Quora -Re: I’ve heard horror stories about the Canadian healthcare system
I’m sure you have. Most of these horror stories are created by PR agencies and “think tanks” who are funded by the for-profit American healthcare players.
Re: As an American, I’d like to clear this up, are you helped immediately if you have a stroke, heart attack, or any form of cancer
I’ll explain this in American terms:
- In both Canada and the USA, doctors are for-profit businesses.
- In both Canada and the USA, doctors are paid a fee for the service they provide.
- In both Canada and the USA, the fee the doctor charge is generally paid by insurance companies.
- In both Canada and the USA, there may be a waiting time between when you book an appointment and you get to see the doctor. That’s independent of which insurance company is paying.
- In both Canada and the USA, some specialists may only accept “referrals” — that is to say that it’s your primary care physician who makes the appointment for you with the specialist. Again, this is independent of which insurance company is paying.
The big differences are the following:
- In the USA, there are thousands of insurance companies, and as a doctor you have to (a) choose which ones to do business with and (b) negotiate their payment rules. And not all insurance companies will pay the same amount. In fact, some can even refuse to pay!
- In the USA, citizens have to find one of these insurance plans and enroll (and pay!) and then deal with the paperwork.
- In the USA, you have to deal with patients who have no insurance. Which can be heartbreaking for both the patient and the doctor.
In Canada, by contrast,
- We have only one insurance plan per province. And it’s a pretty damn good plan: It covers you and every dependent, from birth to death, for almost any medically-necessary procedure, with no co-pays, deductibles, lifetime caps, or other strange rules. The exact payment for every procedure has been agreed to by a committee of doctors, not accountants.
- Every single resident of the province is automatically a member of that insurance plan. Your premiums are paid out of the tax you pay. If you are a minor, or retired, or unemployed, you are still a member and still get the exact same coverage.
- As a result, doctors do not need to deal with patients who have no insurance. They can focus on doctoring. They also have only one insurance company to deal with. In fact, these days it’s totally automated, they enter the details of the appointment into their electronic patient records system and the bill is automatically sent to the insurer, and the payment is automatically deposited electronically to the doctor’s bank account a few days later. This means that the position of “billing clerk” does not exist in the office of most Canadian doctors.
- Extra-special added bonus: There is no way for the insurance company to decl
en.wikipedia.org
