Some Thoughts on “Universal” Health Care

Since the various (mostly Democratic) Presidential candidates have been yammering on about the need for “universal health care” in our country, I thought it might be instructive to share with readers just how such a “universal” system works (or rather DOESN’T) work in another nearby country.

It’s called the Canadian Health System. And while so-called “universal health care” does have many positive aspects, my family’s personal experiences with such a “universal” system have shown that it is FAR from the “nirvana” people south of the border sometimes make it out to be.

First of all, the “free” Canadian Health System only covers basic health care. While it does cover routine doctor visits and so-called “emergency” care visits to a hospital or clinic, the number of doctors available in the system is strictly controlled (spelled “limited”). So, finding (or keeping) a family doctor is sometimes all but impossible. And, by law, there are no “private” doctors or clinics in Canada (except in Quebec…. plus, of course, for Members of Parliament)! And, if you are hospitalized for any length of time, having just government medical coverage means you’ll share a ward with several other people.

Most Americans might also be shocked to learn that prescription drugs are NOT covered in Canadian’s government-provided health care benefit unless you are age 65 or older! It is true that prescription drugs DO cost a bit less in the drugstores in Canada than in the United States. But, in order to get prescription drug coverage (and other such “extras” like a semi-private room in a hospital), most Canadians still must purchase expensive health insurance to “top up” their basic government coverage.

Also, since Canada’s universal medical system is funded largely from provincial and federal sales taxes, if you happen to be out of the country for more than 180 days at a stretch, you are assumed to not be contributing your “fair share” to the system. At that point, your eligibility for benefits is subject to cancellation until you once again establish residency in Canada. You then have to wait upwards of another three months in order to get back into the system. God help you (and/or your wallet) if you get sick during that time and need medical care!

What’s more, your Canadian health coverage is only good while you are in Canada. If you travel south of the border (or overseas) and need medical assistance while you are out of the Country, you must either purchase extremely expensive one-time “travel insurance” to cover these potential medical costs before you leave, or risk paying for that care (usually at the “non-insurance” (full) rate if it’s obtained in the USA) from out of your own pocket. And, if you take more than 5 prescriptions per day (and/or are over 80 years old), good luck in getting insurance that is anywhere near affordable. In most cases you can’t get it…at any price.

And while the general quality of medical care in Canada is excellent, GETTING IT in a timely fashion is something else again. In some provinces, the waiting time for a routine MRI can stretch upwards of six to eight months. My brother-in-law recently endured nearly a year of excruciating pain while waiting for major back surgery. And my wife’s grandson recently had to endure almost four months of intense pain caused by complications from waiting for a hernia operation. In the interim, he couldn’t work

Likewise, waiting times for non-life-threatening surgical procedures can be even longer.

A while ago, a good friend of mine in Canada met with his family doctor simply to set up an input appointment with an orthopedic surgeon for knee replacement surgery. That was in November of 2005. At that time, the first available input appointment with an orthopedic surgeon was for April…in 2007. Needless to say, he re-arranged an extended family vacation to make absolutely sure he was in town for THAT appointment! What’s more, as of today (January, 2008) he’s STILL WAITING for his knee operation to be performed.

Fortunately, my family and I are covered by US medical insurance on the US side of the border. However, my doctor here reports that fully one quarter of his patients are now Canadians coming across the border…and paying cash…. to get their medical care from him. That fact, alone, speaks volumes!

Now, granted, millions of people in the United States still don’t have health insurance. But, if you are truly ill and in need of urgent care, you won’t be turned away from a hospital emergency room in the USA simply because you can’t pay.

Unfortunately in Canada, even some people WITH both government and private supplementary health insurance are, quite literally, DYING while waiting for THEIR so-called “free” health care.


  1. JoyfulC

    Sorry, Keith, but I have lived in Canada since 1982, and during all these years, my husband and I (both skydivers) have had the misfortune to find ourselves at the mercy of the health care system more times than we would have preferred. We also are good friends with many jumpers south of the border who have suffered similar accident track records.

    Our view of the Canadian health care system is top notch. Now, mind you, we only access it when we really truly need it. It’s never for something elective or optional. In every case, we’ve literally had to be scooped up off the hard ground and deposited in the ER in pieces.

    Other than that, we’ve had a few incidents where we’ve needed the services of a family physician. Our biggest hassle in this instance is that, because we so rarely need a family physician, by the time we get back to one, they’ve moved on. A few years back, we connected with a guy who was willing to carry us forward with him from the initial clinic into his private practice. We really like him, but I suspect most people wouldn’t, because he seems to have the approach that humans can generally heal themselve in most situations. And that’s for sure true with Fred and me. We took Fred in with strep throat a few years back, only because we had been indoctrinated to believe that strep throat had to be treated by a doctor. Our guy wrote Fred a prescription for an antibiotic, but told him to hold onto it for a few days before he had it filled — and only to have it filled if he wasn’t feeling better. Sure enough, a few days later, Fred was fine and the prescription got torn up and went in the trash.

    I dunno. I like that in a physician. Generally we’re not the types to run to a doctor over each and every little thing. Neither of us has ever had a flu shot. We’re so healthy that, at the ages of 49 and 58 last year, we moved and did all our own moving — packing, loading and unloading the truck, setting everything up. Last June, Fred went out to the neighbours and helped them get their hay up before the rain fell — and all our neighburs assumed that he was younger than all of them. In reality, he’s a good ten years older, at least.

    The biggest problem with the Canadian health care system isn’t the system itself but probably some of its users. We know a woman who went to the ER when she had a bad headache to get better drugs than she could buy off the shelf. (And we can buy codeine OTC here — not that I’m sure you’d want to.)

    In the US, it seems like because it’s profit driven, there’s ample health care for all the wrong things (plastic surgery, erectile dysfunction treatment, etc.) and inadequate healthcare in areas where it counts the most, like prenatal and pediatric care.

    Someone asked me years ago if I thought that health care was a right. No, I don’t. I think it’s a responsibility — one that we owe one another. It’s to our own benefit that we ensure that mothers have good prenatal care, and that children have good healthcare. It’s to our own benefit that we have universal healthcare to reduce costs of disability and prospects for epidemic. Our healthcare system in Canada is quite good — it’s certain individual Canadians themselves who could stand to pull up their socks.

  2. keith


    In a word…no.

    US Citizens do not require a Visa to visit Canada. That means you CAN come and go as “visitors” to the country indefinitely. But, you have to keep leaving periodically in order to come back.

    And, as a “foreign visitor”, when you arrive at the border, the first questions the Canadian Customs and Immigration people will ask are, “What is your citizenship, where are you going, how long (and with whom) you will you be staying, and when do you plan to leave?”

    So, at some point, if you want to do all the things that living in a country requires (like opening a bank account, renting or purchasing property, getting a license to drive, and/or purchasing and registering a vehicle) then you have to be “landed”.

    And, in order to be “landed” (and unless you qualify for refugee status), you have to either have someone there who can sponsor you (like a spouse or other close relative), OR you have to have something to offer Canada (such as a skill or trade) that Canada needs. The idea here is that you have to prove you won’t become yet another burden on their welfare system.

    Furthermore, in order to live permanently in their country, the Canadians will also want to know if you have a past history of criminal activity. So you’ll have to be fingerprinted, and copies of those fingerprints will have to be sent off to the FBI, as well as the State Police in each of the States you may have lived in the past 10 years. Needless to say, a criminal record…of any kind…is a disqualifier.

    What’s more, and as I said, you ALSO have to take and successfully pass that intrusive physical exam to prove that you won’t become a burden on their medical system.

    The bottom line here is that, even though we share an “open” border with our neighbors to the north, as with the USA, “just anybody” can’t walk across the Canadian border and set up a more or less permanent domicile.

    If you plan to stay, the Canadian authorities will want to know that you aren’t a criminal and that you won’t become an immediate burden on their welfare and medical systems without “pulling your weight” financially.

    Oh..and one other thing…you’ll need to leave your firearms and weapons behind as well.

  3. ekaton

    Keith, is it possible to live full-time in Canada without “landed immigrant” status?

    — Kent Shaw