Everything You Need to Know about Canada Health Insurance

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It is not just the Great White North, the home to polar bears, and where everyone lives in igloos (they don’t, really). Canada is also home to a unique system of publicly funded medical coverage. Canada health insurance has an interesting history, and can be supplemented by private insurance coverage. It is most often compared side by side with health insurance in the United States, and common criticisms center around high wait times for both routine and emergency services.



Publicly Funded

The health care system in Canada is a publicly funded universal health care system. It is free for all citizens and immigrants to apply for. The quality of care is controlled by the federal government, with small differences between provinces. Typically, how the publicly funded Canadian health insurance works is that the patient or client is not involved in any billing or claims. This is all directly billed to the government system you are under. Doctors or hospitals handle the claims process when it comes to communication with the government.

As a publicly funded system, there are limitations to the coverage. It does not include dental benefits at all and does not cover optometric benefits past the age of 18. Certain medical conditions can exempt patients from both these restrictions. There is also no coverage for prescription drugs, or any kind of respite, nursing or long-term care. Private insurance can supplement to provide benefits for these factors. Everyone receives the same standard of care regardless of their socioeconomic status.


The health care system in Canada



Health Care History in Canada

Canadian Catholics were among the first to design hospital systems. They began as places to take care of the impoverished, and more prominent people were taken care of at home. From the beginning, the provincial and federal governments provided subsidies to ensure everyone could be taken care of and provided for, even if they could not pay for services. Canadian medical care has multiple prominent “firsts,” such as the first tumor removal and the first use of anesthetic.

Canada was also one of the first places to adopt a hands-on mentality when it came to teaching the practice of medicine. Doctors at medical schools had clinical practice to enhance their skills and develop specialties. The first female doctors were also from Canada, a right won in 1871.

Private Insurance Coverage. Widespread and official publicly funded coverage was not established until during the Great Depression when the economic downturn made it difficult to provide care. Multiple attempts in the Western provinces to create a provincial system failed after difficulties on start-up.

Saskatchewan was the first province to offer a successful provincially mandated system. Finally, in the mid-1900s, Canada health insurance existed in a recognizable way. It took less than fifteen years for the rest of the provinces to develop working publicly funded systems. The basic foundations of those systems still exist in the current systems used today. Originally these publicly funded systems provided for approximately half the cost of medical needs. Today, this number is higher, with 70% of medical care being funded from multiple sources of government.



High Wait Times

A major criticism of the Canada health insurance program is the high wait times associated with free or low-cost care. Life-threatening situations are seen promptly, but the wait for routine medical care can be anywhere from six to eight weeks. Specialty medical practices, such as orthopedics or internists have a four to six week waiting period. The physician prescribed diagnostic tests such as x-rays, as well as elective surgeries, have two to four-week waiting periods. Even something as basic as an ultrasound requires a two to three-week wait. Regular walk-in clinics can provide you with quick, non-emergency services, but have limits when it comes to their treatment and prescription services.

One particular source of wait time frustration stems from the time spent in emergency departments of hospitals or urgent care clinics. These wait times are often upwards of four hours, even for serious conditions. For something as simple as a broken leg, it can take days to receive complete treatment, especially if surgery is required. Diagnostic services at emergency departments are often not operated outside of regular business hours, except for extreme cases. Even finding a family physician can be difficult. The lack of doctors and nurses and the limits of funding for these jobs is part of the reason that wait times are so high. The provincial and federal governments have been working to increase understanding of chronic medical conditions, reducing the amount of time required to be spent in a doctor’s office.


Comparison of Canada Health Insurance and American Coverage

Due to its proximity to neighboring United States, Canada health insurance is often compared to the privately funded American coverage options. For some patients who live close to borders or can easily afford to travel and take time off work, seeking both routine and emergency medical care in the United States is a common decision. Quite often, unique emergency cases are sent to bordering American towns. This can be due to a lack of beds available within the hospital, especially in pediatric and neonatal areas. It can also be for specialty treatments not available in Canada, such as complex orthopedic surgeries. Canada health insurance would not cover the expenses incurred if you sought medical care in America without being referred by a Canadian physician. On the opposite hand, many Americans come to Canada when possible for a variety of health care reasons. Prescription drugs, for example, are much less expensive in Canada when compared to their cost in the United States.

Canada health insurance has a rich history, and Canada can lay claim to many breakthrough technologies, including lifesaving medicines such as insulin. Though the wait times can be long for routine or non-emergency care, the publicly funded system has more benefits than negatives. With 70% of the medical expenses covered by provincial and federal governments, the system provides everyone with the care they require, regardless of their ability to pay for coverage.