U.S. and Canadian healthcare: A comparison

My postings have been down lately because of a number of medical issues that arose.  I am at that stage in life where I have seen a good few friends pass away, and several of them were younger than me, which I tend to notice.  And although I am still awaiting the results of one ultrasound test, I seem to be OK so far.

While I have had a lifelong hostility towards socialism, I do believe that there are some services which are best provided by government, or preferably by a combination of government and private enterprise.  Healthcare is one of them.

If I have a problem or a concern, I can usually see my ‘general practitioner’ with a week.  Specialists can take longer, of course.  If my ‘gp’ is on vacation, I can see a doctor within an hour or so, simply by walking into the clinic where my doctor shares facilities with maybe two dozen others.  I did that a couple or three days ago, and was given an untrasound appointment for the following morning.  I couldn’t ask for better than that.

All the visits, examinations, and everything leading up to my hip replacement last year, were covered by the Ontario Hospital Insurance Plan (OHIP) except for the extra costs for a semi-private room, which were covered by my now-expired City of Toronto insurance coverage.

In the U.S., I would have had to pay a fortune or have had expensive private coverage.  Those Americans who have healthcare insurance provided by their employers are receiving noticeably  less in wages because of that.

Inability to pay medical bills is a primary cause of bankruptcy in the States.  Of course, we have a higher tax burden in Canada to cover the budgetary requirements, but then again, many hospitals in the States depend on government grants to cover the shortfall caused by uncollectable debts.  The productive part of society ends up paying one way or another…

Under the terms of Canadian Confederation, healthcare is a Provincial responsibility.  But, the financial costs have soared to the point that the Federal government has a Minister of Health also.  This is supposedly to ensure that health care is delivered consistently throughout Canada, but the primary function is to help cover provincial budgetary shortages with federal funds.

Many years ago, until the Ontario government put the screws to it, American hospitals used to really appreciate Ontario patients because they knew they were guaranteed prompt payment in full.

Now, permission for treatment in the States is often witheld on purely monetary grounds, even if the patient will die.

And a few years ago, there was a huge scandal when it was discovered that we had several hundred thousand more OHIP cards issued than we have people living in Ontario.

Americans were obtaining health cards fraudulently, and I would think that most of the population of upper New York State, and a good few from other close-by states, were coming over the border whenever they needed healthcare and getting it off the backs of the Ontario taxpayers.

It was the same in Britain in the 1950‘s and 1960‘s, with the wives of American servicemen stationed in Germany going over to England for a “visit” just in time to go into labour.

We can debate the wisdom of various healthcare systems forever, but in my opinion the ideal system is run by government, with no restriction on the provision of private services to the limit the market requires.

And when I have serious concerns about my health, and am wondering if I might be about to receive a terminal diagnosis, the last thing I want to have to do is worry about financial problems and maybe losing my house.

I don’t claim to have all the answers, but these are some of the issues.

Jeff Goodall.