I went to the doctor yesterday

[TrogL]

I had a question about one medication and wanted a refill on another one.

Doctor: Yes, I'll refill this one but when was the last time you had a cardiogram?
TrogL: (hesitates)
Doctor: That's too long. Let's do some standard blood work while we're at it. (ticks a bunch of boxes)
TrogL: I noticed a thing about testosterone on your wall - what's that all about?
Doctor: Oh, good idea. (tick, tick)

So he's asked for an ECG, CBC, urinalysis, glucose, creatine, cholesteral, testosterone (am and pm) and a bunch of other stuff that's just acronyms - 13 things in total. He's not test-happy - my previous doctor would have ticked half-a-dozen more.

My cost (including the doctor's visit) - $CAN 0.00 including GST.

What's that going to cost in the States?

[Laelth]

1. You make me very jealous. And sad. n/t

:dem:

-Laelth

[glowing]

2. About 3 or 4 different offices, $15-$30.00 in co-pays to GP, then a fee for the

3 to 4 specialists and one trip for bloodwork.. that means a co-pay of $30-$50.00 for each specialist.. (my lab work is a freebie, some I think have to pay $10.00).. Then $15.00-$20.00 to go back to the GP for the results.. and then a round of prescriptions if anything is wrong.. and there are co-pays there.. All the while, shelling out $450.00/ month for coverage.. and this is with an employer based healthcare plan.

[Sub Atomic]

9. And don't forget, one of those tests will somehow be found to be for a

pre-existing condition that you never knew you had. Then you'll spend in excess of a year fighting with the insurance company for them to pay it. That is, if you don't give up and pay it yourself first.

[xxqqqzme]

3. I don't know about the other tests,

but I had a blood work up to check creatine after I had a severe reaction to a drug last summer. That test was $1,021.00

[FoyF]

4. My HMO charges $25 co-pay for Office visit...

nothing extra for the lab work.

[mscuedawg]

5. Would cost my family $25.00 for office visit ... $0 for labs...

...my husband is retired US Navy...we have TriCare.

People should really be upset about gov't run healthcare...

:sarcasm:

[nyc 4 Biden]

6. Not to long ago I had a similar experience with my doctor...

But I live in the US...

My doctor said she believed I had a herniated disc in my back and gave me a bunch of scrips for various tests, mri's etc.. When I went to get the MRI they said my insurance denied it. I received a letter saying I should take some pills for a couple weeks instead. I guess MRIs are more expensive. Meanwhile I was in constant pain. And I thought I had a great healthcare plan from the company I work for. I never took the medicine they recommended, and just gave up on fighting them because it is too draining. Luckily I found that yoga helped decrease the pain dramatically. Hopefully the next time I need healthcare, it can also be remedied with my gym membership.

[MADem]

7. How much of your income do you pay in taxes? You pay--you just don't pay at

point of sale. And if you're not rich, or middle class, someone rich pays a bit for you.

He must suspect you have an issue if he's testing you for this, that and the other, when all you wanted was a question about a medication and a refill? Are your meds rough on your liver?

We'll find out how much it will cost people when we have a decent health care plan.

That wouldn't cost me much. A small co-pay. But I have 'government' insurance.

[TrogL]

10. I think it's mostly routine stuff

I think most of this you're supposed to have done about once a year especially if you're my age (mid-50's) and one medication is deprecated if your heart's acting up.

Income tax - 27% (estimate)
Goods and Services Tax - 5% (does NOT apply to some items eg. groceries)
Provincial Sales Tax - 0% (higher in other provinces)
Alberta Health Care Insurance Plan - 0% (it used to be something like $34/month but waived on a bewildering variety of circumstances - employer normally paid it for you anyway)

Optional stuff (Blue Cross) - covers ambulance, home nursing, private room, dental, ortho, drugs, walkers etc.

Enhanced Prescription Drug Fam 80.40 (Employer kicks in $32)
Enhanced Dental Plan Family 48.00 (Employer kicks in $100)
Enhanced Extended Medical Fam 47.10 (Employer kicks in $20)

[MADem]

12. I am confused--you have "optional" insurance? Ambulances and drugs aren't covered?

Nor is home nursing? Or am I reading you wrongly?

A lot of people have a false impression that everything, from soup to nuts, is covered in Canada. Need an ambulance? Free. Need home health care? Free. Drugs? Free.

Are those optional/enhanced costs annual ones, or monthly? What does "enhanced" refer to?

I have a relative in Canada who gets very nice care, but did have a badly degraded hip and was in a wheelchair waiting for a replacement. He ended up doing the "medical tourism" route and combining a vacation with a hip replacement--otherwise he would have spent the winter on drugs in a chair, waiting his turn.

[TrogL]

15. Not everything is covered and there are wait times

The Canadian system is by no means perfect and there are some deficiencies.

I was at an NDP event earlier in the week and Jack Layton said the next big thing in Canada is going to be "pharmacare" - a plan to make up a lot of that deficiency. Due to the bizarre nature of Canadian politics no matter what party gets in the next election (tentatively October 24th or November at the latest), in order to keep the other parties happy (that's where most of the :crazy: shit happens) they'll have to do something towards this goal.

Canada has a much larger social safety net than just AHCIP (or the local equivalent). They tend to pick up the slack if you're actually in trouble.

AHCIP (or equivalent) pays for (among other things):

doctor visit including specialist

hospital stay in emergency or basic ward (ie not semi-private or private, see below)

medications while in hospital (they often send you home with some as well)

eye exam (but not the glasses themselves)

diagnostic imaging (most common cause of wait times - there's not enough MRI techs)

surgery, anesthetic, dressings, blood and other fluids, oxygen

casts (there's a $1 fee for some bizarre reason)

If you need crutches, you pay a deposit for the crappy wooden kind or if you need them long term, the Red Cross has a different program.

If you're considered handicapped, you qualify for Alberta Income for the Severely Handicapped, then everything's free. If you're on social assistance, everything's free. If you're a Treaty Indian, everything's free.

Most employers of shops larger than about 20 people automatically sign you up for the supplemental insurance (and co-pay the premiums). Blue Cross is the largest but there are a few other companies, all large - lots of opportunity for economy of scale.

That gets you ambulance (not sure why it isn't covered), semi-private room etc. as well as eyeglass, dental and drug plan with reasonable (eg. 80%) co-pay. Some employers opt for the 100% plan so everything's free. Guess mine's cheap.

I'm not sure what the situation is with nursing homes. I know my great-aunt lived to be 102, at a minimum the last 10 years in a nursing home and I don't remember anybody saying a word about what it cost.

Overall, in the Canadian system there are so many overlapping areas of safety nets, that if you truly need help, it will be there in some form or another.

[MADem]

21. I certainly agree that the essential care is there.

I was just surprised at the optional insurance. Is that a once-a-year cost, or every month?

Who will win the next election, do you think?

[TrogL]

23. It's taken out monthly but probably a yearly cost

As to "winning" the next election, perhaps a brief introduction to the wacky world of Canadian politics might be in order.

Canada is a Parliamentary system (similar to Britain's). The election is won by a political party. The head of that party becomes Prime Minister and ostensibly "leads" the country although that leadership is primarily ceremonial - he has no real power at all. There is no equivalent to a President. The Queen signs documents but merely as a formality - the one time she was asked not to the controversy went on for the better part of a year.

There are four main parties.

Conservative - Republican-lite, conservative social, Reaganesque economics (assuming they get away with it which they don't)
Liberal - Centrist but ties to big business, liberal social, Keynesian economics
New Democratic Party (NDP) - left, left, left (they're the ones responsible for the Canadian health care system)
Bloc Quebecois - Quebec nationalists (with no real mandate), all-over-the-place, haven't gotten that far in their thinking

When the Liberals have a charismatic l eader (eg. Trudeau) and good policy wonks (eg. Chretien) they can usually form a majority government and get something accomplished. Currently they have neither.

When the Liberals have managed to get "mud on their face" (name that tune) they go down to defeat and the Conservatives (or whatever the right-wing party is called this week (amusingly, "CRAP" at one point)) often with a minority government, which is when the real fun begins :popcorn:.

In a parliamentary system, the government is in place until it either falls on a Motion of Non confidence or it decides it wants to hold an election (there is a law now in place that mollifies that slightly, but the Conservatives immediately broke that law so :shrug:). But...

...in order to keep "in power" a minority government has to make consessions, and more consessions, and MORE consessions to the point where the NDP (with the least number of seats) is passing bills and the Conservative government's own supporters are up in arms because Harper's turned into a closet Keynesian and saying "if this is what we get for 'winning' an election I'd hate to see what happened if we lost".

So who's going to "win" the next election? I'd say the NDP.

No, I'll never shake hands with Prime Minister Jake Layton (not that I haven't shaken his hands enough times and I have shaken PM Chretien and Martin's hands) - his economic ideas are so "out there" that they make my born-again Communism look like Reganomics, but he's not perceived as having any ties whatsoever into the current economic meltdown, all the health care noise downstairs is making people take a fresh look at some of his ideas for Canada and the NDP is gaining seats in key ridings, especially in Alberta.

I see a minority government - probably Conservative and probably a repeat of the previous scenario:

a lot of social conservative noise with no action

a lot of noise about Reaganomics masking a Keynesian policy to keep the Liberals happy

something on healthcare copied from the NDP playbook

some more bones thrown to Quebec

....unless....

...the Liberals suddenly get a charismatic leader (I don't think what's-his-name is if I can't remember his name - Ignatioff??) and a playbook from hell...

...unless....

hell freezes over

the Bloc Quebecois gives up in disgust

the Conservatives get mired in a juicy political scandal (sex won't do it - Harper could parade in full drag on the steps of Parliament and all that would happen is he'd get invited to the Rocky Horror Show)

the Canadian public still hasn't forgiven Chretien (don't ask why that's relevant - this is Canada :shrug:)

Jake Layton actually listens to his handlers and keeps some of his wilder ideas under his hat

...at which point who knows what Canada might look like.

[MADem]

30. Heh. I actually do understand the system--I was wondering who'd

end up being the Head Cheese (as it were). My pals are saying Harper (who smells way too much like Bush to me) has it in the bag. I haven't been following along, though!!

[Posteritatis]

32. The bag's not as simple up here, fortunately

As the post you replied to said, if Harper wins a narrow minority or something the other parties will be leaning on him nicely. The big issue these days is that people are annoyed enough at politics in general up here (the liberals being rudderless, the conservatives being explicitly Republican, the NDP being, well, insane at times) that they don't want an election at all yet, so the concept's backburnered for a bit.

[MADem]

34. Hmmmmm. Interesting! nt

[TrogL]

33. Depends if the Conservatives (or Liberals) have a leadership review

If nothing changes, I'd say more of the same, Harper getting yelled at by Jack while Michael sits there looking smug.

[dflprincess]

8. Depends on what kind of insurance some has

and whether or not they had reached their deductible plus the max out of pocket expense.

More and more people are getting stuck with policies that would require them to pay this out of pockt if they hadn't met the deductible. And, had they gotten that far, they might get nailed for at least 20% of cost if they hadn't hit their max out of pocket expense (deductibles are not generally applied to out of pocket totals - go figure)

[Hav]

11. .

I'm by far no medical expert and most of the tests you mentioned sound important and reasonable but by the way you described it, I felt that their might be a downside to it, too. If doctors do just about every test that comes to their mind just because the insurance company covers it, at one point, when more and more money is lost every year, there will come the time when there has to be a change. Maybe something like diagnose related groups or that a doctor only gets a fixed amount of money he can spend on a patient because some abused the system. I saw that happen myself.

I hope people don't get me wrong. I'm living in a country with what conservatives call "socialized medicine" and I definitely know to appreciate it.

[TrogL]

13. I was actually surprised at how few he ticked

Even my previous test-happy doctor wasn't doing anything all that unreasonable or the Canadian College of Physicians and Surgeons would be on his case.

The thing is, it doesn't make him any money prescribing more tests. He gets paid only for the office visit. Doctors here (IIUC) aren't allowed to have a financial stake in labs, or if they do, that's the business they have, not dealing with patients.

[xchrom]

14. as the years go by --

we need those blood tests to provide a body of background information.

it's sad -- but a fact of living.

what's awful is those blood tests often then set us up in conflict with our insurers.

we can't HELP getting older -- and we are all treated -- often -- as though the fact of aging is our fault.

[high density]

16. A big problem with US costs is that people with no insurance pay the highest price

What I mean is that most insurance companies have negotiated rates with providers. A person off the street with no coverage might pay $150 for a blood test while an insurance company would only pay $50 for the same test.

[gita]

17. What about the propaganda given regarding people and their docs,

as well as wait time? Can you changed docs if unsatisfied, and do you have a long wait for a normal appointment? What about dental and eye care? Is Canada single-payer? Do you think America can still keep insurance companies and have health care at your quality level.

Oh, and have I asked you enough questions?

[PolNewf]

22. Canada is single payer for ~70% of everything

and all the serious stuff. We have supplimental employer benefit plans from private insurance companies for the other stuff such as the dental, eye care (minus the exams which is covered), misc other medical expenses. Typical coverage is 80%-100% depending on plan. All out of pocket expenses are tax deductable.

The doctor thing is the funniest argument I've seen from Republicans. You can go to any doctor, anywhere, anytime and for any reason. Doctors are private practice, they choose their patients. Government involvement entails receiving the bill from the doctor.

[TrogL]

26. My experiences

I just switched doctors because I moved to a different part of the city, the old practice appeared to be breaking up and the one doctor of the two, yes two that I normally saw was test-happy and prone to prescribing the expensive "perfect" drug for the condition instead of something I could get in generic.

My current doctor runs out of a "walk-in" clinic that has about 10 doctors on staff and is open evenings and weekends including Sundays. If you need to see a doctor and aren't choosy (any can prescribe an antibiotic for a sinus infection, something I'm prone to) and don't insist upon showing up and rush hour, you'll be in within the hour. If and only if you insist upon seeing your own doctor you can book an appointment within a day or so. But doctor's aren't perfect so (and even if you're the first appointment of the day) most people's "15 minute appointment" tends to drag on a bit so your "3 p.m. appointment" is pretty much fiction, but you will get seen.

Your best bet is to find out when you doctor's regular "walk-in" hours are, get there early and get your name on the list. They usually see people in order ....

HOWEVER!!! When you get there, the nurse asks what your problem is. If it's something crucial, you're going to get seen right away (and damn the people with appointments), and if it's anything the doctor can't handle right then, right there you're going to hear sirens and see white coats and get a nice (helicopter if it's bad enough) ride to the hospital to get it taken care of. Oh, and don't get really uptight about the ambulance bill 'cause it's the city that bills for it (why?!?!??) and if it doesn't look like they're going to be able to collect they'll usually see if they can get someone else to pay for it (the province often does) or just write if off if it's a one-time-shot. I've only hear one case of it going to collection and I don't think it worked.

Dental and eye care you're on your own, which is why most rational employers will negotiate a group contract with Blue Cross or equivalent. You can't do your work if your teeth hurt or you can't see what you're doing. I believe all the unions have plans as well if individual employers serviced by that union don't. You can also buy individual plans at an affordable rate but the deductable is higher or they only cover to a certain amount. Prescription and ortho, same story.

The one big glaring hole in the Canadian health care system is mental health services. Psychiatrists are covered, but they're so busy (or so inclined), most are just pill-pushers. Psychologists are NOT covered by basic insurance. Again, however, the secondary social net takes over. Arrangements will be made to associate you with an out-patient clinic. If you're suicidal, a friendly concerned police officer will be at your door within 2 minutes assuming he beat the ambulance, fire truck, social worker and on-the-road-outpatient-nurse-person also on the way. If your case is serious enough, room will be found for you in a regional psychiatric facility.

As to America keeping its existing system - as it stands it won't work. The Canadian system works because it's economy of scale and hierarchy of need vs. greed.

Some of it, also, has to do with the Canadian mindset (and one theory says, the mindset of all cultures in the Targa climactic zone eg. Scandinavia, Siberia, Great Britain). To quote Red Green, "keep your stick on the ice - we're all in this together".

[JuniperLea]

18. About $30 in copays for me...

Which would be $20 after I pay with pre-tax FSA funds.

[busymom]

19. Do judging from your description

He ordered unnecessary tests and they were free?

[TrogL]

28. He ordered the tests he felt were necessary and didn't have to worry that I couldn't pay for them

...because they were all covered under the affordable provincial health care system.

As to "unnecessary" the Canadian health care system encourages proactive treatment - nipping problems in the bud before they turn into something nasty that does becomes a drain on the system.

I'm getting to the age where testosterone levels start dropping off, causing problems such as "hot flashes" (yes, men get them too) hence "good idea"

creatine is something to do with liver and kidney, last I heard they were "necessary" to good health. Dialysis is expensive (but covered)

it'd be nice to know if creepy crawlies are wandering around in my blood :sarcasm:

it'd be nice to know if I'm pissing white blood cells :sarcasm:

considering I haven't had my heart monitored since about 4 years ago when I pulled my intercostal muscles all to hell and throught I was having a heart attack (and jumped right to the front of the line at emergency) and on a medication that affects heart rate, it's probably a good idea to have a boo :sarcasm:

it'd be nice to know if I've got an undiagnosed case of diabetes before I go blind :sarcasm:

it'd be nice to know if my cholesterol level is so high I'm walking a cheeseburger considering my father died of a stroke :sarcasm:

He didn't tick off the pregnancy test even though I tried to talk him into it, nor did he tick most of the other 60 boxes on the form.

[grantcart]

20. No idea without isurance you would be a fool to find out that you had a pre existing condition

[tomm2thumbs]

24. ... I was nervous to hear the ending, ie bottom line

good set up and thanks for posting that story.

nice ending

[newinnm]

25. Nothing for me.

Zero..Zip...Zilch...Nadda

[proud patriot]

27. with insurance my sons bills are mostly from tests

We owe so much just keeping this child stablized .

[tammywammy]

29. I just signed up for health insurance with my new company this week.

Is this all routine preventative testing? Then it would cost me nothing, other than my whopping $13/week I'm paying for all my insurance (and I mean all, health/dental/vision/term-life/etc). I have no co-pays.

[Honeycombe8]

31. My ins. co. would never approve so many tests. nt

[and-justice-for-all]

35. Well let me call the bank to see if they will loan me the cash to pay for it...

I'll get back to you.