Health Care: Big Yellow Taxi Edition

I have always been a proponent of universal health care.  I think we in Canada have a pretty good system.  I personally have never experienced difficulties or unnecessary delays and take pride in the fact that although it is not perfect, at least everyone has access to care here.

However, I did not realize how much I valued health care until recently.  My husband and I are planning on moving to the U.S. for him to go to school this fall.  With the move comes visa wrangling, trying to find housing from afar, coordinating travel plans with friends, and working through the emotions that come with leaving family (especially the older members) for extended periods of time.  On top of all of this, we are also in the midst of the quest for health coverage, which so far has seemed the most daunting.  And here’s why:

If you plan on being outside of the province for longer than 3 months you need to apply to see if the province will still acknowledge you as a citizen and cover you under the provincial plan.  However, even if they do decide to cover you, it only extends as far as what you would get in-province (i.e. if you go to a doctor in the U.S. and they charge $150, the province will only reimburse $30 – the cost of a doctors visit here).  So, regardless of whether or not you have this provincial health coverage, you still need private insurance to help with the rest.

After talking with local private insurance companies I have had to navigate such topics as:

1)      Deductibles – Most are set at $100 (I have found one plan that has no deductible but is more expensive and you still have to deal with topics #2-4).  So if something costs under $100, it comes out of your pocket and if it is over, you still pay the first $100.  Therefore, that doctor’s appointment that cost $150 will still cost you, the patient, $100;

2)      Pre-existing conditions – I understood that this would be the case with most private insurers, I just didn’t know how far it would extend.  If you go to the doctor with a cold it will be covered (well, after the deductible issue is dealt with).  However, if you go to the doctor again because you are still sick with the same cold you are no longer covered because it is now considered a pre-existing condition;

3)      Exclusions – If I happen to get pregnant during our 2 years away I should probably just come back to Canada.  For most private insurers my coverage would be null and void (essentially) because nothing pregnancy related will be covered outside the province and I assume that a lot of health related things could be connected to a woman’s pregnancy;

4)      Reimbursements – This is understandable (you have to do this even if you are in another province most of the time), it is just crummy.  All costs have to be paid upfront and a claim sent to the insurer.  So, even if you do get reimbursed a small amount of your $150 doctor’s appointment, you still have to be able to pay it all upfront and wait for the return.

So, with all of these things floating around in my head I have come to appreciate Canada’s health care system even more.  I have never had to worry about having enough money to cover potential health concerns that may arise, managing “pre-existing conditions”, and trying to avoid getting pregnant (for insurance reasons that least), and I don’t think anyone should have to. 

I think for a lot of people with complaints about our health care system, it may be a case of “you don’t know what you’ve got until it’s gone”.  We take for granted the system that we have in place and do not fully understand the grim reality that exists without it… and I have just hit the tip of the iceberg.