News   Sep 20, 2019
 868     3 
News   Sep 20, 2019
 653     2 
News   Sep 20, 2019
 1.5K     2 

Universal Health Care - Still Not Possible in US

Northern Light

Senior Member
Member Bio
Joined
May 20, 2007
Messages
4,261
Reaction score
3,854
Location
Toronto/EY
Even crossing the Niagara River to shop at Buffalo? What happens should you have an incident on the American side and end up in an American hospital?
Yes.

I think the challenge for me is that the system has huge gaps domestically. Ontario doesn't yet cover out patient cancer drugs for the working age population. They can range from $6,000 to a large multiple thereof.

We don't cover the full cost of medical devices. (hearing aids, wheelchairs, sleep apnea machines).

Dental is an obvious gap.

Also physiotherapy for working age adults isn't covered and can add up in a hurry.

Covering all of that should surely take priority over enabling some cross border shopping or sight seeing.

The cost of travel insurance of a one-day trip to the US is modest. (if you're not a senior, an overnight trip is about $30, 9 random days over a year, about $70).

The burden of buying the coverage for travel is much less than living in Ontario and having to pay for a root canal or cancer drugs.
 

PinkLucy

Moderator
Staff member
Member Bio
Joined
Jun 10, 2009
Messages
7,082
Reaction score
3,026
There are often programs available. My husband wears hearing aids, and although the initial price is quite high, it gets knocked down through various rebates, some of which are income-dependent, others not. My BIL required some expensive chemo, but was told that although it wasn’t covered by OHIP, no one ever actually pays for it because of various programs, and it was indeed all covered. Do we have 100% coverage on 100% of medical costs? No, but there is assistance available, and it’s far better than uninsured people in the US have.
 

Northern Light

Senior Member
Member Bio
Joined
May 20, 2007
Messages
4,261
Reaction score
3,854
Location
Toronto/EY
There are often programs available. My husband wears hearing aids, and although the initial price is quite high, it gets knocked down through various rebates, some of which are income-dependent, others not. My BIL required some expensive chemo, but was told that although it wasn’t covered by OHIP, no one ever actually pays for it because of various programs, and it was indeed all covered. Do we have 100% coverage on 100% of medical costs? No, but there is assistance available, and it’s far better than uninsured people in the US have.
Hearing aids are covered under the medical device program, up to 75%. However, the cap is something like $500 of coverage per hearing aid, and a typical set of hearing aids is closer to 2k.

For out patient cancer drugs, there is the Trillium Drug Benefit.

But the way its structured you still have to pay out of pocket, then get reimbursed. Its also sliding scale.

Suffice to say, our gaps are partially papered over, which is better than the situation for uninsured Americans or many poorly insured Americans, but it certainly isn't adequate.

Studies show 3.5M Canadians have difficulty filling prescriptions due to cost.

My point was merely these issues should be remedied completely, or at least much more completely before we discuss having OHIP cover the tab for travel insurance.
 

PinkLucy

Moderator
Staff member
Member Bio
Joined
Jun 10, 2009
Messages
7,082
Reaction score
3,026
I agree OHIP shouldn’t cover travel costs. In some cases, travellers are covered through their credit cards. Both my brother and my SIL had accidents while out of the country (on separate occasions) and VISA picked up the tab.
 

Admiral Beez

Senior Member
Member Bio
Joined
Apr 28, 2007
Messages
7,265
Reaction score
1,541
Even crossing the Niagara River to shop at Buffalo? What happens should you have an incident on the American side and end up in an American hospital?
My VISA card has travel insurance for that, plus I have 60 days out of country insurance with Sunlife through work. My wife works for the TDSB, and she gets travel insurance at a discount after retirement.

I'm my role as an export manager I travel a lot, so I make sure my insurance is solid. Even so, when I was in Kuala Lumpur in August I made sure not to get sick or put myself under a Proton.
 

Admiral Beez

Senior Member
Member Bio
Joined
Apr 28, 2007
Messages
7,265
Reaction score
1,541
Even traveling within Canada (outside of Ontario) requires travel insurance. What's wrong with this picture?
Not really, almost any emergency event is covered.

https://www.ontario.ca/page/ohip-coverage-across-canada#section-1

What’s covered elsewhere in Canada
When you show your valid Ontario health card in another Canadian province or territory, you will be covered for some of the same services you’re covered for in Ontario including:
  • physician services (e.g. visit to a walk-in clinic)
  • services provided in a public hospital (e.g. emergency, diagnostic, laboratory)
Any service or treatment you receive in another Canadian province or territory must be medically necessary for it to be covered by OHIP.

What’s not covered elsewhere in Canada
Services that are not covered by OHIP in another Canadian province or territory include:
  • services not covered in Ontario (e.g. cosmetic surgery)
  • ambulance services (including transport and paramedic)
  • prescription drugs and other drugs given outside a hospital
  • home-care services
  • fees charged by private hospitals or facilities
  • diagnostic or laboratory services outside of a public hospital
  • long-term care or residential services
  • assistive devices (e.g. prosthetics)
We recommend that you buy private health insurance before leaving Ontario to cover any uninsured services you may need.
 

PinkLucy

Moderator
Staff member
Member Bio
Joined
Jun 10, 2009
Messages
7,082
Reaction score
3,026
What isn't universal about our coverage is distance and travel. When I lived in rural Northern Ontario, if you needed anything other than a GP, a dentist or an optometrist, you had to travel. And that was after waiting six months for an appointment. Even for kids' braces. We used to receive a travel grant to help offset the costs, but for some people it was a real hardship -- a day or two off work, gas or bus fare, meals and sometimes accommodation. Motels near hospitals offered discount rates which helped. There have been some improvements over the years with chemo offered in smaller, more local hospitals, and some diagnostic equipment like CT scans, but it can still be a struggle. I really noticed the difference when I moved to Toronto and had all of the medical services I needed close by and with relatively quick access.
 

Northern Light

Senior Member
Member Bio
Joined
May 20, 2007
Messages
4,261
Reaction score
3,854
Location
Toronto/EY
What isn't universal about our coverage is distance and travel. When I lived in rural Northern Ontario, if you needed anything other than a GP, a dentist or an optometrist, you had to travel. And that was after waiting six months for an appointment. Even for kids' braces. We used to receive a travel grant to help offset the costs, but for some people it was a real hardship -- a day or two off work, gas or bus fare, meals and sometimes accommodation. Motels near hospitals offered discount rates which helped. There have been some improvements over the years with chemo offered in smaller, more local hospitals, and some diagnostic equipment like CT scans, but it can still be a struggle. I really noticed the difference when I moved to Toronto and had all of the medical services I needed close by and with relatively quick access.
True, though, we should add there are geographic inconveniences in most parts of the world that are not very densely populated. Though that fact doesn't make it any less a hardship for those lacking money/time/job security or who have mobility challenges.

Northern Ontario will get a boost in this regard when the hospital in Kenora is replaced. That will bring the first MRI between T-Bay and Winnipeg. There will be other new/enhanced services as well.

Though there will still be many large gaps.
 

lenaitch

Senior Member
Member Bio
Joined
Sep 5, 2017
Messages
1,029
Reaction score
697
My former bargaining unit (I'm retired) now offers out-of-province insurance coverage as an included benefit. It used to be available for a fairly modest fee. Heck, before I turned 60, there wasn't even a questionnaire. Although traveling to another province won't break the bank if you get injured, there are a few fairly high 'co-pay' fees. Some provinces charge $200-300+ for ambulance and you will only get reimbursed $45 by OHIP. The problem with many of the insurance carriers is their first answer to a claim is often 'no' then you have to tangle from there.

I agree that, with all of the challenges and wish list items, out-of-province insurance is not a public policy issue. So long as you are halfways healthy, the cost is relatively minimal. I'm sure many of us have seen, heard about or experienced US medical bills. I was recently researching a drug the wife is prescribed. Up here it runs 3 - 4 cents a pill; down in the States it's 40. We have come to accept our health care system as a quasi-public service. In the US it is big business.
 

PinkLucy

Moderator
Staff member
Member Bio
Joined
Jun 10, 2009
Messages
7,082
Reaction score
3,026
Northern Ontario will get a boost in this regard when the hospital in Kenora is replaced. That will bring the first MRI between T-Bay and Winnipeg. There will be other new/enhanced services as well.

Though there will still be many large gaps.
I’m a Northeastern Ontario alumna. Thunder Bay was 12 hours away

But even a 3 hour drive to Sudbury means a day off work

And then there is winter ...

Nothing is perfect, and it was just a way of life. I didn’t realize it was an issue until I came back down south.
 

Northern Light

Senior Member
Member Bio
Joined
May 20, 2007
Messages
4,261
Reaction score
3,854
Location
Toronto/EY
I’m a Northeastern Ontario alumna. Thunder Bay was 12 hours away

But even a 3 hour drive to Sudbury means a day off work

And then there is winter ...

Nothing is perfect, and it was just a way of life. I didn’t realize it was an issue until I came back down south.
May i ask where in the North-East?

I know MRI has made it to North Bay and Pembroke.

Of course there are a host of other services that have not, and still a bit open space between those 2, or going north.
 

lenaitch

Senior Member
Member Bio
Joined
Sep 5, 2017
Messages
1,029
Reaction score
697
Hearing aids are covered under the medical device program, up to 75%. However, the cap is something like $500 of coverage per hearing aid, and a typical set of hearing aids is closer to 2k.

For out patient cancer drugs, there is the Trillium Drug Benefit.

But the way its structured you still have to pay out of pocket, then get reimbursed. Its also sliding scale.

Suffice to say, our gaps are partially papered over, which is better than the situation for uninsured Americans or many poorly insured Americans, but it certainly isn't adequate.

Studies show 3.5M Canadians have difficulty filling prescriptions due to cost.

My point was merely these issues should be remedied completely, or at least much more completely before we discuss having OHIP cover the tab for travel insurance.
The missus just got a single digital hearing aid last week (she is soooo thrilled). With audiology test, dispensing fee, yada, yada, it was $2300+. OHIP covered $500.
 
Top