Question about Canadian health care

[Char Ell]

Scenario: An American woman flies to Toronto on a business trip. Her flight arrives in Toronto during the evening and she catches a ride on her hotel's airport shuttle bus. After the shuttle arrives at the hotel, she steps off the shuttle's steps but most unfortunately trips as she transitions from shuttle to curb. As she is heading down for a face-to-face with the sidewalk she feels snap-crack-and-pop in her left foot. While her face isn't too badly damaged her left foot immediately starts swelling. When the hotel is asked for help the hotel responds that they cannot provide any direct assistance and advise her and her business colleagues she is traveling with to a local medical center.

 

As an American citizen in Toronto, Ontario, Canada, what are her options for emergency medical treatment for her obviously broken left foot?

 

EDIT: To further clarify, her health insurance doesn't provide coverage outside of the U.S.A. and since she works and lives in the U.S. she doesn't pay taxes to support the Canadian government's health care system.

[The Doctor]

Depends on what treatment she would need. For a broken foot, there would be no surgery, usually, so she wouldn't need a Canadian Health Card, as far as I know. That means it would be free to get fixed up with a cast. If this is the case, however, I'm sure it won't be for long - not with Harper on Parliament Hill.

[Hallucination]

Well, I don't know enough about Medicare to say, but Google (.ca, not .com) is your friend. This should be interesting to find out.

 

Although I have to ask 'Why?' Are you planning to cross the border and jump off a cliff?

 

Edit @ The Doctor: But there are enough Liberals and NDP in Parliament to keep the Conservatives from doing anything, but I'm not sure what stance the Bloc has (if any) on the subject.

[The Doctor]

^ Harper can win over the Bloc. The budget vote showed that.

[Hallucination]

^But will he? Would the Bloc, given the opportunity, give up Medicare?

[Char Ell]

Gentlemen. If you would please confine your comments to the question at hand. Your debate about what direction the current Canadian government may take in regards to Canadian healthcare would more appropriately belong in a separate thread.

 

I'm interested in understanding if an American injured in Canada can obtain emergency medical assistance if they aren't part of Canada's socialized health care system.

[The Doctor]

^ I believe it's open to non-Canadian citizens just as much as Canadians. Jane Doe would get the same treatment Hallucination or myself would.

[Commander Obi-Wan]

It's open to all....plus we're to polite not to. See Canadian Bacon.

[Hallucination]

Alright, after some looking around, I found out that the criteria and conditions for Medicare depend on the province. Since I'm on west side and Ontario isn't, I recommend you ask one of the Ontarian Ahtonauts around here.

 

Edit: Cutmeister, I don't want to be rude, but may I ask you why your interested in Canadian Medicare? Are you going on a business trip or something?

[Jae Onasi]

I actually dealt with this question in my volunteer post (med director for my history group). Because we have a lot of regional sections that have both US states and Canadian provinces included in their makeup, those of us who live in the regions that share a border and also do first aid got into a discussion about what would happen to

a. Canadians who get hurt in the US

b. Americans who get hurt in Canada.

 

The upstart of all that--Canadians get the better deal in the insurance department.

 

Americans traveling in Canada: in an emergency, people are going to get treated without regard to insurance status. If you're having a heart attack, they're going to treat you first and deal with the paperwork later. They're not going to let you die because you don't have the proper card. Aside from the ethics issue, hospitals and governments dislike the idea of increased liability and bad press that they'd receive if they didn't provide emergency care because someone didn't have the right card. If I or one of my family members didn't receive life-saving treatment because of insurance status (no matter what the country), you bet I'd be making about the biggest national or international stink I could create in response, because ethically that's just plain wrong.

 

Broken ankles--these can and sometimes do require surgery (to place pins or plates if the bones are badly broken). An unstable fracture that is in danger of breaking through the skin and couldn't be stabilized enough in a cast or splint would require emergency surgery.

 

Now, the Canadian government is not going to provide routine care. You couldn't go up there and have your tonsils out because you got bad tonsillitis up there. They'd give you some meds for the tonsillitis (which was the immediate problem) and send you back home to the US to get the surgery (the more permanent, but not emergency, solution).

 

You will receive emergency care as an American injured in Canada. However, you will get a bill for the services rendered. And if that emergency treatment includes surgery, it's going to be a very big bill. Treatment in Canada is not free for Americans. If your insurance doesn't cover it (and I'd be surprised that it doesn't, frankly), then you pay out of your own pocket. If I was very worried, I would call the insurance company to find out for sure that it doesn't cover out of country med expenses, and then ask for an insurance rider to cover Canadian travel, or get separate travel insurance that does cover out of country med expenses (but only buy from a reputable, established company, otherwise you might pay a premium and discover that the bad company is just taking your money with no intention of paying claims).

 

Canadians get the better deal--the US would bill the Canadian health service. However, Canadians might have to pay the difference between what the government pays and what is charged, but don't quote me on that last--American hospitals might have to accept what Canada pays and write off the difference, too.

 

@Hall--American Medicare covers only those age 65 and older or who are permanently disabled.

 

This whole discussion does not even begin to touch on potential liability issues that arise if someone fell off the bus, got hurt because the hotel did something negligent, etc. However, Canada is far less lawsuit-crazy than the US on this. If some Canadian organization was negligent, they might be required to pay, but that's something Darth333's far more qualified to comment on than me. However, I addressed the issue above as if it was just a freak accident and no one was liable.

 

Hope that helps.

 

Edit: The take-home message in all this is that if you have a medical emergency, go to the ER and don't worry about the insurance crap.

[Hallucination]

@Hall--American Medicare covers only those age 65 and older or who are permanently disabled.

The Universal Health Care System is often referred to as 'Medicare' here in the True North.

[Mace MacLeod]

IIRC, no Canadian hospital can deny emergency medical treatment to someone in that situation, but as an uninsured foreigner she would receive a bill for services rendered.

[Char Ell]

Edit: Cutmeister, I don't want to be rude, but may I ask you why your interested in Canadian Medicare? Are you going on a business trip or something?

I don't think it's rude of you to ask this. The scenario I describe in post #1 actually happened a couple of months ago to a flight attendant I'm acquainted with. I just need to get more details on what exactly happened to her after she fell to make sure I got the story straight.

Americans traveling in Canada: in an emergency, people are going to get treated without regard to insurance status. If you're having a heart attack, they're going to treat you first and deal with the paperwork later. They're not going to let you die because you don't have the proper card.

That is comforting to know but is a broken foot considered an emergency by the Canadian health care system, e.g. requires immediate treatment w/o regard to insurance status? I'm thinking a broken foot isn't considered life-threatening, just very painful and very difficult to walk on. I understand that if an American citizen and resident visiting in Canada tries to see a Canadian doctor for a sore throat or something along those lines then that individual is not likely to get any medical help. However in this situation a broken foot is a wee-bit more serious than a sore throat albeit not as serious as a heart attack.

[Jae Onasi]

A broken foot would be treated emergently, because the bones need to be set quickly, otherwise it will heal incorrectly and affect mobility.

Also, she'd need an x-ray to make sure none of the bones were in danger of breaking through the skin. That kind of fracture needs immediate treatment because if it breaks through, the risk of infection is quite high. Bone infections can be difficult to treat.

In certain situations they might be able to splint it to get her back across the border, but it does need to be evaluated emergently, if nothing more than to make sure she gets some decent pain medication.

If she has any other health conditions, then that would certainly have an impact. Pain can make blood pressure go up quite a bit, and if she had high blood pressure already, for instance, they'd want to make sure it's staying under control.

I consider any fracture an emergency (with the exception of a closed fracture of a little toe), especially if it involves major bones like the thigh bone or are near organs that we need to continue living (like a skull fracture). However, my opinion and the insurance company's opinion may be two different things.

 

An international flight attendant without insurance coverage that is valid in other countries? That's _really_ strange. If the claim was denied, I wouldn't accept that--I'd go up the chain of command. The initial customer service people are usually pretty good at what they do, but sometimes they're not, and sometimes they just don't know the little details. The supervisors and on up the chain may be able to give a better answer. Keep in mind also that insurance companies have a vested interest in _not_ paying claims. If I were her, I'd also make a big complaint to human resources about how crappy she's being treated by the insurance company. If HR gets enough complaints, and threaten to go with another insurance company, sometimes that makes the insurance company sit up and take notice.