Hi everyone :) I hope the video was helpful in providing a high level look and comparison at the Canadian and American healthcare systems. Just 2 quick points to bring up... #1. I couldn't possibly cover everything in 1 video - the failures of both systems, instances where people slip through the cracks, how we can improve, etc. Much of these things will be touched on in part 2 of the series. Feel free to share suggestions with me if you'd like. #2. at the end of the video in the "final thoughts," section when I arrive at the conclusion that both Canadians and American's will spend approximately the same per year on their healthcare, many assumptions are taken. For instance, the average family income is higher in the US than Canada. In addition, when it comes to privatized healthcare - I understand that not all American have private insurance even if they don't qualify for public coverage, however the majority of Americans do have private coverage which is why the figures used in this video were used to compare to the Canadian system
I've lived under both. Yes, you have to pay in the US. Through my work, I pay about $700/mo. for medical and dental (tax free). Each doctor visit has a $30 co-pay, and I have a $700. deductible each year which has to be satisfied before any procedure is 'free'. Sounds like a lot. But, at a household income of over 100K, my federal tax bill was $8500. And my state has no state tax. And I can get an MRI tomorrow if I need it (and I have). And it's easy to find a doctor - take your pick. And that old canard about patients being throw out of the hospital if they can't pay? Reagan disallowed that back in 1986.
A Canadian friend of mine has been living in the USA for 30+ years, recently she was diagnosed with terminal cancer. Her insurance company cut her off of paliative care. She hired a lawyer and got her care. Definitly a profit driven system.
It is true that hospitals in the United States must provide primary care. It is true that they must stabilize the patient. It is not true that they must give the patient a knee replacement or a heart transplant and it's most certainly not true that they cannot put a patient who cannot afford to pay into bankruptcy. They are required to offer the minimum level of care required to stabilize the patient to the point where they can release the patient to go home, but they can seize that home to collect their fees. If you have adequate private health insurance, or deep pockets, you can get good care, often better and quicker care in the United States. If you don't have these things, you will receive minimal care. The idea that money or no, you will quickly receive that knee replacement in the United States is nothing more than a pipe dream. As for that famous lower tax bill, the simple truth is this. The public cost of Canada's system, the part financed by tax dollars, is cheaper than the public cost of the American system, by more than $2,000(USD)/person per year. Healthcare is not the reason Canada's taxes are higher. The primary reason Canada's taxes are higher is this. Canadian governments pay more of their bills than U.S. governments do. In 2023, Canadian Federal and Provincial governments financed 91% of their spending through revenue and 9% through deficits and borrowing. In the United States, the Federal and state governments, in 2023, financed 78% of their spending through revenue and 22% through deficits and borrowing. This is not something new. You have to go all the way back to Bill Clinton, to find a time when the United States financed more of its public spending through tax dollars and less through deficit than Canada. America's taxes are lower because America runs bigger deficits and borrows more. Yes, America's population is much bigger than Canada's, but remember, I'm not just talking overall, I'm talking per person. The United States Federal and State governments borrowed more than $5,000/person to finance their operations in 2023. In Canada, that figure was $1,600(USD)/person.
It's not free, but it is cheaper than the U.S. system. Government spending on healthcare in Canada, is roughly $2,000/person lower than it is in the United States. Even the public, taxpayer funded portion of our system is cheaper than the public taxpayer funded portion of the U.S. system.
Such a great breakdown of two very complex, very different healthcare systems! Thank you for the video and all the hard work that clearly went into making it!
Very interesting video! Thank you for taking the time to create this and break it down. I am a Canadian who has traveled to the states for long periods due to post-secondary schooling. I am definitely trying to learn more about the differences and figure out the staple differences that may impact my life if I were to move. Looking forward to Part 2!
Thank you so much! I am an American who is exploring permanent residency in Canada. However, as a high earning, relatively healthy person, the tax/healthcare trade off is the biggest concern for me. It’s been hard to find nuanced explanations of the differences, and your video was SO helpful. I’m heading to part 2 now 🤓
Here's a little tidbit for you. The primary reason Canadian taxes are higher than American taxes has nothing to do with healthcare. In fact the public, taxpayer funded portion of healthcare in Canada is cheaper. Canadian federal and provincial governments spent $4,455(USD) per person on healthcare in 2023. The various levels of government in the United States spent $6,980/person. So why are our taxes higher? One word: deficit. In Canada in 2024, our combined federal and provincial budget deficits amounted to about $1,600(USD)/person. In the United States, that figure was more than $5,000/person. Our combined federal and provincial deficits amount to 3% of Canada's GDP. In the United States, that figure is 6%. Roughly 9% of federal and provincial funding comes from deficits. In the United States, roughly 22% of federal and state funding comes from deficits. Our combined federal/provincial debt is about $42,000(USD)/person. In the U.S. that figure is more than $100,000. Canada's taxes are higher primarily because Canada relies more on revenue and less on borrowing.
Yes we do :) The resident union is called PARO and a complete breakdown of our private insurance plans can be found here: myparo.ca/during-residency/#your-benefits A portion of our pay check is taken biweekly to fund this
You should of discussed wait times and specialists and compare that data from each country. There are so many Canadians in Arizona getting surgeries done they would of waited years for in Canada
Hi Lindsay thanks for the insight. Hopefully I will be able to film part 2 in a few weeks. This is also true for imaging as well as many Canadians flee to the US for MRIs and other tests that would otherwise require months of waiting here.
I am in a specialty in Detroit, and before 9/11 (which added some minor hassles to casually crossing the border) I saw 2-5 Canadian patients most weeks who lived in the Windsor-Essex area of Ontario, including retirees, kids, and other people who wouldn't routinely have to travel to Michigan. It dropped down a bit after 9/11, to more like 1-2 per month, primarily patients who lived in Ontario and worked on the Michigan side of the border, and had to cross almost daily anyway. During the worst part of the Covid pandemic, there were no patients from Canada at first, because of all the restrictions in crossing the border. Eventually, there were concessions for people who needed medical care, and they would have temporary clearance to cross the border for the medical visits, and then would need proof of a negative Covid test to re-enter Ontario. Even though it hasn't gone back to what it was pre-pandemic, and certainly not to what it was pre-9/11, I still get the occasional patient from Ontario. At every point, my Canadian patients take my printed or handwritten prescriptions back home to their GP, so they can be rewritten by the GP and filled at a pharmacy in Ontario, so that OHIP will cover the Rx. The occasional exception to this rule is my Canadian patients who work here in metro Detroit, and therefore have insurance in Michigan through their employer that will cover their prescriptions here, and only if it is a short-term treatment with something that is relatively cheap on either side of the border, such as a generic antibiotic. My patients also get a printed bill with diagnosis codes so that they can try to get reimbursement from OHIP. I'm not sure how often that works, or if they have the entire cost covered. For patients who need a minor surgical procedure, which can be completed in the office and only requires local anesthesia, they might choose to have it with me and take a receipt for OHIP reimbursement later, or they might use my consultation note as a way to get a consultation with the same specialty in Ontario moved up on an urgent basis. For more extensive surgical procedures that require general anesthesia and/or access to the OR, they always use my note to get moved up higher on the waiting list for the specialty in Ontario. So basically, my patients who only have OHIP try to have whatever they possibly can paid for in Ontario. And even a good number of my patients who have both OHIP and an employer-based policy from a job in Michigan still try to get whatever they can in Ontario, because drug prices and other things are so much more affordable on that side of the border.
@@TakenTook Hello doctor, with all due respect, OHIP does not cover the costs of medications (as I have shown in my video). Prescriptions are less expensive in Canada than the US (as I have also stated in this video), however everyone over the age of 25 but under the age of 65 will need to pay for any medication received from their pharmacy unless they have private insurance or pay for separate drug plans. Here it a helpful article for the various types of drug coverage in Ontario and who qualifies: settlement.org/ontario/health/ohip-and-health-insurance/ontario-health-insurance-plan-ohip/how-can-i-pay-for-prescription-medicine/ - In regards to your other comments about being moved up lists for procedures if a patient presents a note from a specialist that they have seen in the US - I personally have never once seen or heard from a patient that this has happened to. It is also directly refuted by the Ontario government website: www.ontario.ca/page/wait-times-see-specialist-and-surgery#section-3 - In regards to your comments about OHIP covering costs of healthcare obtained in the US - this is the government of Ontario's official statement on this matter as well as the link to this policy: www.health.gov.on.ca/en/public/programs/ohip/outofcountry/travellers.aspx Out of Country Health Services The Ministry of Health is re-instating OHIP coverage for emergency OOC hospital, health facility and doctor services retroactive to January 1, 2020 at the same reimbursement rates and the same coverage criteria that existed prior to the cancellation of the OOC Travellers Program (treatment is for medical conditions that are acute and unexpected, arose while outside the country, and require immediate treatment) for Ontarians travelling outside of Canada. OHIP will only cover a very limited amount of the costs if you receive emergency health services while you’re travelling outside Canada. OHIP may cover the following OOC emergency services: doctor services (e.g. medical assessments, emergency surgery) emergency outpatient services (e.g. MRIs, CT scans) emergency inpatient services (e.g. hospital stays, nursing services) Best
@@nxtgenmd -- I'm not saying the drugs are free on the Canadian side, or that the entire cost is covered by OHIP. I am saying that the Canadian patients will get the drugs for much cheaper from pharmacies on the Canadian side of the border, because the drug prices are cheaper there for most things. But the Canadian pharmacists cannot honor my prescriptions, because I am licensed in Michigan, and not in Ontario. So my Canadian patients take my paper Rx and printed visit note to their Canadian GP, and the GP writes for the drug with his or her Canadian license, so that it can be filled at a Canadian pharmacy. Even if OHIP is paying zero dollars towards the cost of the drug, and the Canadian patient is completely paying for the drug out of pocket, the cash price of that drug is much cheaper in Ontario than what they would pay as a cash price at a pharmacy in Michigan. All I can tell you is that I have had a number of Canadian patients over the years, although only two of them resumed coming in after the pandemic because of the hassle of going back-and-forth over the bridge and timing the Covid testing so they would be allowed reentry into Ontario.
@@nxtgenmd -- Perhaps the reason I had the perception that OHIP was paying at least part of the cost (after an Rx was re-written by a Canadian physician, and filled by Canadian pharmacy) was because a fair number of my Canadian patients were children being brought in by their parents, therefore under the age of 25. And a handful of them were patients over the age of 65, which based on your reply also sounds like a group that could get drugs covered by OHIP.
My friend who lives in the US has a few similar health issues as me and we are always discussing the differences in care, available resources etc. Also, I was shocked that it says OHIP covers ambulance services...I have always gotten a bill when I've needed an ambulance
It's an interesting comparison for sure - especially since we have many similarities but the differences can really pronounced. If you feel like sharing, I'd love to know how you think your experience here compares with your friend's in the states :) Here's the detailed breakdown for Ontario ambulance coverage if you want to read more: www.health.gov.on.ca/en/public/publications/ohip/amb.aspx#:~:text=Your%20ambulance%20transportation%20costs%20are,ambulance%20service%20medically%20necessary%2C%20and
Ohip pays 200 for an ambulance. The patient pays 45. The price hasn't changed since the 90s. ER doctors rarely fill out the form to make the ambulance medically necessary. It is common for the hospital to collect the money before the person sees the doctor.
@@Farnsworth11-- which is still a bargain, compared to how much it costs the patient for an ambulance to the hospital here in the states. Depending on how much needs to be done to the patient in transit, an ambulance ride here in Michigan can cost between $500 and $1000, and sometimes much more than $1000. And insurance sometimes won't pay for it at all, which is why some patients will decline Ambulance transport and have someone drive them instead.
We know the Canadian healthcare systems, post-COVID, are in crisis. Although we don't see it in the news as often, it looks as though the American systems are in crisis too. I would be really interested in a video comparing Canada and the US specifically in terms of recovery from the pressure of COVID.
Just got home from having a tumur removed from my bladder, 1968-69 left femur and hip rebuilt, 2010 left knee replaced, 2023 right knee replaced and 2024 the right knee replaced ( I was really rough on it). These were all done by excellant doctors with great results. All done in Canadian hospitals for a grand total of $000.00! If I was in the US I would have been selling pencils on a street corner from 1968.
There's some secondary effects that are difficult to quantify. For example, having healthcare tied to your work means there is an additional dynamic at play between employers and employees that isn't present in Canada. Losing your job in the States effectively becomes losing (or at least making more expensive) your healthcare access Very nice video btw :)
Hello sir, your videos are really helpful, but I have a question that an img from india who completed his mccqe and nac exam in his final year of medical college then how he get his PR before apply through carms because it requires citizenship or PR
Services are billed. That’s it. The US gives tax breaks to companies if companies provide a public good. Many pay for private health insurance, so when you see a doc, your doctors company sends your health insurer the bill. FYI I’m having a superficial mass removed & im paying out of pocket. I have health insurance but I’m not using it. My estimate is under 10k usd
There's no health care in Canada!!! Finding a family doctor or walk-in clinic is impossible!!! This country became a disaster and nightmare!!! one has to go to a hospital emergency and wait for 5 hours to see a doctor for a minor or any problem. What kind of country is that?
In a single-payer system, all users are at the mercy of the single-payer. If all-powerful OHIP feels generous, Ontarians get efficient service and high taxes but if he feels stingy Ontarians get inefficient service but hopefully lower taxes.
The reason it is hard to find prices of hospital visits in most states is because in most states it is illegal for hospitals to advertise their prices! Or even post their prices. Which is ridiculous in my opinion. I'm in medical school and I know doctors hate this law. I know patients hate this law. So how is this a law? But typically when you are uninsured, hospitals charge you way less than they would charge your insurance. For a few years I put the $300 I was spending per month on health insurance into a savings account instead in case something happened. I realized I was charged way less that my insurance got billed when I had insurance. Doctors visits with a specialist were about $100 without insurance. I never had to stay in the ER though so I don't know how much that would have been.
Hi Olivia :) thanks for the insight - especially about the law that makes it illegal for hospitals to advertise their prices. I’ll need to look into this more sometime. From what I’ve seen, one of the biggest problems with not having insurance in the US becomes most apparent when accessing emergency services, ICU care or major surgeries - I’m hoping that you don’t need these anytime soon. All the best with your training and thanks 🤙
Big difference is Canadians don't go bankrupt due to healthcare costs nor do they have to resort to "Go Fund me" to help pay for healthcare costs. You didn't mention that in the video, so I figured I would.
Unfortunately, things are not so simple as saying that bankruptcies in Canada don't happen due to healthcare costs. You are welcome to read more on this article from bankruptcycanada.com which describes why 19% of all Canadian bankruptcies list healthcare related insolvency. bankruptcycanada.com/should-i-file-bankruptcy-for-medical-expenses-and-health-care-obligations/ Hospital visits and treatment are usually much less expensive in Canada, but for many patients, unfortunately becoming sick does still lead to financial ruin regardless of where you live. I wish you all the best with whatever you are experiencing right now.
@@TallicaMan1986 Oh really? You would think that after 65 years I would of seen the country go bankrupt by now then. So if it is failing like you say it is we should be bankrupt by now instead of being one of the richest countries in the world. So our currency can't be doing all that bad despite your claims lol. You seem somewhat ignorant as to the actual facts which screams, I'm an American lol. Regardless we Canadians all have healthcare coverage nonetheless. Don't stress yourself about our currency because we're not stressed about it and are doing just fine thanx. By the way have you taken a good look at America's debt load lately lol? As a matter of fact you don't see to many countries going bankrupt because they have universal healthcare We have a freedom that Americans just don't have, we have access to affordable healthcare and prescription drugs. It's called taking care of your own, America should try it sometime.
@kosys5338 are you kidding.... we're not broke yet because were amassing an unpayable amount of debt. You also clearly don't understand America's debt amd why that is Just say you know nothing about our economy and you know nothing about how much money we don't actually have. Other countries with with universal health care aren't importing cheap labour, they keep their population in check and they're taxing them Far FAR MORE than what we're being taxed They also have a way more powerful currency than we do. Youre so hilariously out of the loop that I bet you sincerely believed a labour shortage was happening.
@@kosys5338 Why would we go bankrupt? Being in debt means you don't have money. We keep printing our canadian fun bucks. It's going to be worth 40 cents by the end of next year. Then we'll see how universal health care really is.
The states' healthcare is costly, but doctors work with individuals. Offer payment plans or private plans to the government assistance program. I hear Canada 🇨🇦 is much better. 😮
Don't forget to include wait times in the list of comparisons. Covid-19 has caused them to shoot up in the US, but they are likely still better than in Canada.
Everyone in the US can now get health insurance. The premiums vary by level of coverage, the companies and the states. I like Gold and Platinum packages!
If you have systemic chronic conditions prior to purchasing an individual medical coverage, you may not qualify or have to pay very high monthly premiums which not everyone can afford. Not every employer provides a coverage if a company is under 50 employees. Good luck!
17% of adults with health care debt declared bankruptcy or lost their home because of it. 66.5% of bankruptcies are caused directly by medical expenses, making it the leading cause for bankruptcy. As of April 2022, 14% of Americans with medical debt planned to declare bankruptcy later in the year because of it. Does that happen in Canada?
Medically related bankrupy is much less common in Canada, but does still occur. Not all services are government funded and prescription drugs are often cited as one of the most common causes of medically related bankruptcy in Canada - www.debtreliefcanada.com/types-of-debt/medical-debt/ By contrast, wait times for imaging or procedures often lead to delays in treatment and in some case preventable mortality. According to the national post, an estimated 2000 people died awaiting medical care in Canada - nationalpost.com/news/canada/more-than-2000-patients-in-canada-died-while-waiting-for-medical-care-in-2020-report/wcm/6a469c30-86b1-4a9a-bfc3-576c72559cc6/amp/ Neither system is perfect - but acknowledging the realities of them may help guide future solutions. Thank you.
I’m living in marysville oh usa, canada health care still you can count free my friend, I went asthma specialist with in network my insurance I paid 75 dollar, they show me skin allergies test 750 dollar after my insurance covered price, this means my responsibility to pay 750 dollar, what are you talking about my friend, I have been living in usa for 10 years, and I’m preparing to immigrate to Germany because of this situation, my wife she was stayed hospital in Baytown Texas about Overion sicst just 2 night. In network with my insurance no surgery just antibiotics and pain killer, we got 5000 dollar bill, don’t be funny please
@@John-cncoperator my wife move from canada to the netherlands and marrey me 13 years ago. our system is so must better! need a scan or mri scan,maybe 2 days to wait or sometimes the same day, we only pay a amount of 275 for us together and EVERTHING is include!
To really compare Canada's wait times people don't think about... In Canada, it takes several weeks to see a GP. Then it takes about 6 months-over a year to see a specialist. Does the specialist think you need an MRI? Well that'll be another 3 months. CT scan? That's a little better wait at a month and a half. Then you often have to wait up to 6 months to get your results. It can take over 2 years to just get a diagnosis in Canada that would take 2 days in the US. and that includes the really serious stuff like Cancer. Then for treatment? It can take over another year to have surgery. 10s of thousands of Canadians die each year waiting for surgery. These wait times are life or death for many people. The average Canadian is spending $14,000ish in taxes for healthcare coverage each year according to this video. Which doesn't even include time that may have to be taken off work due to pain and disease while waiting for these procedures. The average cost of health insurance in the US for a family is $20,000 per year with employers covering an average of 73% health insurance cost so the workers pay $6,000ish per year on average. I have never had to wait to get an MRI in the US. Any time it has been an emergency, everyone I know is able to find a specialist that day. If doctors suspect something as serious as cancer in the US, doctors will get all diagnostic tests done that day with just a few days wait for your result. Which can be life saving for any diseases spreading quickly. Soo would you rather pay $14,000 to wait years for treatment? Where you have way less options of where you can be seen or what treatments you even can receive? Or would you rather pay $6,000 per year to be seen right away? Even if you have a high premium of $2,000, that is $8,000 we are paying out of pocket. And still way less than Canadians but with more say.
@@Olivia-bl8ezPerfectly said. When my hubby's doctor found tumor in his left kidney, he was scheduled for surgery and the waiting time is less than 2 wks from when the doctor found tumor. The bill was 18k and he just pay $100 so cheap. My sister had 2x aneurysm and uses Medicaid, that means she don't have to pay anything. Her life was saved from a terrible aneurysm. The best doctors are here in USA 🇺🇸
@@Olivia-bl8ezyou forgot to mention that those who don’t have insurance in the US end up with huge bills that can potentially bankrupt them, whereas no one has to worry about that in Canada. If you lose your job, you lose your insurance. If you go on medical leave for more than three months, your company stops paying their share of your coverage, you go on Cobra and end up paying the full cost of insurance yourself. If you don’t have income, even temporarily, you are in trouble, especially if you need medical help. This does not happen in Canada. There may be delays, but you are covered, job or no job. That’s a huge plus.
My oldest son and his wife had a baby a few months ago there wasn't a hospital bill , I heard in the US it is a $10,000 bill ... Broken elbow is free in Canada and several thousand in the US .. How do you mean US and Canada pay the same for services ..
Not the worst explanation I've seen online, however...? There are 40 million Canadians now in mid- 2023. The income vs Taxes paid scale is not so clear. The 'poverty rate" changes almost every year which lowers the income tax due for an individual. There are many ways to reduce gross income liability for tax and anyone below $18,000 per year may not pay a full amount in the tax data chart at all. Each province has a different tax structure which affects total income taxes due. There are 10 Provinces and with the three territories that share the same scale under the same Federal authority. Most every modern Country uses some form of UNIVERSAL healthcare funding. The USA is all ALONE with complex, multi-level plans, costs, systems and applications. In CANADA, all "911" services are a right, not to be charged, invoiced or billed.
Hi Glen, its a complicated topic for sure. I have made every attempt to display all data sources presented here which should be entirely factual and fairly represented. As is my understanding, the US is not alone with incomplete funding for complex care as China currently operates under a private/public model that does not cover inpatient or some outpatient treatment. The Chinese system also relies on concepts of deductibles, copayments and reimbursement ceilings as I have been made aware. There are pros and cons of each system. For every Canadian that I've spoken with about the pros of our system, I've also met someone who's adamantly against it. However, this is the current situation. Part 2 should be out shortly when I find some time to record. All the best
Hi everyone :) I hope the video was helpful in providing a high level look and comparison at the Canadian and American healthcare systems. Just 2 quick points to bring up...
#1. I couldn't possibly cover everything in 1 video - the failures of both systems, instances where people slip through the cracks, how we can improve, etc. Much of these things will be touched on in part 2 of the series. Feel free to share suggestions with me if you'd like.
#2. at the end of the video in the "final thoughts," section when I arrive at the conclusion that both Canadians and American's will spend approximately the same per year on their healthcare, many assumptions are taken. For instance, the average family income is higher in the US than Canada. In addition, when it comes to privatized healthcare - I understand that not all American have private insurance even if they don't qualify for public coverage, however the majority of Americans do have private coverage which is why the figures used in this video were used to compare to the Canadian system
I've lived under both.
Yes, you have to pay in the US. Through my work, I pay about $700/mo. for medical and dental (tax free). Each doctor visit has a $30 co-pay, and I have a $700. deductible each year which has to be satisfied before any procedure is 'free'.
Sounds like a lot. But, at a household income of over 100K, my federal tax bill was $8500. And my state has no state tax.
And I can get an MRI tomorrow if I need it (and I have).
And it's easy to find a doctor - take your pick.
And that old canard about patients being throw out of the hospital if they can't pay? Reagan disallowed that back in 1986.
Appreciate the first hand experience 🤙 thanks for sharing
A Canadian friend of mine has been living in the USA for 30+ years, recently she was diagnosed with terminal cancer. Her insurance company cut her off of paliative care. She hired a lawyer and got her care. Definitly a profit driven system.
It is true that hospitals in the United States must provide primary care. It is true that they must stabilize the patient. It is not true that they must give the patient a knee replacement or a heart transplant and it's most certainly not true that they cannot put a patient who cannot afford to pay into bankruptcy. They are required to offer the minimum level of care required to stabilize the patient to the point where they can release the patient to go home, but they can seize that home to collect their fees.
If you have adequate private health insurance, or deep pockets, you can get good care, often better and quicker care in the United States. If you don't have these things, you will receive minimal care. The idea that money or no, you will quickly receive that knee replacement in the United States is nothing more than a pipe dream.
As for that famous lower tax bill, the simple truth is this. The public cost of Canada's system, the part financed by tax dollars, is cheaper than the public cost of the American system, by more than $2,000(USD)/person per year. Healthcare is not the reason Canada's taxes are higher.
The primary reason Canada's taxes are higher is this. Canadian governments pay more of their bills than U.S. governments do.
In 2023, Canadian Federal and Provincial governments financed 91% of their spending through revenue and 9% through deficits and borrowing. In the United States, the Federal and state governments, in 2023, financed 78% of their spending through revenue and 22% through deficits and borrowing.
This is not something new. You have to go all the way back to Bill Clinton, to find a time when the United States financed more of its public spending through tax dollars and less through deficit than Canada.
America's taxes are lower because America runs bigger deficits and borrows more. Yes, America's population is much bigger than Canada's, but remember, I'm not just talking overall, I'm talking per person. The United States Federal and State governments borrowed more than $5,000/person to finance their operations in 2023. In Canada, that figure was $1,600(USD)/person.
As someone who was born and grew up in Ontario, this is really eye opening. We throw around "free healthcare" far too much
I definitely agree - there's a lot to love about our healthcare system, but a lot that people don't know about it as well
It's not free, but it is cheaper than the U.S. system. Government spending on healthcare in Canada, is roughly $2,000/person lower than it is in the United States. Even the public, taxpayer funded portion of our system is cheaper than the public taxpayer funded portion of the U.S. system.
Fantastic summary and comparison! Very concise and helpful in exploring the complexities of the two systems
Such a great breakdown of two very complex, very different healthcare systems! Thank you for the video and all the hard work that clearly went into making it!
Thanks dude - I hope all's been well on your end lately 💪
@@nxtgenmd thanks man! Just finishing up 1st year of med school now 💪
@@hunternord3379 Awesome man! Keep up the hard work
Very interesting video! Thank you for taking the time to create this and break it down. I am a Canadian who has traveled to the states for long periods due to post-secondary schooling. I am definitely trying to learn more about the differences and figure out the staple differences that may impact my life if I were to move. Looking forward to Part 2!
Thank you so much! I am an American who is exploring permanent residency in Canada. However, as a high earning, relatively healthy person, the tax/healthcare trade off is the biggest concern for me. It’s been hard to find nuanced explanations of the differences, and your video was SO helpful. I’m heading to part 2 now 🤓
Can we trade citizenships. Please.
Here's a little tidbit for you. The primary reason Canadian taxes are higher than American taxes has nothing to do with healthcare. In fact the public, taxpayer funded portion of healthcare in Canada is cheaper. Canadian federal and provincial governments spent $4,455(USD) per person on healthcare in 2023. The various levels of government in the United States spent $6,980/person.
So why are our taxes higher? One word: deficit.
In Canada in 2024, our combined federal and provincial budget deficits amounted to about $1,600(USD)/person. In the United States, that figure was more than $5,000/person.
Our combined federal and provincial deficits amount to 3% of Canada's GDP. In the United States, that figure is 6%.
Roughly 9% of federal and provincial funding comes from deficits. In the United States, roughly 22% of federal and state funding comes from deficits.
Our combined federal/provincial debt is about $42,000(USD)/person. In the U.S. that figure is more than $100,000.
Canada's taxes are higher primarily because Canada relies more on revenue and less on borrowing.
As a FM resident do you get health insurance?
Yes we do :) The resident union is called PARO and a complete breakdown of our private insurance plans can be found here: myparo.ca/during-residency/#your-benefits
A portion of our pay check is taken biweekly to fund this
You should of discussed wait times and specialists and compare that data from each country. There are so many Canadians in Arizona getting surgeries done they would of waited years for in Canada
Hi Lindsay thanks for the insight. Hopefully I will be able to film part 2 in a few weeks. This is also true for imaging as well as many Canadians flee to the US for MRIs and other tests that would otherwise require months of waiting here.
I am in a specialty in Detroit, and before 9/11 (which added some minor hassles to casually crossing the border) I saw 2-5 Canadian patients most weeks who lived in the Windsor-Essex area of Ontario, including retirees, kids, and other people who wouldn't routinely have to travel to Michigan.
It dropped down a bit after 9/11, to more like 1-2 per month, primarily patients who lived in Ontario and worked on the Michigan side of the border, and had to cross almost daily anyway.
During the worst part of the Covid pandemic, there were no patients from Canada at first, because of all the restrictions in crossing the border. Eventually, there were concessions for people who needed medical care, and they would have temporary clearance to cross the border for the medical visits, and then would need proof of a negative Covid test to re-enter Ontario.
Even though it hasn't gone back to what it was pre-pandemic, and certainly not to what it was pre-9/11, I still get the occasional patient from Ontario.
At every point, my Canadian patients take my printed or handwritten prescriptions back home to their GP, so they can be rewritten by the GP and filled at a pharmacy in Ontario, so that OHIP will cover the Rx.
The occasional exception to this rule is my Canadian patients who work here in metro Detroit, and therefore have insurance in Michigan through their employer that will cover their prescriptions here, and only if it is a short-term treatment with something that is relatively cheap on either side of the border, such as a generic antibiotic.
My patients also get a printed bill with diagnosis codes so that they can try to get reimbursement from OHIP. I'm not sure how often that works, or if they have the entire cost covered.
For patients who need a minor surgical procedure, which can be completed in the office and only requires local anesthesia, they might choose to have it with me and take a receipt for OHIP reimbursement later, or they might use my consultation note as a way to get a consultation with the same specialty in Ontario moved up on an urgent basis.
For more extensive surgical procedures that require general anesthesia and/or access to the OR, they always use my note to get moved up higher on the waiting list for the specialty in Ontario.
So basically, my patients who only have OHIP try to have whatever they possibly can paid for in Ontario. And even a good number of my patients who have both OHIP and an employer-based policy from a job in Michigan still try to get whatever they can in Ontario, because drug prices and other things are so much more affordable on that side of the border.
@@TakenTook
Hello doctor, with all due respect, OHIP does not cover the costs of medications (as I have shown in my video). Prescriptions are less expensive in Canada than the US (as I have also stated in this video), however everyone over the age of 25 but under the age of 65 will need to pay for any medication received from their pharmacy unless they have private insurance or pay for separate drug plans. Here it a helpful article for the various types of drug coverage in Ontario and who qualifies: settlement.org/ontario/health/ohip-and-health-insurance/ontario-health-insurance-plan-ohip/how-can-i-pay-for-prescription-medicine/
- In regards to your other comments about being moved up lists for procedures if a patient presents a note from a specialist that they have seen in the US - I personally have never once seen or heard from a patient that this has happened to. It is also directly refuted by the Ontario government website:
www.ontario.ca/page/wait-times-see-specialist-and-surgery#section-3
- In regards to your comments about OHIP covering costs of healthcare obtained in the US - this is the government of Ontario's official statement on this matter as well as the link to this policy: www.health.gov.on.ca/en/public/programs/ohip/outofcountry/travellers.aspx
Out of Country Health Services
The Ministry of Health is re-instating OHIP coverage for emergency OOC hospital, health facility and doctor services retroactive to January 1, 2020 at the same reimbursement rates and the same coverage criteria that existed prior to the cancellation of the OOC Travellers Program (treatment is for medical conditions that are acute and unexpected, arose while outside the country, and require immediate treatment) for Ontarians travelling outside of Canada.
OHIP will only cover a very limited amount of the costs if you receive emergency health services while you’re travelling outside Canada.
OHIP may cover the following OOC emergency services:
doctor services (e.g. medical assessments, emergency surgery)
emergency outpatient services (e.g. MRIs, CT scans)
emergency inpatient services (e.g. hospital stays, nursing services)
Best
@@nxtgenmd -- I'm not saying the drugs are free on the Canadian side, or that the entire cost is covered by OHIP. I am saying that the Canadian patients will get the drugs for much cheaper from pharmacies on the Canadian side of the border, because the drug prices are cheaper there for most things. But the Canadian pharmacists cannot honor my prescriptions, because I am licensed in Michigan, and not in Ontario.
So my Canadian patients take my paper Rx and printed visit note to their Canadian GP, and the GP writes for the drug with his or her Canadian license, so that it can be filled at a Canadian pharmacy.
Even if OHIP is paying zero dollars towards the cost of the drug, and the Canadian patient is completely paying for the drug out of pocket, the cash price of that drug is much cheaper in Ontario than what they would pay as a cash price at a pharmacy in Michigan.
All I can tell you is that I have had a number of Canadian patients over the years, although only two of them resumed coming in after the pandemic because of the hassle of going back-and-forth over the bridge and timing the Covid testing so they would be allowed reentry into Ontario.
@@nxtgenmd -- Perhaps the reason I had the perception that OHIP was paying at least part of the cost (after an Rx was re-written by a Canadian physician, and filled by Canadian pharmacy) was because a fair number of my Canadian patients were children being brought in by their parents, therefore under the age of 25. And a handful of them were patients over the age of 65, which based on your reply also sounds like a group that could get drugs covered by OHIP.
My friend who lives in the US has a few similar health issues as me and we are always discussing the differences in care, available resources etc.
Also, I was shocked that it says OHIP covers ambulance services...I have always gotten a bill when I've needed an ambulance
It's an interesting comparison for sure - especially since we have many similarities but the differences can really pronounced. If you feel like sharing, I'd love to know how you think your experience here compares with your friend's in the states :)
Here's the detailed breakdown for Ontario ambulance coverage if you want to read more: www.health.gov.on.ca/en/public/publications/ohip/amb.aspx#:~:text=Your%20ambulance%20transportation%20costs%20are,ambulance%20service%20medically%20necessary%2C%20and
Ohip pays 200 for an ambulance. The patient pays 45. The price hasn't changed since the 90s. ER doctors rarely fill out the form to make the ambulance medically necessary. It is common for the hospital to collect the money before the person sees the doctor.
@@Farnsworth11-- which is still a bargain, compared to how much it costs the patient for an ambulance to the hospital here in the states. Depending on how much needs to be done to the patient in transit, an ambulance ride here in Michigan can cost between $500 and $1000, and sometimes much more than $1000. And insurance sometimes won't pay for it at all, which is why some patients will decline Ambulance transport and have someone drive them instead.
What are the differences you all have noticed?
We know the Canadian healthcare systems, post-COVID, are in crisis. Although we don't see it in the news as often, it looks as though the American systems are in crisis too. I would be really interested in a video comparing Canada and the US specifically in terms of recovery from the pressure of COVID.
Just got home from having a tumur removed from my bladder, 1968-69 left femur and hip rebuilt, 2010 left knee replaced, 2023 right knee replaced and 2024 the right knee replaced ( I was really rough on it). These were all done by excellant doctors with great results. All done in Canadian hospitals for a grand total of $000.00! If I was in the US I would have been selling pencils on a street corner from 1968.
There's some secondary effects that are difficult to quantify. For example, having healthcare tied to your work means there is an additional dynamic at play between employers and employees that isn't present in Canada. Losing your job in the States effectively becomes losing (or at least making more expensive) your healthcare access
Very nice video btw :)
Medicaid Cobra
Hey great video! Acceptances just came out for Canada med, can you make a video on some tips for MS1s?
are the monetary values in USD? or are they in Canadian Dollars when talking about Canada, and in USD when talking about United States?
Hello sir, your videos are really helpful, but I have a question that an img from india who completed his mccqe and nac exam in his final year of medical college then how he get his PR before apply through carms because it requires citizenship or PR
Services are billed. That’s it. The US gives tax breaks to companies if companies provide a public good. Many pay for private health insurance, so when you see a doc, your doctors company sends your health insurer the bill.
FYI I’m having a superficial mass removed & im paying out of pocket. I have health insurance but I’m not using it. My estimate is under 10k usd
There's no health care in Canada!!! Finding a family doctor or walk-in clinic is impossible!!! This country became a disaster and nightmare!!! one has to go to a hospital emergency and wait for 5 hours to see a doctor for a minor or any problem. What kind of country is that?
In a single-payer system, all users are at the mercy of the single-payer. If all-powerful OHIP feels generous, Ontarians get efficient service and high taxes but if he feels stingy Ontarians get inefficient service but hopefully lower taxes.
The reason it is hard to find prices of hospital visits in most states is because in most states it is illegal for hospitals to advertise their prices! Or even post their prices. Which is ridiculous in my opinion. I'm in medical school and I know doctors hate this law. I know patients hate this law. So how is this a law?
But typically when you are uninsured, hospitals charge you way less than they would charge your insurance. For a few years I put the $300 I was spending per month on health insurance into a savings account instead in case something happened. I realized I was charged way less that my insurance got billed when I had insurance. Doctors visits with a specialist were about $100 without insurance. I never had to stay in the ER though so I don't know how much that would have been.
Hi Olivia :) thanks for the insight - especially about the law that makes it illegal for hospitals to advertise their prices. I’ll need to look into this more sometime. From what I’ve seen, one of the biggest problems with not having insurance in the US becomes most apparent when accessing emergency services, ICU care or major surgeries - I’m hoping that you don’t need these anytime soon.
All the best with your training and thanks 🤙
Big difference is Canadians don't go bankrupt due to healthcare costs nor do they have to resort to "Go Fund me" to help pay for healthcare costs. You didn't mention that in the video, so I figured I would.
Unfortunately, things are not so simple as saying that bankruptcies in Canada don't happen due to healthcare costs. You are welcome to read more on this article from bankruptcycanada.com which describes why 19% of all Canadian bankruptcies list healthcare related insolvency.
bankruptcycanada.com/should-i-file-bankruptcy-for-medical-expenses-and-health-care-obligations/
Hospital visits and treatment are usually much less expensive in Canada, but for many patients, unfortunately becoming sick does still lead to financial ruin regardless of where you live.
I wish you all the best with whatever you are experiencing right now.
You're right! The country just buries itself in debt with a falling currency.
@@TallicaMan1986
Oh really? You would think that after 65 years I would of seen the country go bankrupt by now then. So if it is failing like you say it is we should be bankrupt by now instead of being one of the richest countries in the world. So our currency can't be doing all that bad despite your claims lol.
You seem somewhat ignorant as to the actual facts which screams, I'm an American lol. Regardless we Canadians all have healthcare coverage nonetheless. Don't stress yourself about our currency because we're not stressed about it and are doing just fine thanx. By the way have you taken a good look at America's debt load lately lol? As a matter of fact you don't see to many countries going bankrupt because they have universal healthcare We have a freedom that Americans just don't have, we have access to affordable healthcare and prescription drugs. It's called taking care of your own, America should try it sometime.
@kosys5338 are you kidding.... we're not broke yet because were amassing an unpayable amount of debt. You also clearly don't understand America's debt amd why that is Just say you know nothing about our economy and you know nothing about how much money we don't actually have.
Other countries with with universal health care aren't importing cheap labour, they keep their population in check and they're taxing them Far FAR MORE than what we're being taxed
They also have a way more powerful currency than we do.
Youre so hilariously out of the loop that I bet you sincerely believed a labour shortage was happening.
@@kosys5338 Why would we go bankrupt? Being in debt means you don't have money. We keep printing our canadian fun bucks. It's going to be worth 40 cents by the end of next year. Then we'll see how universal health care really is.
The states' healthcare is costly, but doctors work with individuals. Offer payment plans or private plans to the government assistance program. I hear Canada 🇨🇦 is much better. 😮
I’m assuming mental health is not covered as well?
Don't forget to include wait times in the list of comparisons. Covid-19 has caused them to shoot up in the US, but they are likely still better than in Canada.
You are mistaking a coinsurance with a co-pay
Everyone in the US can now get health insurance. The premiums vary by level of coverage, the companies and the states. I like Gold and Platinum packages!
If you have systemic chronic conditions prior to purchasing an individual medical coverage, you may not qualify or have to pay very high monthly premiums which not everyone can afford. Not every employer provides a coverage if a company is under 50 employees.
Good luck!
17% of adults with health care debt declared bankruptcy or lost their home because of it. 66.5% of bankruptcies are caused directly by medical expenses, making it the leading cause for bankruptcy. As of April 2022, 14% of Americans with medical debt planned to declare bankruptcy later in the year because of it. Does that happen in Canada?
Medically related bankrupy is much less common in Canada, but does still occur. Not all services are government funded and prescription drugs are often cited as one of the most common causes of medically related bankruptcy in Canada - www.debtreliefcanada.com/types-of-debt/medical-debt/
By contrast, wait times for imaging or procedures often lead to delays in treatment and in some case preventable mortality. According to the national post, an estimated 2000 people died awaiting medical care in Canada - nationalpost.com/news/canada/more-than-2000-patients-in-canada-died-while-waiting-for-medical-care-in-2020-report/wcm/6a469c30-86b1-4a9a-bfc3-576c72559cc6/amp/
Neither system is perfect - but acknowledging the realities of them may help guide future solutions. Thank you.
I’m living in marysville oh usa, canada health care still you can count free my friend, I went asthma specialist with in network my insurance I paid 75 dollar, they show me skin allergies test 750 dollar after my insurance covered price, this means my responsibility to pay 750 dollar, what are you talking about my friend, I have been living in usa for 10 years, and I’m preparing to immigrate to Germany because of this situation, my wife she was stayed hospital in Baytown Texas about Overion sicst just 2 night. In network with my insurance no surgery just antibiotics and pain killer, we got 5000 dollar bill, don’t be funny please
Yet Canadians are the most indebted households in the G7.
@@John-cncoperator my wife move from canada to the netherlands and marrey me 13 years ago. our system is so must better! need a scan or mri scan,maybe 2 days to wait or sometimes the same day, we only pay a amount of 275 for us together and EVERTHING is include!
As an American, I would rather not have a stay in the hospital likely bankrupt me. Those in stay bills can easily hit 5 or 6 figures way too quickly.
To really compare Canada's wait times people don't think about... In Canada, it takes several weeks to see a GP. Then it takes about 6 months-over a year to see a specialist. Does the specialist think you need an MRI? Well that'll be another 3 months. CT scan? That's a little better wait at a month and a half. Then you often have to wait up to 6 months to get your results. It can take over 2 years to just get a diagnosis in Canada that would take 2 days in the US. and that includes the really serious stuff like Cancer. Then for treatment? It can take over another year to have surgery. 10s of thousands of Canadians die each year waiting for surgery. These wait times are life or death for many people. The average Canadian is spending $14,000ish in taxes for healthcare coverage each year according to this video. Which doesn't even include time that may have to be taken off work due to pain and disease while waiting for these procedures.
The average cost of health insurance in the US for a family is $20,000 per year with employers covering an average of 73% health insurance cost so the workers pay $6,000ish per year on average. I have never had to wait to get an MRI in the US. Any time it has been an emergency, everyone I know is able to find a specialist that day. If doctors suspect something as serious as cancer in the US, doctors will get all diagnostic tests done that day with just a few days wait for your result. Which can be life saving for any diseases spreading quickly.
Soo would you rather pay $14,000 to wait years for treatment? Where you have way less options of where you can be seen or what treatments you even can receive? Or would you rather pay $6,000 per year to be seen right away? Even if you have a high premium of $2,000, that is $8,000 we are paying out of pocket. And still way less than Canadians but with more say.
@@Olivia-bl8ezPerfectly said. When my hubby's doctor found tumor in his left kidney, he was scheduled for surgery and the waiting time is less than 2 wks from when the doctor found tumor. The bill was 18k and he just pay $100 so cheap.
My sister had 2x aneurysm and uses Medicaid, that means she don't have to pay anything. Her life was saved from a terrible aneurysm. The best doctors are here in USA 🇺🇸
@@travelloverde1538 thanks for sharing and I hope your husband and sister are doing better now!
@@Olivia-bl8ez Yup! He's back to work and my sister is doing great, it was 8yrs ago when she had her 2nd aneurysm. Thanks ❤️
@@Olivia-bl8ezyou forgot to mention that those who don’t have insurance in the US end up with huge bills that can potentially bankrupt them, whereas no one has to worry about that in Canada. If you lose your job, you lose your insurance. If you go on medical leave for more than three months, your company stops paying their share of your coverage, you go on Cobra and end up paying the full cost of insurance yourself. If you don’t have income, even temporarily, you are in trouble, especially if you need medical help. This does not happen in Canada. There may be delays, but you are covered, job or no job. That’s a huge plus.
assume americans have no private insurance and canadians only government insurance then you compare
My oldest son and his wife had a baby a few months ago there wasn't a hospital bill , I heard in the US it is a $10,000 bill ... Broken elbow is free in Canada and several thousand in the US .. How do you mean US and Canada pay the same for services ..
Not the worst explanation I've seen online, however...? There are 40 million Canadians now in mid- 2023. The income vs Taxes paid scale is not so clear. The 'poverty rate" changes almost every year which lowers the income tax due for an individual. There are many ways to reduce gross income liability for tax and anyone below $18,000 per year may not pay a full amount in the tax data chart at all. Each province has a different tax structure which affects total income taxes due. There are 10 Provinces and with the three territories that share the same scale under the same Federal authority. Most every modern Country uses some form of UNIVERSAL healthcare funding. The USA is all ALONE with complex, multi-level plans, costs, systems and applications. In CANADA, all "911" services are a right, not to be charged, invoiced or billed.
Hi Glen, its a complicated topic for sure. I have made every attempt to display all data sources presented here which should be entirely factual and fairly represented. As is my understanding, the US is not alone with incomplete funding for complex care as China currently operates under a private/public model that does not cover inpatient or some outpatient treatment. The Chinese system also relies on concepts of deductibles, copayments and reimbursement ceilings as I have been made aware.
There are pros and cons of each system. For every Canadian that I've spoken with about the pros of our system, I've also met someone who's adamantly against it. However, this is the current situation. Part 2 should be out shortly when I find some time to record. All the best