Health Care

[4X4]

Well, I paid my bills today. Another $44.00 to Alberta Health Care. And I couldn't help but wonder what our american counterparts (or for that matter, our provincial counterparts) pay for health care or insurance.

In Alberta, a single, 26 year old person pays $44.00 per month. I never really complained about this before, but I'm starting to scratch my head a little. I spoke to my mother today (also an Alberta resident), who was ticked off that she waited 4 hours at a clinic to see the doctor.

How much do the rest of you people pay for this service? What is this advantage that we Albertans and Canadians think we have? Is American insurance so much more expensive per month? Why does my friend from Winnipeg not pay a nickle to AHC?

[RougeUnderoos]

Someone (Cheese ) recently reported that insurance for a 25 year old single guy was in the neighborhood of 10 times that in the States

There was a thread last week but I am too impatient to search it out.

I've heard some weak calls for getting rid of the health premiums.

[Claeren]

Yeah,. insurance i think is usally $300-400 USD/month for similiar coverage in the States.


Also, as someone who works in healthcare, there is little evidence that for 90% of conditions a few hours (or days or months, or the relative unit of measure) makes a difference.

Canadian emergency rooms make sure to see stroke victims, serious accident victims, and other serious contditions (heart attacks, failures, etc) immediately, pushing others back in line. While it is frustrating for the person waiting (who when quized usually thinks they have been waiting 3 times longer then they actually have been) there is little to no effect.

This is one large reason Canadians tend to live longer, have fewer babies die, etc. People are more likely to go to a doctor (because it is 'free') and the wait makes no difference other then to their patience and nerves....



Claeren.

[nfotiu]

I pay $180US/month for my wife and I, and my company pays $563/month. This is for pretty much the best coverage out there. Keep in mind I still have to pay $20 for every doctor visit, and some things are only 90% covered up to a certain amount.

I went through the quote generater here for people who don't get coverage through work, and it comes out to: $41/month for $5000 deductible and 80% coverage to $189/month for 0 deductible 80% coverage. Basically with either of these plans, you end up with a $50,000 bill or more if you get a major hospital procedure. I had my appendix out here, and the total bill was $80,000. If I had one of those insurances, I would be stuck with up to $21,000 in bills. A family of 4 ranges from $254 to $1100 depending on deductibles.

Also if you end up in the hospital in the US, be prepared to spend the next year of your life fight with hospitals/anestheoligists/surgeons/medical supply companies (my appendectomy resulted in bills from 15 different organizations) and your insurance company as they fight about what the fair cost is. Then you have to fight with the credit bureau's as they put everything on your credit report even though it was the insurance companies fault for being late. Not a fun experience. I'll take Canada's system.

[notoepik]

Originally posted by nfotiu@May 25 2005, 06:50 AM
I had my appendix out here, and the total bill was $80,000. If I had one of those insurances, I would be stuck with up to $21,000 in bills. A family of 4 ranges from $254 to $1100 depending on deductibles.

Good Lord no wonder your insurance company was fighting the cost of that. That is an outrageous bill for an appendectomy.

Most US insurances have a set deductible amount that is your "out of pocket" expense. Some are as low as $500.00 per person and some are high, at $5000.00

It all depends on the plan you have. The deductible amount also determines the cost of the monthly permiums we pay. The lower the deductible, the higher the monthy premium.

Insurance companies pay on what they determine to be *reasonable and just* costs. Usually what they pay is about 80% of the bill sent to you. If the medical facility or Doctor you see are is a participating member in the plan then the rest of the bill is waived. You would not have to pay that, it get written off.

$80,000 for an appendectomy seems to be pretty high unless you had some major comlications and spent a few days in a critical care unit. I had a kidney removed 4 years ago and the total cost of that surgery in Seattle was about $27,000. I ended up paying out of pocket expenses of around $5000.00 which included the flight to Seattle and the hotel (connected to the hospital) for my husband.

[ernie]

When we were in the states my wife and I paid half at $380 a month, her company paid the other half at $380 a month....2 people under 30 no kids, no health problems.

We also had to pay $20 each doctors visit, that money did not include any dental (I know alberta health care doesn't either but I've talked to many people who think you get dental when you are shelling out that much), we only got the choice of 3 doctors in our city, drug coverage was 80 % if and only if you bought generic otherwise it was only 30% coverage (so if a new more promising drug was on the market for a condition you might have you would pay nearly all the cost), birth control pills were not covered in our coverage, there was a once a year co-pay of $30 for drugs, you could only get prescriptions for a month or two at a time (i.e. a wife on birth control had to visit the doctor every 2 months to get a new prescription...they don't want lengthy prescriptions written in case you no longer have coverage), you were only covered at one hospital in town or affiliated ones in other towns and not the others and were only covered with one ambulance service. Not to mention that some insurance providers have little clauses that seem to suggest they can drop you with no warning if you start costing them a little too much money. I don't know what the co-pay was for hospital visits...thank goodness we never had any of those.

The company I work for now provides 80% of the money to the american office employees....to the tune of about $750 /employee per month (the office is in an expensive state). The canadian employees get additional coverage for under $100 a month that includes a ton more stuff than what the american employees receive (message therapy, chiropractor, DENTAL, choice of doctors, etc. etc. etc.)

There is no question that lineups and what not are shorter in the states if and only if you have coverage. But coverage is expensive for a person or business so many people do not have coverage in the states because of that. For those people Canada would be a much better place to be.

As a whole, the impression that we got on the doctors were that they were more prescription writers than physicians in the states compared to Canada. Here the answer isn't always some drug and they spend more time looking for solutions to problems than just trying to cover up the symptoms with drugs. BUt we were never seriously ill so we are talking standard family doctors here and of course we had limited choice and really can't compare...it may have just been those doctors.

The way I look at it is that extra we pay in taxes here in Canada isn't much more than what we would shell out in health insurance and then dental down in the states. Atleast in canada you don't need to be worried about not having coverage when you get to the hospital.

Not to say the canadian system can be improved...it certainly can. Quite frankly there has to be a black hole somewhere where all this money goes because it certainly doesn't get to the staff and end users of the system. It's tied up in bureaucracy and over-management instead of being used on the front line for staff, beds, and equipment.

[nfotiu]

Originally posted by notoepik+May 25 2005, 01:11 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (notoepik @ May 25 2005, 01:11 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-nfotiu@May 25 2005, 06:50 AM
I had my appendix out here, and the total bill was $80,000. If I had one of those insurances, I would be stuck with up to $21,000 in bills. A family of 4 ranges from $254 to $1100 depending on deductibles.

Good Lord no wonder your insurance company was fighting the cost of that. That is an outrageous bill for an appendectomy.

Most US insurances have a set deductible amount that is your "out of pocket" expense. Some are as low as $500.00 per person and some are high, at $5000.00

It all depends on the plan you have. The deductible amount also determines the cost of the monthly permiums we pay. The lower the deductible, the higher the monthy premium.

Insurance companies pay on what they determine to be *reasonable and just* costs. Usually what they pay is about 80% of the bill sent to you. If the medical facility or Doctor you see are is a participating member in the plan then the rest of the bill is waived. You would not have to pay that, it get written off.

$80,000 for an appendectomy seems to be pretty high unless you had some major comlications and spent a few days in a critical care unit. I had a kidney removed 4 years ago and the total cost of that surgery in Seattle was about $27,000. I ended up paying out of pocket expenses of around $5000.00 which included the flight to Seattle and the hotel (connected to the hospital) for my husband. [/b][/quote]
I ended up being in the hospital 11 days, and the thing was he kind of botched it a bit and paralyzed my bowel. So the fight was whether the doctor should pay for the extended stay, or the insurance company.

And the 80% up to a max out of pocket, etc, only usually applies the better company plans. If you are left on your own insurance, you usually have a huge deductible and you are stuck with th 20% co-pay without a maximum.

[notoepik]

Originally posted by nfotiu@May 25 2005, 07:32 AM

I ended up being in the hospital 11 days, and the thing was he kind of botched it a bit and paralyzed my bowel.

Well that explains that huge bill but,

While I hate to promote another lawsuit in the medical industry, it sounds like you may have a just cause there nf

[nfotiu]

Originally posted by notoepik+May 25 2005, 01:46 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (notoepik @ May 25 2005, 01:46 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-nfotiu@May 25 2005, 07:32 AM

I ended up being in the hospital 11 days, and the thing was he kind of botched it a bit and paralyzed my bowel.

Well that explains that huge bill but,

While I hate to promote another lawsuit in the medical industry, it sounds like you may have a just cause there nf [/b][/quote]
The bowel paralysis was temporary. It started functioning after 8 or 9 days. So no permanent injuries. And the insurance company did eventually settle with the hospital, and I did get the medical companies to eventually withdraw their reports to the credit bureaus. In the end, not much to sue for, other than some major hassles, and a very uncomfortable 9 days.

[notoepik]

Thank goodness it all turned out fine nf, but what a nightmare to go through.


Fotze, a major part of my job right now is liason for the my office, a clinic with 16 health care providers, to the drug company reps.

Incentives such as golfing at luxury resprts, educational conferences in Hawaii and river rafting on pristine rivers is gone. About the only incentives drug companies hand out these days are stickie note pads and some nifty pens. And food. Lunch is catered to the office everyday if we want by a drug company wanting to share valuable information with my bosses. Let me tell you, it has been an extremely unhealthy 2 years

[4X4]

Wow, I guess it can be more expensive.


Anyone from another province? How much do you guys/gals pay for provincial health care?

[MarchHare]

Originally posted by 4X4@May 25 2005, 10:17 AM
Wow, I guess it can be more expensive.


Anyone from another province? How much do you guys/gals pay for provincial health care?

When I was living in New Brunswick, there were no extra fees you had to pay beyond regular taxation. Granted, taxes are higher there, so it's hard to make a direct comparison.

[Cheese]

Originally posted by 4X4@May 25 2005, 12:17 PM
Wow, I guess it can be more expensive.


Anyone from another province? How much do you guys/gals pay for provincial health care?

nothing extra here in Ontario...cept as mentioned above we have the PST. Overall our taxes are similar in comparison to Alberta.
We also dont have user fees here as Albertans do.

[Bend it like Bourgeois]

To be fair, AB Health premiums cover less than 10% of the actual health care costs.

I don't know if you can make an apples to apples comparison, but we 'pay' about 3000 per person for Health Care in Alberta, plus another $1000 or so in out of pocket expenses.

We get billed $500 a year or so (as an individual) for Health Care premiums, but that's little more than a token.

Klein's kids look at the premium as a way of reminding us all that health care isn't free. Personally I think that's goofy, as most people never actually see the bill.

They can't figure out how to get rid of $800 mil in spending, which is the bigger issue, but funnily enough they don't want to talk about that as much.

[flmsfan2004]

I am so thankful everyday that I live in Canada. About a year and a half ago we found out my mom had a brain tumour. This is a list of her treatments thus far:
- aprox 2 week hospital stay (private room)
- craniotomy (brain surgery)
- some facial reconstruction surgery
- 2 CT Scans
- 6 MRI's thus far
- 6 weeks radiation treatment
- 12 months of chemo treatments
- dozen's of doctors appointments and so on

ALL we've had to pay (which hasn't been covered by our plans) for is her phone line that she had while in the hospital. My dad is a teacher, i think his plan covers 75-80% of all her perscription medicine. My mom is done all her treatments and is doing excellent now- the tumor is virtually gone. I'm thankful that our system covers so much, if we were living in the States I couldn't even imagine what the bill would have been, i'm sure it would be well over $100,000. It is hard enough dealing with the emotional stress when a loved one gets sick, people shouldn't have the burden of having to deal with financial fall out from the treatments they receive.

[Cheese]

Originally posted by flmsfan2004@May 25 2005, 02:04 PM
I am so thankful everyday that I live in Canada. About a year and a half ago we found out my mom had a brain tumour. This is a list of her treatments thus far:
- aprox 2 week hospital stay (private room)
- craniotomy (brain surgery)
- some facial reconstruction surgery
- 2 CT Scans
- 6 MRI's thus far
- 6 weeks radiation treatment
- 12 months of chemo treatments
- dozen's of doctors appointments and so on

ALL we've had to pay (which hasn't been covered by our plans) for is her phone line that she had while in the hospital. My dad is a teacher, i think his plan covers 75-80% of all her perscription medicine. My mom is done all her treatments and is doing excellent now- the tumor is virtually gone. I'm thankful that our system covers so much, if we were living in the States I couldn't even imagine what the bill would have been, i'm sure it would be well over $100,000. It is hard enough dealing with the emotional stress when a loved one gets sick, people shouldn't have the burden of having to deal with financial fall out from the treatments they receive.

hear hear...great post! Heres hoping your mom makes a full recovery as well!

How awful it would be to beat such a nasty problem to find you need to claim bankruptcy for the cost of it.

[Bend it like Bourgeois]

Originally posted by flmsfan2004@May 25 2005, 11:04 AM
I am so thankful everyday that I live in Canada. About a year and a half ago we found out my mom had a brain tumour. This is a list of her treatments thus far:
- aprox 2 week hospital stay (private room)
- craniotomy (brain surgery)
- some facial reconstruction surgery
- 2 CT Scans
- 6 MRI's thus far
- 6 weeks radiation treatment
- 12 months of chemo treatments
- dozen's of doctors appointments and so on

ALL we've had to pay (which hasn't been covered by our plans) for is her phone line that she had while in the hospital. My dad is a teacher, i think his plan covers 75-80% of all her perscription medicine. My mom is done all her treatments and is doing excellent now- the tumor is virtually gone. I'm thankful that our system covers so much, if we were living in the States I couldn't even imagine what the bill would have been, i'm sure it would be well over $100,000. It is hard enough dealing with the emotional stress when a loved one gets sick, people shouldn't have the burden of having to deal with financial fall out from the treatments they receive.

All the best to your family.

I don't think it's fair to say the bill would have been $100,000 in the US though. The bill might have been similar, possibly less, possibly more. The care also might have been similar, possibly worse, possibly better.

You could also say the same things had your mom lived in a different prvince in Canada. Care and cost care vary widely even within our borders.

[RougeUnderoos]

Originally posted by Bend it like Bourgeois@May 25 2005, 12:25 PM

I don't think it's fair to say the bill would have been $100,000 in the US though. The bill might have been similar, possibly less, possibly more.

I think it's fair to say that the cost would have been more than 100 grand if a complicated appendectomy runs 80 grand.

[nfotiu]

Originally posted by Bend it like Bourgeois+May 25 2005, 06:25 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Bend it like Bourgeois @ May 25 2005, 06:25 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-flmsfan2004@May 25 2005, 11:04 AM
I am so thankful everyday that I live in Canada. About a year and a half ago we found out my mom had a brain tumour. This is a list of her treatments thus far:
- aprox 2 week hospital stay (private room)
- craniotomy (brain surgery)
- some facial reconstruction surgery
- 2 CT Scans
- 6 MRI's thus far
- 6 weeks radiation treatment
- 12 months of chemo treatments
- dozen's of doctors appointments and so on

ALL we've had to pay (which hasn't been covered by our plans) for is her phone line that she had while in the hospital. My dad is a teacher, i think his plan covers 75-80% of all her perscription medicine. My mom is done all her treatments and is doing excellent now- the tumor is virtually gone. I'm thankful that our system covers so much, if we were living in the States I couldn't even imagine what the bill would have been, i'm sure it would be well over $100,000. It is hard enough dealing with the emotional stress when a loved one gets sick, people shouldn't have the burden of having to deal with financial fall out from the treatments they receive.

All the best to your family.

I don't think it's fair to say the bill would have been $100,000 in the US though. The bill might have been similar, possibly less, possibly more. The care also might have been similar, possibly worse, possibly better.

You could also say the same things had your mom lived in a different prvince in Canada. Care and cost care vary widely even within our borders. [/b][/quote]
Realistically a teacher's wife in the US would probably have decent health insurance. Might be out a couple thousand for co-pays at most. Probably stuck with an HMO, and will have to go to the hospital they tell them, and use the doctors in their plan though.

The bigger problem in the US is people without full-time jobs including unemployed/part time workers/contract workers/self employed etc. I lived in an apartment building when I first moved into North Carolina, with lots of mid twenties guys working various part time jobs, or helping their friend out with his contracting business, etc who didn't have health insurance, or had the huge deductible/high co-pay type insurance. Those are the people who would be declaring bankruptcy going through something like this.

[Bring_Back_Shantz]

Just out of curiosity, what is an HMO?
I've heard it on TV a bunch of times, and never in a good light.
Anyone care to expalin exactly what an HMO is?