Canadians and Europeans

Reply Thu 20 Aug, 2009 11:18 am
Will you please state your country of origin and post your objective opinion on whether health care is better or worse in your country than your best understanding of the USA policies, how your countries healthcare differs from the American system ,if your healthcare is "socialized" medicine and if so in what form?

It's a serious question and I'd really appreciate it . thanks
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Reply Thu 20 Aug, 2009 11:55 am
@Bi-Polar Bear,
I live in the U. S. and we are insured by business men who only insure people who arnt sick. I sure as hell dont want government interfearing with our business men makeing money so I am against single payer health insurance. By the way I am also a brain dead conserative.
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Reply Thu 20 Aug, 2009 12:03 pm
canadian, have had very little interaction with the health system personally, no operations, but any time i've had a problem involving a hospital or doctor, i've had prompt service, and it's free

had some chest pain last fall, turned out not to be heart related, but was taken into the emerg immediately, kept for about 7 hours while they monitored the situation, had two rounds of blood tests, and within two weeks of release i'd had a stress test and echo cardiogram as a precaution, great service, and oh yes, all free

Reply Thu 20 Aug, 2009 12:19 pm
@Bi-Polar Bear,
American. Socialized healthcare, and boy does it suck. My doctor is paid $88.00 per visit under Medicare, as opposed to the normal office call charge of $137.00. I count myself lucky he keeps me on as a money losing patient. Few doctors in town do, and so far as our Farmington Senior Center is aware, there are no doctors in town who accept new patients under Medicare.
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Reply Thu 20 Aug, 2009 02:05 pm
American, and the health care system where I live in Florida sucks as well. The only meds that I take are for type II diabetes and they are cheap. Lord pity me if I have to go to one of the two closest hospitals here.

A question for the Canadians. What percent of your income goes toward supporting your socialized medicine there?

Walter Hinteler
Reply Thu 20 Aug, 2009 02:36 pm
@Bi-Polar Bear,
Well, we got what is now know as a "mandatory health insurance system" in 1883, when the (very) conservative chancellor of the Reich and prime minister of Prussia "made" this law.

However, the history of "socialised" medicine goes further in German history, from the "brotherhoods for the ill", "hospital foundations" and similar during the Middle Ages to the General state laws for the Prussian states, the civil code of Prussia, promulgated in 1794, where explicitly the duty of the state to care for the poor and ill was named in a law.

Over the decades, there were some minor and little bigger changes made to a mandatory health care system.
But nothing really which changed it totally - though it often was tried .... and always thought to have happened by those who used it.

So how does it work, now and today?

In Germany, statutory health insurance, which covers 90 percent of the population, is financed by a payroll "tax". The individual’s premium is not a per-capita levy, as it is in the United States. It is purely income-based. Ostensibly, about 45 percent of the premium is contributed by employers.

Non-working spouses and children (up to 27, if they aren't at university, national services or don't earn any other money) are automatically covered, too.

Unemployment insurance pays the premiums for unemployed individuals, and pension funds share with the elderly in financing their premiums, which are set below actuarial costs for the elderly.

We've (still) about 190 different health insurance companies within this system.
However, since shortly, they don't differ in premiums anymore (by law) but only how they "support", some pay the fees the gymns, or alternative medicine or ...

We can go to any doctor we like and to any hospital we want to go to.
You pay 10 Euros for the first doctor's (for three months, once only) and 10 Euros per day in hospital (but only for 28 days).
Medicine on prescription ranges from totally free up to about 7 Euros.
However, you don't have to pay more than .... 1 or 2 percent of your income per year.

Well, you can the above better written and with some more details >HERE>.
Walter Hinteler
Reply Thu 20 Aug, 2009 03:09 pm
@Walter Hinteler,
I want to add something about our system, which - as I have observed it personally - is very different from the one in the USA and in the UK, but similar in Austria, Switzerland, and a couple of other European countries:

when we are ill, we go to a doctor, a normal family doctor (general or internist), or to a specialist's ... practise.
They send you to the hospital, if needed.
(In our suburbian village of 4,300 inhabitants we have two 'normal' family doctors, two internists, one paediatrician, one psychiatrist, three orthopedic surgeons, one general/accident/hand surgeon, one rheumatologist (specialised internist), two dentists and additonally two psychologists, three physiotherapist's practises and one ergotherapeutic practise.

Since we are a "spa town", we've two sanatoriums here (thermal, salty water) where patients stay after operations for three to six weeks.
The doctors there [not listed above] are internists, specialised in rheumatology, cardiology and orthopaedic surgery. They've ordinance hours for 'out patients' (= normal citizens) as well.

All other specialists are to be found in town (70,000 inhabitants incl villages), a catholic and an Evangelical (which means nothing at all for patients).
Both have about 400 beds, the catholic has urology wards, geriatric wards and orthopaedic wards additionally to the general and accident surgeons wards and the various internists wards.
The latter are in the Evangelical hospital as well, they additionally a a children surgeons ward, a children hospital, neurology wards and gynaecology wards (the latter, because the catholic hospital didn't do abortions).

In one of the villages we've a psychiatric hospital with a couple of wards (for half of the district, though).

As said above, we usually go to 'our' doctor or a specialist.
If we get ill over the weekend or at night .... no, no, ... we call a the number from the "doctor on emergency duty", that are (here, differs from town to town) pools of family doctors and specialists (about two practises per day), who than will either ask you to come to their practise (during day time) or visit you at home. (What nearly all family doctors do.)

Dentists have the same service.

Or you go to the "ambulance" in one of the hospitals

But you don't -normally- go there .... besides that you're driven by an ambulance.

Emergency medicine in Germany does not only mean emergency medical care in hospitals or surgeries. It also means that a special "rescue car" with an emergency doctor is send to accidents, suspected strokes, unclear internist and similar cases.

Well, I just wanted to show the differences which I noted personally.
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Reply Thu 20 Aug, 2009 03:15 pm
couldn't really say, it's just part of the taxes we pay, looking at my 2007 taxes, i paid about 400 dollars a month in taxes, that's split between federal and provincial (your state)
Reply Thu 20 Aug, 2009 03:23 pm
I doubt anyone could come up with such a figure for the US, either.
Walter Hinteler
Reply Thu 20 Aug, 2009 03:29 pm
The highest someone can pay here is about $830 per month, the lowest about $170, depending on how much you get as salary/income.
But that includes your spouse and children ... as well as the premium for 'long term care'. (That will pay you about roughly 60% of costs you have in a seniors' home, or a bit less when you get ambulant seniors' services.)
Reply Thu 20 Aug, 2009 05:09 pm
@Bi-Polar Bear,
reporting in from canada
the canadian health care system certainly needs a "major tuneup" imo .
most of the money is collected through various taxes and only a small direct premium is charged by most provinces - again , as part of the income taxes - just on a separate line in the annual tax return .
governments should put the cards on the table and tell us that we have to pay more to get better care - but it's a political football - the opposition would tell the people/taxpayers that "their" government can do it for less .
imo the medical people are often overworked ; we need more nurses , doctors etc. but it's "too hot to touch" (lots of "commissions" keep investigating and making reports ... but the action is lacking ) .
wouldn't want to abandon our system , but .. see above ...
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Reply Thu 20 Aug, 2009 05:13 pm
@Walter Hinteler,
I did not take the question to mean the direct, personally paid percentage.
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Reply Thu 20 Aug, 2009 05:39 pm
djjd62 wrote:
[...] any time i've had a problem involving a hospital or doctor, i've had prompt service, and it's free [...]

While, of course we do not pay directly at treatment time, we do as Canadians (which I am) pay personal medical premiums (paid by self or employer), and we pay via income tax as well.

Personally, I prefer our Canadian system, even though there's problems with it. The alternative can be scary. I would not have wanted to go bankrupt trying to pay for my cancer treatments in the U.S. It's too sad to read about folks this has happened to.

Letty wrote:
A question for the Canadians. What percent of your income goes toward supporting your socialized medicine there?

I think this is a very difficult question to answer, as the income tax goes into general revenue. The Federal gov't doles this out to the various provinces in transfer payments.
Reply Thu 20 Aug, 2009 10:42 pm
Australia.....there is a universal health scheme, paid for via taxes.

One can opt to add private, which allows faster service for elective surgery and also part pays for stuff like dental, glasses, physio etc.

One can still use the public system.

It requires more taxes as our population ages, but I am agahast at the American system.

Reply Thu 20 Aug, 2009 11:19 pm
dlowan wrote:
. . . but I am agahast at the American system.

What system would that be?
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Reply Fri 21 Aug, 2009 12:34 am
These are the monthly healthcare rates in BC, each province is different, but close.
$54 for one person
$96 for a family of two
$108 for a family of three or more.
A private combined drug/eyeglass and dental plan is about the same. Several companies or industries(as part of unions etc.) have some of these if not all or more benefits secured in their contracts
Most companies that offer health care as an benefit either pay half or all the bill for both plans. If you can't afford the fees, there is a sliding scale based on income from nothing up.
Taxes are based on income as well, and we do pay a lot, but we tend to make more per hour over the average american wage. So, I guess it evens out.
Regardless, I believe this is still cheaper than most plans in the US and no one can be denied care regardless of the status of their account.
Reply Fri 21 Aug, 2009 01:46 am
Definately cheaper from a personal standpoint. Still not sure of the cost to the government. In the US, insurance bought through an employer plan is paid with pretax income, and any employer contribution is tax deductable, and not considered income to the employee. The government cost is in lost taxes, which varies with each individual, as both personal and corporate taxes are progressive. This all makes it really hard to determine the real costs. Oh, and most employer plans have either a co-pay, co-insurance percent, or both. Some can probably be had with no co-pay, but the cost would be high.

For whatever it is worth, when I was doing payroll only about 1/3 of eligible employees accepted the plan. That may have been due to high employee turnover in the oil & gas well servicing business. In that particular plan, employee portion for one person had just risen to about $62.00 bi-weekly. The coverage was very good, but that's way more than the $54/month/person in BC.

It would be nice to have guaranteed care, without having to later declare bankruptcy.
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Reply Sat 22 Aug, 2009 09:58 am
Back when I was going to university, health care costs comprised about 33% of the annual federal budget. I have no idea what percentage it is today.

As previous Cdns said, most provinces have a reasonably inexpensive basic medical care plan which provides for your basic care - doctor's visits, referred specialist visits (some are no longer covered or the doctors charge more than what the government pays so you pay the difference), emergency and hospital visits/stays. All operations, except elective surgery, are covered. All referrals are covered, see above. Also you get a certain nunber of visits to a chiro, massage therapist, etc on your basic.

What's not provided by the provinces is Extended Benefits, such as eye exams and eye products/services, dentistry, and specialty items like crutches and the like.

I'm now living in Alberta and as of Jan 1 of this year, basic medical is provided free of charge to all Albertans. But the cost was cheap before.

Yes, there are problems with the system but I'd rather have our problems than have to pay the huge costs some Americans face.

I think if they got Nurse Practitioners to see patients who can be treated by them instead of doctors, and hired more LPNs to do bed pan duties and the like and let nurses do nursing, we'd save a lot of money. Also, you have to go to the doctor now to get your prescription refilled, which is often stupid (as with a topical ointment). And too many times you have to go in to your doc to get referred to a specialist when we might know ourselves what we need (corn removal, for example), so that's another way we waste money and time.
Reply Sat 22 Aug, 2009 10:39 am
Mame wrote:
[...] you have to go to the doctor now to get your prescription refilled [...]

Recently here in B.C., Mame, we know have a set-up whereby you can go to your pharmacist to have "longterm repeatable repeat" prescriptions refilled without going to your doctor.
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Reply Sat 22 Aug, 2009 12:23 pm
mame wrote :

I think if they got Nurse Practitioners to see patients who can be treated by them instead of doctors, and hired more LPNs to do bed pan duties and the like and let nurses do nursing, we'd save a lot of money.

yes , mame , there is certainly a real need to shift certain medical procedures to qualified nurses .
my doctor insists on doing everything by himself - b.p. check , vaccinations - things that could easily be done by a nurse .
some days one hears about shortage of nurses , other days i hear from nurses looking for a job - i honestly don't know which is true !

i hope more provinces will allow pharmacists do handle simple refills of prescriptions .

i also believe that my doctor looks forward to do some "simple" things in between seeing very sick and demanding patients . he sort of needs a break sometimes - i believe .

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