I won't say any more about American health care aside from it being deplorable but a little improved by Obama when he was President. It did mean that some middle class people had to pay more for private health insurance and more less well off people received better care, if they could take out health insurance.
But let us compare Canada to Australia for medical care. Both are very confusing and complicated but they generally work well enough most of the time. Here is an edited of what Jackie in Toronto sent me when I asked her about Canadian health care.
Americans don't know a lot about our healthcare and yet they say they don't want it. I don't understand this. (Me either)
Jim Carrey, a Canadian, explains this perfectly.
Here is a video featuring him and another Canadian explaining our system.
It's quite long but a few minutes will give you the idea. It helps that the presenter is a good speaker and rather attractive. No, not the bloke with Jim Carrey.
Canada's provincially based Medicare systems (I am alert and alarmed at multiple Medicare systems. We have one federal one) are cost-effective because of their administrative simplicity. In each province, each doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses healthcare to be involved in billing and reclaim at all. (So, it does not cost to go to the doctor in Canada) The Canada Health Act does not cover prescription drugs, home care or long-term care or dental care (same here), which means most Canadians rely on private insurance from their employers or the government to pay for those costs (private health insurance paid by employers has happened here but it is a matter of history). Provinces provide partial coverage for children, those living in poverty and seniors.
Under the Canada Health Act, prescription drugs administered in Canadian hospitals are provided at no cost to the patient. (the same in Australia. If our medication is on the Public Benefit Subscription list, it will cost health care card holders, that is pensioners, unemployed etc about $5. It will cost wage earning people like me up to a maximum of about $35).
A health card is issued by the Provincial Ministry of Health to each individual who enrolls for the program in the province and everyone receives the same level of care. There is no need for a variety of plans because virtually all essential basic care is covered, including maternity but excluding mental health and home care. (Of course maternity is covered here. Mental health, technically yes, practically, not very well. Home care is an absolute mess, but in theory paid for from taxes with a co-contribution).
Canadians don’t pay coinsurance of 30 percent or 50 percent if they have an outpatient procedure or go to an urgent care clinic, charges that are becoming increasingly common in the States. They don’t worry about paying a gigantic bill if they happen to use an out-of-network doctor or hospital. The publicly funded system north of the border bases patients’ access to medical services on need, not on the ability to pay. (This is good, and much as it is here).
We have two walk-in clinics within a block of our place, simply walk-in, swipe your card and you are seen. No money involved. Need a tetanus shot, no problem. Need a shingles shot, there is a free shot over the age of 50, or you could opt to pay for a newer, more effective shot that will cost you about $200, but we are covered with our insurance plans. (While we do have private health insurance here, so far as I know nothing will cover you for the superior shingles shot. You do get the basic shingles shot after a certain age, perhaps 65.)
I, personally have never paid for any medical services. I've had a couple of operations as has John. I've had two hospital stays, John has had more, appendix, gall bladder, toe, kidney stones, no cost to us.
We have two walk in clinics (As Mother uses and sees the same doctor each time. It is a bulk billing clinic. The cost is paid by the federal government. I have my own doctor, who charges me about $75 and I am reimbursed about $37 by the government.)
Because it’s publicly funded, Canadian health care is more equitable. There’s no such thing as buying a platinum plan and getting first-rate coverage or a cheapo bronze policy and paying 60 percent of the bill yourself. We have American friends and they talk about how glad they are that they have these “platinum” plans. (Of course the health care coverage for the rich and the middle class in the US is ok. That is why there is not a rebellion)
Prescription drug coverage is a different thing. Drug benefits are quite unequal in Canada, and the lack of them is a pretty big hole for about 10 percent of the population. There is no universal drug benefit, although two provinces have mandatory drug insurance — you can get it from an employer or buy it from a public plan. About 40 percent of the population gets coverage from their employers.(I am thinking our prescription medicine system is better, but perhaps not by much)
John and I are extremely lucky to have medical and dental insurance plans from our employers that continue even after we retired. (No such thing as dental in Australia. While there is public dental care, you can wait years)
Not all Canadians are that lucky. If you can’t afford the premium, there are subsidies. (Subsidised private health insurance? As far as I know everyone who has private health insurance in Australia receives a subsidy)
You qualify for the Ontario Drug Benefit (ODB) program when you turn 65 years old. (Same here, I think)
Jackie added a little more.
When it comes to a family doctor you can find one you like if she/he is still taking patients. I have my own ophthalmologist and GP. GPs are easy to get an appointment with and dates/times can be worked out. They will refer you to specialists and it make take a month or two to get an appointment with the specialist but it is manageable. (Very much as here.)
I mentioned walk in clinics close to us and they are easy to find anywhere around the city, every few blocks in fact. Bulk billing clinics here, walk in and wait and no cost to you.
Hospital emergency rooms are crowded and waits are long. But then some people are stupid and go there for the littlest thing instead of using a walk-in. (Same here, and trivial problems cause much delay. As happens here, in Canada you would be triaged by a qualified person. If you stubbed your toe and are seeking treatment, expect just about everyone else to be be seen first. Accident victims with serious injuries, heart attack victims, etc will all be dealt with before you with your sore toe.)
Thanks for the info Jackie. I conclude neither your system nor ours compare as well to what is the system generally in Europe or dare I say it, even Britain, but are vastly superior to the US system. In both Canada and Australia, if you have a serious medical problem, you will be treated for free. Less serious problems, you may have to wait for a while.
We have had some experience of our system over the last year. We have top hospital cover private health insurance, and so used it. We are about $4000 out of pocket. This is so wrong.
We have learnt a lesson. Our twin friend who died from cancer had the best of care at little cost to him for over four years in the public hospital system. We should have used the public hospital system and saved $4000. There may have been a wait. We wouldn't be able to choose our appointment time, we wouldn't be able to choose who did the surgery, but what we would get would be the best of care by a very efficient public hospital and also a top surgeon or a junior supervised by a top surgeon.