Friday, April 8, 2011

An American in Vancouver: Canadian Health Care

Thanks for stopping in for my grand opening of Health Care On Location!

This blog came about because I'm a health care geek in Vancouver for an extended stay. My husband is a regular on a new TV show that shoots in Canada so I have come here to be with him.

He's worked here a number of times since the late 1980s and I've always made a point of asking Canadians what they think of their health care system. For many years, I never heard a bad word except for the physician's wife who thought her husband should make more money.

So I used to be utterly convinced that the things we heard in the U.S. about problems with the system were strictly free marketeer propaganda. But the last time I was in Vancouver, about four years ago, I heard some negative reports.

Consequently, I decided to make a project during my sojourn here of recording the comments of Canadians of all walks of life regarding their health care system. I wrote up a number of these conversations, sent them out to my mailing list, and began toying with the idea of expanding the project into a blog about health care systems in various countries around the world. After all, I had heard so many people in the US hold forth with great authority about how health care works in Canada or in Europe. And most of them, as it turns out, don’t really know what they’re talking about. So without further ado, here’s the first installment of Health Care On Location…

As I sat on the plane flying up from Los Angeles, I began chatting with my seatmates. It turned out they were both Canadian citizens. So I decided to begin my project with a random sampling of two. Of particular interest was the woman who had duel citizenship, Canadian and U.S. She was a 59 year old middle class educator whose first words when I began my questions were ...

"Americans are stupid when it comes to health care."

In the thirty years she has lived in Canada, her family has had to use the health care system rather extensively. From the time when her daughter was four years old and she had idiopathic thrombocytopenic purpura (low platelet count with no known cause) to her husband's bout with cancer, she always felt they received high quality care with no delays. OK, Canadian health care scores 1.

My other seatmate was a 32 year old sales manager for Minolta. He first wanted me to explain the new U.S. health care law, the Affordable Care Act. A half hour later, I had given him a brief outline of the plan with its complex ifs, ands, and buts. Then he wanted to know what the taxes are on someone earning $100,000 per year. I thought, "Ah, healthy young man resentful of high taxes." But he surprised me by saying:

"I'm happy we're paying higher taxes because we're receiving better services."

I kid you not! His mother is a nurse and he had comments about nursing shortages and the problems hospitals have because of government budgets. But ultimately he said, "If you compare us to the U.S. we're really lucky." I had the impression he hadn't had any major health problems but he too had no complaints about waiting times or quality.

An added plus -- The young man lives a few blocks from our apartment and has offered to show me around Vancouver!

Well, that's all for now. I guess Canada scored 2 for today. Next time, I'll tell you what I learned about the health care not covered by the plan the government provides.


  1. Yay! I'm so proud of you Cuz! And I'm dying to know... did you get a medical degree while I wasn't looking? How do you have a simple conversation with someone on a plane and remember idiopathic thrombocytopenic purpura ????

    So talented. ;D

  2. Thanks, Lora! I write it down phonetically and look it up when I get home. But after all these years as a Doctor's Daughter and Health Care Advocate, I feel like I should be getting close to a medical degree. Just don't ask me to perform surgery.

  3. Comrade,
    Good reading. I look forward to more.
    All best,
    Patrick Kerr

  4. Hats off to you, Joan...keep it coming!

  5. Welcome to the blogsphere. I loved your first post. Hope you have a good time in Vancouver and have no need to see the health care first hand.

  6. I commend you on your blog and look forward to hearing what you learn. You should read the book "Deadly Spin" by Wendell Potter. Briefly, he was an insurance company insider who explains how he and others have worked to build corporate profits at the expense of the American Health Care system. His insights will give you a lot of ammunition for your blog.

    Kat Hermes

  7. LOVE the blog. Things I am curious about: what happens to patients who are NOT legal residents of the province? What does it cost to educate a health care provider in Canada? Are lab tests and imaging (MRIs, CTs, etc.) utilized at rates equal to those in the US? Are there shortages of primary care providers in Canada? Do the wide disparities between primary care and specialist incomes that exist in the US also exist in Canada? Keep the info coming!

  8. Great questions, Beth.  Some of them took awhile to research.

    Non-residents are provided with emergency care in British Columbia.  They are supposed to provide a credit card or $600 cash but they will receive care and be billed, if necessary.  Other than that, I was not able to find any way that non-residents receive care without paying.  Here is one Canadian physician's response to that question:

    "LIKE VISITING AMERICANS WHO'D LIKE TO USE OUR HEALTH CARE SYSTEM???? People who are not legal residents of Canada are not covered by our publicly funded health care system- why would they be? We'd have a flood of Americans trying to get health care in Canada if that were the case! If the question is whether Americans can come here and buy health care, yes they can. They just can't have it for "free" out of the public purse. Does the writer mean "illegal aliens"? I don't know about this, but I'm sure you can do some research yourself to learn more.  If you have any legal status in Canada (except "visitor"), you get health care."

    The cost for medical school per year runs between about $5,000-$20,000. 

    The utilization of MRIs and CT scans vary from province to province.  The highest rate of MRIs is in New Brunswick at 51 per 1,000 people; the lowest is Prince Edward Island at 23 per 1,000; US is 91 per 1,000.  The highest rate of CT scans is New Brunswick at 193 per 1,000 people; among the lowest is British Columbia at 106 per 1000; US is 228 per 1,000.

    I do hear lots of complaints about a shortage of primary care physicians in British Columbia.  It is difficult to be accepted as a new patient by a family physician.  However, there seems to be no problem seeing a family physician at a neighborhood clinic.  

    There is some income disparity between family physicians and specialists.  But it is not as dramatic as in the US.  I found some figures from 2005-2006 regarding physicians' salaries.  The average for a family physician was $212,000 per year.  There were a number of specialists whose average salaries were under $300,000 per year.  The highest earning specialists were thoracic surgeons who averaged $479,000 per year.

    Keep coming back!

  9. Assuming your primary care physician enjoyed 15 minutes with you, that is about the normal time you'll get before they shake your hand and dash off to the following patient. occupational therapy