mgk321 long post from Canada

Discussion in 'Chit Chat' started by caffey, Jul 24, 2007.

  1. caffey

    caffey New Member

    Hi there. I am responding to your question on the arthritis board. I love to discuss our 2 health care systems. I am learning so much from you all. So here goes.

    I live in Ontario. There may be subtle differences from province to province.

    We have basic universal health care for everyone from the homeless to the elite.
    Our basic health care covers:
    1. any visits to doctors including specialists, suregeons, emergency visits no limit, there aren't doctors for the elite and poor. We all see the same doc.
    2.basic room in a hospital and full care. Meals, meds, tests, etc.
    3. Blood work done in a lab, drs. office, emerg
    4. xrays, u/s, ct.scans, mris. etc. done in and out of the hospital
    5. Home care nursing is covered
    6. You can choose your own family doc- although the gov't is starting to clamp down on people who are doc. shopping.
    7. Medications are not covered unless you are on social services or if your income is less than $50,000( I think per year I think) and you spend a certain % of you income on medication. Then we have a gov't program that is called Trillium for those people ( the working poor) and ODB ( Ontario Drug Benefit) for those on social services. Trillium has a deductible depending on your income. ODB has $2 co-pay on each rx. But the gov't is clamping down and there are certain drugs that they won't cover no way no how. These are usually the newest drugs. So some drugs they will cover on what is called a limited use form which is a coded number and is good for a year and some drugs they won't cover at all and some are covered on what is called a Section 8. It is good for a year. But you have to tell them how you used all other drugs in that category first. Sometimes they accept it and sometimes they don't. They turned me down for Lyrica for example.

    Now if you have private insurance depending on your coaverage.That is where you get
    2. meds
    3. glasses
    4. pt. ot etc ( in the hospital it is coverd but not out)
    5. private mris etc
    6. private nursing
    etc. etc.
    All the perks

    Our health care system is good in the fact that everyone is entitled to the same basic health care. No one is denied. There are a lot of abuses in the system. I have noticed there are cut backs in the last couple of years in what is being covered, longer wait times etc. and meds that are needed are denied. They have to draw the line somewhere. Applying for the new drugs for ra is a living nightmare. A lot of the abuses are in the area of the emerg dept. or doc. offices with kids. No one is to be turned away. There are abuses in second opinions. I think after a second opinion you should have to pay for it.

    If you have any further questions please feel free to contact me at any time.
  2. Denamay

    Denamay New Member

    Thanks for the update re. Canadian Health Care.

    Waiting time seems to be problem in some areas but not all.

    Edmonton has a world class hospitals with great medical breakthroughs and research.

    We also have a provincial drug plan that includes a co. payment, so drugs are not too big of a problem. You are right about the newer drugs sometimes not being covered.

    We had a provincal government that cut back on staffing and even closed down hospitals and reduced the number of beds in others.

    This happened about 10 years ago and now we are paying the price.{Our premier was trying to introduce the American system of medical care}

    Some would like to see us go to a private US system, but I say "No."

    We are not perfect by any means but after reading some of stories of posters on this board I am so thankful for what we have! Love Denamay
    [This Message was Edited on 07/24/2007]
  3. caffey

    caffey New Member

    You are right. For all our griping and complaining we are so fortunate. I would be so sunk without our system. I almost cry hearing the horror stories for the people in the US. For the world's superpower it is awful. As you know we have no easy answers to health care but it makes for interesting discussions. My greatest personal opinion is that with techonology and meds etc. we are keeping people alive who would have been dead 20 years ago and how do you put a price tag on that? You can't. We are getting ready to open our new much needed hospital in Oct. It will be the largest in ON. It is sad. They can't staff enough. Dalton McGinty has promised the current one will stay open. I don't know where he thinks the staff will come from. Anyways we could talk forever.
  4. mgk321

    mgk321 New Member

    This is so interesting. I knew nothing specific about the Canadian system but many people are saying we should adopt one just like it. All the Democratic candidates running for president have a plan. I wanted to be able to compare the plan with what we have, which is pathetic.

    I am fortunate enough to have good health insurance but my drug costs are high but not as bad as they would be if I had to pay full price the way you do. On the other hand, I have a disabled sister who is trying to get by on Medicare and the new system, which the Republicans think in wonderful, is a farce. She falls into the "donut hole," the point where the patient has to pay cash for their prescriptions, very early in the year. Just one of her prescriptions costs her over $300! How do they expect you to live on what you get from Disability and pay for your medications, too? She is struggling to stay off of welfare but they make it very hard. And unlike most bipolars, thank God, she doesn't go off of her meds but I can imagine that many would and use the expense as a reason. Oh, I didn't mention that she's bipolar and that's why she's unable to work. So I know firsthand how people struggle in this country.

    I am very fearful that when my husband retires and we go on Medicare that our supplemental insurance will cost a fortune. I'm fifty-eight and he is sixty and doesn't plan on retiring for quite a while but when the time comes, and if they discover I need to be on RA drugs, it's going to be scary. All our savings will disappear.

    As for poor and homeless people, I think we should be ashamed that the so-called "richest" country in the world allows anyone to go without healthcare. But I won't get on my soap box! :)

    And how interesting that Ontario is different from Edmonton. I just assumed that all the provinces were the same. For us, the states are all identical. Health plans available to people who are on Medicare, Part D (the drug part) differ from state to state. And I suppose that it's nice that they have some kind of help for people on Medicare as we had nothing when my parents were still living. A good portion of their income went toward meds.

    Thanks so much for the info, I'll be sure to ask you both!

    Stay well!