Experiencing Medical Care Overseas: An Inspiring Medical Reality

I recently returned from the Greek Isles on a cruise vacation that started in Venice.  My wife and I sat down next to a couple at dinner from Canada, and we began to swap stories.  The conversation gradually turned to health care, and then it got very interesting.

Our new Canadian friends Ashley and Chris pay 18% income tax a year, plus another 13% sales tax for public services including their health care – a total of 31%.  (Actually it’s a little less than 31% because they don’t spend everything they make, and hence are not taxed the full 13% sales tax on all their income). In fact, they’ve never spent a dime on sickness or wellness.  Everything’s covered from congestion to cancer.  They wanted to know what it was like in the United States.

I started by letting them know our federal and state taxes (combined) are usually around 25% .  We do pay a sales tax of an additional 7% for a combined tax rate of about 32% (or a little less, because we don’t spend everything we make either). 

For roughly the same amount of tax, they get free health care coverage, and we do not.  In fact, I informed them that my wife and I have spent more than ¾ of a million dollars in out of pocket costs on health insurance and an occasional visit to the doctor.

They were shocked.  “That would bankrupt us,” they said.  (They actually turned white at the realization.)  We told them we were lucky, and had good enough jobs to pay the nearly $20,000 a year in health premiums and deductibles, and still live a nice life. Many in the U.S., we informed them, DO go bankrupt as a result of medical costs. (More than 10,000 Americans each month file bankruptcy due to medical bills, or an inability to work because they can’t get care.)  “Well, that’s something we’ll never have to worry about,” Ashley and Chris agreed with relief. 

“But what about getting services when you need them?” we asked.  “We’ve heard you sometimes have to wait a long time to get what you need.”  They looked at us with puzzled faces.

“If you’re condition is not of an immediate need, like a future knee replacement that is not acute, then you will have to wait your turn. But if your need is reasonable, like you have broken arm or a fever, or a sore throat, you can get seen immediately by one of many clinics near your home.  It’s same-day service, really.” 

Oh, by the way, Canadian free medical services include pregnancy and delivery coverages, all hospital charges, eye care, chiropractic services, and even massages if you want them.  

“Diseases are often discovered earlier here too.  Instead of holding out on going to a doctor because of the cost, we can go with any concern and get it dealt with early on.”

We also learned everyone receives 1 year of maternity or paternity leave at 55% salary, or at their option, can have 100% child care services covered for one year if they choose to go back to work.

I asked, “How do the doctors like your system?”

“They’re happy,” said Chris.  They can spend a lot more time with you.  They’re paid to care, not make money.”

***

The next day I sprained my ankle on a hike on the island of Crete.  When I got back to the ship, I sought out the medic on board, and hoping to get an ankle support band to contain the swelling, along with ice and ibuprofen.  “We better take X-rays to rule out any break,” said the doctor. 

The woman ahead of me was after some medication for a condition she did not share with me.  She was informed her doctor’s visit would be $40.  “I’m not used to paying for this, you know.  I’ve never paid for any medical services.”

“Where are you from?” the attending nurse asked.  “Canada,” she responded.  She was a bit shocked that her medical need would cost her a whole $40.

 “I suppose you’re used to this,” she said, now talking to me.  I replied, “Yes, we’d pay 4 - 5 times that just to see the doctor, without the medication.  Her jaw dropped.  “Thank God I live in Canada!” she said.

Before walking out the door, the woman said, “They scare you there, don’t they, telling you they can’t afford to provide medical care for all of you.  But they’re wrong.  Yes, we pay a little more in taxes for it, but it’s worth it.  I don’t see why your government doesn’t allow it.”

I did the math and figured out if I had the chance to pay a sales tax of 13% instead of 7% over my working life, I would have saved more than $550,000 in medical costs.

My three new friends were dumbfounded, trying to grasp the draconian practices of delivering health care in the United States.  And they were delighted that their country, at least where health care was concerned, was one of compassion, caring, and sensibility.