Understanding the Canadian health care system
While Canada may not be the first country on your list of new homelands, there is no doubt that this particular area of the world is becoming more and more popular as the economy continues to grow and prospects continue to improve. For many years Canada has been seen as a “poor cousin” of the United States of America but the last few years have seen Canada begin to stand on its own 2 feet and increase its presence in the worldwide marketplace.
For any expats looking to move to Canada, health care in Canada is a subject that needs to be addressed sooner rather than later as there are obvious consequences if you go unprepared and know nothing of the system. As we have mentioned on numerous occasions, those who move overseas under the impression that they are moving to a like-for-like new health care system will have a rude awakening especially in countries such as Canada.
Moving to Canada
While there may be many opportunities for employment in Canada, there are three basic ways that expats can move to the country which include:-
Temporary work permit
A Canadian temporary work permit (TWP) is one of the more popular options for those looking to move to Canada on a temporary basis and then potentially permanent. However, in order to receive a TWP you would need to have an employer and employment offer in place under a labour market opinion (LMO). This would effectively confirm to the Canadian authorities that you would be to pay your own way when in the country therefore reducing benefit liabilities for the Canadian authorities.
Permanent residence
As with any move overseas, permanent residence in Canada is by far and away the more favoured option for anybody looking to the country as it does open many doors for you. The easiest way to gain a permanent residency in Canada is if your occupation is on the list of 38 occupations regarded as important by the Canadian authorities. It is worth monitoring this list because it does change and will open up new opportunities in the future.
British Universities North America Club
Commonly referred to as BUNAC, the British Universities North America Club has been around since 1962 and is one of the oldest and more prominent of the international work exchange programs. Offering students the potential to move overseas for work experience there is no doubt that the BUNAC has been a significant success over the years and continues to be well-respected.
The cost of health care in Canada
For those looking to move to Canada it is worthwhile noting that after three months of legal residency in the country, each and every person will qualify for “free” health care in Canada. However, there are certain boundaries and certain situations which are and are not covered by the free healthcare system and you need to be aware of exactly what you are letting yourself in for and any additional costs which may be incurred.
In simple terms, the free Canadian health care system covers visits to your doctor, specialist visits, hospital visits and treatment. However, it does not cover prescription drugs, dental care and other potentially non-vital medical treatment. You must be fully aware of what is and what is not covered before you move to the country otherwise there could be expensive costs to be incurred.
Health insurance in the workplace
In the Canadian forum there are a number of posts regarding health care in Canada with a number of people suggesting that many employment sectors in the country will offer some form of health care insurance to their employees. If you’re lucky enough to qualify for a position in one of the “skilled occupation” sectors then there is a chance that you may receive some form of employer assisted health care insurance.
If you look at it from an employer’s point of view, it is vital that employees, whether from overseas or Canadian nationals, have access to medical care because ultimately they want them to spend as many days as they can at work because of their value to the economy and the local area. The exact details of employee health care schemes will obviously differ from company to company and from occupation to occupation so it is definitely something you should be asking about if you decide to take up a position in Canada.
Pre-existing medical conditions
If you’re looking to move to Canada with a pre-existing medical condition, such as diabetes which is covered on the form, you need to be aware of your rights and potential cost. Conditions such as diabetes would not qualify directly for the free Canadian health care system although ultimately if you do have some kind of seizure or attack then you would obviously receive treatment. However, for those who require medicine and prescriptions on a regular basis, there is every chance that you will need to cover the cost of this yourself – assuming you have no private health care insurance in place.
The Canadian health care system
Figures from the Organisation for Economic Cooperation and Development (OECD) suggest that Canadian health care spending by the government will top $171 billion in 2008 which is said to cover around 71% of total Canadian health care costs. This works out at approximately 10.6% of gross domestic product (or around $5000 per person) and is slightly below the average of fellow OECD members. However, it does compare less favourably to the neighbouring United States of America where 15.2% of GDP is taken up by the government funded health care costs.
For those who have not come across the Canadian health care system before, this is a federally sponsored system whereby the actual service is provided by private sector companies and doctors with the cost covered by the government. Commonly referred to as a “single payer system” this basically means that the cost of services and treatment is covered by the government at a predetermined rate across the country. This also means that even if a patient does not qualify for free healthcare in Canada the doctor involved cannot charge more than the standard government rate.
It is also worth pointing out that the cost of some prescriptions and treatment is again part of the federally sponsored system with prices agreed between the Canadian authorities and pharmaceutical companies. This leaves little room for error and misunderstanding for those who make it their business to have a basic knowledge of the concept in the country. For the record, the only areas of health care in Canada which are wholly private are dentistry and optometry.
Waiting times in Canada
While the health care system in Canada has developed over the years one of the main problem areas has been that of waiting times which have, even by government standards, been far too long. The problems seem to revolve around specialist appointments, major surgery such as hip replacements and radiation treatment as well as other specialised areas of medicine. Back in the early 2000 it was claimed that 57% of Canadians were waiting four weeks or more to see a specialist and rather alarmingly nearly 25% of visitors to a doctor’s surgery were made to wait four hours or more.
Thankfully we have seen significant investment by the Canadian authorities into the problem of waiting times with $5.5 billion invested back in 2002 to kick start the fightback. There has been more investment poured into this area of the system since 2002 and the regional authorities will be publishing more detailed waiting times and patient guarantees in 2010. The new system will allow the various provinces of Canada to prioritise one of the following areas for priority treatment – cancer care, hip and knee replacement, cardiac care, MRI, cataract surgeries and primary care.
Getting used to the system
While there are many similarities with regards to health care systems around the world, no two systems are wholly alike and anybody moving overseas needs to appreciate this. As you would expect, the standard of treatment and priority cases can and do vary between the various Canadian provinces as there are certain opt out clauses and opt in clauses for the local government authorities.
Medical skills shortages in Canada
While the Canadian system now receives billions of dollars a year in investment there are still chronic shortages of skilled medical staff in various areas of the health care system. In 2006, figures revealed that there were 2.1 doctors per thousand of the population in Canada which was well below the OECD average of 3.1. The figures are no better for nurses with 8.8 nurses per thousand against an average of 9.7 per thousand amongst fellow OECD members.
Even back in 2006 the average doctor in Canada was earning over $200,000 before expenses with some states offering doctors in excess of $230,000 a year to retain their expertise. There are numerous areas of the medical system which are experiencing chronic shortages which has seen doctors and nurses become a main part of the “vital list of skills” required by the Canadian authorities.
Private health care in Canada
On the whole, private health care in Canada is not something which is encouraged by the authorities even though around 30% of all health care costs come from the private sector. There are various pricing policies in place across the provinces which ban private healthcare companies from charging above the government rate for various treatments and advice. Even though there are some specific areas of the Canadian population, such as those without medical insurance and non-Canadian residents, who are exempt from these restrictive pricing regulations there is no doubt that the authorities would rather keep overall control of the healthcare sector than encourage private healthcare companies to flourish.
Health care in the US
While the effect of extended waiting times is beginning to diminish in Canada as the government looks to invest more money into the system, over the years many people have crossed the border into the US for medical treatment in order to avoid “unacceptable” waiting times. In a bizarre about turn, it was also revealed that many US citizens travel over the Canadian border to acquire their prescription drugs because on the whole they are significantly cheaper in Canada (many people now acquire prescription drugs via the Internet from Canadian sources).
Summary of the Canadian healthcare system
As long as you are resident in Canada then you will qualify for free healthcare even if you have to wait a maximum of three months – for those who have just moved to the country. However, as with countries such as the UK we have seen healthcare costs in Canada spiral higher which places yet more pressure on the national budget and ultimately Canadian taxpayers.
Conclusion
Those who are looking to move to Canada are likely to be pleased with the Canadian health care system which allows free healthcare for all permanent residents of the country. While it would be foolish to suggest that the system is in any way the finished article, there have been great strides made with specific problem areas such as waiting lists and access to specialist advice and treatment.
The lack of encouragement for the private healthcare sector is something which has probably kept the cost of private healthcare relatively low compared to other countries. Even though there is private healthcare available this particular area of the Canadian health system is heavily policed with a number of restrictions on the charges which can be made to regular Canadian citizens.
While healthcare is obviously a major issue if you are looking to move to Canada, one of the main problems you may have is actually receiving the relevant visas and confirmation that you are welcome. Canada is not one of the easiest countries to gain access to, unless you are in a profession which is on the “most wanted list”, and many people have tried and failed to settle in the country.
On the whole the healthcare system appears to have a good base and the government is very keen to keep tight control of the federal system and the private healthcare sector. These are elements which will obviously ensure costs are kept as low as possible for those who require private healthcare but on the downside it will restrict investment into the private health care sector in the future.
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