By Erin Drushel

A Canadian Perspective on American Health Insurance

[avatar user=”ErinDrushel” size=”thumbnail” align=”left”]Erin Drushel[/avatar]

The first official day to start signing up for health insurance in the U.S. under the Affordable Care Act’s (ACA /  Obamacare) Health Insurance Marketplace starts October 1st this year, followed by the Act’s full implementation in 2014.

Despite this law having been on the books since 2010, there have been some 40-odd attempts to repeal it, fights to try to defund it, and an ever-growing confusion with many Americans over what exactly it all means.

It’s days like this I really miss my Canadian (Ontario) healthcare.  Today and most days that end in “y.”

In Ontario, I paid my taxes, got my card, and could go to the doctor or emergency room, and that was the last I had to think about it.  All I had to worry about was getting better.

Recently, I had to make a trip to the ER here in Ohio.  First and foremost, I have no complaints about the service.  Everyone was very professional and kind.  However – despite having health insurance coverage – my visit was not worry-free from a coverage standpoint.

My husband’s last (employer-based) insurance company required notification of an ER visit within 24 hours – and if you didn’t provide notification, you could be held responsible for the full bill.  So, trying to get a hold of the insurance company at 3am on a Saturday to find out whether or not this was their requirement was quite nerve-racking.

We did find out the following Monday (between 9am and 5pm) that ER notification was not a requirement.  Whew!

However, the worries don’t end there.

Along with our coverage’s monthly premiums (over $300/month), for ER visits we also have a $100 co-pay, plus are responsible for 20% of the services provided up to $3000.  Now that’s annually, so if that 20% reaches $3000 in a year, anything beyond that is just the required co-pay until it resets the next year.  But, like most people, we don’t have $3000 lying around.  So at 4am, sitting in a hospital bed, we’re not only worrying about what is wrong, but also whether or not we can even afford to find out.  (And – we’re still waiting for the bill.)

…I miss my Canadian healthcare.

Now, to be fair, my U.S. insurance covers prescriptions whereas my Ontario coverage didn’t.  And it’s a good thing too – when people talk about cheap Canadian drugs, they aren’t kidding.  (For example, one of my asthma medications costs $100 in Canada; I looked up its listing here: $170).

So, more than $300 a month in premiums off the paycheque (in addition to taxes, etc.), plus the co-pays for doctors and emergency visits, and the co-pays for prescription drugs (my asthma medication has a co-pay of $60) – having U.S. medical insurance does not take all of the added worries out of healthcare.  However, it does take the excessive financial burden out of healthcare.

To be clear, I have no problem paying my fair share – to help those who legitimately can’t afford it and share the load with those who are burdened beyond their share with health issues – I just expect the shared costs to be fair.

And with Obamacare – once fully implemented – the freedom to find insurance more suitable to your needs without the fear of being rejected because of pre-existing conditions will be a huge plus.  Even if we find our current employer-based insurance is best for us, at least we will have had more options when looking.

In short, I think there are some legitimate concerns about Obamacare mixed in with the nonsensical, ignorant ones.  But, the reality is we won’t see those concerns adequately addressed until some years after full implementation, at which time we will see how the insurance markets eventually stabilize within each state.

That being said – as a Canadian – it’s clear to me that Obamacare is a necessity.  No one plans to get sick or injured and no one should be forced into bankruptcy to pay for their resulting healthcare bills.

A shared insurance system where everyone has access to healthcare is just good sense.

– Erin Drushel