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["Fred Enga" <fenga AT astechman.com>]

Hello guys, sorry for coming to this thread late, but work got in the way.

I live in British Columbia, Canada.  Before moving here I lived in Ontario,
Canada and before that in Pennsylvania and before that in most parts of
Europe, so I have a wide experience of various health systems.

One of the first things to understand is how Canada is organised.  We are a
federation. There are 10 provinces and three territories, and we have a
federal central government.  We function more like a not-so-developed
European Common Market, and our Provinces are closer to being separate
countries than US States'  Each Province has a Premier, and the province
supplies the health care, the education and the infra structure we have,
within the guidelines that are set out by the Federal Government as the
minimum standards that each Canadian can expect.  Therefore there is No
Canadian Health Care system, but an Ontario system, a British Columbia
system etc. The Federal Government looks after the three territories.

Here in BC, basic medical coverage for a family of 4 is Canadian $ 110 per
month.  This gets you all doctors visits, all specialist visits, all x-ray
and diagnostic tests, all hospital treatment, all medications dispensed
while in hospital, all physiotherapy (except from industrial accidents,
which are covered from the Worksafe federal program for accounting reasons)
and long term care for the elderly.  Prescription drugs are not covered
except for seniors and the unemployed as well as the low income workers. You
just find a local doctor and register with them and there is no further
administration required except to not lose your plastic health care card,
which is accepted throughout Canada as there are reciprocal arrangements
between the provinces.  You can also use any walk in clinic without
registration.

Where a lot of the US 'propaganda' comes from is the infra structure side.
We are a large country with a small population.  The whole country has the
population of California and, for example, British Columbia is twice the
size of Texas.  This means that each province has to supply hospitals to
service a widely separated population and this costs a lot.  In the large
cities, i.e. Vancouver, the population density is high and the facilities
are world class.  In the remote towns, the running costs of the local
hospitals are higher due to small demand, therefore there are some shortages
of doctors, who prefer to work in the more benign climates and more
civilised cities, and so these local hospitals, which are designed and built
to Federal standards, are clean, comfortable and efficient, but will be
behind the larger cities in numbers of MRI machines and Ultrasound systems.
This means that people there frequently will be asked to travel to the next
larger city for these tests, or wait for the local facility to be available.
Most of the stories you hear about test waiting periods are from people who
do not wish to travel to the larger city for the test, and so are waiting
for the local facility.  If you are hospitalised and need these tests, our
system transports you there by ambulance or helicopter or plane to get these
tests.  It is not unusual for an Inuit patient to be flown to Vancouver or
Calgary for tests.  Our system does this regularly. So, given this scenario,
we understand that getting an ultrasound for back ache will be moved down
the priorities compared to people who need the test for life threatening
problems,  On the other hand, we have here in BC walk in breast cancer
clinics where there is no referral needed to drop in and get a complete
breast cancer screening.  There is absolutely no wait for breast cancer
anywhere in Canada.......but don't hold your breath for plastic surgery
unless you require it as a consequence of accidents, in which case there is
no wait.

Now, we also have private insurance top up coverage.  This is usually
supplied via your employer and covers, as a minimum, the upgrading of the
hospital room from the standard 4 patient federal design to a semi private 2
patient room, or even a private room in some cases.  Some of these top up
insurance plans cover part or all of prescription drugs.  We do not have
dental coverage in Canada, apart from basic coverage for seniors and the
unemployed and low earners, so most of use rely on the top up insurance for
dental coverage.  The price for this coverage is reasonable, but orthodontic
coverage can make a top up more expensive for a 'gold standard' policy,
which is paid for by the company. Some companies pay the whole premium, and
in others the company pays a portion of the premium.  The company part is
considered a taxable benefit. It is amusing that most of these policies are
supplied by US companies for the most part.............

So, here in brief is a simplified outline of the "Canadian System".
Everyone is covered, and the system, while not perfect, functions very well.

On the other hand, the excessive salaries of some of the unionised hospital
employees (cleaners and food service workers in particular0 were very out of
line in BC for a while to the point that the Hospital services cost the
province more than the health care......a change of government here to the
right from the union supported party, lead to some unrest while that
situation was forcibly corrected.  This are now much better, although
paramedics are still behind.

Hope this helps

Cheers

Fred Enga



-----Original Message-----
From: homestead-bounces AT lists.ibiblio.org
[mailto:homestead-bounces AT lists.ibiblio.org] On Behalf Of EarthNSky
Sent: August-08-09 2:26 PM
To: Homestead List
Subject: Re: [Homestead] The future of eldercare in the US

I still don't have the answers to these questions...Does anyone have any 
specific knowledge?  I know there has been a lot of talk about the 
Canadian system, but I am talking about the US legislation...

> 1.  They have heard that good medical care for those over the age of 59
> will be hard to find.  They have heard rumors that fewer diagnostic
> tests will be performed, fewer will get timely referrals to specialists,
> and medications will likely be generic only.
> Is there any kind of age breakdown-special circumstances for seniors,
> etc. -cut in the new proposal?

> 2.  What does the new plan say about those who intend to have surgeries
> overseas?  Will insurance companies pay for elective surgeries and
> treatments done elsewhere?
> 
> 3.  If Medicare is cut, exactly where will those cuts come from?  Will
> it be at the expense of our elderly, and eventually us, those who are
> approaching being able to eat off the senior menu-the AARP crowd?  Right
> now, I have a neighbor who has stage 4 prostate cancer who needs several
> surgeries, non-cancer related, blood clots, etc.  His former physicians
> are no longer accepting Medicare patients and the closest physician he
> has found that will accept him as a patient is down outside of Atlanta.
>  That is a long drive for someone who is sick and elderly.  Is this an
> omen for the future of eldercare?


-- 
Duct tape is like The Force:  There's a Light Side, a Dark Side, and, of 
course, it holds the universe together.
EarthNSky Farm, NW Georgia, USA
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