Thursday, October 03, 2013

A Discussion with Canadians About Healthcare

Over an incredible Mexican meal and several bottles of wine one night in Canada, Connie, her mom (who cooked incredible Tacos al Pastor), her mom’s partner Saul (the Mexican who detailed the recipe) and I discussed life in the UK versus life in Canada, via life in the US. It might be forgotten, but for 12 months I lived in the US and have first hand experienceof their healthcare. Connie grew up in Canada and all her life has suffered from a chronic illness (read her incredible blog post about it here) and since moving to the UK has dealt with the NHS with this illness, so between us we have a good experience of the healthcare systems in the three countries. Her mom too has health issues that Canada has dealt with, and her partner has horror stories about the Mexican system.

Before I write any more, a caveat: when in the US I had full medical coverage. Connie, as a Canadian, didn’t. This is important to colour our opinions.

This discussion came up not regarding the Affordable Care Act (or Obamacare) in the US, but in light of the US Government Shut-down currently taking place, and it’s relevance, I thought it might be interesting to write about and understand Canada’s healthcare system. I think there is a common misconception about Canada’s healthcare – at least, I had one. I think that majority of the UK understand it as if the Canadian system is the same as the UK system, but it’s not. The Canadian system is built on insurance just like the US system, but instead of it being covered by employers (meaning that the unemployed don’t have any) the insurance is actually backed by the Provincial Government.

The Provincial and Federal system is subtle, and probably alien to someone from the UK, but it’s actually quite simple. But what it means is that if you go out of your home province (like Connie’s brother Abe has done) you are actually not technically covered by your in-province healthcare. Of course, bi-lateral agreements exist between provinces to cover out of province healthcare, but it’s not like me rocking up to an English hospital and getting treatment, as some treatments are not covered out of province.

Also (and here’s the shocker) not all treatments are covered. For example, certain medications are not given under the insurance. Some healthcare options, like long-term treatments, or medications, are charged for. Before leaving the UK for Texas, a prescription would cost a couple of quid or £10 for unlimited fillings over a period of time. Upon returning, Scotland had made all prescriptions free. In Canada, you pay low prices compared to other countries, but you still pay for them – a single medication Connie used to take being $100 a month compared to £free in Scotland. And the same prescription bought in the US out of healthcare was $160. Mexico is a rather different story all together too.

When describing the NHS to Canadians, they couldn't believe how good it was. They get it, the idea of universal healthcare, but they don’t have the perfect system. They sit in the middle between the two poles of the healthcare system, it seems, but it is a lot better than the US. Once you take this reaction, it seems odd that when explaining healthcare to some sets of US citizens, they react aggressively and don’t want the universal system. They’d rather pay less tax and fund insurance, leaving those without the ability to cover healthcare with even less. A selfish view, to my eyes.

To me (a person someone recently described as a socialist, and meant it as an insult amusingly, misunderstanding various definitions) I find this abhorrent. I am a huge fan of the welfare state system, and welcome any move towards it. In fact, the more I look into myself and discover who I am politically, the more I find independence from the kind of thinking that threatens my long held healthcare and welfare wishes attractive, and thusly the more a Yes vote next year looks likely. I like Britain, but I hate the slide the Conservatives are starting and the promises made by the Scottish Government over independence more in line with my own feelings.

It is fun and makes me proud that when describing our healthcare to people that it sounds unreal, or fake, or even impossible, and their realisation it isn't this fictional system, and works as we describe it. And I’ve repeated many times before, I don’t think anything makes me happier to live in the UK than the NHS.


What a waffling ramble. Sorry about the unfocused post. Thought dump.

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