Canadian Health Care: One Pastor's Experience

by Rev. Bruce Ervin
Lead Pastor, Knox United Church
Toronto, Ontario, Canada

I am a citizen of the United States living in Canada. I am a member of the Christian Church (Disciples of Christ). For seven years (1980-1987) I served as the Pastor of Hillcrest Christian Church in Toronto, Ontario. Since then I have maintained my membership at Hillcrest while pastoring churches in The United Church of Canada.

I live in a country whose health care system is dedicated to delivering health care services to people who are sick. It doesn’t concern itself with making profits for big, privately owned insurance companies. It knows nothing of pre-existing conditions or co-payments or other factors which may prevent access to the health care that one needs. There’s no such thing as having too much income to be covered by Medicaid but too little income to afford one’s own health insurance. Everyone is covered, regardless of income.

Here is how it works. If you are sick, you go to the doctor. If you don’t have a family physician, you go to a walk-in clinic. Some people will go to the emergency room, but unless you have a genuine emergency requiring hospitalization, there is no need for this. There are plenty of walk-in clinics in Toronto and other Canadian communities.

Before you see the doctor, you must show your health card, which is issued by the provincial government. This proves that an account has been set up in your name by the provincial Ministry of Health. If it is your first visit to this particular doctor, you will be asked to fill out a form which asks standard questions about your medical history and that of your family, and what medications you may be on. Then you wait to see the doctor. Could be five minutes; could be half an hour or more. It depends on whether or not you have an appointment and how busy the doctor is that day.

The doctor will examine you, provide his/her diagnosis, prescribe medicine, send you for tests, refer you to a specialist. In other words, you will receive standard medical attention. When you’re done, you may check back with the receptionist to book another appointment or get forms for tests or a referral. But there is no exchange of cash. You don’t have to pay anything at the doctor’s office. No matter who you are. No matter what your income.

If you need to go back to your doctor for repeated visits while you are healing, no problem. No insurance company is going to tell you that you have exceeded some kind of quota on visits to the doctor. If you must visit a specialist for treatment for your condition, no problem. No insurance company is going to tell you that you aren’t covered for the treatment which that specialist is providing. If you must undergo a long series of tests, no problem. No insurance company is going to tell you that some tests are covered and some aren’t. Well, yes: occasionally there will be a test that isn’t covered by the publicly funded health plan. I had to pay $40.00 for such a test the other day. But the other nine tests which my doctor ordered were covered by our publicly funded universal health care system. And occasionally there will be a treatment that is not covered by our system. You’ll be out of pocket for most physiotherapy, for example. But you won’t be out of pocket for chemotherapy or treatment of a heart condition. Nor will the government make decisions about who is insured and who is not, who gets what treatments and who does not, who lives and who dies. If you are a resident of Canada, you are insured. If you have a medical condition, you are treated. If you move from one province to another, you are still covered by health insurance. The same rules and the same coverage apply to everyone, regardless of who you are, how much money you make or where you live.

Not only do you not have to pay anything at the doctor’s office; in most Canadian provinces you don’t have to pay insurance premiums. The cost of your health care is covered by your provincial and federal taxes. In Ontario (along with Alberta and British Columbia) we do pay a modest premium. But in this province it is simply collected with our provincial taxes. We all have to pay taxes. It is part of our responsibility as citizens of an advanced, progressive nation. It is a way of sharing the load of human care. With a private insurance plan, the larger the group that is insured, the lower the cost to each individual. In Canada, that large group is the entire population of the nation, all 34 million of us. That keeps the cost down for everyone. Canadians pay $3,700 per capita for health care, while citizens of the United States pay $6,700 per capita. It is something like when Jesus invited people to come and share their burdens with him (see Matthew 11:28-30). The yoke is easy and the burden is light when it is born by strong shoulders. Jesus’ shoulders are strong indeed. So is the combined strength of the shoulders of 34 million Canadians.

There is one problem: sometimes you do have to wait a while to see certain specialists and receive certain treatments. The less serious the condition, the longer you have to wait. I have just waited four months to see a rheumatologist so that I can have my aching knees examined. An inconvenience, but not life threatening. I have known parishioners who have waited a month to see an oncologist. That is unacceptable. But I have also known parishioners who have gone to their family doctor for a problem they’ve been having and have been in the oncologist’s office later that week. Doctors try to fit you in for rapid treatment according to the seriousness of your illness. The longer waits sometimes occur when the evidence suggests that your health condition is not putting you in immediate danger. If your body or intuition tell you otherwise, getting a second opinion or other forms of advocacy on your behalf can sometimes reduce the wait time. But the long wait is a problem. We need to train more doctors in Canada. And we may need to put more public funds into the health care system.

The priority of the Canadian health care system is to heal people. Therefore the funds are allocated so that doctors, nurses and technicians can do the work of healing that they’re called to do. The priority of private health insurance companies is to make money. Therefore funds are sometimes withheld from people needing healing because allocating maximum funds for maximum healing would erode their profit margin. When citizens of any nation see a doctor, our priority is healing. It is wonderful to have a health care system whose priorities match one’s own.