My Impression Of The Canadian Healthcare System
Stanley Feld M.D.,FACP,MACE
Cecelia ad I just returned from a trip to
Halifax, Cape Breton Island and Prince Edward Island. It was a phenomenal trip.
It was too early in the fall season for the
trees to turn color but the weather was great and the countryside was glorious.
We had planed to go there 49 years ago on our
We did not have time to get all the way to
Halifax, Cape Breton or Prince Edward Island. We had to drive back to New York
City to start my medical internship on July 1st. 1963.
Cecelia and I decided it was time to go for it.
We stayed in Port Hood on Cape Breton for five
days, enjoyed the singing and dancing and had a wonderful drive around the
I am a friendly guy and I was curious about how
the folks on the street like the Canadian healthcare system. I was tired of
listening to the Democratic Party’s propaganda.
The propaganda contradicts Canadian and former
Canadian physicians feeling about the system.
I spoke to a lot of people in the town we visited
about their feelings about the Canadian healthcare system.
I came away with several impressions.
Dr. Kurisko practiced surgery in Canada before coming to the
United States to practice surgery.
Dr. Kurisko description
of the Canadian Healthcare System is very accurate. It reflects the feeling of
the people who have need to use the system.
Canadians are comfortable
with their medical entitlement. Everyone said they like the fact that if they get sick
they will not get “wiped out” by the costs as Americans might be.
I found a You Tube about the
Canadian system with responses of the common man. It clearly expresses this
This is the impression of a
group of people. The question is the possibility of a bias in selection of the
Upon deeper questioning of
the people I spoke to, my conclusion is that once people get used to a medical
entitlement they are very hesitant to give it up even if it restricts their
freedom of choice. Only 20% of the population uses the healthcare system at any one time.
The second conclusion is
that this is the way the healthcare system is in Canada. Canadian feel they must
live with it and get over complaining about it.
The things they did not like
about their healthcare single payer system is the very high sales tax in
addition to federal and provincial taxes.
The income tax baseline is lowe than
the U.S. and the income earned at the top rate of tax is lower than in the U.S. If you combine all taxes paid the rate is above 50% for some income brackets and at least 30% for
the lowest income bracket.
I was not aware of the fact
that the sales tax on everything in Canada is 15% in addition to business taxes
and personal income taxes. There is both
a province tax and a central tax on purchases.
Up to $41,544 15.00%
41,545–83,088 22.00 %
83,089–128,800 26.00 %
128,801 and over 29.00 %
Everyone pays federal
income tax in Canada. Fifty percent of U.S. citizens do not pay Federal income
In addition to federal
income tax each province tax is slightly different Below are a few examples.
Up to $36,146 5.06%
36,147–72,293 7.70 %
$100,788 and over 14.70%
10.00% All income
Up to $40,919 11.00%
$116,912 and over 15.00%
Up to $37,774 5.05%
$75,551 and over 20%
Up to $37,150 9.10%
$74,301–120,796 12.40 %
$120,797 and over 14.30%
Up to $29,590 8.79%
$150,001 and over 21.00%
We visited Halifax, Nova
Scotia and Charlottetown, Prince Edward Island but spent most of our time in
The long waiting times to
see a physician in the office and in the ER was a constant complaint.
The people complained about
the shortage of physicians. Their impression was that a lot of physicians fled
to the U.S. causing the physician shortage.
There were few small towns
with physicians. Bigger towns had small hospitals and physician shortages.
Larger towns had tertiary hospitals. These hospitals were full service hospitals.
These hospitals rationed care
The emergency rooms of any
size hospitals are always jammed. Sometimes you can wait for 6 hours and not
see a physician taking care of anyone.
One lady told me she had a
tremendous stomachache. She went to the ER waited more than 6 hours without
anyone in the ER seeing a physician. After 6 hours the pain started to subside.
She was so fatigued she went home.
I guess that is one way to
cure a patient. It took her 4 days before the pain to subside.
Another complaint was
follow-up visits by a patient with her own physician. The patient was a 65-year-old
diabetic female. Her physician was diligent. He wanted to see her every three
months. She could only get an appointment in 5 months.
One 55-year-old male with
heart disease said the healthcare system has been fine for him. He calls his
cardiologist at home. He is an interesting case and the cardiologist will see
him the next day.
Many complained about the
waiting time for special test such as CAT scans and MRIs, hip and knee
replacements and cardiac catherizations.
Waiting times for hip and
knee replacements can be more than one year.
The Fraser Institute released
a report outlining the government financial difficulties with the Canadian healthcare system.
“A 2011 report by the Fraser Institute concluded that
Canada’s health care system is spending at an unsustainable rate. Six of ten
Canadian provinces are on track to spend half of their revenues on health care,
according to the institute.”
that Canada’s health system produces rates of growth in health spending that
are not sustainable solely through redistributive public financing,” the report
I think it is about time Americans paid attention to
Obamacare. It will be worse for all.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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