Moms Rising just came out with a great myth busting fact sheet. As a Canadian, I would like to tell you a little about the myths that are circulating and pepper them with a dash of reality from my experience with the public health care system and what I have heard from some of my friends and followers about the American system.
Myth #1: I will be denied the health care services that I need
People seem concerned that in a public health care system, they will be denied services that they need. While there are certainly some isolated cases of, for example, new experimental procedures not yet being covered by the public health care system, for the most part everything you could possibly need is covered. It is as simple as that. If your doctor sends you to a specialist, it will be covered. If the hospital operates, it will be covered. Most doctors have a list posted on their wall of things that involve an extra fee and those are usually optional personal needs (e.g. getting certain vaccinations for a trip overseas, having a detailed physical done and forms completed for a job-related health check, having the doctor fax or call in a prescription renewal to your pharmacy because you neglected to go for a follow-up appointment in time to get a renewal).
But in the United States, with private health care, things you thought were covered may not be as @blm03 found out the hard way. Or, in other cases, it may not be a surprise to find out that something you need or your child needs is not covered by insurance, but it sucks nonetheless. @blm03, like many others, has found that procedures, specialists and therapies that her kids need are not covered by insurance because they are a result of a preexisting condition or are not considered a medical necessity. In other cases, as @hippytrish told me via e-mail, there are waiting periods before you are eligible:
For most insurance plans, they won't pay for a birth or prenatal/postnatal care until you have had the plan for at least 9-12 months, depending on the company and plan. So if you happen to get pregnant when you first get insured with a new job, expect to pay the entire cost of birth and prenatal care out of pocket, which is probably around $10,000 these days. If you end up with a c-section, obviously it's more. And you have to pay it all.
In Canada, there is no issue of preexisting condition or waiting periods between jobs and your doctor decides what is a medical necessity, not the insurance company that is trying to protect its bottom line. We do have private dental insurance instead of public in Canada and I have experienced these same frustrations. Things not being covered, only being partially covered, and getting estimates from the insurance company of what they will cover that are impossible to decipher, resulting in surprises when I submit the claim.
Personally, I like knowing that if my doctor says something is needed or even desirable, that it will be covered.
Myth #2: I will be put in a queue and may die or suffer while waiting for service
The nice thing about the public health care system is that people are seen based on how urgent their health issue is, not based on how shiny their insurance card is. So when you see a doctor, go to the emergency room, or need an appointment with a specialist, you will be seen first if your situation is the most urgent. You won't be seen first because you have better insurance.
@BreastfeedingM was concerned that her child would have died in a country with public health care. She wouldn't have gotten the quick care that she needed in a life threatening situation. I have sat in an emergency room in Canada, waiting for my turn. I waited, writhing in pain, with a sprained ankle while people with life threatening situations that came in after me got triaged quickly and taken right in to a doctor. Not people with better insurance, people with a better credit history, people with a doctor that had more pull. No, just people who had a more urgent health situation than mine. A few hours later, I had my x-rays taken and was sent home with crutches and pain meds, happy that the people whose situation was more urgent that mine got seen before I did.
I did wait in line that time in the ER and have other times when my situation was less urgent than others. But when I go to my doctor's office for an appointment, she is generally running on time. Often, if I show up a bit early, I even get in early. That stands in contrast to what some have told me about the United States, like this tweet from @hippytrish:
Unlike in the United States, as pointed out by @fentonslee, Canadian clinics and hospitals won't ask for prepayment of medical services .
You also do not need to fear that a trip to the hospital will bankrupt you. Via e-mail, @kunsthure said "When I was still working as a paramedic before becoming a SAHM, I had patients having heart attacks that didn't want to go to the hospital because they didn't have insurance and couldn't afford the bill". Or in other cases, people will find that their medical bills are piling up due to the co-pays, deductibles, and so on, and at some point they may have to decide not to undergo certain medical treatment because they just can't afford it anymore despite having insurance.
In Canada, if you need to see a doctor, even if your bank account is empty, your credit cards maxed out, and the creditors beating you down with a stick, you will get to see a doctor. And the bill will not be in the mail. Health care is a right, not a privilege. Health care is there to make you healthier or to save your life, not to bankrupt your family.
Myth #3: It is too expensive
Americans worry about paying more taxes. They worry about the cost of socialism. They worry that people who don't work and don't pay taxes will be getting health care on their dime.
First of all, there are plenty of uninsured people getting health care in the United States and are unable to pay the bill. That raises the costs of insurance for those that are insured.
Second, it is much less expensive to keep people healthy than it is to pay for emergency procedures for those that haven't been taking care of themselves. When you have a public health care system, there is a greater imperative for the government and society to work on health promotion to prevent health problems. Things like ensuring women have support for breastfeeding, helping people to quit smoking, battling the food industry when it packs our food full of crap, those are all issues that are public priorities. They aren't seen as simple personal choices. Because these things impact the health of our population, they impact the cost of delivering health care services, and it makes sense for the government to go to bat for its citizens and create an environment that helps them to take care off themselves.
Third, in a public health care system, there is no incentive for hospitals or doctors to do more expensive procedures for personal financial gain. Sure, our c-section rate is higher than it should be, but it is nowhere near as high as in the United States. You don't have to wonder when your doctor recommends a procedure, whether it is truly in your best interest or just a way to put more money in his bank account.
Lastly, in our public health care system there is an incentive for the government to take actions (regulatory or otherwise) to keep the costs of health care as low as possible. In the United States, according to @kunsthure:
As a result, costs are driven up and also insurance companies lobby doctors to convince them to prescribe cheaper alternatives to drugs in order to keep their costs down. So patients either end up with very expensive meds or the wrong med.
But you don't need to believe my anecdotal evidence. Just look at the United Nations data on per capita health expenditures by country. In Canada, our expenditures are US$3173 per person. In the United States, they are US$6096. That is almost double the cost despite the fact that there are not significant differences in the health of our populations (a joint Canada-U.S. study in 2004 found that 88% of Canadians and 85% of Americans reported being in good, very good or excellent health).
There are more stories, many more stories, about the injustices people have faced in the American health care system. Canada's public health care system is not perfect. There are problems, but they are run of the mill problems compared to the horrific situation of lack of coverage, dismal coverage and skyrocketing costs in the United States. To read more about the human stories behind the American health care crisis, check out Health Care Stories for America.
Are you scared of a public health care option for the United States? If so, what scares you about it? What would you like to know about the Canadian system?