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Aug. 12th, 2008 02:38 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
jawnbcAlong with intense passion, love and respect, ![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
querrelle and I also share psoraisis. I mention this only because we, from time to time, slop on some steroidal creme when the condition is exacerbated. And he noticed last night that our current tub of the stuff seemed to have lost its potency. "No worries," I thought "I'll just get a renewal from Shoppers." And so I rang up, gave them the prescription number: I have no more refills left, but they'll call my doctor and I'll be able to pick it up tomorrow, if not tonight. How much will it cost us? Ultimately, nothing.
Which is entirely too unremarkable.
Canada, contrary to disinformation, does not have a public healthcare system: instead we have several mandatory public health care schemes. Each province and territory runs its own scheme, and there are schemes for Aboriginal persons and members of the Canadian Forces, all operarting under terms defined by the national Canada Health Act (CHA). The CHA's principles are mostly straightforward: there can only be a single-payer system and physicians who opt out of that system are excluded from providing care to persons who are covered. There can be no exclusions due to having any medical condition, and personal income does not entitle (or bar) anyone to receive a different level of care. Provinces or territories that fail to enforce the Act lose Federal funding as a result. The way costs are managed is that each scheme--Health Insurance BC here--sets how much insured services costs. And there are a number of instances where patients must try the most cost effective treatment first: if it doesn't work, authorization is required for more expensive ones.
Thus, if I need to go to my doctor, I pay nothing. If I need to go to the Emergency Room, I pay nothing. If I am hospitalized, I pay nothing, though I may be in a ward with up to 6 patients. I pay for none of the meds administered in hospital: they are also covered. As an aside: about 1/3 of the hospitals in BC are not government owned, but they do either opt-in or opt out. All are in, here in BC.
Prescription drugs costs are subsidized through bulk purchasing (the government of British Columbia effectively buying medications for its residents). Only senior and persons of limited means get free or reduced prescription costs, though here in BC after a certain annual threshold (a percentage of one's previous year's taxable income) of prescription expenses is reached the prices drop to about 10% of cost--or become entirely free. There are also special provisions for free medications for mental illness, cancer treatment (not side effects sometimes though) and HIV meds where those are dispensed free of charge. It is a bit more complicated than that, but that's the gist of it.
Even so, both of us have supplemental health insurance through our jobs. Mine covers 80% of prescriptions and most dental procedures;querrelle's 100%. The rules, however, mean I submit to my insurer first, then the other 20% is paid through his employer's scheme. Paradoxically, my scheme pays the 80% up front, while his requires paying out of pocket and being reimbursed. We also get vision, massage, physio, orthotics, fellatio, and makeovers. And a private or semi-private hospital room upgrade, if hospitalized in Canada. And $1,000.000.00 a year out of province/country traveller's health insurance. On each of our employer schemes. Recently Himself needed a crown and both our plans covered 50%. So we paid nothing.
None of this is really free, though. The supplemental coverage is a taxable benefit, so it does cost us each a bit--but more than pays for itself with the coverage we take advantage of. As for our public insurance scheme here in BC, it's funded by federal and provincial taxes and monthly premiums of around $100 a month for the two of us--though, again,querrelle's employer pays our monthly premium and its a taxable benefit. Tax-wise, I pay roughly 30% (a little less actually) in income tax to all level of governments here; were I still living in New York City the rate would be over 45%. Sales tax here is 12%; in NYC 8%.
But today, watching an old episode of Oprah, I remembered what my life was like before I came to Canada. I remember breaking my tail bone skating in 1988, riding the subway 40 minutes to a "better" neighbourhood with a better (private) hospital, waiting for 4 hours and being given a 1 month off from work note and a bill for $500. My employer's health insurance scheme back then was excellent--90% coverage--but I had to pay the bill and wait 4-6 weeks to be reimbursed. My take-home salary back then was about $1100 a month. But the hospital took Visa, which is telling in and of itself.
Last year my parents faced losing their entire savings--including their home--because of Ma's emphysema. Their "excellent" health insurance maxed out after one month of rehab: she was in for over 4 months. Parts of Da's diabetes care are only partially covered. Their insurance covered us all 100% for basic primary care when I was a kid--but when we were all healthy. It's when people get sick--and need their insurance to kick in--that the system becomes cruel.
Our system up here isn't perfect...but for the most part it suffers the same challenges all established democracies face: a lack of health care professionals willing to work in rural areas, a massive increase in the need for knee and hip replacements as the boomers' joints start going ka-boom, and the scumbag big pharma companies gouging everyone because ostensibly "research" is expensive, when in reality it's salespersons and marketing executives flying first class and eating surf and turf that adds costs to each pill or vial.
These very real challenges require innovation and creativity, things which are not wholly the purview of the private (profit-oriented) sector. In fact, waitlists in BC for many procedures are coming down. In neighbouring Alberta they've almost been eliminated, through government managed public-private partnerships. Under a single payer public health insurance scheme.
Health care is a human right. Not basic health care, or emergency care. Health care.
querrelle and I also share psoraisis. I mention this only because we, from time to time, slop on some steroidal creme when the condition is exacerbated. And he noticed last night that our current tub of the stuff seemed to have lost its potency. "No worries," I thought "I'll just get a renewal from Shoppers." And so I rang up, gave them the prescription number: I have no more refills left, but they'll call my doctor and I'll be able to pick it up tomorrow, if not tonight. How much will it cost us? Ultimately, nothing.Which is entirely too unremarkable.
Canada, contrary to disinformation, does not have a public healthcare system: instead we have several mandatory public health care schemes. Each province and territory runs its own scheme, and there are schemes for Aboriginal persons and members of the Canadian Forces, all operarting under terms defined by the national Canada Health Act (CHA). The CHA's principles are mostly straightforward: there can only be a single-payer system and physicians who opt out of that system are excluded from providing care to persons who are covered. There can be no exclusions due to having any medical condition, and personal income does not entitle (or bar) anyone to receive a different level of care. Provinces or territories that fail to enforce the Act lose Federal funding as a result. The way costs are managed is that each scheme--Health Insurance BC here--sets how much insured services costs. And there are a number of instances where patients must try the most cost effective treatment first: if it doesn't work, authorization is required for more expensive ones.
Thus, if I need to go to my doctor, I pay nothing. If I need to go to the Emergency Room, I pay nothing. If I am hospitalized, I pay nothing, though I may be in a ward with up to 6 patients. I pay for none of the meds administered in hospital: they are also covered. As an aside: about 1/3 of the hospitals in BC are not government owned, but they do either opt-in or opt out. All are in, here in BC.
Prescription drugs costs are subsidized through bulk purchasing (the government of British Columbia effectively buying medications for its residents). Only senior and persons of limited means get free or reduced prescription costs, though here in BC after a certain annual threshold (a percentage of one's previous year's taxable income) of prescription expenses is reached the prices drop to about 10% of cost--or become entirely free. There are also special provisions for free medications for mental illness, cancer treatment (not side effects sometimes though) and HIV meds where those are dispensed free of charge. It is a bit more complicated than that, but that's the gist of it.
Even so, both of us have supplemental health insurance through our jobs. Mine covers 80% of prescriptions and most dental procedures;
querrelle's 100%. The rules, however, mean I submit to my insurer first, then the other 20% is paid through his employer's scheme. Paradoxically, my scheme pays the 80% up front, while his requires paying out of pocket and being reimbursed. We also get vision, massage, physio, orthotics, fellatio, and makeovers. And a private or semi-private hospital room upgrade, if hospitalized in Canada. And $1,000.000.00 a year out of province/country traveller's health insurance. On each of our employer schemes. Recently Himself needed a crown and both our plans covered 50%. So we paid nothing.None of this is really free, though. The supplemental coverage is a taxable benefit, so it does cost us each a bit--but more than pays for itself with the coverage we take advantage of. As for our public insurance scheme here in BC, it's funded by federal and provincial taxes and monthly premiums of around $100 a month for the two of us--though, again,
querrelle's employer pays our monthly premium and its a taxable benefit. Tax-wise, I pay roughly 30% (a little less actually) in income tax to all level of governments here; were I still living in New York City the rate would be over 45%. Sales tax here is 12%; in NYC 8%.But today, watching an old episode of Oprah, I remembered what my life was like before I came to Canada. I remember breaking my tail bone skating in 1988, riding the subway 40 minutes to a "better" neighbourhood with a better (private) hospital, waiting for 4 hours and being given a 1 month off from work note and a bill for $500. My employer's health insurance scheme back then was excellent--90% coverage--but I had to pay the bill and wait 4-6 weeks to be reimbursed. My take-home salary back then was about $1100 a month. But the hospital took Visa, which is telling in and of itself.
Last year my parents faced losing their entire savings--including their home--because of Ma's emphysema. Their "excellent" health insurance maxed out after one month of rehab: she was in for over 4 months. Parts of Da's diabetes care are only partially covered. Their insurance covered us all 100% for basic primary care when I was a kid--but when we were all healthy. It's when people get sick--and need their insurance to kick in--that the system becomes cruel.
Our system up here isn't perfect...but for the most part it suffers the same challenges all established democracies face: a lack of health care professionals willing to work in rural areas, a massive increase in the need for knee and hip replacements as the boomers' joints start going ka-boom, and the scumbag big pharma companies gouging everyone because ostensibly "research" is expensive, when in reality it's salespersons and marketing executives flying first class and eating surf and turf that adds costs to each pill or vial.
These very real challenges require innovation and creativity, things which are not wholly the purview of the private (profit-oriented) sector. In fact, waitlists in BC for many procedures are coming down. In neighbouring Alberta they've almost been eliminated, through government managed public-private partnerships. Under a single payer public health insurance scheme.
Health care is a human right. Not basic health care, or emergency care. Health care.
