Of course not. Canada's healthcare system is not, at the point-of-care, a business. Whatever business arrangement that exists is between the government and providers, not me and my doctor, so the latter relationship is not directly constrained by economic concerns, as is the case here in the US. If that appointment had taken place in Canada - and let's be clear first that it would not have, as I would have been insured unconditionally since birth and able to deal with each issue as it arose - the doctor would have either helped set up a treatment plan then and there, or she would have let me know that it would require another visit or two to go over everything, as here.
The difference is that I would not personally be out 1-3 weeks worth of food money for each visit, just establishing my baseline. In neither case would what happened be a "matter of billing" because I would never receive a bill.
You seem not to understand the Canadian health system. Privately owned clinics are allowed to enter in contract with the provincial government and be paid by the public insurance system for services provided. This is the framework under which the doctor was operating.
Doctors of all stripes are allowed to open their own practice take on cases privately. There is simply no profit in opening a private practice to deal with difficult to diagnose cases affecting generally poor people requiring dozens of experts to investigating over multiple years. That's why no doctors decided to set up a private practice to deal with these patients - there is no profit motive. Too much work, and too little pay.
As a young, relatively healthy someone who has also experienced both Canadian and US healthcare, I much prefer the Canadian system. In the US, my insurance was billed 14k USD for a simple diagnostic procedure (stress echocardiogram) that normally would cost a few hundred dollars. I ended up being on the hook for over 2000 USD.
Yes, I got an appointment within a few days, and I got the cardiologist's report shortly after. But when I had a simple question about the report, my doctor suggested I book a follow-up appointment (and get charged another few hundred dollars) to get my question answered. I said no thanks - I'll take my chances and ask my friend in med school. If I knew ahead of time how much the original diagnostic would have cost, I might have had second thoughts about that as well. And while there seems to be nothing wrong with me, for other people in a similar situation that decision could end up being the difference between life and death.
I've had standard lab work done in Canada and have no complaints about the wait. But I'd take waiting a few weeks if that means no one will choose to forego life-saving diagnostics because of extortionate health care costs.
So you’re against how universal care is setup in Canada? Each visit has a billing code for a certain amount of work. If you brought up other issues you’d be told to make another appointment.
I'm a Canadian, living in America and therefore not a benefactor of Canada's healthcare system, even if I'm visiting Canada. On a trip to Canada a near car accident caused abdominal pain for my pregnant wife and a subsequent trip to urgent care to confirm if everything was OK. The bill was $600.
In the capitalist paradise of the United States, as I sit here, covered by top-of-the-line health insurance...
My wife needed 3 months to schedule a sleep doctor appointment, 3 months to schedule a minimally-invasive surgery (That manages to bill her, and the insurer wrong), and every time she needs a re-fill of her prescriptions, it's a complete fucking crap-shoot of whether or not:
1. The manufacturer managed to produce enough pills to fill its orders.
2. The pharmacy bothers to call her, to notify that the prescriptions are in.
3. That the prescriptions are actually in, and that she didn't waste her time walking to the grocery store.
Meanwhile, on my side of things, I end up watching my insurance get billed $750 for 5 minutes of a doctor's (And 15 minutes of his assistant's) time. This is truly the most humanitarian, efficient, and accountable medical system on the face of the planet.
> Canadians, on average, faced a four and a half month wait for medically necessary treatment after referral by a general practitioner.
'Medically necessary' is an irrelevant qualifier. All treatment is medically necessary, if it weren't, the GP wouldn't prescribe it, and Canada wouldn't pay for it.
The term you're looking for is 'Non-life-threatening'.
I am honestly curious: how that was paid for in your case. I’m an American who has needed urgent care in Canada and I was not billed. How did the reverse work, especially in your case where it was clearly planned?
Canada is almost unique among developed countries with government healthcare in that it doesn't also have a parallel private medical system for those who can afford to pay for it. So naturally rich Canadians will often pay for private healthcare in the US.
I'm originally Canadian but have lived in Australia for the past 10+ years (in Melbourne). We've never had any issues getting medical appointments with local doctors (usually "bulk billed" so we pay nothing or a very nominal amount for the appointment). But we also have private medical insurance, which is required above a certain age (30 something), that we use occasionally for specialist appointments. But even then the out-of-pocket fee is something like $70 which is fine.
Unlike Canada, AFAIK most countries in Europe (e.g., Sweden, France, Spain, Germany) have parallel private medical care, so Canada really is unusual in that respect.
There are some rules hobbling the private system in Canada that don’t exist in every country with universal healthcare. As I understand it, if a doctor participates in the public system they’re limited in their ability to accept private-pay patients. Happy to take correction here from Canadians who know better.
And that's why author's practice survived despite the hostility of the US government. They started treating Canadian patients:
> The first patients to arrive after we posted prices were Canadians. This was instructive, as these patients had so-called insurance coverage. There was no access, however, to the care that many of them required. The most common story then as now for the Canadians was a patient waiting two years to see a gynecologist for a hysterectomy to stop their bleeding, bleeding usually so severe that intermittent transfusions were required. For $8,000, which covers the facility, surgeon, anesthesia, pathology, and an overnight stay at the surgery center, Canadians can end their nightmare. The first question a Canadian asks when they call us is how long they’ll have to wait. Our answer that there is no waiting time is met with disbelief. A Canadian friend of mine has told me the old joke that no Canadian is truly content unless standing in line.
All thanks to the success of a "state-directed monopsony" of a "developed country".
Ah, I replied to the wrong comment. "Canada is that it's basically the only country in the world wherein it's illegal to pay a doctor to help you" - this is factually untrue. There are private medical clinics in Canada. Doctors are not allowed to bill both provincial health systems as well as the patient at the same time.
I'm Canadian but lets be realistic, there are many things that would cause serious financial hardship due to medical costs in Canada. A friend of mine right now is suffering through intense pain from her teeth that aren't being fixed because she doesn't have money/insurance. She's deciding between healthcare and money.
You can also lose your life on a waiting list in Canada. Not much purpose in having $23K in the bank but being dead.
For sure you're not going to get a $23K bill for a bug bite but you will pay $3000/month for chemo, etc. Lots of things aren't covered by medicare, and they're quite expensive. Canada is more like a $23K bill for getting cancer, or other long term/terminal illnesses.
What I want to know is, how much does it cost to provide that service to you? Not how much do you pay, but how much does it cost? If it's greater than $100 a month (how could it be less?), then someone is paying. What portion of Canada's budget is spent on the health system? Are you paying for your healthcare indirectly via taxes (in which case you're just unaware of the true cost) or is someone else paying (in which case you just won the redistribution game, congrats).
It still costs something to provide medical care. It's not like Canada doesn't need to pay their doctors. The cost in the U.S., contrary to public opinion, is not driven by insurance company greed. So, assuming the cost is about the same in Canada, how did you succeed in shifting the cost elsewhere in a manner that you're satisfied with?
And, if we were to replicate such a plan in the U.S., do you think we'd see similar results?
The difference is that I would not personally be out 1-3 weeks worth of food money for each visit, just establishing my baseline. In neither case would what happened be a "matter of billing" because I would never receive a bill.
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