgery in Emergency on the day of.  At a followup two days later, things were getting worse, not better and there was a real danger of the infection going systemic, not just in the gum or the jaw.

She was admitted to hospital and the next night was on the table, under general, being operated on to get deep down into the infection.  There was bag after bag of IV antibiotics, some serious pain meds, x-rays, a CAT scan, more, different IV antibiotics as well as post-surgical care and regular hospital services.  Four days later, she is finally discharged, with another two weeks of daily IV antibiotics on home care at a local community care clinic.  Yes, she’s fine, on the mend, thanks for asking.

Turns out it was a Clindamycin-resistant staph infection, Clindamycin being the oral antibiotic of choice for dentists for a patient with an abscessed tooth.  In this case, through simple bad luck, the infection was exactly the kind that was resistant, which is why she didn’t get better in a couple of days and the whole trip to the Emergency department over the Easter weekend.

We did a little back of the envelope calculation and figured that the cost of her treatment was not too far from either side of $20,000 to $30,000, considering about $2,500 to $4,000 a day for a hospital stay.  Then general anesthesia for the second dental surgery, which ain’t cheap no matter how you calculate it, just by counting the people in the OR.  Then the Infectious Diseases folks and lab techs who diagnosed the clindamycin-resistant staph, necessitating the change of medications.  Nursing care, meds, meals and the usual overheads.

We’ll put it right in the middle, call it $25,000 worth of medical care.

Our biggest cost was parking.  $13 a day for four days while admitted and another $13 for the first visit to Emergency.  $65 bucks.  (We’re certain I spent at least that on coffee while waiting with her in hospital over the course of her treatment.)

The rest of that bill was paid for by our health care system, by that 7% to 10% more income tax we pay for universal health care.  No bill was presented to us.  We didn’t have to mortgage the house.

Per capita, the Canadian system, fully taxpayer funded, costs about $4,000 per person, to cover everybody in the country.

That’s 11% of our Gross Domestic Product going to healthcare.

The American Medicaid system, which doesn’t cover everybody, for the barest, rudimentary coverage, only at certain hospitals, and with only certain doctors, under certain circumstances costs the America taxpayer $9,600 per.

That’s 18% of your Gross Domestic Product going to healthcare.

You tell me why.


14 responses to “Health Care In Canada

  1. forgot to say the gas to get to the hospital. An other couple of coffees worth.

  2. I don’t know who the dim wit was who wrote this but I’m going to clarify things.
    1. Our health care in Canada is not funded by the local tax payers of that measley amount of money, it is not funded by the government it is funded by businesses who pay an employer health tax based on 10% of your $ figure of your payroll every year for your business. A average McDonald’s payroll or any other fast food service is over $ 1 m per year. So just for every McDonald’s and Burger King and every other business in Ontario that you don’t frequent pays approximately $100,000 per year to the government to pay for health care. That’s just a health care tax on top of regular corporate tax, WSIB, unemployment insurance and everything else.
    2. In America it is your choice to go to your doctor who is cheaper than the hospital ER. You can always get into your doctor in the US in case of emergency because they can see as many patients as they want to in a day. Canadians have to go to the ER because the government does not allow our doctors to see as many patients as they want. They are very limited to 1 patient every 15 minutes. It would take a week to a month to get into see your family doctor.
    3. Americans don’t have to wait 6 months for an MRI, or 1 year to see a specialist. Some specialists 2 years. You have to be sick for all that time in Canada.

    • I would be the dimwit, so let’s dissect your comments one by one.

      1) Yes, we have employer taxes in Canada. So do 195 other countries in the world. Get over it. Taxes pay for health care and where they come from is not material, which is why I quoted the percentage of GDP. If your beef is that employers carry too much burden of taxes for health care, then back it up with some facts and figures, or go do the other thing.

      2) Yes, it is not always the easiest to see your primary care physician, as OHIP rules tend towards suckage. You can see your primary care physician in the US, as long as your health care provider says you can, not your physician, unless you want to pay directly, off the books, because your insurance company will look at your claim history and visit history to determine your score for your premiums and adjust accordingly. Too many visits (a frequent flyer in the jargon) and your premium goes up as you are a risk for future illnesses, or are encroaching on their profitability per client.

      3) Depends on the ailment doesn’t it? I spent five YEARS on a waiting list for opthalmic surgery to correct a badly aimed (meaning cross-eyed) eye. I don’t see out of it anyways, so no big issue and understood that it was considered near-cosmetic surgery in an adult. Americans don’t have to wait for an MRI? You tell a private MRI clinic that you don’t have coverage, or you’re on Medicaid and can’t afford the over-the-counter price for an MRI and let me know exactly how quickly they’ll see you. I can answer that question for you: You’ll be invited to get the hell out, or to sign up with a loan company, conveniently offered by the MRI clinic. The annual interest rate for most third party medical loan services is 24% to as high as 44%.

      I have yet to claim that health care in Canada is perfect: It isn’t perfect, there are problems, to be sure, but it’s a damn sight better than having to mortgage the house because you tripped over your own two feet.

      • Jay McKillop

        Thank you.

      • Thank you very well said Road David. She must be a business owner worried about having to pay more. Healthcare is a human right. Everyone has the right to Healthcare it doesn’t matter if you are rich, poor, have a job or no job and homeless. I cannot believe so many people are so heartless and have no compass for humanity. Canada healthcare might not be perfect but healthcare in American really sucks not only for people with no insurance but for people with insurance paying high premiums, co-pays and out of pocket expenses. We too wait months to see our PCP’s, Specialist and MRI’s etc.

      • Thanks for your comment Diane. Some folks also noticed that Cindy didn’t bother replying with some facts and figures, so she cares enough to spout off once but not enough to back it up in an open discussion. Oh well.

    • Businesses who pay the employee tax? WTF are you talking about? You mean the INCOME tax that is deducted from the SALARY or WAGES that the business pays the employee in return for the employee’s work?! That is not the business paying it, that’s the EMPLOYEE paying it from the money they have earned.
      A Canadian wrote this article. My comment is written by a Canadian (me). I suspect you are an American no? I think we might know our own system just a smidge better than you.

    • Actually there is often a good chance you won’t get in to see your primary care either, FYI. Sever shortage of primary care providers here (US) and you’ll end up in the E.R. anyway

    • Brenda Watt

      I was an employer and I know I payed cpp and uic but I don’t know where this other health tax comes in..never seen it..did they take it from uic cause it wouldn’t be CPP…I have had 3 MRI’s and the longest I waited was 2 days. I guess it was the Drs call and this is the difference…if it’s a necessity the dr will keep you in hospital to speed this procedure along..I don’t know where people get the info they do…POLITICS maybe!!!!!!

      • I think the consensus among the folks replying is that Cindy is either high, deluded or living in a universe of ‘alternative facts’.

        As for MRI wait-times, the Ottawa General is next door to CHEO (Children’s Hospital of Eastern Ontario) If CHEO’s MRI isn’t busy, usually overnight, adults are shuttled from the General to CHEO for their MRI, if the General’s MRI is heavily booked. Although not perfect, administrators are making sure that the high-end gear is being used as much as possible.

        Routine procedures (colonoscopy, some day-surgeries in ortho or opthalmic) are shifted to outlying hospitals like Kemptville, Riverside or the QCH, to take the strain off the two Level 1 trauma hospitals in Ottawa, (the Civic and the General) that take the bulk of emerg cases. Again, not perfect (and a bit inconvenient for a routine op) but it’s a way to use the resources as efficiently as possible by keeping the resources booked.

  3. Funny how that works that primary care givers are too busy to see their patients. Given a choice between seeing a patient at Medicaid minimum (whatever that might be) or doing a few vials of Botox for whatever the market will bear, which do you think the physician will choose? Like it or not, doctors are in a business and have to cover their overhead and we don’t have a problem with that. We do have a problem with accountants and clerks making medical decisions.

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