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.
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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