Anyone interested in this should also check out Canadian home prices, rental prices, the broken healthcare system and the peanuts that Canadian tech companies pay. You will be glad you did before jumping ship.
Yes, but that's an unacceptably low standard. Canadians (myself among them) spend way too much time looking to the US to feel better about themselves and way too little time looking to the world to see how they could improve. It's virtually impossible for me to see a doctor where I live (capital and second largest city of Canada's third largest province) outside of going to the ER. It's nice that ER trip won't bankrupt me, but that's not good enough.
What do you make of the local tech market in Victoria? Are there many tech companies with offices downtown or do most people end up working remotely? It seemed a lovely walkable city when I visited recently.
Supposedly the tech industry here is pretty significant, but there aren't a lot of "HN-y" companies...I think Workday has an office here but that's about it. There's a few bespoke software shops and mobile game makers, probably a fair number of companies that do government or naval contract work, and some "eco" tech - companies that make sensors for underwater monitoring and stuff. I don't know much about all this, myself - as you said, I work remotely for a US company.
The usual Canadian caveat definitely applies: tech salaries are way lower than in the US. And the discrepancy between those salaries and cost of living here is pretty extreme even by Canadian standards.
We're also suffering from the typical West Coast city problems of homelessness/drug abuse/mental illness/property crime.
But, on the flip side: you get the best weather in the country, your backyard is some of the most beautiful nature on the planet, we have a vibrant and unique and walkable downtown, we have tons of great biking infrastructure, and there's reasonably convenient access to both Vancouver and Seattle when you need them. I love it here; it's a city with a lot of problems but a lot of potential.
I love it here too, but as someone young(ish) with a stable job and who got into a home outside the downtown core before the latest boom.. it's a lot easier to look past Victoria's faults.
As someone that's used to live in Canada and is currently in the USA, this is not true. Six month wait time to get an x-ray for a hairline fracture, people dying because of long wait times for cancer screenings etc. In the USA things are expensive but you at least get access when you need it.
What does an endocrinologist have to do with a hairline fracture? Also, 4 months to see a specialist in the USA isn’t really uncommon if your case isn’t urgent.
That's correct, if a doctor has ordered an X-Ray for you, you can walk into a lab and get it right away. The GP made up that specific example and it was wrong but I think their broader point is correct that there is a severe lack of access to basic health services in Canada. In British Columbia, about 25% of the population has no access to a family doctor, and an other 35% or so report being unable to easily book an appointment with them. Wait times to see a specialist actually are many months, and doctors are reluctant to give any referrals to them. In fact, it is difficult to get doctors to take anything seriously. IME they do very little proactive work and getting them to think critically about what could be the underlying cause of an issue rather than just telling you to try Tylenol is very difficult. There is zero recourse and you can't go to a different doctor because it's impossible to find a family doctor these days, at least in the Vancouver area. I've called dozens of practices within a couple hours of Vancouver and none are taking patients. Many literally turn off their phones and don't answer them anymore because it's easier to only have patients email them. There are no consequences for bad service because again, you have no choice, and of course they don't care about negative reviews.
It's common for doctors to have a "single issue per visit" policy these days, which is completely ridiculous because obviously a patient's entire overall condition should be taken into consideration when deciding on a strategy to address issues. And patients are not themselves medical professionals, they are not really in a position to say that two different symptoms are actually unconnected. But doctors are paid by the government on a per-appointment basis so they want to churn through as many as possible. They want you out the door ASAP.
We basically are dealing with third world level of care in this country, and Canadians accept it because "at least we're not America". Even middle class Canadians are being forced to travel to the US to receive basic services in a timely manner.
I agree with almost everything you wrote except for the conclusion. In no way is this a third world level of care. Your statement that middle class Canadians are being forced to travel to the US to receive basic services in untrue. The situations where Canadians are travelling to the US are very few and far between and for very specialized things, like specific spinal surgery procedures. We should absolutely be doing it Canada in a timely matter, but don't blow things out of proportion.
I particularly agree with doctors doing little proactive work, but this is very doctor dependant. I've had doctors who are like this, and others who been quite proactive. I don't see what that situation would be any different in the US.
Honestly asking though, what good is that? They can't take a look at you really, they can't refer you to a specialist, or order any tests for you, and if they find something somehow, they can't prescribe anything or perform any procedures. Or am I mistaken?
I was not meaning to convey confidence in my question, I don't have any experience in paying for out-of-province doctors, that's why I asked the question in the first place, and even asked if I was mistaken. I was asking if all of those things are the case or not...
It’s true that doctors are limited in what they can do without a physical exam. But a lot of doctors’ appointments are for things that can be handled remotely, such as renewing a prescription.
You're wrong. Maybe you lucked out, know someone who pulled some strings for you, or or you're just a liar, I don't know. But the Canadian Institute for Health Information published "Wait times for priority procedures in Canada, 2022"[1]
Presumably wait times in the US are made shorter by the fact that many people can't afford medical treatment at all. If it's expensive then it's less accessible, or inaccessible, by definition.
No, that does not follow. Just because the government aims to provide access to everyone doesn't mean that they do. 25% of British Columbians have no family doctor, and up to 60% find it difficult to get an appointment with one. Seeing a specialist can take a year, in many towns there's no doctor at all and the community has to get by with a nurses only. Canadians have no control and no choice when it comes to their health care, they are completely at the whim of the doctor who only wants to churn through as many appointments as he can, since he's paid on a per-appointment basis. We cannot exercise choice because the fact that we found any family doctor at all makes us one of the lucky ones and likely we can't get any other.
My point was simply that the wait times in any medical system can be shortened by increasing prices. The fundamental problem of insufficient capacity remains; the burden is just shifted onto a smaller set of people.
I didn't mean to minimize the issues with Canada's medical system, and I can understand why there's so much frustration from people who have to deal with it.
For the large majority of Canadian residents there is nothing technically stopping them from traveling to the US for healthcare, paid out of pocket. Some people do that, in some situations, particularly for those who live just north of the border, but it's uncommon. Some reasons:
- From the experience of people I know who have needed urgent care (heart attack, cancer, anorexia, broken bones, etc), my Ontario provincial health system works pretty well, and was often excellent. The people I know received timely, high quality treatment (despite all the bad press in the news these days), at zero out of pocket cost.
- The areas that Canadian healthcare is most falling behind on are (a) access to primary care, and (b) treatment of serious things that probably won't kill you (e.g. joint replacements, cataract surgery). For (a) few people are going to travel to the US to see a family doctor. For (b) this is mostly seniors, who usually decide to grind through another 6 months on the hip replacement wait list rather than pay US$50k today.
- US healthcare is very expensive if you're paying list price. Waiting longer and getting free care in Canada often looks pretty good by comparison. Any reimbursement from your provincial health insurance will be a small fraction of the total US bill. Maybe you could save a month on getting treatment for your cancer or whatever, but is that month worth US$100k or whatever out of your family's life savings? Most people decide "no".
- Where will you live in the US while receiving treatment (e.g. for cancer)? Will your job allow you to be away? The cost of travel and lodgings adds to the cost of the already expensive healthcare. And if you feel crummy (e.g. because you have cancer and you're on chemo) you don't want to have to go through airports and live in hotel rooms, you want to be in your home.
- If despite all the above you decide to be a medical tourist, why would you choose the US? Once you're hopping on a plane and paying cash, there are often better countries in the world. I have heard of people going to Mexico, Lebanon, and India for treatment, and much lower cost than the US, while still getting high levels of care.
Lots of Canadians do just that. Even when I was a kid, long time ago, my best friend had to go to the US for urinary tract surgery. It is effectively a 2 tier system with the second tier being "Go to the US".
If you're in the bay area, you made it to USA and therefore have "good" health insurance. Try paying for your own health insurance out of pocket if you lose your job, and you'll quickly realize that same insurance google provides will cost you upwards of $2500 / month without any copays or deductibles.
You get access to it when you need it IF you have paid for insurance. Otherwise, maybe you're on a bronze plan and whatever specialist you need to see costs $10K out of pocket, on top of the $30K in coverage you already have to pay just for base insurance.
> You get access to it when you need it IF you have paid for insurance. Otherwise, maybe you're on a bronze plan and whatever specialist you need to see costs $10K out of pocket, on top of the $30K in coverage you already have to pay just for base insurance.
When I was shopping, I didn't see any difference in coverage by changing the metal. I went with the Bronze, because it had the least total for monthly costs + out of pocket max, which in theory means if I don't use much, I pay less, and if I cap out, I pay less. The other metals make more sense, IMHO, if you have a lot of contact with the medical system, but not enough to hit the out of pocket max. Of course, employer based plans can be a lot better than marketplace plans, most/many marketplace plans don't over coverage out of your home area/state, where a lot of employer based plans have nationwide coverage. It's a mess.
Not paying your medical debt doesn't necessarily 'send' you to bankruptcy(stays on credit report for 7 years generally, unless enforced by a court order - which it usually doesn't), you have to actually file for it. But we're arguing with semantics so I'll just agree with you.
However, that is not what you said.
Your comment implied that someone has to be approved by insurance to receive treatment, which is not true.
People get denied all the time at the pharmacy for lack of insurance. Without insurance many drugs are simply unaffordable and they get turned away for lack of funds.
It is because this always comes from the perspective of younger people.
Canada might be better if you are 20 and break your arm.
No one over 50 and worrying about death would rather be in Canada though.
I had family members who had heart attacks at roughly the same time, one in the US and one in Canada. It is unbelievable how slow everything goes in Canada when they were both needing basically the same treatments.
There are many dimensions by which to compare healthcare systems (e.g. availability of care, cost, quality, speed) and different samples and statistics to consider (means, medians, 10th-percentiles, different demographic groups e.g. different races, different worker groups e.g. tech workers).
It's complex, but overall the US system is better than Canada's. It's not as clear cut comparing the US to some European countries, but with Canada it's mostly clear cut. And it's especially clear cut for tech workers. If you work in tech, you're highly likely to have very good coverage through your employer, you will almost surely experience much better availability and speed of care, probably better quality, and the extra out-of-pocket costs are absolutely dwarfed by the superior pay in the US.
It's not terrible though. I broke a bone 6 months ago. 2 hours in the ER including x-rays. Orthopaedic surgeon consult 4 days later, including more x-rays. All at no additional cost to me.
After pandemic Canadian health started to noticed how much they messed up during and the PR machine started an error correction course, so you probably got the benefit of that. I'm glad that you did, but it's not the same experience for everyone. It's good to be grateful but terrible to bring down others who don't receive the same thing as liars or ignorant.
Or if whoever is manning ER deems you unworthy of services. Happened to me personally. The problem is that they think they're providing free service so they provide a shitty one. What they're neglecting is that it's not free and everyone is forced to pay their salaries by unfair taxation.
Absolutely. I know a few people planning an internal transfer within their companies to move to the US from Canada. The high cost of housing, the terrible winters and the inadequate healthcare have become unbearable.
The impression I've always had of Canada is there simply isn't enough country to sustain their level of socialism. Conservatism can be important esp. when trying to conserve resources.
Specifically, despite having higher population per square mile than the US (1 person per 10 miles compared to 1 person per 80 miles), they have about the 6th of the population, and fewer major city centers (about 10 > 500k in Canada versus about 30 > 500k in the US).
Fewer large city centers translates to fewer tech companies, more competition for housing hence home and rent increases, less reliable health care, and of the fewer tech companies that do exist they have a smaller market, hence lower pay.
Climate/terrain is also a huge issue, large portions of their provinces are either frozen tundra or "back-woods-y", which is great if you want to live on a farm or go long-distance skiing or sledding, but pretty poor for building population centers. I wouldn't want to be living there right now with the recent outbreaks of fires and smoke/smog, either (not all their fault, but).
This is not a set of problem unique to Canada, either - depending on where you live in the US the health care system can be equally or worse broken, thanks to localized over-population or under-population - e.g. Maine/Alaska have a lot of problems with being both poor and barren states with mostly tourism for industry, and simultaneously absurdly expensive to live in due to their tourism, states like NYC and SoCal suffer extreme over-population that necessitates small fortunes to even maintain a meager lifestyle and drive out lower-class workers, and on the flip side overly conservative states like Texas suffer from rampant corruption and as a result healthcare and utilities are generally some mix of unsafe, unaffordable, in-accessible, outside of the large city centers (and now in some cases illegal thanks to recent political events in the US).
> Specifically, despite having higher population per square mile than the US (1 person per 10 miles compared to 1 person per 80 miles), they have about the 6th of the population, and fewer major city centers (about 10 > 500k in Canada versus about 30 > 500k in the US).
I think you have this way backwards. Canada has a larger land mass than the US, but about 10% of the population.
It has more land mass, but the vast majority of it is uninhabitable. The US has a lot of habitable area; only large parts of the western states are uninhabitable because it's a desert, and some parts of the far northern states (ND, MN, etc. plus most of Alaska) because it's too cold.
3,855,103 sq m 36,991,981 people in Canada is 36,991,981 / 3,855,103 ~= 10 people per square mile.
3,794,100.43 sq m ~300 000 000 people in US is 300 000 000 / 3,794,100.43 ~= 80 people per square mile.
So yes, US is more populated (which is what I incidentally thought initially, I figured it was map skew not a units flip so I didn't question it), but my point remains - Canada has fewer population centers than the US.
