Whenever I thought of Canadian vs US hospital and US healthcare, I was always worried. I have heard many stories about the high cost of US healthcare for what you get.
One of my friends (who is a dual Canadian and American citizen) told me she fell on the bus after the bus driver pressed the breaks too hard. A few people on the bus fell (including her) and were urged to get checked out at the hospital. She obliged and said nothing was really done at the emergency department (just a general check, no x-rays or blood tests or anything) but she was given a bill of $5000. At that time she was a student and did not have any form of insurance, so she felt she had no choice but to threaten to sue the bus company (or maybe she did sue, I forget!). The bill was eventually settled by the bus company.
A Canadian traveler’s financially worrying scenario comes true for us recently- having to go to a US hospital and face the high cost of US healthcare. What I thought was another ‘man cold’ on the flight for our recent trip to Washington DC turned out to be something serious and my husband ended up getting admitted to the hospital. Though it was only for one day and he recovered remarkably well with intravenous medication- he’s still on the mend and the flight back home was a bit intense as he was still not feeling well. I can’t say specifically what health condition he had as I want to respect his privacy 🙂
I am a “dot the I’s and cross the T’s” type of person so I called our travel medical insurer to inquire about the closest hospital or the recommended hospital and they recommended this one. The insurer said it had good ratings and also said this hospital had good rates.
The Emergency Room Visit
Unfortunately my husband went to the emergency room by himself after our toddler went to sleep. He was adamant that he did not want our toddler to be woken up and taken to the hospital– so I stayed. It was a rough night for both of us, and we just communicated via text to update each other throughout the night. He was seen by triage in the ER fairly quickly and it is comparable to the speed of triage assessment in Canada, though his condition was relatively acute (even though he was walk-in).
He received diagnostic testing shortly after he was seen and then results were available and communicated to him in a few hours. He received intravenous medication treatment very soon after and then in the morning they told him he was being admitted. I visited him the next morning with our toddler and waited until we spoke to the specialist. All of this is comparable to experiences in a Canadian hospital emergency room (or at least Vancouver, can’t speak for other parts of the country!).
The Commonalities between Canadian vs US Hospital
The commonalities between Canadian vs US hospital include the professionalism of the healthcare staff. The nurse was great and offered our toddler some apple sauce because she saw he was getting squirrelly and needed some food distraction.
There was a lot of waiting.
Waiting to speak to the specialist physician when they said rounds would start at 10:00am and we didn’t end up seeing the physician to discuss the plan until 1:30pm.
I don’t think that’s much different from US and Canadian emergency departments.
The Surprising Differences
There were some surprising (and pleasant) differences between the Canadian vs US hospital.
- I expected the hospital to be very clean with very modern equipment compared to Canadian hospitals, and the place didn’t look very clean at all and the equipment didn’t look very new- perhaps this was only specific to the hospital we visited in the US, who knows!
- My husband got a very organized folder containing a computer print out of all his lab tests, the treatments ordered and given, the reason he came to the hospital, and some discharge plan instructions. It was very organized and complete, and useful for him to take back to his primary care provider in Canada and also to keep for his own reference.
- He was asked to put in an order for his meal (and was told he could order ANY TIME!) and there was a plethora of food options (including ice cream!) to choose from- instead of just one option
- When he was admitted to the ward, they gave him a small sized toothbrush, toothpaste, grippy socks, mouthwash, etc. and other things to make his stay more comfortable (usually you would have to ask for these things or you would get a few of these things but not all)
- The nurse from the emergency department actually took us up to the ward and the nurse from the unit waited with my husband to be picked up via taxi when he was discharged
- The hospital mattress apparently would move/ shift periodically by itself (to keep skin happy I suppose) and also warmed up!
- Bar code scanning- whenever he received a medication he would get his bar code on his wrist scanned to confirm his name and identity
Being asked for Payment 4 Times
Finally, the other surprising difference between Canadian vs US hospitals (well perhaps not so surprising) was being asked for payment many times.
When someone would come to the room I mistakenly thought it was the aforementioned specialist physician coming to discuss the plan and treatment. However, it was people asking about whether we had insurance coverage (we did, but they didn’t accept direct payment from our insurer, we had to pay up front and then will get it reimbursed).
Then another person would come around and double check that we had paid or wanted clarification because on their documentation it said that we were ‘uninsured’ in their system.
Surprisingly, we got a 60% discount because we ‘paid up front’ so the final bill was actually not very much for all that was done. It was around $1400 USD. We thought we would be billed again after he moved up to a hospital ward but I suppose they charge every 24 hours instead of separating the costs by what was actually done. My husband felt satisfied with the care he received and felt the $1400 (and even ~$3000 USD without the 60% off) was not bad at all considering all that was done.
Update: April 2019- Actually we got mailed another bill, for another $6000 USD- I’m still waiting for the itemized receipt so that we can claim this with our insurance. So in total, this less-than-24-hour hospital visit cost over $7400 USD. My husband’s only comment was that he should have ordered more food, lol.
Travel Medical Insurance
In any case, we are glad we have travel medical insurance through my extended health benefits. Obviously if we didn’t have extended health benefits we would definitely have bought travel medical insurance when stepping foot outside of Canada anyways. I called our insurer to double check that it would be covered and it sounds quite promising that everything would be covered, even the discharge prescription.
Related: End of Life Planning Checklist in Canada
Canadian Healthcare System Pros and Cons
The Canadian healthcare system, I think, gets a bad rap.
Many people think there are Canadian healthcare problems (and I’m not saying there aren’t, because there are!).
Forbes recently said that 3% of Canadians are on a waitlist for some kind of medical care by the end of 2017 (that’s a lot of people). I think for anything non-urgent there is more of a waitlist (like waiting months to years for elective hip or knee surgery) but you do get access to good care when you need it if it is urgent.
We also had a good experience at the hospital during my labor and delivery a few years ago and were appreciative that we did not have to pay the hospital bill for that (well we paid through our income taxes of course), or deal with insurance when I am post-partum sleep deprived.
While I can’t comment on the general experience of Canadian vs US hospital and healthcare (because an emergency room and hospital visit is just one tiny aspect of healthcare as a whole), we were surprised at the efficiency of the US hospital visit and the little details, including the very thorough discharge summary and having a print out of the blood work and testing that was done. At the end of the report, there was even a blurb about warning signs for “heart attack and stroke” (which is not remotely related to my husband’s presenting concern). I assume that this is probably because in the US, there is more healthcare associated litigation so communication and access to information is probably quite paramount.
Have you had healthcare encounters out of your home country in the US (or in Canada)? Was it expensive?
Do you find there are similarities and differences between Canadian vs US hospitals?
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20 thoughts on “Canadian vs American Hospital Visit: Our Experience”
Very interesting but difficult experience I’m sure. Here’s to good health! The most important asset of all. Tom
@Tom- Sante! Yes, the most important asset of all. Without health there is nothing 🙁
My experience with healthcare has been good for the most part, it also helps that I’ve been healthy all of my life(knock on wood) so I don’t have to deal with being admitted to the hospital a whole lot. I’m sure that will change as I get older and my health will predictably not as be great as before.
Sounds like you guys had a good experience at the hospital in DC as it should be in most of them.
@Kris- Yeah it was pretty good! My husband even got a call requesting feedback on how the hospital visit went! Talk about customer service 🙂
Interesting stuff, haven’t visited a hospital in the US so don’t have any experience but sounds like the ER’s in the state are quite efficient even though you do end up waiting a bit just like the Canadian ones. I think it could get a bit annoying to have ppl coming in and ask for insurance coverage/payment info multiple times. Can you imagine if you’re dealing with a more serious condition?
@Tawcan- Yeah, it would be quite the hassle. Maybe it wouldn’t have been an issue if we had coverage that was very clear in the first place (or approved). It wasn’t approved so we had to pay upfront first.
This was so interesting! I’ve also experienced US hospital care, but it was for a very minor issue. I was in and out and all I needed was a prescription in the end.
But it was a bit scary to receive the bill and have to pay for it upfront. I was in my early twenties when this happened, so didn’t think to call ahead to my insurance company to check that it was an approved hospital.
Will have to keep that in mind if we’re ever in need of healthcare again while traveling!
@Chrissy- I think they were fine approving any hospital (the insurance company) but they said the one we opted for would be easier and they could pay up front (unfortunately this was not the case, haha).
Some years ago my wife fell early in the morning leaving the bed and hit her head on the wall. It become obvious shortly that she was in some trouble so I called 911. Firemen provided the first response with an Ambulance behind them in about 15 minutes. I was asked about preferred hospital but the only one I knew of was the Mayo Clinic in the city. The team leader said that given what they suspect she should go to acute treatment facility and suggested one. She was taken away very quickly. By the time I got there she was through a CT scan and were waiting for the next steps. The Trauma director came in and said that fortunately there is no bleeding in the brain (as they would have to operate quickly, but she would be admitted for followup and observations. Later an administrator came in to get information on insurance etc. Our insurance had a direct payment policy which the hospital followed but they asked for an up-front deposit. I asked what would that be and they suggested $5000 which I paid on a credit card (later refunded by our insurance company). They have done a variety of tests in the meantime. She was kept in the hospital for 2.5 days and was discharged with a bad concussion. Treatment was very good.
The interesting part is that the total bill came to about $44000 US as I found from our insurance company. The insurance company (excellent by the way), told me that they never pay bills from the US as submitted but go through a review/negotiation process. It took several month to do that and at the end I found that our insurance company actually paid about $14000 US on the initial billing.
Obviously if you are on your own with not much experience and leverage to deal with the US health institutions you may be in a lot of financial trouble.
@Ivan- Thanks for sharing your experience- good that your wife is doing well. Wow, the Mayo Clinic, top notch health care (with a top notch price!). I was pretty surprised by the ‘discount’ (for paying up front) I guess negotiations happen frequently with insurers and health institutions.
Getting sick outside your home province can be catastrophic without insurance or resources. We are Ontario residents . My husband became ill in British Columbia during a weekend visit.
His care was good and paid for by OHIP. Three ambulance transfers were billed at the non resident rate of $650 . Fortunately we have year round travel coverage and workplace travel coverage which took care of that along with some of my 2 week hotel and living expenses to a maximum . Car rental was not covered. They paid for a family member to fly out and join me.
Repatriation back to Ontario was not covered . Unlike getting sick in another country, this event was not costing the insurance company any hospital expenses so there was no incentive to repatriate . BC health care and OHIP would not pay for this either.
This was possibly going to be a long term illness and I needed to get back to my home and family . I made arrangements to pay for the $58,000 medical transfer . I saw no other option. As a last ditch effort , I called my credit card company travel insurance and they agreed to pay for the transfer (which they successfully partially claimed back from the 2 insurers who refused) In the end my husband improved greatly and the medical transfer was done with us all on a commercial business class flight at a fraction of the cost.
My husband fully recovered. Me not so much.
Oh my gosh! I NEVER gave outside of province coverage any thought. I’d always assumed we’d be covered by the government just because we were in Canada. This is eye-opening for me. Thank you for sharing Margaret.
So, in hindsight, what would you recommended people do to mitigate risks when traveling inter-provincially?
@Margaret-Oh geez what an ordeal. Thanks for sharing your experience. $58K for a medical transfer- yowza. That’s good that you were able to get it reimbursed or taken care of in the end and he was able to go on a regular flight. It’d be nice if we had more of a unified health care system where it wouldn’t matter which province you were in- though this would be quite an ordeal to organize.
There is now interprovincial coverage plans which can be found on line.
However like all insurance , it is important to read the small print. Many will only repatriate you from another province if you die. Some will only repatriate your dog or car.
Bottom line is , with all travel, you need insurance, you need the right insurance and you need to be prepared to fight for your rights under your policy. .
Because of my husband’s age the credit card coverage was only for trips originally booked for less than 8 days which this was. So you can see that there are so many variables.
Hi Margaret, I appreciate that you took the time to reply with this extra info. Thanks to your story, I’ll be much more careful when buying travel insurance in the future. You may have saved us a fortune, and a lot of heartache.
While doing some maintenance on my vehicle in FloridaI some years ago ! ripped the skin pretty well completely off a knuckle. I phoned my insurance company and we agreed I would go to the local (good reputation) hospital. After arriving there I was triaged and went into the waiting room. I was subsequently ushered into an office where a young lady took all of my insurance details. I was in the waiting room for half an hour or so and then taken in to a cubicle (same little examination room as anywhere else), about 1 of 50 in the Emergency “room”.
This is pretty quick, I thought. Ha! Five and a half hours later I saw a doctor who sewed my knuckle back together. Seven stitches were required. Cost was $1,100. The negotiated cost was $700, a hundred dollars a stitch. Some months later, at home, I knocked the skin off another knuckle, you’d think I’d learn, and went to the walk-in at my doctors office. As he was sewing me back together I told him the Florida story. “You know how much I get for this? Twenty one dollars, 1 stitch or 7.”
One noticeable difference in the US was the pin-strip suited young ladies with folders and iPads wandering around – they were the financial people and came to visit my cubicle several times.
The wait times were no different. I found out later that the jurisdiction I was in has a service requirement that required people be in the Emergency room within something like 30 minutes. The simple way around this was to build a pile of cubicles in the Emergency room and have people wait there.
This year, in the local newspaper where we were in Florida, was a long article about ambulances and how service was impaired by the lack of Emergency spaces. My thought was “Wow! Except for the different town and hospital names this could have been straight out of the Ottawa Citizen!”
A Florida friend who is on the same medication as I, pays US$1,200 for a 90 day supply. I pay C$378.
@John- Glad your knuckle is intact. Yes, your experience sounds very similar to mine (with the financial people milling about). It is quite a shame that doctors in Canada are paid under $30 for a visit, and yet people complain about visit times with their doctor being only 5-10 minutes. If each person took 30 minutes, a GP would make $480, before overhead costs!
Thank you for comparing these two systems!
Let me get this straight… you have people in Canada who are suffering with things like bad hips and knees (both needed for walking mobility), and they still have to wait months to years to have the surgery? That seems horrible. Hip and knee pain and arthritis is not an “annoying nuisance.” It’s not the same as waiting to get a wart removed. It can hinder a person’s quality of life.
Why is there such a wait list? Why can’t Canada help those who need an elective surgery and those who need more urgent procedures at the same time like some other countries?
@Liz- I agree! We have an imperfect system here, things are prioritized for urgency but it is of no cost. I have heard of people going to the United States or abroad for their hip/ knee surgery.