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Posted 11/11/2012 4:35 AM (GMT 0)
DMC posted something about a webinar a couple of days ago, hosted by the CCFA. I had never been to this website and I am blown away at all the information on it. The CCFC which is the Canadian foundation, doesn't have anything close as far as info goes.

I've only just started to explore the website, and if what is on there represents the standard of care in the US...Wow! I'm not having anything close to this level of care. I'm talking bloodwork and stuff.

How about the other Canadians here? Are you getting regular bloodwork? Is there ever any talk about nutritional status? Different inflammatory markers checked etc? Did you get checked for parasites and stuff? Not me, I don't even really get a chance to talk to my GI and I've never waited less than 1hour and 45 minutes for my 6 minute appointment! All he wants to know is my frequency and if I'm still bleeding. Every question I've asked is basically dismissed.

I'm in an underserviced city in Canada, so that is a big factor, and I know the doc is doing the best he can, but I'm just so upset by this.

Well, thank goodness this forum is here and I've discovered that website. I am going to really have to work on educating myself and figuring out some diplomatic way to get the GI to spend some time with me.
Posted 11/11/2012 4:49 AM (GMT 0)
That wait time is just absurd, especially since UC sufferers would most likely be some place more comfortable than a doctor's office.

I haven't seen the particular webinar you mention, but I haven't gotten any special tests since I started getting treated for UC. My doc will usually ask when I last had a blood test done since he often worries about calcium levels. At the current rate, it seems like I visit 4 times a year to assess if the medicine is working and then I seem to be looking at colonoscopy once every 1 or 2 years.

I can tell you that business is good for my doc. The office visits aren't cheap under my private insurance and he drives a VERY nice car.
Posted 11/11/2012 4:54 AM (GMT 0)
Or the lack of medicine.
Posted 11/11/2012 7:25 AM (GMT 0)
Regular bloodwork for whatever the hell the GI feels is necessary. Current GI only cares about hemoglobin and frequency, but he does check my inflammatory markers. Parasites are checked if my usual anti-flare methods dont work. I can get in to see my GI within 3 weeks as a max that I have had. He does run an hour late for 20 min appointments which he tried to keep short but I keep them nice and long with my annoying questions (I like stuff explained in medical detail). Note i am in a major city in Canada.

Anyways my suggestions is get an appointment. Then riddle him with questions. Make a list! Tell the doc how you feel (maybe theres cramping or bloating) because if UC was a condition with two variables we wouldnt need this forum. Good luck.
Posted 11/11/2012 8:05 AM (GMT 0)
Well when I lived in Montreal going to a regular clinic was hell let alone the emergency!
If id go to a clinic I could wait from anything from half an hour to 3 hours. And by 10 am the clinic was booked for the day.

In the emergency it;s anyones guess. The fastest way to being seen im afraid is my ambulance lol

But I think Quebec was one of the worst province for health care due to extreme shortage. I have friends who can't find a family doctor. Nurses were so on a shortage that they had to call back retired nurses from their retirement a few years ago.

I was lucky for 2 main reasons: my dad's boss knew the head of the GI department so I had quick appointments and I lived with a gp for a few months and she would give me anything i want.
But living with a gp got me the other side of the story and it sure is hard on them. She told me at the emergency clinic she can see up to 55 patient in a regular 8 hours shift!

So the thing is Canada have the same standards of care I think but the shortage makes it very difficult for the staff to cover all the needs in a timely matter and best is to find a hospital or clinic that is less busy!
Posted 11/11/2012 8:26 AM (GMT 0)
I live in Gatineau, Quebec. I think it's adequate. I can't really complain. I had 3 colonoscopy in a year, my meds are paid for, I get my appointments ever so often.
Posted 11/11/2012 9:40 AM (GMT 0)
Not all doctors are good doctors, no matter the field.

I've had great care, but the wait for initial appointments with specialists can take a long while, unfortunately.

I do get in with my doctors fairly quickly if I have a huge problem...

I have blood testing done by both my GP and GI.

My GI did initial stool sample testing for whatever...which I assume would include parasites.

My meds aren't free, per se. I have to pay for them and I'm covered through my husband's plan and provincial plan after a deductible amount. With my husband's plan, 80% of the deductible is refunded.
Once my deductible is reached, everything after that is free. In March, I can get topped off for 3 months worth of refills. Which is nice...but this year, the deductible has been increased. I might reach it.

q
Posted 11/11/2012 12:56 PM (GMT 0)
In the US I think it matters how good your insurance is! I get into my GI within a weeks time. I don't need a referral where some insurances here do. Insurance is so expensive. I guess I'm one of the lucky ones. Costs about $800.00 a month.
I found New York to be better then here in Florida for Doctors. So many older people here. There are so many doctors!!!
Posted 11/11/2012 1:44 PM (GMT 0)
Insurance is the big difference. If you have decent insurance then you get decent treatment. That's what some of the big fight is all about in American politics. If you have decent insurance then you don't want goverment run healthcare - and there are a lot of people who do have decent insurance (mainly through their employers). Republicans often get chastised as being against healthcare but that simply is not true. They are for controlling the costs of healthcare, making insurance more affordable for everyone, and their main arguement is that government is nothing but a big bureacracy that spends one trillion dollars more per year than it takes in and can't possibly know how to control costs. While government run healthcare can be "free", a godsend to many (especially to those with major health problems), it creates long lines, limited options, and less quality care for everyone. The Republicans didn't want this and over 50% of Americans really didn't want Obamacare either. Obamacare care is good for 20%-25% of Americans, including me (that's why I selfishly voted for Obama), but the other 75%-80% of Americans are going to get screwed out of the deal, one way or another.
Posted 11/11/2012 2:24 PM (GMT 0)
Lodi

I am a Canadian living in the US. I was diagnosed in Toronto and lived a number of years there with UC before moving to rural New Mexico. It is a bit harder for me to compare because of the urban/rural difference in my living arrangements but here are my observations.

1) Standard of care (what your doc determines are the appropriate tests etc for you) depends on the doc not the country. In the states, I have educated myself on the potential problems resulting from my meds and then have requested the appropriate tests myself (ex. blood tests for kidneys while on asacol etc.). I dont worry about inflammation markers.....for me that is pretty easy to tell from symptoms.

2) Wait times for appointments were far shorter for me in Toronto. When I flared I would be able to see my doc within days. However, now I live in Taos NM and my current doc is in Santa Fe NM. The drive is 4 hours return and my doc books his appointments at least 6 weeks out. However, he is awesome about returning my calls when I am having trouble and doing meds over the phone. It means I do not have the close monitoring I would enjoy at times, but I feel supported. If I were in real trouble, I would have to go to the hospital though. When I feel I need an overall consult in NM, I book an appointment to drive down to see him. I must admit, in New Mexico I really need to be on top of my disease more so than in Toronto. In some ways I feel like I am the doc and just make requests for meds based on my own research. The Canadian system is far more paternalistic.

3) I have never been kept waiting for that long in either docs office. But it sounds as if your doc is trying to take care of the most people he can given a doc shortage......which may be a noble effort....I dont know.

Really, if I had to choose between the systems overall, I would choose the Canadian. It is down right ruthless here. Survival of the fittest. I disagree with the understanding that The affordable Healthcare Act is only useful for a few. 

Not sure if that helps. I guess I would say make a list of questions when you visit your doc and educate yourself as to the tests you want and need....... the paternalism involved in the Canadian system makes us Canadians less likely than Americans to advocate for ourselves. This way of advocating for myself is  probably the most important thing I have learnt from living in the US and I am glad for it.

Posted 11/11/2012 4:04 PM (GMT 0)
American healthcare for UC can be fantastic if you have great insurance, either through your work or you pay for it yourself (which is expensive).

If you cannot afford insurance or you have lousy insurance that covers only catastrophic illness then having UC can be very expensive because you will pay for all meds, procedures and tests out of your own pocket and they are generally very expensive.

The upcoming phase-in to the Affordable Care Act will allow more Americans to afford insurance and very importantly not be turned down because they have UC or any other pre-existing condition.

The people who would be most comparable to Canadian healthcare would be US people on Medicare. So the question is really: how does US Medicare treatment of UC compare to Canadian healthcare for UC because both are government administered.

I don't know because I'm not Medicare age for several more years. I have private insurance that costs $560/mo with a $6000 deductible. I have a fairly large pool of doctors and specialists in my plan but I pay for everything until over $6,000 deductible so that would either be a very bad year or one with a colonoscopy (this year).

Many people like me go without insurance because they either cannot afford it or they think they are not getting anything for the expense. They may think it's ridiculous for me to pay $560/mo and get nothing paid for but it guarantees me that a medical event will not financially bankrupt our family. I also get reduced billing from my doctors because I have insurance. Self-pay people (uninsured) have to pay whatever the doctor decides to charge them. Insured people pay a negotiated (by the insurance company) amount even if the healthcare company doesn't actually pay it.

Many people I know are just hanging on until they hit Medicare age, hoping nothing bad happens.

I voted for President Obama because I think people of all ages should have access to affordable healthcare, not just people over 65.
Posted 11/11/2012 5:13 PM (GMT 0)
I'm afraid that if and when Obamacare starts, that we may have the same issue here. The long wait times. Right now I usually have to wait up to an hour to see my primary but I only wait 10 minutes to see my GI.
Posted 11/11/2012 5:36 PM (GMT 0)
With Obamacare US will have lots of problems. Its not going to be easy to switch systems. It has to be done but the transition period will be full of troubles.
Posted 11/11/2012 5:40 PM (GMT 0)
I live in Southwest Florida, in an area that is a 90% Medicare-covered population, so comparable I think to what ACA will be like. There is very little wait time in either my family internist or my GI and there are many doctors here, not limited services in other words.

And as far as what doctors prefer: my DH who becomes Medicare age in 3 months asked our primary care doctor what Medicare plan to look at at. His office manager said "straight medicare" meaning not a Medicare Advantage plan which is an HMO or PPO-like plan. Doctors like Medicare because it pays on time with no forms hassle. I have heard this from other sources since then.

We are still deciding but as it stands now his health insurance will go from private pay $560/mo $6000 deductible to Medicare at $100/mo $140 yearly deductible. That is the difference between private pay healthcare versus being in a huge pool of people who get lower negotiated costs.
Posted 11/12/2012 1:51 AM (GMT 0)
I'm in southern California, and I have insurance that I pay for myself / out of pocket. I'm 30, it is about $188/month, but it does not cover brand name prescriptions (so not Asacol), only generic. I pay 30% of my costs up to a maximum of $7500 / year, and after I hit that number I pay 0. I have never even come close to that, and this year, after 2 ER visits and a colonoscopy, I think I've only made it to about $3000.

I don't need referrals to see specialists, and I live less than a mile from a very nice, well funded private hospital. I think I pay more for my healthcare in exchange for flexibility.

It was 4 weeks to get the initial appointment with the GI, but from the 1st appointment it was only about 8 days until I had the colonoscopy, and a week after that for the in-person follow up with biopsies and diagnosis information. I get calls back from my GI the same day if I have a concern, and he is very hands on with my prednisone taper and with any concerns I have. He is big on supplements / probiotics and anything that will even potentially help.

So I'm lucky, because I've had this single payer insurance for at least 6 years, and I've always had my employer give me a stipend rather than adding me to their plan - because that way if I switch employers or lose a job, I have continuity of insurance and no problems with rates skyrocketing.

This is a great thread. I've read the entire 2400 page "Obamacare" bill, and honestly it is too early to predict what, exactly, it will do.
Posted 11/12/2012 2:08 AM (GMT 0)
One thing I wonder about Obamacare, which I don't think the legislation even addresses, is concerning getting family insurance through your employer. I can see companies saying that they are only giving insurance to their employee only and the rest of the family would have to fend for themselves. Right now a lot of employers offer coverage for single people and family coverage for families at a higher rate. The family coverage obviously costs more but what if they started refusing to offer family coverage at all, because of family members like us driving up their costs? Of course the law does say that they can't refuse people because of a pre-existing condition, and they can't charge us more because of it, but nowhere in the law does it say that employers have to offer family coverage, only employee coverage for those in good sized companies where the employee works at least 32 hours per week. Obviously several employers will also change full time jobs into more part time jobs so they don't have to offer insurance at all.
Posted 11/12/2012 4:08 AM (GMT 0)
You know, this forum is such a great resource. Thanks everyone for the thoughtful input. I think my post was a bit whiny and self indulgent. I'm frustrated with this crappy disease and not knowing how to help myself though.

There has got to be a way to mesh the best of the two systems. Joma, I really appreciated those comments and yes, I think the GI doc is trying to do his best under subpar circumstances. At the clinic I go to, I found out the doc is seeing follow up patients in between procedures. I guess I just have to squeak louder to get my turn. In this same clinic, I see my GP and I never wait longer than 15 minutes. My GP was pretty frustrated having to take on the GI's roll for me last week. He referred me because he doesn't have the expertise but the GI is so busy, he isn't really using his expertise.

Ah, I just need to come to terms with my disillusionment and understand that UC is one of the diseases that 'they' just don't really understand yet. Also, I need to focus on the positives. I'm really glad I have the internet so I can look up info and (try to) educate myself. I'm lucky that I don't have to pay for treatment that they don't even know if it works or not. I am really glad I have a smartphone so when I do have to sit in a waiting room for 2 1/2 hours, I can sit and read the things i want to!
Posted 11/13/2012 12:20 AM (GMT 0)
Lodi, I'm a fellow Canadian living in rural Nova Scotia (nearest town has a pop. of about 3,500) and my experience so far makes me feel left to my own devices, frankly. I saw my family physician the day after blood suddenly appeared during a middle-of-the-night bathroom visit (which freaked the heck out of me). He did a physical exam, said it might be internal hemorrhoids and put me on meds for that with instructions to come back in two weeks. Two weeks later I reported a few more blood episodes plus frequent diarrhea and lots of gas and he said he would refer me to a surgeon for a colonoscopy. I asked about seeing a GI and he said it would take at least four months to see one. For the next seven days it was about 10 trips a day, blood every time, urgency, pain, energy level dropping, etc. and no word from surgeon's office so I called my doc and he said go to emergency. They did some standard blood work, said my blood levels were fine and made an appointment for me to see the surgeon four days later. She was able to fit me in for a colonoscopy a week after that which was good because the original referral apparently didn't even make it to her desk until three weeks after I'd had the colonoscopy. When I came around after the scope the surgeon was already gone and all I got was a prescription sheet from one of the nurses and a note to see the surgeon again in three weeks. I had to ask the nurse "was it ulcerative colitis", otherwise I wouldn't even have been told that much. When I called the surgeon's office to make a followup appointment they couldn't fit me in until four weeks. At that appointment she told me how extensive it was, asked how my symptoms were, and said to stay on the meds, same dose, and see her again in a month (her receptionist booked the appointment for six weeks).

Nothing against the surgeon, she's very nice, but as far as I can tell, she's a general surgeon with no GI speciality. It leaves me wondering, will she be responsible for my care from now on? Shouldn't I be seeing a GI? And what do I do if my symptoms suddenly get really bad again -- call the surgeon and wait weeks to see her? See my family doc (takes a week or more to get in to see him) and wait four+ months to see a GI? I suspect that we probably share a regional GI with several other communities across the province. I read posts where people recommend switching GIs if you're not happy with the service you're getting from the current one; I don't think we have that kind of freedom of choice here in the boonies.

To sum it up, I'm happy with the ER service I received because it sped up the colonoscopy process, and I'm very grateful I don't have to pay for such procedures or doc visits, but I'm feeling rather left at loose ends. Perhaps if I lived in a large urban centre like Halifax it would be different, but in rural Nova Scotia, the family docs are overworked, and the specialists are few and far between and overworked.

Posted 11/16/2012 1:04 AM (GMT 0)
I live in a tiny suburb of Atlanta, and there are SO many GIs that they seem competitive. I found an amazing one. She's got great bedside manner and is so helpful. She checks my blood every time I come in and takes great care of me. I've recommended her to a lot of friends with GI issues.
My wait time is always less than 30 minutes (sometimes 5 sometimes 30) but it's always a pleasure, which is surprising considering the nature of the visit.

I pay $400/month for family insurance coverage at work with a $1500 deductible for a great PPO. I work for a small company and am afraid that our insurance cost is going to go up very soon. Right now, the company pays SO much for my insurance and my amount is very small compared to theirs. It will most likely be subject to a Cadillac tax when Obamacare kicks in and I will have to pay out the nose for my excellent coverage. Yes, I'm selfish. I work really hard for my money and my prices are going to go up so that healthcare can be "affordable" for everyone else, just not me. Yea, I'm a jerk. I love my coverage and all of my doctors, but I'm gonna be pissed off when I have to pay more for it and wait longer when I've done nothing but work hard and take care of myself and my family. I'm a brat and want things my way!
Posted 11/16/2012 1:51 AM (GMT 0)
I'm in the metro Atlanta area, too.  There are a lot of GIs.  My situation sounds a lot like mmmmmriley.  I get insurance for me and my family through work.  about $500 per month, 1500 deductible.

I like my GI well enough, but he doesn't talk much about diet or anything outside of what is "mainstream" medical approaches.  It can be a wait to see him--usually about a month or so.   Once there, I usually wait about 30 minutes to see him.   If I needed a colonoscopy, I could get one pretty quickly.  I do have to have a referral through my insurance, which is a pain in the butt but not a big deal.

Chinamom

 

Posted 11/18/2012 3:35 PM (GMT 0)
I'm a Canadian living in Arizona. The main problem in Canada is the constant waiting for everything. There are many more resources available to you here in the U.S. on short notice.

When I first started having UC symptoms in Canada back in 2003, I was told that I would have to wait 8 months to see a GI doc, even though I was losing weight rapidly and losing an extreme amount of blood. Luckily my wife was a nurse at the time and pulled strings behind the scenes to get me in to see a gastro within a few weeks.

The main problem here in the U.S. is your insurance is usually tied to your employer, so you can be screwed if you lose your job. You can pay out of pocket to keep your insurance but it will bankrupt most unemployed people due to the high cost.

Sadly what the U.S. government has come up with to solve the problem will make things worse for the 90% of people with good insurance to make it better for the 10% without. Fewer middle class people will have access to world class facilities like Mayo or Cleveland clinic once they get dumped on to the exchanges, and many millions will.
Posted 11/18/2012 3:50 PM (GMT 0)
Hey CGk, I'm curious, how did you end up living in US (Arizona) if you're Canadian.
Posted 11/18/2012 4:38 PM (GMT 0)
I'm in the US and on Medicare.

I am happy with the Affordable Care Act because it provides for free annual preventive screenings for Medicare patients and limits the amount participating doctors can charge. Pre-existing conditions are no longer a big issue and parents can keep college age kids on their insurance.
The millions who have lost their jobs because big corporations have shipped jobs overseas (to increase profits) will also benefit from having access to medical coverage. Big corps like Walmart are able to keep prices low because they don't provide health care and other benefits.
The Act may have flaws but it's a start in the right direction.

I pay about $200 a month in total for Medicare premiums and secondary ins premiums from my former employer's health ins.
Medicare pays 80% of a predetermined "fair" cost after meeting the annual deductible. There is a $500 deductible on my secondary health insurance after which they pick up a portion of the cost that Medicare hasn't covered.

It can get complicated and I find that not everyone in the doctor's and Medicare offices really know the rules.

Fortunately, I am able to get 2 colonoscopies in 2012 without spending a fortune. When I add up the costs for the Dr, anesthesiologist, pathologist, facility, etc the total for each colonoscopy is approx. $5,000.

A large number of older people in the US have, in the past, gone bankrupt and lost their homes because of medical expenses.
I believe the new laws will help to solve that problem.

From CNNHealth.com
Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine.
Posted 11/18/2012 5:14 PM (GMT 0)
Actually Walmart does provide health care and other benefits, not to mention a higher wage than a lot of other retail establishments. They always get the shaft because they are number one and have some fat cats making millions per year. Everyone always aims at number one. The truth is they are a lot better place to work for than many retail places or restaurants. They also get a lot of discrimination lawsuits but the truth is they hire a lot of minorities of all differnt kinds, including the handicapped. They are probably the biggest employer of minorities and the handicapped.
Posted 11/18/2012 6:16 PM (GMT 0)
gary
Sorry, I was mistaken about Walmart who (under pressure) offered some health care benefits to ee's about 3 years ago.
Last time I checked they were telling their ee's in MA to go on Medicaid.
Here is a recent article indicating that they are now reducing benefits (and it's not because of Obamacare).

http://www.nytimes.com/2011/10/21/business/wal-mart-cuts-some-health-care-benefits.html?pagewanted=all

I worked as a Pension Consultant for several years for a large Insurance Co in MA. Part of my job was overseeing the termination of defined benefit plans for companies who wished to reduce their costs. The result was that ee's were left with the task of saving for their retirement just when jobs began to disappear overseas.
I saw firsthand the greed exhibited by big corporations and found it a chilling experience.

It's interesting to me that of all the points I made in my post, you chose to comment on the Walmart issue.

As an American, I am proud that at least some of my/our tax dollars will go to helping our own people instead of buying off dictators and warlords in foreign countries and financing unnecessary wars.
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