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Old 01-06-2011, 10:04 PM   #41
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In Canada, we have a law called The Canada Health Act which guarantees every Canadians and permanent residents EQUAL right to access universal health care, free of charge.

Health care costs are paid by each provincial governments. Doctors (MDs) bill the province for the services they provide to patients, ALL hospitals are governments run, no cost to patients (not a penny), there's no private hospital in Canada.

All procedures are regulated by the governments, income of all doctors (MDs) is capped by the provincial governments, obove which will be paid a percentage, that's the law.

Because it's regulated by the governments (income capped, no unnecessary procedures like in the US to be performed), it drives the health care costs DOWN.

This means the rich and poor are treated the same, no queue jumping. That's the beauty of Canada !

A documentary aired by CBC in December: Public Health Private Life. The cardiologist in the documentary said "MDs in Canada are paid 50% of those in the US but I stay in Canada not because of money, it's because I like the health care system in Canada"
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Old 01-07-2011, 07:33 AM   #42
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What would the procedure for recieving health care in canada if I were visiting? would I be charged nothing or is there a procedure that they use to figure the cost? as there are no private hospitals and the doctors salaries are capped, who figures what I would owe?
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Old 01-07-2011, 08:50 AM   #43
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In Canada, we have a law called The Canada Health Act which guarantees every Canadians and permanent residents EQUAL right to access universal health care, free of charge.

Health care costs are paid by each provincial governments. Doctors (MDs) bill the province for the services they provide to patients, ALL hospitals are governments run, no cost to patients (not a penny), there's no private hospital in Canada.
Can you get treatment anywhere in the country or is it in any way restricted to the province in which you live? I never thought to ask before. I know Canadians pretty much love their system.

A lot of Americans see it as triage and think there are many Canadians coming to the US for procedures in lieu of waiting - I haven't seen that.

I would take the Canadian system in a heartbeat. All this angst we are going through with regard to healthcare is just so much crap. So many countries provide it as a service paid for by taxes. I'd gladly pay more taxes if that's what it provided. Considering what I pay for healthcare (currently $475/month single coverage) - I doubt if the additional tax would be more per year.
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Old 01-07-2011, 10:08 AM   #44
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I notice that some of you were moving abroad or thinking of it to recieve affordable healthcare. do you think it will be cheaper over there? do the people who moved to mexico realize better or cheaper healthcare? can anyone through out some numbers as far as costs in which countries?....
As far as cheap health insurance good luck with that. I would still like to hear more from people in canada, mexico, and other countries about the cost of health care.
Hi Frank,


Billy and I are familiar with health care service and prices both in Thailand and in Mexico, and I can tell you the following:


1. ** Generally there is no waiting for weeks for service. If you are ill and want to see a doctor, you can simply show up at his office. This is true for Bangkok and Chiangmai, (Thailand) or Chapala, Mexico. If there are other people in the waiting room, you might have to wait an hour or hour and a half. If you arrive when they open, you can be the first to be seen. Or you have the choice to simply go to another doctor’s office.



2. ** Office fees to see a general practitioner in Chapala range from 150 Pesos to 200 Pesos, currently about $12 - $17 USD. To see a specialist in Chapala or Guadalajara, the office visit runs 300 – 600 Pesos, or $25- $50.


3. ** To have your teeth cleaned in Chapala it runs from $12 - $21 USD, to have a porcelain crown put on it is $100 USD, a root canal with post inserted into the tooth before a crown is placed on it is $188 USD


4. ** An Echo Cardiogram in Guadalajara is $100USD


5. ** A full executive physical in Chiangmai, Thailand with stress test, all appropriate blood work, x-rays, abdominal sonogram, PSA tests or female mammogram and pap smear will run from $250 - $350 USD with your tests, results and doctor consultations all done the same day, in the same location. You can have it done in the morning, go out to lunch and then meet the doctor in the afternoon for any information about your results.


6. ** You can schedule a colonoscopy in a Chiangmai hospital for tomorrow and it will run you $350 USD, and the prep procedure is more humane than in the States. The day before your hospital visit you eat normally. If your appointment is at 8 in the morning, you awake at 5 a.m., and prepare 2 liters of a special solution, drink it, and by 7 a.m. you are cleaned out. Take a cab to the hospital and by 11 a.m you are finished, complete with your take home DVD to present to any doctor in the future as your baseline. The hospital takes you to your home via ambulance, included in the cost.

Some time back, we wrote a piece for The Motley Fool called Medical Vacations: The Retiree Health-Care Solution? which listed cities, countries, hospitals and prices for certain procedures. If you are interested in utilizing this option, I recommend that you take a look at this piece as well as our Medical Tourism page.

While this choice might seem outrageous or extraordinary for some people, it is becoming more of a common alternative, with medical tourism being a $160-billion worldwide industry and growing. Singapore and Thailand are both medical tourism leaders.

LuvSouth

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This means the rich and poor are treated the same, no queue jumping. That's the beauty of Canada !
In regards to Canada’s health care system, here is a recent article that might shed some unconventional light on the topic:

Canada’s public health care at crossroads
Private medicine makes inroads as nation struggles with long waits
Canadian health care at the crossroads - MarketWatch

or you might want to read articles written by Brian Day, the former President of the Canadian Medical Association – pros and cons of the Canadian system and the possibility of Canada opening its doors for Medical Tourism.


Why B.C. should become a destination for medical tourism
By Brian Day, Special to the Sun April 19, 2010


In general, no one is pushing anyone to ‘try’ medical tourism. However it has been our experience that having more tools in our toolbox proves useful.

Best,
Akaisha
Author, The Adventurer’s Guide to Early Retirement
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Old 01-07-2011, 10:29 AM   #45
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Akaisha has summarized very well some advantages of the health care delivery systems of selected international locales. Most of the services mentioned are preventive in nature, or routine. I have no reason to believe that there is any difference in quality in N. America versus the locations described.

I would add from my long experience practicing in the US that during a more serious illness or those with numerous complications, nonroutine surgery, many expats choose to return to the US, mainly to be nearer to family and support systems. Practicing in both Fla and AZ, we saw many from Mexico, Central and South America. I don't know if that was because they felt the care here was superior, or rather for other reasons.

Be wary of those who assume that care is superior (better outcomes) in North America relative to other developed countries or in developing countries in local centers of excellence. The US no longer has a monopoly on quality or results.
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As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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Old 01-07-2011, 11:28 AM   #46
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What would the procedure for recieving health care in canada if I were visiting? would I be charged nothing or is there a procedure that they use to figure the cost? as there are no private hospitals and the doctors salaries are capped, who figures what I would owe?
In Canada, everyone has their own health card which entitles us to access health care, free of charge.

When we visit a clinic or hospital, we show our health cards and the staff will record our card numbers and bill the government.

When American or other non Canadian visiting clinics or hospitals, obviously they have no health cards to produce, so the staff will charge them according to the services.

For a brief visit to a clinic, say a flu or stomachache, it's $27 (I think) per visit. For hospital visit, I don't know the costs but there are procedures to charge patients, item by item. Say, to be admitted to ER, it's this $, for hospital stay, it's this $ ... and so on.

But one thing I pretty sure (not 100% sure) that for the same treatment in hospital in Canada, say a broken arm caused by car accident, it's cheaper in Canada than the US. Why ? Because Canada will only perform procedures that are necessary as opposed to hospital in the US that perform UNNECESSARY procedures. We Canadians, most of us, know that ! We know as soon as the US hospitals found out we had medical insurance or top up insurance, they would treat us Candians like KINGS, performing so many UNNECESSARY procedures. Say, a minor hospital visit, they, the US MDs insisted we stayed in hosptials for ... OBSERVATIONS and hence perform numerous tests ... and bill it to the insurance companies ? US$20,000 per minor US hospital stay ... I think it is a shame that private US hospitals do that to Canadians, and probably to Americans as well ...

But I think if you really need hospital care, you might want to check out how much to buy travel insurance in Canada (I think it's definitely cheaper than US$17,000 per year, this US$17,000 is RIDICULOUS TO CANADIANS), then you can access the Canadian health care ...
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Old 01-07-2011, 11:53 AM   #47
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Can you get treatment anywhere in the country or is it in any way restricted to the province in which you live? I never thought to ask before. I know Canadians pretty much love their system.

A lot of Americans see it as triage and think there are many Canadians coming to the US for procedures in lieu of waiting - I haven't seen that.

I would take the Canadian system in a heartbeat. All this angst we are going through with regard to healthcare is just so much crap. So many countries provide it as a service paid for by taxes. I'd gladly pay more taxes if that's what it provided. Considering what I pay for healthcare (currently $475/month single coverage) - I doubt if the additional tax would be more per year.
Say, if I visit Quebec for 3 months, I don't have to change my OHIP (Ontario Health Insurance Programme), clinics and hospitals in Quebec will bill directly to the Ontario government.

I think there are only a very very very small number of Canadians going to the US to get treatment in lieu of waiting. Those are the ones who either have extra cash to burn or the treatment is not available in Canada and they don't want to wait.

In general, if treatment is not available in Canada, the province will send the patient to the US to get treatment, paid by the Ontario government based on procedures in Ontario. There is a list what is considered valid and what's considered not valid to send patients to the US to get treatment.

Say if treatment is available in Canada but the patients will have to wait for 3 months, but they have extra cash and don't want to wait, that's fine, they simply check in private hospital in the US and be treated like KINGS.

I think the additional tax you pay will definitely less than private insurance Americans are paying. To put it bluntly, we are not paying an additional US$17,000 per year specific for health care in Canada per person. So the US$17,000 per year is RIDICULOUS to Canadians.

The reasons are simple: US hospitals perform unnecessary procedures, US hospitals charge MORE per procedure compared to the same procedure in Canada, MDs in the US charge 100% (double) compared to MDs in Canada charge. That explains why Americans pay US$17,000 per year per couple (?), it's absurd and ridiculous to Canadians !
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Old 01-07-2011, 11:53 AM   #48
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.........We know as soon as the US hospitals found out we had medical insurance or top up insurance...........
LuvSouth, what kind of "top up" insurance do you get before you travel to the US? How expensive is it?
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Old 01-07-2011, 12:03 PM   #49
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LuvSouth, what kind of "top up" insurance do you get before you travel to the US? How expensive is it?
This is "how" it works ...

We Ontarians have our own OHIP (Ontario Health ...) which covers out of province and out of country to certain limit.

Then we have our own employer's plan which tops up the OHIP.

If we didn't have employer's plan like a number of snowbirds, we simply purchase a top up plan from insurance companies specifically caters to Canadian travelers. The top up plan will kick in at mid night as soon as OHIP reaches the limit AND/OR private employer's plan expires.

The cost, I recall and depending on ages and pre ex conditions, for me is around $280 to $350 for 6 months for MY AGE, No pre ex conditions. Then I tried to make myself "older", the rate goes up to $500-800 for 6 months, again no pre ex conditions.

My advise: Travel when you are still healthy ...
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Old 01-07-2011, 12:05 PM   #50
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I tend to think patients will get the same quality of health care in both Canada and the US. They are both developed countries.
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Old 01-07-2011, 12:13 PM   #51
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I also think this is how it works and why it's cheaper for Canadian snowbirds to get top up insurance for 6 months, say.

Because Canada already has a good health care system as a foundation, when a visitor is admitted to hospital in the US, the top up insurance will pay for the cost beyond Canada covers. Once the patient is stabalized after a few days (for argument sake), he/she will be flown back to Canada to receive care which is cheaper.

So the top up insurance company does NOT have to pay for extended period of stay in US hospital for double/ridiculous US hospital charges.

That's why top up insurance quoted me CAD$280-350/6 months (no pre ex conditions), and CAD$500-800/6 months with increased age (older), again no pre ex conditions.

This CAN'T be done in the US if you are Americans as you Americans will have to stay in the US hospitals no matter what, and get charged ridiculously, hence you pay US$17,000/year to get insurance. It's ridiculous to Canadians ...
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Old 01-07-2011, 12:23 PM   #52
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This is in response to: Medical tourism or private hospitals in Canada

First of all, I agree no system is perfect including the health care system in Canada. Canada is notorious for it's long wait time. I don't know how long but occasionally it's like 8 week wait time to see a specialist, some times 4 weeks, 2 weeks ... depending on where and who and what ...

Having said that, if it's emergency, you will get treatment in Canada. Just to to ER of any hospitals in Canada.

Medical tourism: Well, we have the Canada Health Act which will punish ANY PROVINCE, Alberta in this case, for charging patient. Alberta learned a lesson from the federal government

In order to allow private clinics (which charge the patient directly), the federal government will have to change the Canada Health Act. Do you think it's so easy to change it ? Canadians highly value their own health care system and feel proud because they are protected by the Canada Health Act: Every one can access health care regardless how poor or rich they are, no queue jumping.

Whether you are Comrad Black or a common, you get the same treatment, that's the beauty of Canada !
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Old 01-07-2011, 01:36 PM   #53
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Here at Lake Chapala in Mexico about half of the snow bird visitors are Canadian, and they seem to share LuvSouth's astonishment that we U.S. citizens put up with our broken health care system. One of the problems, clearly, for we ER types is that the vast majority of the population still has employer-based group health insurance and so doesn't feel the pain of sky-high private insurance rates that are going up at ~20-50% per year.

You can get a sense of just how unique the U.S. is if you look for travel insurance from any number of sites. There are always two rates: one for "entire world excluding U.S." and another much higher rate for including the U.S. assuming your home country is elsewhere. When we return to the U.S. we usually buy insurance from World Nomads (.com) and that cost is one of the biggest factors that limits our time back home. A quick trip to the E.R. could easily cost 20 grand or more without insurance - enough to cover major surgery or cancer treatment down here.

Sadly the media in the U.S. seems to almost never report on this being a uniquely American problem that no other civilized country in the world will put up with. As the old bumper sticker says, "if you're not outraged, you're not paying attention."
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Old 01-07-2011, 04:19 PM   #54
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I would add from my long experience practicing in the US that during a more serious illness or those with numerous complications, nonroutine surgery, many expats choose to return to the US, mainly to be nearer to family and support systems. Practicing in both Fla and AZ, we saw many from Mexico, Central and South America. I don't know if that was because they felt the care here was superior, or rather for other reasons.

Be wary of those who assume that care is superior (better outcomes) in North America relative to other developed countries or in developing countries in local centers of excellence. The US no longer has a monopoly on quality or results.
This works in reverse as well: I have a friend who is from the UK and has told me his Plan B for cancer or other major illness is to return to the UK not just because of the cost but also for the family support system even though he thinks the quality of care could be slightly lower in the UK.

I have done no research myself nor do I have any personal experience with health care in the UK (which is more than a little surprising considering some of my adventures in the UK).
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Old 01-07-2011, 05:21 PM   #55
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Here at Lake Chapala in Mexico about half of the snow bird visitors are Canadian, and they seem to share LuvSouth's astonishment that we U.S. citizens put up with our broken health care system. One of the problems, clearly, for we ER types is that the vast majority of the population still has employer-based group health insurance and so doesn't feel the pain of sky-high private insurance rates that are going up at ~20-50% per year.

You can get a sense of just how unique the U.S. is if you look for travel insurance from any number of sites. There are always two rates: one for "entire world excluding U.S." and another much higher rate for including the U.S. assuming your home country is elsewhere. When we return to the U.S. we usually buy insurance from World Nomads (.com) and that cost is one of the biggest factors that limits our time back home. A quick trip to the E.R. could easily cost 20 grand or more without insurance - enough to cover major surgery or cancer treatment down here.

Sadly the media in the U.S. seems to almost never report on this being a uniquely American problem that no other civilized country in the world will put up with. As the old bumper sticker says, "if you're not outraged, you're not paying attention."
As said, private health insurance in the US is ridiculous ! And I express my sympathy to those who paid US$17,000/year and are facing a 10 or 15 or 20% rate hike every year.

I agee, as you said, it's a broken health care system in the US.

I can only suggest Americans talk to their congressmen/women when comes election time.

I suggest the following (I think it can be done):
- Put a cap on MDs, make it the law !
- Set guidelines to rule out UNNECESSARY procedures (so that Canadians are not treated like KINGS in US hospitals). This will scale back the costs in ER, in turn will reduce the private insurance rates.
- Introduce punishment to MDs who perform UNNECESSARY procedures. If caught, they will be fined heavily. This will stop them from milking the insurance companies, hence reduce the RIDICULOUS rate of US$17,000/year.
- Expand more public hospitals. This will slowly reduce the number of private hospitals as there are only a fixed number of patients/year.
- Scale back the salary of MDs. Introduce more ethic courses to MDs. MDs are to help patients, not to milk the insurance companies. I am sure a lot of MDs are not one of those bad apples who milk the insurance companies, hence a ridiculously high rate !

Why do Americans put up with this ridiculously high private insurance rate is beyond my and most Canadians' belief !

Good luck !
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Old 01-07-2011, 05:25 PM   #56
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Why do Americans put up with this ridiculously high private insurance rate...
So we can keep the street lights on in our National Forests.
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Old 01-07-2011, 05:26 PM   #57
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So we can keep the street lights on in our National Forests.
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Old 01-07-2011, 05:55 PM   #58
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From all reports care and costs in Thailand are exponentially better than here, but that's a very long trip.
My uncle retired to Thailand, and despite having Type 2 diabetes (controlled by diet), he pays under $2000 a year for medical insurance and is happy with the quality of care, though I've not intensively questioned him about it. He spent a lot of time in his career working and traveling in SE Asia and South America, so he may have a different set of standards than somebody who has lived in the US their entire life, but it is interesting to see for sure. Fits into some of my retirement scenarios.
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Old 01-13-2011, 02:28 PM   #59
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Message to LuvSouth: cool it, eh?

just edited ignore list.....
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Old 01-13-2011, 07:19 PM   #60
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...
I can only suggest Americans talk to their congressmen/women when comes election time.

I suggest the following (I think it can be done):
- Put a cap on MDs, make it the law !
I agree it needs fixin'. But...

Show me a case where price controls worked (in the long run, big picture view).

Quote:
- Set guidelines to rule out UNNECESSARY procedures (so that Canadians are not treated like KINGS in US hospitals). This will scale back the costs in ER, in turn will reduce the private insurance rates.
Define 'UNNECESSARY'.

Quote:
- Introduce punishment to MDs who perform UNNECESSARY procedures. If caught, they will be fined heavily. This will stop them from milking the insurance companies, hence reduce the RIDICULOUS rate of US$17,000/year.
See above.

Quote:
- Expand more public hospitals. This will slowly reduce the number of private hospitals as there are only a fixed number of patients/year.
And replace them with a monopoly? No thanks.



Quote:
- Scale back the salary of MDs. Introduce more ethic courses to MDs. MDs are to help patients, not to milk the insurance companies. I am sure a lot of MDs are not one of those bad apples who milk the insurance companies, hence a ridiculously high rate !
See comment on price controls above. Sure, some ethics courses will solve the problem, we should have sent Bernie Madoff to one, Everything solved.

Quote:
Why do Americans put up with this ridiculously high private insurance rate is beyond my and most Canadians' belief !
These ridiculously high private insurance rates are largely a RESULT of government intervention. Why be surprised when the group that was responsible for much of the problem isn't welcomed with open arms when they say "Hi! I'm from the Government and I'm here to help you"!.


Quote:
Good luck !
It'll take more than that. From what I understand, the Canadian govt system has some significant differences (not just two dominant parties - a HUGE difference, IMO) that make getting real solutions a bit more of a reality.

-ERD50
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