Just How Free is Canada’s Healthcare?

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Did you know that Canada’s free healthcare system was all thanks to Kiefer Sutherland’s grandfather? Most people know Kiefer from his television show, 24, but Canadian historians know he is also the grandson of Tommy Douglas, the first leader of the New Democratic Party (NDP) and “father” of socialized medicine.

Douglas and the NDP believed that healthcare was a social good, rather than a political commodity. It seemed clear to him that Canadians needed a universal healthcare plan to offset the rising costs of medical care. If you want to learn more about his vision, visit the Canadian Encyclopedia website for more details.

Canada’s provincial and territorial systems of publicly funded healthcare are informally known as Medicare, and are guided by the Canada Health Act of 1984. Through this program, the government ensures standards and quality of care, and provides some coverage to vulnerable populations.

Medicare includes coverage for hospital services such as surgery, hospital fees and most importantly, doctors’ visits, and is available for Canadians all across the provinces and territories. As we all know, without any insurance, a simple day surgery can cost thousands of dollars. With Medicare, citizens can receive emergency and some elective treatments without fear of bankruptcy.

However, Medicare is different in every province. It’s tough to know if something that Quebec covers would be covered by Ontario without doing some research. For example, one province may have coverage for vision care services, while another may not.

Our friends in the United States often express their frustration about not having a proper healthcare plan for all US citizens. They look at what we have and assume that everything is covered here in Canada, but that’s simply not the case. While our healthcare coverage is markedly better than our friends to the south have, it’s far from perfect.

The gap between what is and isn’t covered by Medicare is large enough that many Canadians need private health insurance as well.

The Provinces and Territories

Each province’s coverage is unique and similar at the same time. Across Canada, the plans all cover physician fees and hospital services, but one province may cover things that their neighbour doesn’t. The chart below gives some examples of coverage, but they are not limited to the services listed.

ProvinceSome Covered Services
OntarioDoctor visits, hospital fees, limited travel, medication and eye exams for children and seniors
British ColumbiaDoctor visits, hospital fees, massage therapy, naturopathy, acupuncture
AlbertaDoctor visits, hospital fees, some hospital room, eye exams

More often than not, provincial plans are enough to help someone in an emergency, but not quite enough for any low-risk injuries or long-term ailments. About 70% of health costs are covered by the provinces, but what about that other 30%?

What (Typically) Isn’t Covered

While some provinces will cover prescription medications, (Quebec, Ontario for children, seniors, and those with low incomes), most provincial healthcare plans will not. While it’s true that medications are the most utilized healthcare measures, they are often excluded from coverage.

Vision care services are often partially covered under the provinces, but there is usually an age limit, or only eye exams are covered. Some provinces will fully cover exams for children or those aged 65 and up.

Hospital rooms are another expense that often must be paid out of pocket, but it depends on the type of room. Some plans will cover semi-private and private rooms up to a certain amount and only if medically necessary, but most will only cover a standard ward room.

Travel insurance is rather consistent across the country, in that there IS some. It’s very limited and all provinces advise that you obtain supplementary travel insurance coverage.

No provincial plan is perfect, and none will cover everything, but it’s certainly better than nothing at all! To find out what your provincial plan does or does not cover, refer to our article on Canada’s Provincial Health Plans.

Supplementary Insurance and Why You Need It

Some people (mostly those who have never been very sick) feel that there is no need to get a private insurance plan, but they couldn’t be more wrong. While it’s true that as Canadians, we are blessed to have so many things covered under the provinces, it’s still not enough.

What if something unexpected happens? What if you need emergency surgery? Sure, the surgery itself will be covered, but what about your hospital room? What about your medications needed for healing? What about any subsequent therapies such as physio or massage?

You could be diagnosed with a serious illness, such as cancer, diabetes, or arthritis. With pre-existing conditions like these, your options for supplemental coverage are vastly reduced.

It’s better to have an insurance plan in place and not need it, than to not have one and then need it desperately. The very definition of insurance, according to Merriam Webster is “a means of guaranteeing protection or safety.” Protection and safety, especially in the form of healthcare, are very hard to guarantee, so having that assurance is crucial.

When you measure the cost of unexpected treatment or medication against the cost of a monthly insurance premium, you’ll find that it’s much safer and more cost effective to have an insurance plan.

Nobody plans to become sick or injured, but it happens to people every day. The best thing you can do is plan ahead and make sure that if something does happen, you’ll be covered. Don’t depend on Medicare to carry you through your health woes. It’s a great help, but ultimately you’ll be glad you had a supplementary health insurance plan to cover the rest.

Call our office today and we’ll be happy to help you find the perfect plan for you and your family. Our staff is trained to assist you and go over your options carefully. You’ll be glad you called us!


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