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Question for my American melanoma warriors

Forums General Melanoma Community Question for my American melanoma warriors

  • Post
    MaryMary73
    Participant

      I live in Canada (Toronto to be exact) so our health care system is quite different from the US. The actual medical care in Canada is basically the same as in the US but we are not charged for any medical procedures or surgeries (including staying in the hospital for any length of time, medications received during the hospital stay, etc etc) that we have done (unless it is cosmetic). We do pay for our own medications but for those of us who have insurance coverage through our employers, we are usually covered from 80% to 100%.

      I live in Canada (Toronto to be exact) so our health care system is quite different from the US. The actual medical care in Canada is basically the same as in the US but we are not charged for any medical procedures or surgeries (including staying in the hospital for any length of time, medications received during the hospital stay, etc etc) that we have done (unless it is cosmetic). We do pay for our own medications but for those of us who have insurance coverage through our employers, we are usually covered from 80% to 100%.

      In the US, I know it is very different. What happens if someone suspects he or she has melanoma and they do not have insurance coverage? How much would it cost for a visit to a family doctor? A dermatologist? A biopsy to see if a suspicious looking mole is melanoma? Surgery to remove healthy skin around the melanoma (once diagnosed) in order to attain clear margins?

      Maria

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    • Replies
        Suzan AB
        Participant

          Congrats on living in Canada where there is real national health care!  So far in my journey, with the continued raising of my deductibles when I was diagnosis in 12/07 my out-of-pocket deductibles are…drum roll please…..$6,000.00 for 07,  $6,000.00 for 08, $7,500.00 for 09, and $7,500.00 for 10.  Now the the real kicker…we have a new deductible of $10,000.00 for 2011.  Tatatadah!  Now remember those amounts do not even include what my husband's small business employer pays…about $441.00 per month or so, lets see that is approx. another $5,292 per year.  Boondoggle!  Just for the last three years the total is approx.  $42,876.00

          I have had health insurance, some years being double covered (approx. 15 years), all of my life.  If we consider just the amount paid in by MY employers…it is approx.  $185,000.00 for 35 years (premiums only, does not include deductibles paid).  This does not include medicare or SSI and the like.

          Perhaps the amount paid is not that bad.  All I know is that it is a struggle right now. 

          How much do you pay into your health care system?  Is it through taxes?

          My best,

          Suzan AB, stage IV

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            MaryMary73
            Participant

              Hi SuzanAB,

              Thank you so much for your reply.

              In Canada, our healthcare is covered by our income taxes and the amount you pay in income taxes depends on the amount of your salary. I'll give you some personal information. My yearly salary is $55,000 (peanuts). I get paid every 2 weeks by my employer (I work for an insurance company) so that means I receive 26 paychecks per year. I pay about $200 per paycheck for income taxes to the federal government. I pay another $35 per paycheck for my own personal insurance which covers 90% dental (no limit), 80% prescriptions (no limit), $400 every 24 months for eyeglasses, $100,000 for life insurance, disability insurance and up to $2000 per year for other medical expenses such as  physiotherapy/psychology/etc. That $35 also covers my husband and we both have the exact same coverage. Income taxes in Canada pay for everything from healthcare to education to paying down the national debt and everything in between (who really knows where our taxes go!). In Toronto, for example, The Princess Margaret Hospital is a world leader in cancer treatment and care and it is totally free to all citizens in this province (whether they work or are on a fixed income or have no income at all).

              I think it's horrible that not only are my American friends battling this rotten illness or any illness for that matter, but they are also worrying about money at the same time. Just awful. That needs to change. Healthcare should not cost anyone their homes or their life savings nor should anyone go without the care they need because they just don't have the money.

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              washoegal
              Participant
                Yes, in some ways the U.S. system seems cruel. However, where else can you find all the clinical trials available. Canada has the Princess Margaret Hospital, look at the hundred plus research hospitals the U.S. has.

                If we could get our act together on a few fronts, which I won’t go into here as this isn’t the place to get political, we could probably cut our costs significantly. To have great health care you have to pay for it one way or another. Canada pays for it though taxes. We pay for it individually. True that means everyone may not get the same level of care. But I have found, I have a disabled sister, that if you are persistent you can get the care you need.

                Mary
                Stage 3

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                washoegal
                Participant
                  Yes, in some ways the U.S. system seems cruel. However, where else can you find all the clinical trials available. Canada has the Princess Margaret Hospital, look at the hundred plus research hospitals the U.S. has.

                  If we could get our act together on a few fronts, which I won’t go into here as this isn’t the place to get political, we could probably cut our costs significantly. To have great health care you have to pay for it one way or another. Canada pays for it though taxes. We pay for it individually. True that means everyone may not get the same level of care. But I have found, I have a disabled sister, that if you are persistent you can get the care you need.

                  Mary
                  Stage 3

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                  MaryMary73
                  Participant

                    Hi SuzanAB,

                    Thank you so much for your reply.

                    In Canada, our healthcare is covered by our income taxes and the amount you pay in income taxes depends on the amount of your salary. I'll give you some personal information. My yearly salary is $55,000 (peanuts). I get paid every 2 weeks by my employer (I work for an insurance company) so that means I receive 26 paychecks per year. I pay about $200 per paycheck for income taxes to the federal government. I pay another $35 per paycheck for my own personal insurance which covers 90% dental (no limit), 80% prescriptions (no limit), $400 every 24 months for eyeglasses, $100,000 for life insurance, disability insurance and up to $2000 per year for other medical expenses such as  physiotherapy/psychology/etc. That $35 also covers my husband and we both have the exact same coverage. Income taxes in Canada pay for everything from healthcare to education to paying down the national debt and everything in between (who really knows where our taxes go!). In Toronto, for example, The Princess Margaret Hospital is a world leader in cancer treatment and care and it is totally free to all citizens in this province (whether they work or are on a fixed income or have no income at all).

                    I think it's horrible that not only are my American friends battling this rotten illness or any illness for that matter, but they are also worrying about money at the same time. Just awful. That needs to change. Healthcare should not cost anyone their homes or their life savings nor should anyone go without the care they need because they just don't have the money.

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                  Suzan AB
                  Participant

                    Congrats on living in Canada where there is real national health care!  So far in my journey, with the continued raising of my deductibles when I was diagnosis in 12/07 my out-of-pocket deductibles are…drum roll please…..$6,000.00 for 07,  $6,000.00 for 08, $7,500.00 for 09, and $7,500.00 for 10.  Now the the real kicker…we have a new deductible of $10,000.00 for 2011.  Tatatadah!  Now remember those amounts do not even include what my husband's small business employer pays…about $441.00 per month or so, lets see that is approx. another $5,292 per year.  Boondoggle!  Just for the last three years the total is approx.  $42,876.00

                    I have had health insurance, some years being double covered (approx. 15 years), all of my life.  If we consider just the amount paid in by MY employers…it is approx.  $185,000.00 for 35 years (premiums only, does not include deductibles paid).  This does not include medicare or SSI and the like.

                    Perhaps the amount paid is not that bad.  All I know is that it is a struggle right now. 

                    How much do you pay into your health care system?  Is it through taxes?

                    My best,

                    Suzan AB, stage IV

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                    MichaelFL
                    Participant

                      I'm sure it will vary some here and there, but I was in beteween jobs when diagnosed and treated in August-September 2008. My initial derm visit to remove 4 moles was $432.00, and about $600.00 to have them sent to pathology, and about $3400.00 to have a WLE and follow ups for the two that came back melanoma. The total I paid myself was was about $4432, give or take.

                      Michael-stage 1b, two years and two months NED.

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                        MichaelFL
                        Participant

                          P.S. I skipped my family doc and went straight to a derm. I did not need a referral.

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                          MaryMary73
                          Participant

                            Hi MichaelFL,

                            Thank you so much for your reply.

                            What happens to someone who just doesn't have over $4400? Are they refused medical care?

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                            Lori C
                            Participant

                              If you do not have cash up front you have several choices.  Lose everything – your job, your home, all assets worth more than $2000 total –  and qualify for Medicaid, and then good luck in finding a specialist who will treat you and accept it (they don't have to) or try to negotiate with a care provider to take payments.    Many people are living in terror of becoming too ill to work because they will then lose their group health insurance.   Yet the very nature of an illness that requires brutal treatments means there are long periods of time when you are simply unable to work.  Catch 22.

                              Will, my friend with melanona, had a disability and his father was a veteran, so despite being young, he had both Medicaid and Medicare, and as a result got excellent care for no cost.  However, he also had to earn less than $2000 a nonth to qualify for this.  Otherwise, he lost everything. 

                              I lived in two other countries – Australia, and Israel – and both had superb national health care systems.  In the US, medical bills are the number one cause of personal bankruptcy.  It's a horrible situation.

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                              Lori C
                              Participant

                                If you do not have cash up front you have several choices.  Lose everything – your job, your home, all assets worth more than $2000 total –  and qualify for Medicaid, and then good luck in finding a specialist who will treat you and accept it (they don't have to) or try to negotiate with a care provider to take payments.    Many people are living in terror of becoming too ill to work because they will then lose their group health insurance.   Yet the very nature of an illness that requires brutal treatments means there are long periods of time when you are simply unable to work.  Catch 22.

                                Will, my friend with melanona, had a disability and his father was a veteran, so despite being young, he had both Medicaid and Medicare, and as a result got excellent care for no cost.  However, he also had to earn less than $2000 a nonth to qualify for this.  Otherwise, he lost everything. 

                                I lived in two other countries – Australia, and Israel – and both had superb national health care systems.  In the US, medical bills are the number one cause of personal bankruptcy.  It's a horrible situation.

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                                MaryMary73
                                Participant

                                  Hi MichaelFL,

                                  Thank you so much for your reply.

                                  What happens to someone who just doesn't have over $4400? Are they refused medical care?

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                                  MichaelFL
                                  Participant

                                    P.S. I skipped my family doc and went straight to a derm. I did not need a referral.

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                                  MichaelFL
                                  Participant

                                    I'm sure it will vary some here and there, but I was in beteween jobs when diagnosed and treated in August-September 2008. My initial derm visit to remove 4 moles was $432.00, and about $600.00 to have them sent to pathology, and about $3400.00 to have a WLE and follow ups for the two that came back melanoma. The total I paid myself was was about $4432, give or take.

                                    Michael-stage 1b, two years and two months NED.

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                                    mlbjab
                                    Participant

                                      Hi Maria,

                                      In the US, most people do have insurance through their company or privately.  If you have an education and a decent job you are almost always covered by the company you work for.  There IS some deductible…I pay $120 a month for a family of 5 and then each Dr visit is $30.  BUT our taxes are not nearly as high as countries w/ Universal Healthcare so that makes up for it.  Most people can see whatever Dr they choose and there are many to choose from in most cities.  I do not need a referral to see a specialist and I can choose a Dr who is close to my home (my derm is less than one mile from my home).  There are 6 others within 20 miles of my home.  If I see a derm who doesn't return phone calls promptly, rushes me, or I just don't like…I can "shop around" until I find one I like.  My Dr works for ME and not my Government.  The quality of care is better too.  I did read that you were told you ahd in situ..when you actually had stage I.  Obviously someone dropped the ball there.  Stage I can spread, in situ can not (hypothetically) so there really is quite a difference.  

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                                      mlbjab
                                      Participant

                                        Hi Maria,

                                        In the US, most people do have insurance through their company or privately.  If you have an education and a decent job you are almost always covered by the company you work for.  There IS some deductible…I pay $120 a month for a family of 5 and then each Dr visit is $30.  BUT our taxes are not nearly as high as countries w/ Universal Healthcare so that makes up for it.  Most people can see whatever Dr they choose and there are many to choose from in most cities.  I do not need a referral to see a specialist and I can choose a Dr who is close to my home (my derm is less than one mile from my home).  There are 6 others within 20 miles of my home.  If I see a derm who doesn't return phone calls promptly, rushes me, or I just don't like…I can "shop around" until I find one I like.  My Dr works for ME and not my Government.  The quality of care is better too.  I did read that you were told you ahd in situ..when you actually had stage I.  Obviously someone dropped the ball there.  Stage I can spread, in situ can not (hypothetically) so there really is quite a difference.  

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                                          NicOz
                                          Participant

                                            I don't live in the US so have no personal experience (only my opinion based on what I heave read on here and through US friends) so I won't comment on its healthcare model. I WILL say, however, that people under OUR universal healthcare model we CAN choose our docs (specialist included). There is still a choice. And a referral? Simple matter of a letter from  a GP (what do you call them PCP?) so no big deal IMO. In fact, to me, it's sensible- and they can also be given without a 3/12 month validity when required, so does not require regular referrals/visits to GP.

                                            My docs work for ME too. If there were financial considerations that they adhered to, then I don't know why on earth they would have performed 7 VERY expensive craniotomy surgeries (plus several SRS) on a palliative patient? "And it a 6(?)% tax, I've never had an issue with public health insurance. Medications are subsidized for those approved by our PBS, and if *I* want to take an unapproved drug, then I only have to apply through the SAS (special access scheme) and I have the option to pay for it (which I haven't had to as the one pharma I have discussed un approved drug for access has resulted in my being supplied for nothing, ty BMS :D) I am thankful for our healthcare.

                                            I don't wait for necessary surgery, AND I get my surgeons of choice. I also get reimbursed for all travel (whether air or car) for consults etc, for all but $50. I pay nothing for scans. Or doc visits- if I saw them "privately" I would but it (not being a private patient- but even then a govt would pay a large percentage of the consult) would only be a small percentage of the consult cost.

                                            I love our healthcare model. That we enjoy fewer clinical trials have more to do with the size of our population than anything else.

                                            And lastly (running away now as I have a small child requiring requiring copious interaction (memory games, dancing and singing *sigh :P) I just want to mention this: "The quality of care is better too.  I did read that you were told you ahd in situ..when you actually had stage I"

                                            So NO medical professional in the US has ever mad e a mistake? Wow! :) They're human regardless of where they're from and mistakes are always going to be made…

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                                            NicOz
                                            Participant

                                              I don't live in the US so have no personal experience (only my opinion based on what I heave read on here and through US friends) so I won't comment on its healthcare model. I WILL say, however, that people under OUR universal healthcare model we CAN choose our docs (specialist included). There is still a choice. And a referral? Simple matter of a letter from  a GP (what do you call them PCP?) so no big deal IMO. In fact, to me, it's sensible- and they can also be given without a 3/12 month validity when required, so does not require regular referrals/visits to GP.

                                              My docs work for ME too. If there were financial considerations that they adhered to, then I don't know why on earth they would have performed 7 VERY expensive craniotomy surgeries (plus several SRS) on a palliative patient? "And it a 6(?)% tax, I've never had an issue with public health insurance. Medications are subsidized for those approved by our PBS, and if *I* want to take an unapproved drug, then I only have to apply through the SAS (special access scheme) and I have the option to pay for it (which I haven't had to as the one pharma I have discussed un approved drug for access has resulted in my being supplied for nothing, ty BMS :D) I am thankful for our healthcare.

                                              I don't wait for necessary surgery, AND I get my surgeons of choice. I also get reimbursed for all travel (whether air or car) for consults etc, for all but $50. I pay nothing for scans. Or doc visits- if I saw them "privately" I would but it (not being a private patient- but even then a govt would pay a large percentage of the consult) would only be a small percentage of the consult cost.

                                              I love our healthcare model. That we enjoy fewer clinical trials have more to do with the size of our population than anything else.

                                              And lastly (running away now as I have a small child requiring requiring copious interaction (memory games, dancing and singing *sigh :P) I just want to mention this: "The quality of care is better too.  I did read that you were told you ahd in situ..when you actually had stage I"

                                              So NO medical professional in the US has ever mad e a mistake? Wow! :) They're human regardless of where they're from and mistakes are always going to be made…

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                                              bcl
                                              Participant

                                                Nic, your health care reminds me of the health care of my youth in the UK….similar but better than ours in Canada  ( the docs almost seem like part of the family. ) Our specialists here do require us to go back the the GP after 6 mos for a referral. (stupid stupid rule)  In a perfect world it would be lovely if they would learn from eachothers best practices. (Sorry I brought up your SRS treatment below hon, I'm bad for that when I want to make a point…)

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                                                bcl
                                                Participant

                                                  Nic, your health care reminds me of the health care of my youth in the UK….similar but better than ours in Canada  ( the docs almost seem like part of the family. ) Our specialists here do require us to go back the the GP after 6 mos for a referral. (stupid stupid rule)  In a perfect world it would be lovely if they would learn from eachothers best practices. (Sorry I brought up your SRS treatment below hon, I'm bad for that when I want to make a point…)

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                                                  NicOz
                                                  Participant

                                                    :)  Don't worry about it, hun. LINAC SRS isn't ideal in terms of patient comfort, but it has comparable outcomes with gamma and cyberknife (and I have the adorable Bob looking after me having been the president for the ISRS only 5 years ago as well as being a pioneer of SRS in this country- adorable man :D) I'll admit I had one bad experience with it, but that was likely because a reaction to the additional codeine I had in a effort to reduce brohchitis symptoms/coughing in order to get through the treament- since that I've been treated like a princess and there is no 'cavalier" assumption that I am superwoman *gasp* :P

                                                    (should I put in the footage of the halo application? *grin*) Anyhoo hun- gotta run. Although I've been told the potatoes I just cooked her are "better than God's" (*snort*) I am now about to sort her bath. (Need to get myself an international calling card thingy, eh?)

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                                                    NicOz
                                                    Participant

                                                      :)  Don't worry about it, hun. LINAC SRS isn't ideal in terms of patient comfort, but it has comparable outcomes with gamma and cyberknife (and I have the adorable Bob looking after me having been the president for the ISRS only 5 years ago as well as being a pioneer of SRS in this country- adorable man :D) I'll admit I had one bad experience with it, but that was likely because a reaction to the additional codeine I had in a effort to reduce brohchitis symptoms/coughing in order to get through the treament- since that I've been treated like a princess and there is no 'cavalier" assumption that I am superwoman *gasp* :P

                                                      (should I put in the footage of the halo application? *grin*) Anyhoo hun- gotta run. Although I've been told the potatoes I just cooked her are "better than God's" (*snort*) I am now about to sort her bath. (Need to get myself an international calling card thingy, eh?)

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                                                      LV
                                                      Participant

                                                        While it may be true that 'most' Americans have health insurance, approximately one in six do not. Which sounds fine, unless you're one of the have-nots. And not all insurance is the same.

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                                                        LV
                                                        Participant

                                                          While it may be true that 'most' Americans have health insurance, approximately one in six do not. Which sounds fine, unless you're one of the have-nots. And not all insurance is the same.

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                                                          lhaley
                                                          Participant

                                                            Our health insurance is based on my pension. If something happens to me ( stage IV) then my husband has no insurance!  Yes, he can get cobra but that is very expensive and I believe can only be bought for 18 months.  His job does not offer insurance.  I know too many Americans that have no health insurance. 

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                                                            lhaley
                                                            Participant

                                                              Our health insurance is based on my pension. If something happens to me ( stage IV) then my husband has no insurance!  Yes, he can get cobra but that is very expensive and I believe can only be bought for 18 months.  His job does not offer insurance.  I know too many Americans that have no health insurance. 

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                                                            nicoli
                                                            Participant

                                                              I think our health care in America is a national shame. I have a college degree and worked in law offices for many years. Health insurance for our family of 4 with a deductible of $10,000 cost me over $400 each month. And that is the norm for the families that I know.  So it is no wonder that approximately half of all Americans do not carry health insurance. I am not longer employed and my husband's income is small so we have had no insurance for the past several years.

                                                              In most states, the poor can get on a health care program and go to local county health clinics but the quality of doctors is not that great. They are mainly young doctors right out of school or more likely, physician's assistants. This program will help pay for hospital stays also but not for other providers. Some providers will give you a discount on their costs if you don't have insurance. Under this program, my scalp surgery cost me $1,000 for the surgeon, $1,500 for the anesthesiologist, and only $200 for the hospital  If you need other medical help, you just have to pay up or do without. Many, many families go bankrupt due to medical bills.  In my case, I had to put some medical bills on credit cards and literally beg my other medical providers to accept small monthly payments.

                                                              The very poor (maybe like under $20,000 a year for a family of 4) can get Medicaid ( an national medical welfare program for the very poor) and that pays most of your medical bills. But this is not available to anyone without children living in the home except under certain circumstances.

                                                              I have had friends in Canada and England and I think their health care system is much better despite the horror stories we Americans have been told about "socialized medicine".

                                                               

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                                                              nicoli
                                                              Participant

                                                                I think our health care in America is a national shame. I have a college degree and worked in law offices for many years. Health insurance for our family of 4 with a deductible of $10,000 cost me over $400 each month. And that is the norm for the families that I know.  So it is no wonder that approximately half of all Americans do not carry health insurance. I am not longer employed and my husband's income is small so we have had no insurance for the past several years.

                                                                In most states, the poor can get on a health care program and go to local county health clinics but the quality of doctors is not that great. They are mainly young doctors right out of school or more likely, physician's assistants. This program will help pay for hospital stays also but not for other providers. Some providers will give you a discount on their costs if you don't have insurance. Under this program, my scalp surgery cost me $1,000 for the surgeon, $1,500 for the anesthesiologist, and only $200 for the hospital  If you need other medical help, you just have to pay up or do without. Many, many families go bankrupt due to medical bills.  In my case, I had to put some medical bills on credit cards and literally beg my other medical providers to accept small monthly payments.

                                                                The very poor (maybe like under $20,000 a year for a family of 4) can get Medicaid ( an national medical welfare program for the very poor) and that pays most of your medical bills. But this is not available to anyone without children living in the home except under certain circumstances.

                                                                I have had friends in Canada and England and I think their health care system is much better despite the horror stories we Americans have been told about "socialized medicine".

                                                                 

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                                                                bcl
                                                                Participant

                                                                  Hi Maria, you forgot to add in 13% HST goods and services tax Ontarians pay. Not that I mind paying for universal health care myself, I just wish it was more evenly distributed. 

                                                                  I love the fact we're not bankrupted when we have a medical emergency, and really feel for the thousands of Americans who are faced with crippling medical bills. But I'd hate to leave the impression that all of Canada has state of the art melanoma care when we have such a long way to go. Those of us who don't live in major centers like Edmonton, Montreal or Toronto (Halifax too if I'm not mistaken) often find it difficult to access standardised care and treatments. Patients have to search to find modern (and more humane)  procedures such as gamma knife for brain mets (instead of the more primitive SRS – and I mean primitive – Nic has shared video with some of us the past.) or the much less invasive VATs surgery for lung mets.

                                                                  Unfortunately the entire Canadian province of British Columbia doesn't have a single melanoma specialist. (The oncs are sorted alphabetically; so much for personal interest.)

                                                                  As a stage 1b I'm concerned with early cancer detection, but our cancer center refuses to teach skin checks or take photos of moles. A dermatologist (not a cancer specialist) is paid for 15 minutes, two-four times a year to complete a symptom check list (very clinical and rushed) and do a full body scan of moles and lymph nodes. Ironically, the locals claim we have the best cancer care in Canada. I don't see how they can all be the best, unless they‘re measuring apples and oranges. (Or as Joan said below, square footage. Joan’s been researching this stuff for years, so I tend to believe her when she speaks of hospital preenings.)

                                                                  I think what concerns (and angers) me the most is when I hear about shattered melanoma patients being told to get their affairs in order at stage three. (Especially when I come here and see American Stage 3’s NED for years.) Or 1b's not offered SNB’s. (Neither of these examples are particularly rare.)

                                                                  In general, melanoma in Canada is not seen as a cancer that can be managed, let alone cured, except in the very early stages, and/or in a few select cities. And while I'm very grateful for the care I have received, I refuse to become complacent until all of our citizens have a decent chance.

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                                                                  bcl
                                                                  Participant

                                                                    Hi Maria, you forgot to add in 13% HST goods and services tax Ontarians pay. Not that I mind paying for universal health care myself, I just wish it was more evenly distributed. 

                                                                    I love the fact we're not bankrupted when we have a medical emergency, and really feel for the thousands of Americans who are faced with crippling medical bills. But I'd hate to leave the impression that all of Canada has state of the art melanoma care when we have such a long way to go. Those of us who don't live in major centers like Edmonton, Montreal or Toronto (Halifax too if I'm not mistaken) often find it difficult to access standardised care and treatments. Patients have to search to find modern (and more humane)  procedures such as gamma knife for brain mets (instead of the more primitive SRS – and I mean primitive – Nic has shared video with some of us the past.) or the much less invasive VATs surgery for lung mets.

                                                                    Unfortunately the entire Canadian province of British Columbia doesn't have a single melanoma specialist. (The oncs are sorted alphabetically; so much for personal interest.)

                                                                    As a stage 1b I'm concerned with early cancer detection, but our cancer center refuses to teach skin checks or take photos of moles. A dermatologist (not a cancer specialist) is paid for 15 minutes, two-four times a year to complete a symptom check list (very clinical and rushed) and do a full body scan of moles and lymph nodes. Ironically, the locals claim we have the best cancer care in Canada. I don't see how they can all be the best, unless they‘re measuring apples and oranges. (Or as Joan said below, square footage. Joan’s been researching this stuff for years, so I tend to believe her when she speaks of hospital preenings.)

                                                                    I think what concerns (and angers) me the most is when I hear about shattered melanoma patients being told to get their affairs in order at stage three. (Especially when I come here and see American Stage 3’s NED for years.) Or 1b's not offered SNB’s. (Neither of these examples are particularly rare.)

                                                                    In general, melanoma in Canada is not seen as a cancer that can be managed, let alone cured, except in the very early stages, and/or in a few select cities. And while I'm very grateful for the care I have received, I refuse to become complacent until all of our citizens have a decent chance.

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                                                                    AndyD
                                                                    Participant

                                                                      I grew up in Canada but have been an American citizen for the last 20 years. My father is a doctor in Canada. My melanoma started in my left leg and my aunt in Canada also has melanoma in her left leg. From time to time she and I compare notes. There are pros and cons of each system.

                                                                      My wife and I pay $500 a month each for healthcare with a $4,000 deductible each. I choose that deductible level and have hit it twice (mainly because of 5 day hospital stays for bi-chemo and IL2). You either pay for healthcare out of your pocket, or you pay through taxes…there is no free lunch.

                                                                      I believe in Canada the PST and GST is 13% or 15%? If you spent $25,000 a year on 'stuff'…that is 5% x 25,000 = $1,250 more paid than American counterparts. If you use an automobile you play $4 a gallon of gas instead of $3…so if you spend say…$50 a week on gas in the US…you spend almost $1,000 a year more in fuel. If you drink liquor or smoke, and spend $1,000 a year on booze, you spend $1,000 more in canada. That's $3,000 right there in sales tax, gas, and liquor…which easily buys quality health insurance in america.

                                                                      I've probably had 15 PET scans in 10 years in american (I believe they cost roughly $5k each on the street? My co-pay is $450)…my Aunt has had zero in Ontario…why? Because in Canada, the PET is still considered experimental (I don't know if this has changed recently?). I don't think I'm over stating when saying a PET scan is 'standard' now when assessing melanoma and other cancers.

                                                                      In the past I've emailed my oncologist about new tumor(s) and been operated on the 'next day'…I think this would be difficult in Canada. My doctors did not blink when offering me bio-chemo and IL2 (expensive treatments).

                                                                      I think my aunt would say she has had excellent care in Canada. I would as well say I have had excellent care in America. I don't mind paying for my healthcare out of pocket.

                                                                      hope this info is useful

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                                                                        AndyD
                                                                        Participant

                                                                          I wanted to correct one of my statemtents but don't know how to edit…my wife and I pay $500 a month for the two of us…not each.

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                                                                          AndyD
                                                                          Participant

                                                                            I wanted to correct one of my statemtents but don't know how to edit…my wife and I pay $500 a month for the two of us…not each.

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                                                                          AndyD
                                                                          Participant

                                                                            I grew up in Canada but have been an American citizen for the last 20 years. My father is a doctor in Canada. My melanoma started in my left leg and my aunt in Canada also has melanoma in her left leg. From time to time she and I compare notes. There are pros and cons of each system.

                                                                            My wife and I pay $500 a month each for healthcare with a $4,000 deductible each. I choose that deductible level and have hit it twice (mainly because of 5 day hospital stays for bi-chemo and IL2). You either pay for healthcare out of your pocket, or you pay through taxes…there is no free lunch.

                                                                            I believe in Canada the PST and GST is 13% or 15%? If you spent $25,000 a year on 'stuff'…that is 5% x 25,000 = $1,250 more paid than American counterparts. If you use an automobile you play $4 a gallon of gas instead of $3…so if you spend say…$50 a week on gas in the US…you spend almost $1,000 a year more in fuel. If you drink liquor or smoke, and spend $1,000 a year on booze, you spend $1,000 more in canada. That's $3,000 right there in sales tax, gas, and liquor…which easily buys quality health insurance in america.

                                                                            I've probably had 15 PET scans in 10 years in american (I believe they cost roughly $5k each on the street? My co-pay is $450)…my Aunt has had zero in Ontario…why? Because in Canada, the PET is still considered experimental (I don't know if this has changed recently?). I don't think I'm over stating when saying a PET scan is 'standard' now when assessing melanoma and other cancers.

                                                                            In the past I've emailed my oncologist about new tumor(s) and been operated on the 'next day'…I think this would be difficult in Canada. My doctors did not blink when offering me bio-chemo and IL2 (expensive treatments).

                                                                            I think my aunt would say she has had excellent care in Canada. I would as well say I have had excellent care in America. I don't mind paying for my healthcare out of pocket.

                                                                            hope this info is useful

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