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My Impression Of The Canadian Healthcare System

Posted Sep 19 2012 7:19pm
Stanley Feld M.D.,FACP,MACE

 

Cecelia ad I just returned from a trip to Halifax, Cape Breton Island and Prince Edward Island. It was a phenomenal trip.

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It was too early in the fall season for the trees to turn color but the weather was great and the countryside was glorious.

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We had planed to go there 49 years ago on our honeymoon.

We did not have time to get all the way to Halifax, Cape Breton or Prince Edward Island. We had to drive back to New York City to start my medical internship on July 1st. 1963.

 Cecelia and I decided it was time to go for it.

 We stayed in Port Hood on Cape Breton for five days, enjoyed the singing and dancing and had a wonderful drive around the Cabot Trail.

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I am a friendly guy and I was curious about how the folks on the street like the Canadian healthcare system. I was tired of listening to the Democratic Party’s propaganda.

The propaganda contradicts Canadian and former Canadian physicians feeling about the system.

I spoke to a lot of people in the town we visited about their feelings about the Canadian healthcare system.

 I came away with several impressions.  

 Dr. Kurisko practiced surgery in Canada before coming to the United States to practice surgery.

Dr. Kurisko description of the Canadian Healthcare System is very accurate. It reflects the feeling of the people who have need to use the system.

 

 h ttp://youtu.be/At9q6uFR3gU

Canadians are comfortable with their medical entitlement. Everyone said they like the fact that if they get sick they will not get “wiped out” by the costs as Americans might be.

I found a You Tube about the Canadian system with responses of the common man. It clearly expresses this sentiment.

 

This is the impression of a group of people. The question is the possibility of a bias in selection of the people interviewed.

Upon deeper questioning of the people I spoke to, my conclusion is that once people get used to a medical entitlement they are very hesitant to give it up even if it restricts their freedom of choice. Only 20% of the population uses the healthcare system at any one time.

The second conclusion is that this is the way the healthcare system is in Canada.   Canadian feel they must live with it and get over complaining about it.

The things they did not like about their healthcare single payer system is the very high sales tax in addition to federal and provincial taxes.

The income tax baseline is lowe than the U.S. and the income earned at the top rate of tax is lower than in the U.S. If you combine all taxes paid the rate is above 50%  for some income brackets and at least 30% for the lowest income bracket.

I was not aware of the fact that the sales tax on everything in Canada is 15% in addition to business taxes and personal income taxes.  There is both a province tax and a central tax on purchases.

 

Federal Tax Rates

Up to $41,544                                        15.00%

41,545–83,088                                      22.00 %

83,089–128,800                                    26.00 %

128,801 and over                                  29.00 %

 

Everyone pays federal income tax in Canada. Fifty percent of U.S. citizens do not pay Federal income tax

In addition to federal income tax each province tax is slightly different Below are a few examples .

 

British Columbia       

Up to $36,146           5.06%

36,147–72,293         7.70 %

$72,294–83,001          10.50%

$83,002–100,787        12.29%

$100,788 and over      14.70%

 

Alberta

10.00% All income


Saskatchewan

Up to $40,919     11.00%

$40,920–116,911   13.00%

$116,912 and over 15.00%

 

Ontario

 Up to $37,774      5.05%

$37,775–75,550      9.15%

$75,551 and over    20%

 

New Brunswick

 

Up to $37,150        9.10%

$37,151–74,300     12.10%

$74,301–120,796    12.40 %

$120,797 and over  14.30%

 

Nova Scotia

 Up to $29,590         8.79%

$29,591–59,180        14.95%

$59,181–93,000        16.67%

$93,001–150,000      17.50%

$150,001 and over     21.00%

 

We visited Halifax, Nova Scotia and Charlottetown, Prince Edward Island but spent most of our time in the countryside.

The long waiting times to see a physician in the office and in the ER was a constant complaint.

The people complained about the shortage of physicians. Their impression was that a lot of physicians fled to the U.S. causing the physician shortage.

There were few small towns with physicians. Bigger towns had small hospitals and physician shortages. Larger towns had tertiary hospitals. These hospitals were full service hospitals. These hospitals rationed care

The emergency rooms of any size hospitals are always jammed. Sometimes you can wait for 6 hours and not see a physician taking care of anyone.

One lady told me she had a tremendous stomachache. She went to the ER waited more than 6 hours without anyone in the ER seeing a physician. After 6 hours the pain started to subside. She was so fatigued she went home.

I guess that is one way to cure a patient. It took her 4 days before the pain to subside.

Another complaint was follow-up visits by a patient with her own physician. The patient was a 65-year-old diabetic female. Her physician was diligent. He wanted to see her every three months. She could only get an appointment in 5 months.

One 55-year-old male with heart disease said the healthcare system has been fine for him. He calls his cardiologist at home. He is an interesting case and the cardiologist will see him the next day.  

Many complained about the waiting time for special test such as CAT scans and MRIs, hip and knee replacements and cardiac catherizations.

Waiting times for hip and knee replacements can be more than one year.

A 2011 report by the Fraser Institute concluded that Canada’s health care system is spending at an unsustainable rate. Six of ten Canadian provinces are on track to spend half of their revenues on health care, according to the institute.”

“We conclude that Canada’s health system produces rates of growth in health spending that are not sustainable solely through redistributive public financing,” the report concluded.

I think it is about time Americans paid attention to Obamacare. It will be worse for all.

 The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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