BC equivalent of a Medicare card

[Guest Snew]

Hi everyone,

 

I just moved to BC from NS, and I am going through the process of trying to get a new HealthCard in case I need to go to the hospital or my family doctor. The only information on any sort of card I could find was the MSP CareCard, and that has a premium of 54$ a month! I am pretty sure this is not a plan based card, like Blue Cross or Green Shield, becuase it seems to talk about hospital services on the MSP website, not things like visiting the dentist and such, which is different. Considering I thought healthcare was "free" (i.e we pay for it through taxes) in Canada, could someone please tell me if this is the medicare card equivalent in BC, or if there is another card with no premiums I just can't seem to find.

 

Forgive my ignorance, I just moved here Any help is appreciated!

 

Snew

[Guest kellyl20]

premium depends on your level of income.

give MSP a call and they will walk you through it.

Not really free as there is a premium, unless you qualify for premium relief.

[Guest Snew]

Thanks for the info Kellyl20! I still think it is bizarre that you have to pay a premium. I did read the bit about premium assistance based on how much you make, but I am pretty sure in other provinces (at least NB, where I am originally from) everyone just gets the free healthcard, no matter what their income. You just sign up when you move there and one is popped in the mail after a three month waiting period.

 

Any other thoughts anyone?

[Guest happy2bme]

If you are a student or low income you will not have to pay for your health care premium. There is a form to fill out when you apply and you just provide your last income tax return statement as proof of low income. It's really easy to do, not a bunch of red tape

 

There are two provinces that I know of that charge a health care premium, B.C and Alberta. Why they are allowed to charge a premium and other provinces don't, I don't know. It may have something to do with the provincial tax systems, maybe they don't pull enough out of the provincial coffers as opposed to higher taxed provinces ie. Manitoba. But I'm sure this has come up in med schools, so med students out there chime in!!!

[Guest Snew]

Thanks happy. I figured it may have something to do with the taxes. Bizarre none the less! I am currently looking for work, so I am pretty sure I would not have to pay the premium until I get a job. Thanks for the info!

[Guest sensodyne]

you might still have to pay a premium if you made enough money last year. your current year premium depends on your last year's income even if you're currently unemployed.

 

jeez, I didn't know until today that only BC and AB charge a premium for health care.

[Guest AnxiousBoy]

Welcome to the American style Health Care system. We call our insurance company the government:rollin

[Guest ssc427]

Not even close my friend. $54/month is almost free compared to the US. Down there you'd pay ~$3500/year as a healthy student on a University plan!!! And if you're sick and not a student then double or triple that amount.

 

It makes me upset when people complain about the $54/month. Especially when that's the max you'll ever pay and people with low incomes pay nothing. If I ran BC people with low incomes would still pay nothing but people with high incomes would pay much much more.

[Guest sensodyne]

I'm assuming that you're an American. If so, then maybe you don't know that about half of our income goes to the gov't right off our pay cheques as tax. yeah, welcome to Canada. The gov't takes half our income, then takes more away later. oh did I mention that we also pay 14% tax on goods and services?

[Guest Nehpets]

Doesn't matter how you pay for health care....it costs what it costs. If you don't pay for it with taxes (PST, GST, Income, etc.), then you just have to pay for it some other way. The beauty is you can move to another country if you don't like this one. It's up to you...but maybe if you travel a bit you will realize how good we have it and you won't complain about paying taxes because the benefits we get are amazing.

N.

[Guest ssc427]

Doesn't matter how you pay for health care....it costs what it costs. If you don't pay for it with taxes (PST, GST, Income, etc.), then you just have to pay for it some other way. The beauty is you can move to another country if you don't like this one. It's up to you...but maybe if you travel a bit you will realize how good we have it and you won't complain about paying taxes because the benefits we get are amazing.

N.

 

Exactly my point. I am Canadian but have lived abroad for 5 years. Because of this I know how great things are here and how important it is that we protect them. I am not willing to practice medicine in any country that doesn't have socialized health care. I know we pay alot of taxes but few of these dollars trickle down to medicare. By having premiums we force these dollars to go into the health system. Dealing with the other high taxes is another issue entirely. Ignoring the other taxes, the wealthy do not pay enough health premiums IMO.

 

But this is just the tip of the iceberg. There are a zillion other problem facing health care as everyone on this forum will know because we all just revised this stuff for our UBC interviews.

[Guest sensodyne]

socialized health care is a great idea but only great when it works well. i wouldn't call a system with long waiting-lists, shortage of doctors in rural areas, and GPs seeing 10 patients per hour a successful one.

 

oh and when i don't want to pay the PST, I go to Alberta. :lol

[Guest Nehpets]

It is better than a system where a large percentage of people aren't covered at all. I would rather wait 2 years for a hip replacement than not get one at all. And, despite its problems, our system is better than most. And as an Albertan, where monthly health premiums are $44 and the lack of PST is to the province what healthcare is to Canada, I can say that I would gladly pay more taxes to keep the system equal and fair.........but the powers that be have a different vision it seems.

N.

[Guest happy2bme]

"I can say that I would gladly pay more taxes to keep the system equal and fair."

 

 

 

I beg to differ that our system is fair.

 

I will tell you with certainty that when you are a med doc and you or your immediate familiy need a certain test or surgery, you will get it faster than jane doe who lives down the street. That's not fair or equal.

 

Also with health care the "squeaky wheel" gets the grease, but you have to know who to talk to, write to, complain to. and you will be more than likely to get treatment/referrals quicker. Sometimes it involves sweet talking the receptionist of the specialist, contacting the sister of a hospital administrator or writing to your health minister while carbon copying a particular reporter of a national news outlet. Fair? no Equal? no. But I have done some of the above with success to help someone close to me. What infuriates me is that I actually have HAD to do that because the care which should have been more timely wasn't! This is how bad some aspects of our system have become, unfortunatly I don't have the answer to fix it. What I do know is that even though I don't agree with everthing the prov of Alberta is attempting to do, at least they are ATTEMPTING! The feds and most other provinces just sit back complaining and spinning their wheels.

 

Even if Alberta's plans flop, the province and rest of Canada will hopefully learn from their mistakes, make adjustments, and try again.

 

That's just my rant for the week, ahhhh my chest feels lighter!

[Guest Nehpets]

Well, whenever humans are involved, the system will be flawed. Unless you want to be taken care of by robots, that will likely never change. In general, the system is MORE fair and MORE equal than the US system. And I don't think it is fair to say other provinces sit around and do nothing (that is a very "Albertan" attitude). The system has been and will continue to evolve, hopefully for the better.

N.

[Guest happy2bme]

"And I don't think it is fair to say other provinces sit around and do nothing (that is a very "Albertan" attitude). "

 

 

Now, now, I didn't say they did nothing....I did say they complained and spun their wheels! LOL!

 

I have lived in 2 other provinces, ( BC and MB), not representative of all of Canada I realize, but I can't say that the "system" has evolved very much in the way of healthcare delivery in either place. But maybe you can fill me in on any significant changes in your province...

 

It just seems that everyone talks about changing the system to make it more viable, but no one is actually doing anything about it. And then when someone starts thinking out of the box (whether it works or not), people just try to villianize the changes that are being proposed.

 

The medicare system was conceived at a time when premature babies usually died, heart surgery was rare, pharmaceuticals were limited, PET scans and other new tech was the talk of science fiction novels..... The cost of healthcare and it's innovations today would boggle the minds of the founders of Medicare, and I doubt they would be saying Raise Taxes some more to fund our excess overages.

[Guest Nehpets]

Hey Happy,

 

I have lived in both BC and Alberta too so I doubt I can tell you anything you don't already know. Perhaps other provinces would be able to change this system more if their leaders had no fear of losing an election (and thus weren't accountable for their actions). I just don't think any of the changes currently proposed by Alberta deal with the fundemental problem--that costs are increasing faster than revenues. Nothing Klein has proposed will decrease costs, but insted only shift the burden to the people who use the system. Now this might not be a bad thing, but until we actually address the issue of rising costs, any system we have will be unsustainable in the long term (regardless of how we pay for it). So I am not trying to "villanize" anyone as you suggest....a more 2 tier system might be what is best for everyone....but again without addressing costs, it is doomed to fail.

 

N.

[Guest Snew]

I love Canada, and Canada's healthcare system, and we are fortunate to live in a country where everyone can receive care. I was just surprised that you had to pay a premium in BC, that's all. I understand that it gets paid for in some way or another in other provinces, be it through taxes or whatever, I had just never heard of a direct bill to patients in Canada before. I did learn however that if you for some reason do not pay your premiums, they will not cut off your healthcare.

 

BC is a great province though, loving the mountains in my backyard

 

Any students from other provinces care to comment on their province's healthcard system?

[Guest sudoku]

hi Snew,

i had a personal experience with MSP. To let you know, if you don't pay MSP premium, they WILL CUT YOU OFF without warning you. My dad and I had the same initial so when the mail comes as "J. Smith". I thought it belongs to my dad and didn't pay. Guess what?

 

I got sick and had to see a doctor, had lab tests, X ray etc etc. done... My bill was 1000$. I gave them my MSP card, my citizenship cards etc... but...i still got charged. They even send my account to a collection agency. The GP wanted cash before he even saw me.

 

Medical care is definitely not free. A few months later, when my account is activated again, they said they don't pay "retrospectively?". So i was still on the hook for the amount charged to me. I'm in BC btw.

 

So, free healthcare is quite a "misnomer" (well, at least in Vancouver).

sudoku

[Guest sensodyne]

oh wow...they sent your bill to a collection agency? jeez, and I thought they did that only for unpaid parking tickets.

[Guest Snew]

Oh wow, I am sorry to hear that sudoku! I can't believe they charged you that huge medical bill. The MSP website said that even if you don't pay your premium, your healthcare won't be cut off, but your situation begs to differ!

 

"Failure to Pay

 

All BC residents are required to be enrolled for provincial health care benefits under the Medical Services Plan and are billed a monthly premium for this coverage (unless eligible for 100% premium assistance).

 

Due dates for payment of premiums are indicated on your bill. Your account will not be cancelled if you do not pay your premiums, however, collection action will be initiated to collect the outstanding balance.

 

If you are unable to pay, please check the Financial Assistance information on this web site for assistance that may be available to you. Failure to remit premiums does not constitute notification for cancellation of enrollment."

[Guest Lurkergonepublic]

Nothing Klein has proposed will decrease costs, but insted only shift the burden to the people who use the system. Now this might not be a bad thing, but until we actually address the issue of rising costs, any system we have will be unsustainable in the long term

 

If you'll take the time to read Alberta's published 3rd way documents, rather than simply rely on what the nightly news choses to report and sensationalize, you'll see that very little of it is actually 'shifting the burdern of cost on consumers."

www.gov.ab.ca/home/index.cfm?page=1370

 

Most of the recommendations are focused around increasing efficiency, and focusing on prevention. If actually carried out and somewhat successfull as hoped, this actually does focus on the rising costs issue. Granted its far from a permament, total solution, but I agree with happy that it is a bolder step in the right direction than many others have been willing to take.

 

Allowing doctors to work in both hospitals AND clinics, may actually increase the number of docs doing hospital time, becasue they won't feel completely tied down by it. Using pharmacists and nurse practicioners to take care of some routine medical care that really doesn't need a doctor will lower the provincial medical bill, and free doctors for more important things. Anything focused on prevention that works is going to do the same. It might not all work for the best, but I think it's a good start. I do agree that just changing who pays for something is unlikely to solve the cost or supply issues - studies consistently show the US spends far more per capita on health care than Canada does, there's simply less of it coming directly from tax revenues.

[Guest Nehpets]

Hey Lurker,

 

I've read Klein's 3rd-Way proposals and I'm not impressed. Long-term, I don't think it solves anything. For example, letting pharmacists and LPNs do some "routine medicial care" sounds fine, but over time they will likely demand equivalent fees because they are doing the same work as doctors. As for letting doctors work in both the public and private systems, again I don't see this as a way to save any money. They are likely to work in the system where they will receive the most money...which might end up increasing costs as private and public hospitals compete for staff (which are already in short supply). Again, this is all just speculation and we will see if it works...but I have my doubts.

 

N.

[Guest Lurkergonepublic]

Nehpets,

 

Possibly true, but it really depends how it's implemented. I don't think they're talking about private hospitals here. When we talk about public and private systems, we have to realize that this is already what we have: for the most part, hospitals are public (almost completely government run), but your family doctor (or a specialist's office) is a private facility - it is owned and operated by a doctor(s) who use their billing income to pay staff and expenses, and take what's left as personal income. It doesn't often matter to the patient where they are treated because our insurance system is completely public, so they don't pay no matter where they see the doctor. That is the difference between Canada and the US - we are guaranteed access to public insurance at fixed rates, while most Americans (or their employers) must chose a private insurance company, which is able (I'm generalizing here) to charge whatever they want, and pick and choose who they cover, how much they cover, etc.

 

I think the theory behind outsourcing work from hospitals to clinics, is that the clinic can do it more efficiently, at a lower total cost - publicly run companies are rarely known for their efficiency. Admittedly this is not always the case, and I think it should be constantly evaluated to see if it worked, case by case. Alberta already did that with eye surgeries, and I've heard stories that it is costing teh system more per surgery, although it would be interesting to trace exactly why.

 

Doctor's are paid by the province, based on specific fees they are allowed to charge per visit, or per proceedure - it doesn't matter if they do it in a hospital or a clinic, they provincial billing fee is the same. The only way abandoning a hospital is going to make the doctor more money, is if he can squeeze in more clinic visits than the hospital scheduling will allow - and hence more people will have been treated anyway. There is the possibility of the doctor charging the patient directly a little extra at the clinic, but that is what is currently a direct violation of the Canada health act. Actually, specialists have already been doing that across Canada for years, and I'm not sure how that jives, but it's a different story.

 

We already have a problem with Doctor's chosing money over patient well-being. My last family doctor would only allow about 7 minutes per patient, and strictly 1 complaint per visit - it often took weeks or months to book an appointment with him for your quick - 2nd item. This earned him a lot of money, because he can bill the province per visit ($17.50 per visit, last time I checked). If he makes you come twice, he gets double what he would if he treats your sinus infection and athletes foot in the same visit.

My current doctor is different. If necessary, you can make a two day before, or even same day appointment. I have shadowed with him, and he usually deals with several complaints at once, and will even look over multiple family members with similar problems at once. He can only bill for the one visit, even though he spends 10 to 15 minutes per patient. He will sometimes answer quick questions over the phone and email - he can't bill for that. He treats his patients much better than the other guy, but makes less.

 

Fee reform is about fixing that problem (as well as the fact that an opthamologist makes more in an hour doing routine, safe cataract surgeries, than a small town ER surgeon makles doing an emergency apendectomy at 2AM to save a kids life). It has been cried for by public health defenders (educated ones) for years. Of course it all depends on the details, but at least these proposed reforms are potentially on the right track.

 

I recommend reading Prescription for Excellence by Micheal Rachlis. He is very much a public health defender, and focused on reforms to save the system. Despite Ralph's reputation, I was pleasantly surprised to see that about 7 of the 10 proposed changes seems straight out of Rachlis' book. What bothers me the most is opening the door for private insurance. That, I think is where the slippery slope lies, but we will see.

[Guest Nehpets]

Well, I hope you are right Lurker. Like I said, I have my doubts. I just worry that if there is a pay differential between the systems (likely higher billing fees in the private), then the public system will lose staff (of all types). But we will see. And as for the 1 complaint/visit.....technically that is how the system is setup.....but I don't agree with being that strict about it (in most cases). But like you mentioned, hopefully reforms will take care of this. The changes will be interesting to watch, if nothing else.

 

N.