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Health Care in the US vs. Canada & elsewhere

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Posted 9/5/2009 1:44 AM (GMT 0)
I was curious, how do the overseas healthcare systems compare to the US system? Is it terribly expensive overseas? Our healthcare has gotten to be so expensive. I added up the health care costs for just my husband and myself including premiums, drug costs and I figure it is costing us over $600 a month. It is getting so expensive and the costs are just for me. He has a premium but thank God he is healthy as a horse.  We have a PPO, not an HMO. Premiums are high and we end up paying  a lot of the leftover costs after the insurance pays the hospital. Access to care is ok but a lot of the docs and or their staff are really jerky and hard to deal with. I have to travel 60 miles to a good GI. Are the docs and other staff good in other countries?  My drug costs aren't too bad though. I haven't seen this topic yet here. Thanks for the dialogue.
Posted 9/5/2009 2:56 AM (GMT 0)
I'm in Canada, we get to claim our meds under the medical part of our taxes so long as the entire medical part is a certain percentage...do you get to do the same in the US? We don't get all of our medical expenses back via claiming them through taxes, just a %. But we don't pay out of pocket for hospital trips or doc office trips, each province in canada has their own health care which is run individually by each province, in Alberta for example (where I live) we used to pay about 400.00/yr total for a family of 4 (but now we don't have to pay cuz the province has changed it, of course I'm sure we still are paying for it through some other form of taxation)...we get taxed ALOT in canada and don't get near the breaks that people in the US get...

for example, you know the "cash for cars" thing you guys have for like a 4500.00 amount you get for trading in your old car, ours is 500.00, big whoopie! We also don't get to claim our mortgage on our taxes, unless you own a property that you rent out, then you have to claim it so they can stick it to you not so they can give you any $$ back.

Bottom line, as far as our health care system goes in canada, there are pros and cons like in the US.


Good docs are hard to come by anywhere in north america.


:)
Posted 9/5/2009 12:15 PM (GMT 0)
I am in the USA and have been to GI specialists locally, as well as in England and India.

I was a student in England so I was covered by the NHS. And any out of pocket costs were minimal. I did not have to pay out of pocket for visits to the GI specialist or for blood tests. Prescriptions were a flat rate per prescription -- it didn't matter which drug it was. I think it was something like $10 per prescription. The doctors I saw were great, because I managed to get referred to one of the better places in England. However, the downside is that initially it can take a while for them to see you, as they put you on a waiting list. Also, if your UC isn't getting into remission easily then they can be overeager to get you to see a surgeon.

The doctors that I saw in India were very thorough. The costs of getting tests done is very low there, and I got a lot of tests done. Also the medicines are extremely cheap there. An extensive blood test was about $15. The same test costs me about $250 in the USA. The quality of health-care is comparable to whatever I have seen in England or the USA, and maybe even better in some ways as they studied vitamin deficiencies thoroughly, and even discussed natural therapies with me. Both of the doctors I saw in India had worked or trained in the USA and Germany, and been doing this for decades. However, India seemed to be the opposite to England, as they didn't think things were that bad for me, and were surprised that surgery was recommended in England. The only problem is India is not the best place to be when you're in a flare because the lines seem to be extremely long everywhere, and if you're not close to a hotel, it can be a challenge finding a reasonably clean toilet.

My doctor in the USA is good too. He explains everything thoroughly, and definitely knows what he's doing. And after I was initially diagnosed, I would call in with questions, and they got back to me promptly with relevant feedback. But...everything's expensive here.
Posted 9/5/2009 12:29 PM (GMT 0)
I live in Scotland and we have the NHS healthcare scheme wherby everybody who works pays a % from their monthly salary depending on how much they earn.  Although everyone whether working or not is entitled to the healthcare through the NHS. 

When I read some of the horror stories from people living in the states it horrifies me that some people have a hard time getting the medication that the require because they can't afford it.  I suppose we are really lucky living in the UK although I would agree with the previous post that the downside is getting a diagnosis.  It took me about 5 months to get the proper tests and diagnosis and the last 2 months were complete suffering, I have never felt so bad and I have had about 8 flares since then.  I lost about 5 stones in weight (although needed to lose about 2 anyway after having my first baby).  Even for illnesses that could be terminal there is waiting times for initial appt's or scans so some people pay privately for these to get them done quickly.

But for treatment now when in a flare I can usually get seen at my consultant or his nurse within 1 week (but can get advice over the phone immediately from a specialist nurse).  The hospital is a 10 minute walk from my house and I pay £17 every 4 months which covers all my prescriptions for any medications that I require.  There is talk that prescription charges may be abolished altogether in the future.

Posted 9/5/2009 1:07 PM (GMT 0)
No system is perfect, is it? Here it is just so expensive that even people who have it available to them at work can't afford the hundreds of dollars a month just to have the insurance. Then, the polities often have huge "deductibles" some as high as 3,000 people have to pay before their insurance starts paying. So, a lot of people just don't go to the doc unless they are dying or hurt in an accident. Thanks so much for the responses.
Posted 9/5/2009 1:45 PM (GMT 0)
I’m in Toronto, Ontario, Canada. As pb4 has said all provinces in Canada have their own health care plan. The basic rules are set by the federal government but they are implemented by each province. The standards can vary between provinces. Here in Ontario we have no fees or co pays. It is funded through income taxes and everyone is covered. Medication and dental are not covered but the province has a plan for drugs that helps seniors and low income people. Most companies provide good drug and Dental plans for their employees. They can afford it because they have no other medical expenses to pay. I pay noting for any of my prescription drugs. I had jpouch surgery last October and January and the only out of pocket expenses I had was for a TV and telephone in my room. I have had only good experiences with our health care system.
Posted 9/7/2009 2:58 PM (GMT 0)
I am in Sweden. I pay SEK 1800 for the medicines and SEK 1000 for the doctor's visit *may it be consultation or any tests like colonoscopy). Anything that goes beyond this per year is free. The drugs are expensive but thanks to the system, I get half year's dose for free. The major disadvantage is the queue. It took more than 6 months for me to get first colonoscopy so overall 1 year before I was officially diagnosed as UC patient, even though I told them that my parent has it. But now that I am in the system, I am practically taken care of and its blissful.

Posted 9/7/2009 3:42 PM (GMT 0)
So it seems we can either suffer because we can't afford care or suffer because we have to wait so long for care.

Even though I'm retired, I continue to be covered on my former employer's insurance. It costs $400 a month for me and my husband. We have a $20 copay for PCP and $35 for specialists. In addition, we have a $1500 per person out of pocket maximum copay for other treatment. I max that out with my first two Remicade treatments, then any hospitalizations or surgeries, Remi, etc. are a free ride.

When I'm eligible for Medicare, my insurance costs will go down to about $200 and many of the out of pocket expenses will go away.

Thank goodness for good insurance, even though it is expensive!

Posted 9/7/2009 4:27 PM (GMT 0)
USA, Chicago here:
Annual cost for a private policy, family of 4 with a HSA(Health Savings Account that keeps premiums low and deductibles high) is almost $650.00 per month. The deductible is $5600. per year before one dollar is paid out. Then %80-20 till $12,600. At 12k, we hit the out of pocket max, and start over again each January. We have hit this max. 3 years in a row.
I called an infusion center about my daughter's Remicade, and they quoted me 4k per infusion. The current charge at the University of Chicago is $15,900---yes this is not a typo---in fairness, it does include a doctor visit to sign off on the drug, and she is on a big dose.
I am not bright enough to fix the health care mess in this country, but I am sure glad there is an effort on to fix things. Insurance regulation would be a big first step-they are currently allowed to "fix" prices with each other. Most other industries are not allowed such latitude. My care is regulated by insurance companies, so there is already someone between "me and my doctor".
Posted 9/8/2009 2:40 AM (GMT 0)

It seems like insurance benefits can vary widely here in the US depending on where you work and overseas people can have long waits to get diagnostic testing. That doesn't seem too great. What if you had cancer? Do you have to wait months to get chemo too? Do people get routine colonoscopies covered every 10 years when they are over the age of 50 then?

Posted 9/8/2009 4:07 AM (GMT 0)
Hey. I'm a 24 year old male in the USA. I live in the midwest. I have a high deductible insurance policy... 5,000 dollars is the deductible. However, my premium is only $125 a month. I had this before I was diagnosed with UC, and am incredibly thankful for it. Why?... because of it's medicine co-pay. I take 6mp and pentasa. Without the insurance I'd have to pay like 500 dollars a month or more. Instead I pay a 15 dollar co-pay on generics and 35 on name brand medicine. The insurance also has contracted limits on what certain health care providers can charge. Almost a year ago I had a sigmoidoscopy and the hospital wanted to charge 2800+ total. Instead I only had to pay around 1,300 or so. It's still a lot of money, but the insurance is still a Godsend.

As far as the care I receive... I am pleased with it. I go to a GI clinic with many great doctors. I am usually able to see mine within a short time. I had a busier doctor that I would usually have to wait a month to see, but switched from him partially for that reason. They listen to what I have to say and let me actually have a say in my treatment options.

I have not been in another country to compare the care. I just thought I'd mention how it has been for me here in the midwest.

Zach
Posted 9/8/2009 4:12 AM (GMT 0)
I have no insurance and it is very stressful. At the same time, I do think I get away with lower healthcare costs than those who have insurance. I go to the doctor once or twice a year and I pay out of pocket. The office appointments cost anywhere from 100 to 400 dollars. I do regular lab testing and everything else. Luckily, I know how to work the system to my advantage to some extent. I have learned about patient assistance programs, so while insured people are paying 50 or 100+ a month for drugs, I usually pay zero for my drugs. I sometimes think that it doesn't add up to get insurance and do things the right way because I would end up having to pay for things I get for free now and after the costs I was paying, I will end up making the same income. Currently, I am able to work at home and that is my dream. I am so much happier with this lifestyle. Unfortunately because of insurance issues, I know ultimately I will have to go back to working fulltime. In my opinion, it is no way to live when you work a job you don't care for because you need insurance. I hope something enables me to continue to be happy. smilewinkgrin
Posted 9/8/2009 6:43 AM (GMT 0)
In the UK if they suspect cancer they have a 2 week deadline to get you seen in the hospital and then another 28 days to get your surgery or other treatment commenced which isn't so bad.
I've always found the GPs to be the problem, convincing them that something is genuinely very wrong and not being continually fobbed off, it can be very difficult to be referred to a specialist, (it took me almost 10 years, and then I was referred because of making myself a difficult customer over the fistulas).
I'm not sure about routine colonoscopies for all after your 50, the certainly do if you have a family history of bowel cancer, I know that they take stool specimens from all over 50s to check for blood.
I pay approximately £60 a month, to cover our 'national insurance', this includes healthcare, police, fire service and some other ites and bobs.
I was shocked when I saw the amount you guys in the USA can be out of pocket, it does seem like a very flawed system, everyone in this country is entitled the same care.
There is also the option to go privately. If you condition is life threatening the NHS works very well, but things like an elective hip replacement can take up to 8 months.
Posted 9/8/2009 12:10 PM (GMT 0)
I think people who live outside the USA probably won't realize how big a deal having a job in the USA is. When given a choice of jobs, often the benefits, such as the medical coverage can be a determining factor of which job to choose. And if you don't have work then getting private insurance can be several hundred dollars a month out of pocket. If you have a pre-existing condition then it's often difficult to get private insurance.

There was a story on CNN today about someone who re-enlisted in the US army, after being unemployed, mainly so that he could get health coverage through the US army for his child.

They predicted that with so many people being unemployed in the USA at the moment, there probably will be an increase in people joining the army to get medical benefits. The man who they profiled was killed in action a month after enlisting.
Posted 9/8/2009 1:41 PM (GMT 0)
Rio, you are absolutely right, I've been horrified by some of things I've read on here relating to your insurance system.
Sometimes those that live in the UK are a little too quick to criticise our system, but I think although sometimes we have to wait to access the service, once you are in the system it's pretty good.
I think you guys get just as rough a deal with your unemploment benefits, don't you?
Posted 9/8/2009 5:46 PM (GMT 0)
Well, I believe if they don't fix the health care system in the US, we won't ever get our economy back. We have good docs but you need insurance and it is very expensive for many people. You can luck out with good insurance on a job though. I had a friend who had BCBS but worked at a different place. She paid nothing for a week's stay in the hospital for a bad GI bug. I had a colonoscopy and workup, it cost me over $500 at the same place. So, it is all about the deal they cut with the hospitals. It would be nice if we had some kind of universal coverage and everyone could choose from a plan. It is also very expensive for employers. The UK and other European/Australian systems sure sound better to me but I've been accused of being a "socialist" here in the US. Can you believe some people here took their kids out of school because they didn't want their kids to hear President Obama speak? They didn't want their kids to hear what they called "socialist propaganda" and that they could raise their own kids. Meanwhile, where was ole' bubba Bush when 911 happened, in a school. Nobody said a word about that and he can't even speak intelligently anyway. Sometimes, I want to move away from the US for more than just health care. All Obama wanted to do was encourage kids to stay in school, study hard and take care of themselves. If most parents did that, the kids wouldn't be failing and dropping out so much. Another huge problem in the US. Ok, I am ranting and raving. I should stop. LOL.... God bless all of us!
Posted 9/9/2009 1:27 PM (GMT 0)
I am in Canada and as others have mentioned there are pros and cons to each system. The huge pro here in Canada is that my health care is not dependent upon me working. Everybody has access to health care.
Posted 9/9/2009 2:20 PM (GMT 0)
Sometimes I think it would be nice to have a choice -- I do have excellent health care, but I worry about when I retire...I'm not sure if it's going to be a need or a want at the time I do retire, but I see so many elderly people working just for health care. It's hard for me to imagine doing this job at the pace it is when I'm 65...just to have the health care. Sigh...

Posted 9/9/2009 5:14 PM (GMT 0)
I had national health care when I lived in Taiwan. It was inexpensive, and I never had a problem seeing a doctor right away when I needed one.
Posted 9/9/2009 8:41 PM (GMT 0)
Wow, so now Taiwan probably has better health care than the united states. Wow!! Was it up to date healthcare with technology and knowledge? That speaks volumes. Sometimes I think we are just too big.
Posted 9/28/2009 8:15 AM (GMT 0)
I am of the opinion that health care insurances differ greatly all over the world. I think that the US is rather expensive and besides this has a weak insurance system. At the moment I am living in Germany and I am of the opinion that they have a good insurance system and it is not as expensive as it is in the US. Another system which differs all around the world is the car insurance system. I actually always thought is more or less the same all over the world but this is definitely not true. The US auto insurance system differs greatly from European systems. Even within the EU the systems are different. I am of the opinion that it would be good to have a consistent system.
Posted 9/28/2009 12:31 PM (GMT 0)
Here in Canada the system is under strain but works remarkably well. Walk up the street to your local clinic and get seen by a GP right away, get tests done right away (CAT scans or colonoscopies involving specialists can involve a wait, though), get booked into a hospital bed and stay in for as long as necessary. All without a penny exchanging hands. You have to pay for your meds outside of hospital, but not while in. As mentioned above, you get a rebate on meds on income tax. Finding a regular GP is tough where I live right now, but the local clinic doctors take all comers on the spot.
Posted 9/28/2009 9:05 PM (GMT 0)
Well, I am a 63 year old female. I have to pay for my own insurance since I am retired but not yet old enough for Medicare. I pay nearly $400 a month in premiums. I also pay a $30 co pay to a family doctor, $50 to my GI. Last year I paid $200 co pay for my colonoscopy. This year it is $300. Since I have had UC since I was 15 my GI insists I get a yearly colonoscopy to screen for cancer. For years it cost me a lot of money. Then it went down for a few years when every one was wanting screening. But it started going up again.

(edited)


I was really steaming today when I saw the colonoscopy has gone up so much. I have friends who have Type 2 diabetes and the insurance pays for all their tests and their medicines are cheaper. While their disiease is partially life style, mine is autoimmune and I had no part in getting sick.
I feel people with IBD are treated unfairly.........that's the mood I am in today.

 

4. No posts that attack, insult, "flame", defame, or abuse members or non-members.

Post Edited By Moderator (Judy UC) : 9/28/2009 3:52:36 PM (GMT-6)

Posted 9/28/2009 9:51 PM (GMT 0)
Let's keep this conversation constructive, please. This is a support forum and not a place to flame any person or group of people. It's also not a place for discussions of social or political systems.
Posted 9/28/2009 9:57 PM (GMT 0)
I keep hearing that the US health system need to continue to be capitalistic because there is enough money in it to keep the research going that the whole world benefits from. Do you think there any truth to that?

I agree, insurance companies are a big part of the U.S. problem.
Also, doctors are completely non-cost conscious. They waste a lot of resources, no incentive not to! And doctors should never be able to refer patients to labs or hospitals they own, because when they do suddenly more tests and surgeries are ordered.

Well, I could go on for hours, but I'll stop there.
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