American with questions about Canadian health care

[Canuckistani]

Says something about the US medical system if people have US insurance and still make sure to keep up their Canadian coverage. Probably because the US coverage will have co-pays and previous condition exemptions. If they maintain residence in Canada, then they'll have to pay Canadian taxes on the US earnings, if the US taxes are less than what they would have paid in Canada.

[bush_cheney2004]

Except it's illegal. You must reside in BC for at least 180 days per year to be covered.

It may be illegal, but that doesn't mean they don't do it. 180 days = 6 months

[bush_cheney2004]

Says something about the US medical system if people have US insurance and still make sure to keep up their Canadian coverage. Probably because the US coverage will have co-pays and previous condition exemptions. If they maintain residence in Canada, then they'll have to pay Canadian taxes on the US earnings, if the US taxes are less than what they would have paid in Canada.

They have to do this to hedge their bets until getting that oh so coveted permanent resident Green Card.

[guyser]

Actually it does happen. Maybe you're just unaware.

Fraud? Yes

Any business has that problem. Your point?

[Canuckistani]

They have to do this to hedge their bets until getting that oh so coveted permanent resident Green Card.

Then it has nothing to do with medical systems but is an immigration matter. Just as Americans coming north will have to maintain their US coverage until they are eligible for Canadian coverage.

[Wilber]

It may be illegal, but that doesn't mean they don't do it. 180 days = 6 months

Exactly, you have to reside here for six months, not just nip over the border every six months.

[bush_cheney2004]

Then it has nothing to do with medical systems but is an immigration matter. Just as Americans coming north will have to maintain their US coverage until they are eligible for Canadian coverage.

It does to them. Loss of an employee sponsor means having to go back to Canada, so it is prudent to maintain provincial medical insurance eligibility and coverage. One guy explained the whole game to me in 2007...he ultimately got his green card. Another with a pregnant wife told me that they dreaded waiting for medical services back home, and didn't mind paying the deductible and co-pays for his American provider.

I work in the IT industry and meet lots of other nationals from around the world. They all have similar and different reasons for working in the USA. One of them is often quick access to medical services.

Edited December 14, 2012 by bush_cheney2004

[bush_cheney2004]

Exactly, you have to reside here for six months, not just nip over the border every six months.

Agreed...but clearly you can see how the scam works. It's not difficult to fake residency for six months.

[Wilber]

Agreed...but clearly you can see how the scam works. It's not difficult to fake residency for six months.

I'm just telling you what the law is. It's fraud and if you are caught it will be treated that way.

[bush_cheney2004]

I'm just telling you what the law is. It's fraud and if you are caught it will be treated that way.

OK...I will let them know !

[bush_cheney2004]

Since Canadian employees in the U.S. can get employer provided health insurance, what do American employees in Canada get? The shaft ?

Or do they have to buy health insurance in Canada?

[Canuckistani]

Since Canadian employees in the U.S. can get employer provided health insurance, what do American employees in Canada get? The shaft ?

Or do they have to buy health insurance in Canada?

If they are residents of Canada - ie here longer than 6 months, they get Canadian coverage - no xtra charge. In BC they would have to pay $133/mo for a family of 3+, unless they are low income.

[Wilber]

Since Canadian employees in the U.S. can get employer provided health insurance, what do American employees in Canada get? The shaft ?

Or do they have to buy health insurance in Canada?

That would depend on what kind of deal they had with their employer. Many employers have supplementary insurance. I'm sure basic ensurance is available for anyone who doesn't qualify for public insurance.

[bush_cheney2004]

If they are residents of Canada - ie here longer than 6 months, they get Canadian coverage - no xtra charge. In BC they would have to pay $133/mo for a family of 3+, unless they are low income.

OK...so Canadians can get insured immediately in the US, but Americans have to wait six months for coverage. And it is illegal to buy insurance for procedures covered by the province ?

[Canuckistani]

OK...so Canadians can get insured immediately in the US, but Americans have to wait six months for coverage. And it is illegal to buy insurance for procedures covered by the province ?

No, since they are not covered. It's illegal for a doctor to provide service under the govt coverage and also have a private practice. He can go all private if he wants, but not many do.

[bush_cheney2004]

No, since they are not covered. It's illegal for a doctor to provide service under the govt coverage and also have a private practice. He can go all private if he wants, but not many do.

Well, there have to be many thousands of people in Canada who are not covered. "Universal coverage" is a myth!

[Canuckistani]

Well, there have to be many thousands of people in Canada who are not covered. "Universal coverage" is a myth!

Who are these people - recent arrivals. They have to arrange for transitory coverage until they are covered by the govt plan. That's nothing like your what is it 12% of legal residents who are not covered. Just that if you move to Canada, you have to be aware you would need coverage until you are deemed a resident.

Edited December 14, 2012 by Canuckistani

[guyser]

Well, there have to be many thousands of people in Canada who are not covered. "Universal coverage" is a myth!

Probably many thousands.

We call them tourists.

There are millions not covered in the usa .

They're called citizens.

[Canuckistani]

Probably many thousands.

We call them tourists.

There are millions not covered in the usa .

They're called citizens.

You said it better than I did.

[Wilber]

OK...I will let them know !

Perhaps you should. As border service computers become more and more integrated, it will be, if it isn't already, very easy to look at who spent how much time in either country. As services get more strapped it is only a matter of time before government agencies come looking for that information in search of tax revenue and fraud. I keep track of the amount of time I spend in the US as I get asked regularly at the border. I get the impression it is a test because I am pretty sure he already knows. Same coming back to Canada when I am asked when I left. I never try to BS them.

[Moonlight Graham]

Unfortunately, I'm not going to give all of your questions the depth that they deserve, but I'll give you some brief answers that reflect my opinion only

Lots of great info cyber, thanks. You seem to know a lot about the system.

You bring up a good point about overuse. I haven't seen a triage nurse suggest to anyone that they just go to a clinic. If you go to an ER, they will see you. However, they do have posters all over the waiting room that list the walk-in clinics in the city. It's heavily implied, but I don't think they can turn you away.

Wow I can't believe a triage nurse wouldn't suggest a clinic (in your experience). It makes sense that they can't turn you away, but you can often get into a clinic much faster than in the ER (at least in my city), especially for non-emergencies, so the suggestion would be helpful for patients. I think a big issue is once business hours are over most walk-in clinics close, so the ER is the only choice for many after 4pm. My family doctor has an after-hours clinic we have access to which helps the burden of ER wait-times.

Sometimes it's covered, sometimes it's not. If you're checked into the psych ward at a hospital because you're on suicide watch or something, it is covered by medicare. If you personally decide to go see a psychologist or psychiatrist, it's not covered. I'm not sure, but I think it may be covered if you're referred by a family doctor though. Again, meds are not covered. So if you're prescribed Zoloft or something, you'll pay out of pocket.

Hospital psych ward is free. Seeing a psychiatrist/psychologist based in hospital as an out-patient is also free. Many psychologists/psychiatrists with a private practice aren't covered, even if you have a referral, but you can find ones that are covered/free. Certain institutions like universities/colleges will offer free counseling services also.

Most prescription meds for any medical needs can be covered by provincial plans (like the Trillium Drug Program: http://www.health.gov.on.ca/en/public/programs/drugs/opdp_forms.aspx) if you have a low enough income, you just pay a deductible based on your income.

[Moonlight Graham]

Also, to everyone and anyone on MLW who suffers from health problems, or knows someone close who does, I wish you all good luck in recovery and good health.

[cybercoma]

I think that the fact that wait times are not monitored by most people to be a great concern. They make good copy for the media if they increase drastically. If they increase slightly nobody seems to know or care.

Since we don't have an open marketplace with competitive providers, it's incumbent on citizens and experts to monitor the system. They don't. Canada has an unfortunate culture of acceptance when it comes to monopolies, and we have done very little to demand better. This needs to change IMO.

I don't have the study readily handy, but when researchers interviewed people across the country about health care those that had been through the system gave it a great rating. Those that haven't used the system very much were the ones that gave it the lowest ratings. The authors suggested that much of the "problems" people think we have with our system is more related to their fears about the system not being there for them when they need it. Meanwhile, those that do need it and are in it have very few negative things to say about it.

[cybercoma]

My biggest problem with our system, is people that live outside of Canada, that only come back for medical care. And that nobody knows just how much things cost, they just know that it's generally paid for.

That's funny. When I was out of the country for a year, I came back and had no medicare until the waiting period expired.

[Michael Hardner]

I don't have the study readily handy, but when researchers interviewed people across the country about health care those that had been through the system gave it a great rating. Those that haven't used the system very much were the ones that gave it the lowest ratings. The authors suggested that much of the "problems" people think we have with our system is more related to their fears about the system not being there for them when they need it. Meanwhile, those that do need it and are in it have very few negative things to say about it.

I'm not sure what to do with this story. I guess I'd like to see a continuous study of people who'd been through the system - publish regularly and categorized by type of visit - that would be good.

Even better would be for the average person to name this survey - or some institution that regularly surveyed healthcare - immediately when asked how they measure the performance of the system. That would be really great.