3 ms·

Why does Canada not have private healthcare? I kind of like systems like uk or Norway where there is a free system providing the floor and a private system if y

Why does Canada not have private healthcare? I kind of like systems like uk or Norway where there is a free system providing the floor and a private system if you want better treatment. Both the Canadian and the U.S. system is a bit weird to me.

msbarnett 4y ago
Broadly speaking, this is opposed in Canada by some due to the perception that the existence of a private parallel system will be weaponized to undermine the public system, as many feel has happened to the NHS in the UK.
- lbrito 4y ago
  I'd say they have a point. Brazil, where I've lived most of my life, has had its single payer public Healthcare modeled after the UK, and the private healthcare sector which is supposed to be a "complement" to the "universal" public system, is instead parallel to and competing with it. This competition probably is an erosive force. Public Healthcare absorves the heaviest blows: expensive surgeries, cancer treatment etc are mostly or only done by the single payer public system, while private Healthcare enjoys mostly low severity cases.
  - cnasc 4y ago
    > Public Healthcare absorves the heaviest blows: expensive surgeries, cancer treatment etc are mostly or only done by the single payer public system, while private Healthcare enjoys mostly low severity cases. If there was no private system, the public system would pay for all of that. What you’ve described actually seems like it goes easier on the public system by allowing it to specialize on certain kinds of issues
    - lbrito 4y ago
      Except it doesn't; the public system also handles basic stuff like vaccinations, free medicine, first response, "walk-ins" etc. It has to maintain a huge infrastructure to keep those services - Brazil is a huge and extremely diverse country. The basics are actually the thing it does best; covid vaccination for example went well once the political stuff was handled.
      - cnasc 4y ago
        > It has to maintain a huge infrastructure to keep those services It seems like the ceiling here is the amount of investment it would put in to manage 100% of the health needs —- I don’t see how the parallel existence of a private system causes the public system to be larger than it would be if there were no private system
novok 4y ago
It does exist, it's just you completely have to pay out of pocket, and if you opt out of it as a doctor, you cannot take any public healthcare system patients either, which means your limited to a few rich people 'executive health' checkups and such. It's a complete either / or system. 'benefits' that cover the few items not covered by the public system also typically do not cover such non-public doctor visits either. Usage is so rare that most Canadians are unaware of such things. Canada has a family doctor crisis because they barely pay them, flat out. Often a pure family doctor doesn't even hit $200k, so any med student today is going to go some specialty route. It needs to equalize with walk-in clinic rates or it will continue to not have good supply.
- nicoburns 4y ago
  $200k!! (presumably Canadian Dollars, which works out at ~£126k). Here in the UK a typical GP salary is ~90k, and while we do have trouble retaining doctors that is almost entirely due to working conditions (hospitals and practices are understaffed so medical staff end up overworked). I've only very rarely heard doctors complain that they are underpaid. I can definitely see that rates ought to equalised across different medical career paths though.
  - stormbrew 4y ago
    I'm not really sure about other parts of the country (health care delivery is a provincial responsibility so beware any "health care in canada is X" take: they likely really mean Ontario or maybe Quebec or BC), but the part I live in (Alberta, home of #3 on this list) has a family doctor crisis that's more complicated than just yearly pay. It's a combination of: - A government that is outright hostile to health care workers, including fighting a battle against their unions during covid to reduce pay. The health minister famously went to a doctor's home and berated him from the driveway for tweeting something negative about him. Again, during the pandemic. - Some specific changes to the pay schedule for doctors that makes it very difficult for them to spend more than 15 minutes with any given patient without losing out on income. - The introduction a teledoctor system that pays better but most of the people on the other side of it don't live or work in the province. And that's ignoring other kinds of medical workers, where they've done various things to force specialists to take on fewer patients, cut nursing headcounts to the bone, etc. Every medical professional I've interacted with for the last few years (even before the pandemic) has seemed exhausted and on the verge of packing up and leaving.

msbarnett 4y ago

Broadly speaking, this is opposed in Canada by some due to the perception that the existence of a private parallel system will be weaponized to undermine the public system, as many feel has happened to the NHS in the UK.

lbrito 4y ago
I'd say they have a point. Brazil, where I've lived most of my life, has had its single payer public Healthcare modeled after the UK, and the private healthcare sector which is supposed to be a "complement" to the "universal" public system, is instead parallel to and competing with it. This competition probably is an erosive force. Public Healthcare absorves the heaviest blows: expensive surgeries, cancer treatment etc are mostly or only done by the single payer public system, while private Healthcare enjoys mostly low severity cases.
- cnasc 4y ago
  > Public Healthcare absorves the heaviest blows: expensive surgeries, cancer treatment etc are mostly or only done by the single payer public system, while private Healthcare enjoys mostly low severity cases. If there was no private system, the public system would pay for all of that. What you’ve described actually seems like it goes easier on the public system by allowing it to specialize on certain kinds of issues
  - lbrito 4y ago
    Except it doesn't; the public system also handles basic stuff like vaccinations, free medicine, first response, "walk-ins" etc. It has to maintain a huge infrastructure to keep those services - Brazil is a huge and extremely diverse country. The basics are actually the thing it does best; covid vaccination for example went well once the political stuff was handled.
    - cnasc 4y ago
      > It has to maintain a huge infrastructure to keep those services It seems like the ceiling here is the amount of investment it would put in to manage 100% of the health needs —- I don’t see how the parallel existence of a private system causes the public system to be larger than it would be if there were no private system

novok 4y ago

It does exist, it's just you completely have to pay out of pocket, and if you opt out of it as a doctor, you cannot take any public healthcare system patients either, which means your limited to a few rich people 'executive health' checkups and such. It's a complete either / or system. 'benefits' that cover the few items not covered by the public system also typically do not cover such non-public doctor visits either. Usage is so rare that most Canadians are unaware of such things. Canada has a family doctor crisis because they barely pay them, flat out. Often a pure family doctor doesn't even hit $200k, so any med student today is going to go some specialty route. It needs to equalize with walk-in clinic rates or it will continue to not have good supply.

nicoburns 4y ago
$200k!! (presumably Canadian Dollars, which works out at ~£126k). Here in the UK a typical GP salary is ~90k, and while we do have trouble retaining doctors that is almost entirely due to working conditions (hospitals and practices are understaffed so medical staff end up overworked). I've only very rarely heard doctors complain that they are underpaid. I can definitely see that rates ought to equalised across different medical career paths though.
- stormbrew 4y ago
  I'm not really sure about other parts of the country (health care delivery is a provincial responsibility so beware any "health care in canada is X" take: they likely really mean Ontario or maybe Quebec or BC), but the part I live in (Alberta, home of #3 on this list) has a family doctor crisis that's more complicated than just yearly pay. It's a combination of: - A government that is outright hostile to health care workers, including fighting a battle against their unions during covid to reduce pay. The health minister famously went to a doctor's home and berated him from the driveway for tweeting something negative about him. Again, during the pandemic. - Some specific changes to the pay schedule for doctors that makes it very difficult for them to spend more than 15 minutes with any given patient without losing out on income. - The introduction a teledoctor system that pays better but most of the people on the other side of it don't live or work in the province. And that's ignoring other kinds of medical workers, where they've done various things to force specialists to take on fewer patients, cut nursing headcounts to the bone, etc. Every medical professional I've interacted with for the last few years (even before the pandemic) has seemed exhausted and on the verge of packing up and leaving.