Health Care Around the World

[Karlynn]

Since we are in an early election season in the US, a lot of talk is going on about health care. The US needs to work something out, but I find it scary because if I wasn't allowed to choose who I saw and when I saw them 20 years ago, I'd be dead now. Michael Moore did a documentary called "Sicko" which I haven't seen yet, where he lauds Cuba's health care, as well as Canada and some European countries with socialized medicine. It sounds all very good on paper (tape), but I read things here from our members that live outside the US and think it's not all as wonderful as it sounds, particularly for those like us who have ongoing health concerns.

So - to the point - I'd like to hear from members in countries outside the US about how your health care system works and what you feel the positives and the negatives of the system are for you.

*Note - this thread isn't intended to be a political discussion, just a fact finding discussion. So please no talk of what political candidates are or aren't doing please.

 

[Cooker]

Cooker For President
sorry.....could not help myself

 

[Cooker]

Karlynn....this should be a great thread. I am looking forward to hearing from those abroad.

 

[Lynlw]

Karlynn, Oprah had a show w/ Micheal Moore and someone from the insurance industry ect on yesterday, I usually don't watch her, but this was very good,I don't know if you can see it online anywhere but it was very informative

 

[Freddie]

From Canada,
I was given a surgeon and a cardio. In my case I had no time to find a second
opinion. My GP told me that these two guys were the best. There wasn't much I could do.
In general, I don't pay for Doctor visits, lab work or ER at the hospital. Clinics/hospitals do charge for crutches and casts. There could be more.
I'm sure other Canadians will tell you more

 

[Adrienne]

First of all, I saw Michael Moore on Oprah, although I have not seen Sicko. Although I am on his side about the fact that everyone should have health care, I find that he does not tell people about the bad points in health care in Canada and other places. He said something like "Oh, well maybe for certain non-life-threatening things, you have to wait a bit longer in Canada...".

Well, each province in Canada handles its own health care, but I can tell you that in Quebec the waits to see a specialist are LONG. Besides that, there is a shortage of GPs, so even if you don't like your GP (if you are lucky enough to have one) you do not dare leave him or her.

But back to specialists, when I had endocarditis in 2004, the microbiologist who oversaw my case said that I needed a valve operation and that the cardiologist that had seen me when I was in the hospital agreed. I was told that I should have it within the next several months. I got a referral from the microbiologist to get another opinion at the Montreal Heart Institute (since that is the "crème de la crème" for heart ailments). I called the Heart Institute and the secretary said to fax her the referral, but that there was a waiting list of FIVE months!!! Here, I was just told that I should have the operation within the next several months, and I had to wait 5 months just to see someone!!! Well, then I saw my cardiologist (ex-cardiologist), and he said no, no, you don't need an operation, blah, blah, blah. Although I didn't know who was right, I felt less pressed by what I heard. So, then a cousin of mine in NY who is a doctor had me come down and he had an echo done on me. When the cardiologist that works with him came back from vacation, he looked at the results, and he said I SHOULD get the operation rather fast!!!!! So, then my husband and I got out the heavy guns! My husband called this doctor who is a friend of his family (their mothers were very good friends). Long story short - because of this guy, I was able to see a cardiologist at the Heart Institue in about a month and a surgeon (who became my surgeon) at the Heart Institute in about 3 months (which actually was 5 months after I had first sent in the referral).

I could go on with the details, but I think you get the picture. Although I had a wonderful, superb surgeon, waiting to see him is another story.

When it comes to needing hip replacements and other orthopedic procedures, the wait is at least 6 months even if the person is in excrutiating pain! I guess Michael Moore would say that this is not life threatening.

From what I have heard about certain European countries like France, they have a combination of public and private health care. I think that is what Canada needs. Actually, there are some private clinics in Montreal, but the doctors have to opt out of the public system. In certain European countries, doctors can work in the private sector as long as they do a certain number of hours in the public sector.

Anyhow, yes, the U.S. needs to do something so that everyone gets health insurance, but Michael Moore gets on my nerves the way he presents it.

 

[Kate]

Hi Karlynn,
I know you specifically requested information from those outside the U.S., but I'd like to share my experience of our own healthcare system.

Like you, I've felt very lucky over the past 13 years to have the kind of medical insurance that allowed me to go to the cardiologist for regular check-ups, choose to have my surgery at the Cleveland Clinic and receive the benefit of cardiac rehab.

However, I had no medical insurance from ages 18 - 27, despite being either employed full-time or in school full-time. As a result, I went years without seeing a cardiologist, despite knowing of my medical condition. When I passed out at work from an irregular heart beat and was put on the cardiac ward for observation for 2 days, the resulting bills (well over my annual income at the time) were completely overwhelming. I made too much money to qualify for aide and too little to pay them off in a timely manner. My credit took a serious blow that took over a decade to fix. Needless to say, I didn't receive follow-up care or the prescriptions that could have stabilized my heart beat and perhaps slowed the growth of my aortic aneurysm.

I guess my point is that, much as I like having freedom of choice, I also remember how awful it felt to be in the hospital at 22, scared out of my wits about my heart, and even more worried about how I was going to pay the bill. I don't have a clue how to solve the problem that will adequately deal with both the desire for high quality care and the desire for universal care, but I hope there is one. Kate

 

[Karlynn]

Thanks so much to those who have shared so far. I look forward to reading more.

BMac and Adrienne - how prevalent are law suits in Canada? That's definitely one of the factors that has driven up the cost of health care in the US.

16 years ago, my VR's total bill was $40,000. The cost in the US today makes that look like the cost for a wart removal now.

 

[WayneGM]

I for one am extremely grateful for our Ontario health care system. It has its flaws, but it was there when I needed it. I got Dr. Tirone David as my surgeon at no cost to me (at least directly....I do pay taxes to the government) and had my surgery more or less on schedule (a two week delay due to being bumped by a higher priority patient). Except for the room upgrade and prescriptions after discharge, both which were covered by my company benefits plan, I wasn't out of pocket a dime......ok I rented the TV and phone so I was out a little

 

[Adrienne]

I agree with what BMac just said.

 

[maka]

I can?t comment about the Health Care in Canada or England, but I certainly can about the United States and Cuba.
In the United States, I have regular Medicare and can go to any doctor of my chioce as well as to the best hospitals. When I decided to have my MV repaired, I called one of the best doctors at the NY Presbyterian Hospital and made an appointment for the FOLLOWING week. The surgeon introduced me to some of his team members and spent way over an hour answering my questions.
And then he told me, when you are ready, give me a call and we?ll schedule the surgery for a week after that. The total cost including a week in the hospital and another in a nurse/reha home plus a week visits at home rehabilitation was way over $100,000 and I paid less than $1,000.

As to Cuba, unfortunately the hospital that Moore visited is NOT available to the Cubans and only to tourists,,,,imagine for a moment living in a place where the natives are prohibited to enter hotels and are not admitted to the decent hospitals. The hospitals available to Cubans lack the most essential equipment and the patients have to bring their own sheets and pillows.
I volunteer with a group that sends medicines to Cuba through the Catholic churches and people ask for even the most elementary drugs including vitamins.
I sent some over the counter drugs to a relative months ago, and she was so grateful for the great drug for arthritis that was included and how much it helped her ......the name of it...TYLENOL

 

[Bina]

Here in Canada, every pay cheque I have ever earned has had a deduction called Medicare. We grew up with this and have never questioned why we have this deduction. It has covered GP and specialist visits, as well as many ER trips for my family; including the X-rays, broken arm cast, blood tests, ultra sounds, EKG, and ultimately my complete pre-op and OHS.
Yes, waiting in the ER can be 1-7 hours, (according to triage), and waiting for non-life threatening surgeries can be 6-12 months.
Many cities now have a 2 tier system in place....if you have the $$$ the choice is yours....pay for private care, or be grateful for the free public care.

 

[pamela]

Unfortunately, as I've mentioned in another thread, in small talk, I'm a heavy user of the health care system. I remember trips to the ER for fevers, stitches and sprains. I've always had an annual checkup at our GP's office and began my current count of at least 13 general anesthetic surgical procedures when I was 12 and had a tonsillectomy.

Many of the interventions I've had were while I was in the military, the federal government paid these bills directly. Once I was admitted to my home town hospital, while I was on leave, for an emergency appendectomy. This turned out to be a misdiagnosed pelvic DVT that once discovered kept me on my back with immediate IV heparin and antibiotics. I was in the hospital for 2 weeks and unable to travel for an additional 2 weeks. I saw the bill, 127,000 dollars, in 1982. The other related lab and doctor's appointments were handled by the military, as were the oral meds and my reduced duty capabilities during recovery.

My heart valve disease and the OHSs to replace them have been through the public purse. I am thankful the system is in place since the additional insurance I have only covers 80% of all non-hospital-doctor referred services. This insurance also covers partial drug prescriptions, equipment purchases and aids to daily living. I also received visits from the Home Care nursing services for dressing changes and general well-being monitoring.

This knee injury has cost me a bit more, in that in order to move the surgery ahead, quickly I paid for an MRI in a private imaging facility. Unfortunately, within a week of having the image I'd developed a blood clot, so my surgery was delayed until I was finished coumadin therapy. I'm still happy with the access to orthopedic specialists and anesthetists I've been granted. My consult was within 3 weeks of the injury and my surgery was to have happened inside of 4 weeks from that time.

Even so, I'm satisfied that I haven't been kept waiting for unreasonable lengths of time and the system has come through when I and my family have needed it.

I can't imagine coping with even the most recent medical emergencies in my life if I'd have had to stress about paying the tremendous costs of last year's OHS for myself and this summer, for my son's ground and air ambulance transportation and 24 day hospital stay, 10 of which were in a private room. He had 9 surgeries with vascular, ortho and plastic surgeons all involved at least 50% of the time. He suffered 2 saline soak dressing changes in a sterile field every off-surgery day, massive IV drugs and 2 blood transfusions. He's still receiving therapy with physio and occupational depts and the standard above-elbow prosthesis with the education and time that learning to use it will entail. There has been no waiting for treatment in his situation.

I'm happy and proud to be a Canadian. If it costs me 30% of my income to pay for medical coverage, so be it. At least everyone's billed the same at the end of it all.

 

[sue943]

I live on a very small island, just 45 square miles and with a population of about 85,000 people. Until a few years ago we didn't have a dedicated cardiologist, just physicians who had an interest in cardiology. Now we have a cardiologist.

We have a mixed medical system, we pay a contribution towards seeing our GPs but hospital treatment and the services of specialists in the hospital is free unless you wish to pay as a private patient. The health care comes from our taxes.

As we are so small, it simply isn't practical to have specialists in some areas of medicine, for instance cardiac surgery. The doctors wouldn't see enough patients to keep up with their skills. As a result we are sent to England for less common procedures. We are referred to some of the best hospitals in England, all at no charge to ourselves.

In my own case, I had a stroke and was admitted to a public ward. I asked to be transferred to a private room as I had private health insurance. When my health deteriorated, the heart murmers became more serious, I was airlifted to England in a private aircraft at no charge to myself, then taken to one of the best heart centres in the UK. This was as an NHS patient, there was no charge to me as the health system here in the island paid for my treatment. I was allocated a cardiologist and cardiac surgeon there, both extremely eminent men.

When I needed surgery I opted to have private treatment in a small hospital, using the cardiologist and cardiac surgeon allocated in the NHS hospital, I was perfectly happy with them.

I am more than happy with our health service here, we get excellent doctors working in our hospital, state of the art equipment. Obviously some procedures cannot be done here for the reason I stated, for instance we have no cath lab so travel to England. It isn't worth us having one as it wouldn't be used enough to make it viable.

What I particularly like about socialised medicine is that we are not customers, there is no profit factor to be taken into consideration. The doctors get paid exactly the same whether they operate on you or not, the physicians such as the cardiologists work hand in hand with other doctors.

Also I like not having to shop around for a doctor or surgeon, I expect my doctor to do that for me, for me to be referred to the best person for the case.

I like our medical system.

 

[dlangton]

In the US too you can die wating for emergency treatment at very good hospitals. I waited five excrutiating hours while kidney stones ripped their way southward before I was triaged in to the ER at Methodist Hospital in Brooklyn.

My AVR experience at Bellevue Hospital Center in Manhattan prompts me to testify to the magnificence of the public hospital system in NYC. I received excellent treatment, probably on a par with the Cleveland Institute, and the bill was nowhere near the astronomical figures people report in these forums. After having been through that, nobody can justify to me the huge costs of OHS in the US. Our system of insurance -controlled delivery of medical care is a huge racket, pure and simple. My apologies to all who have incurred such expense, but Michael Moore is right. (Concerning his movie, I have mixed feelings. He is a polemicist who uses propaganda methods and it is probably true that ordinary Cubans do not have access to the superb treatment featured in 'Sicko.' Having said that, however, I fully support his conclusion that the US needs a system of free medical care like that of Canada or France, though the ascent of Sarkozy probably means changes ahead for the French.)

 

[WayneGM]

Bina - what province do you have this in?

I have never had this deduction - have lived all my life in Ontario. I have Tax, Employment Insurnace & Canada Pension but no medicare deduction.

There used to be a separate OHIP deduction in Ontario and they did away with it quite a few years ago and the costs were funded through our overall taxes. The Ontario Liberals reintroduced a separate levy to the individual after the last election but it's still hidden in with the income taxes deducted at source so you don't see it. No matter how they collect it, we ultimately pay since it's publically funded and we're the public.

 

[Bina]

Bina - what province do you have this in?

I have never had this deduction - have lived all my life in Ontario. I have Tax, Employment Insurnace & Canada Pension but no medicare deduction.

I grew up in quebec.....but I guess the Medicare is not a separate deduction anymore.
In Ontario, on our income tax form each year we pay an Ontario Health Premium.
Salaries under 20,000 the amount is zero.
Salaries over 200,000 the amount is 900$
Most people fall into the middle range of 450-600$

 

[kbheart]

The hospitals available to Cubans lack the most essential equipment and the patients have to bring their own sheets and pillows.
I volunteer with a group that sends medicines to Cuba through the Catholic churches and people ask for even the most elementary drugs including vitamins.
I sent some over the counter drugs to a relative months ago, and she was so grateful for the great drug for arthritis that was included and how much it helped her ......the name of it...TYLENOL

From what I've read there is a shortage of medications in Cuba because of the US embargo. I'm surpised that the US government allows you to send medications to Cuba.

The Cuban system has also been a leader in training doctors to serve in 3rd world nations. They have started many quality medical schools for people all over the world. A colleague of mine produced a documentary movie called "Salud!" that describes the Cuban medical system without the rhetoric that Michael Moore included. Cuba actually has a lower infant mortality rate than the United States. There are some problems but they have been leaders in improving healthcare.

 

[aussigal]

I am a regular stay-at-home mum who doesnt have much to do with politics so forgive me if this is not a thorough and totally accurate description of our system...this is just what I understand of it.

In Australia we have Medicare, and we are also encouraged to buy private health insurance which entitles us to even greater refunds and choices for our health-care. Medicare costs us about 1-2% of our annual income and is paid along with our taxes once a year. (I will correct this if it is wrong and no other Aussies beat me to it)

Personally this works pretty well for our family,. We have Private health insurance which costs us about $120 per month for top-cover. This entitles us to about 90-95% refund on most stuff eg: elective OHS in private hospital, dental treatment, Physio etc...If we go to the GP/PCP it costs around $45 and we can claim around half that back through Medicare...X-rays and blood tests and other similar treatments are also claimable through Medicare. Going to the ER of a public hospital is also free of charge for everyone. Prescription medicines are subsidised by the government with the PBS scheme and are mostly quite affordable with almost all of the common medicines under $30 and around $5 for unemployed and pensioners.

Medicare entitles everyone including those who have private health insurance to free treatment in public hospitals. The trouble with this system is that those who are low-income unemployed & often pensioners need to wait sometimes up to 2 years or more for Elective surgery. Thankfully emergencies are treated ASAP. Our poor public hospital system is under alot of pressure as not everyone has private health insurance. Those who do have insurance are lucky , they can still enjoy benefits of Medicare or alternatively choose to have treatment in private hospitals and get a pretty fair refund on their expenses.

Those in Australia who are reliant on Medicare and/or have ongoing health problems often dont think our system is real great but for our family and for all those Aussies who do have private helath insurance, it works pretty well.

 

[lance]

I echo the previous postings about health care in Canada. For the most part our facilities and doctors are second to none. Of course there are a few exceptions.

We don't leave the hospital with a bill in our pocket. Everything is paid for by taxation. I think we pay in a different way--wait times are sometimes lengthy for many procedures and emotionally draining. I was diagnosed with congestive hear failure in early May and received my valve at the end of January the following year which I think was typical in 1999. Hopefully things have changed. At that time medical staff appeared overwhelmed and even simple items like an extra pillow or the request for a fresh gown were not responded to. The pillow was brought from home and I found my way to the supply closet myself. Hopefully that was just that particular hospital at that particular time. I could go on but that's enough. Even so we are very fortunate when compared to other countries.