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It’s NOT Free!

Health care costs billions.

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Melanie_Fuller Melanie Fuller, director of Wellness at Alberta Blue Cross

Despite the popular misconceptionand false assumptionabout Canada’s health care being “free,” more and more Canadians are jarringly finding out (especially since 2019) that Canada’s national health care coverage is not only NOT free, it is also not enough. 

The contemporary need for health care is stark and undisputable. And the health care landscape has changed. 

More than 44 per cent of adults (20+) have at least one chronic disease. Some 80 per cent have risk factors. Mental health is a surging problem, with one in five Canadians now suffering from mental health illness each year.  

One key health care factor is the reality that Canada is dealing with an aging population, and a projected 68 per cent growth in the country’s senior population over next 20 years.  

Canada’sand Alberta’schanging demographics are a key factor when it comes to the demand for additional, private health care coverage.  

And there is consensus that, in addition to invaluable health care benefits for individuals, health care benefits are also a must for today’s smart business. Melanie Fuller, director of Wellness at Alberta Blue Cross, explains that there are now updated, new pressures and priorities for business leaders and employees. “For leaders, the priorities now include economic uncertainty, attracting and retaining talent, engaging the workforce to support growth, training and talent development, diversity and the environment, social and governance, change management and the growing priority of employee health and wellbeing.” 

Underscoring that public health care is not free, she highlights difference ways additional benefits resonate for different demographics. “For example, our young adult product was designed with the younger demographic in mind, offering robust mental health coverage and support, digital services such as virtual care, and different plan design options that cater to differing budgets. 

In contrast, our retiree product is for early retirees or seniors who are leaving the workforce and may not need as much prescription drug coverage, she says, because turning 65 provides prescription drug coverage through the AHS plan. Our retirement guide helps those who are looking to retire understand what is and is not covered on government plans, versus what health care they might need covered on private plans. 

Health care needs and benefits can also differ based on the medical conditions and Alberta’s changing demographics.  

“For example, with the younger demographic, we see more claiming for drugs that treat ADHD (attention deficit hyperactivity disorder), versus older demographics where there is more demand for asthma, arthritis, Type 2 medications and other health situations.” 

The trending shows that, particularly since the recent pandemic health crisis, Canadians are embracing the need for a broader range of care than traditional health care. They are smartening-up about the cliched and faulty assumption that public health care is sufficient and free. And savvy employers and employees are increasingly relying on additional health care options. 

The facts about Canada’s public health care show that in the 2023 federal budget, Ottawa committed $196.1 billion in health funding over the next 10 years. To receive their portion, provincial and territorial governments follow established criteria for public health insurance. 

The growing revelation that public health care is not free includes sudden awareness that not all aspects of health care are covered. Also, what are employers and employees doing about health care needs which are not covered. 

The focus of Canada’s public system is traditionally on hospitals, diagnostics and doctors. A perfect learning lesson example is a broken ankle. It gets X-rayed, diagnosed and fixed, usually in a hospital, at no direct cost to the patient. The necessary out-patient physiotherapy and other recuperation is usually not covered. 

For employers and employees, there are many health care extras and etcetera’s, adding up to millions and billions of dollars in out-of-pocket expenses. The extras impact employers, employees, individuals and families. 

“Individuals need coverage for medications, dental, paramedical services, extended health benefits, life insurance and travel insurance, usually not covered or not fully covered under public AHS coverage,” Fuller explains. 

It is why the need for additional health care and health care coverage has become a necessity, not an option. 

“For some individuals that may otherwise be healthy and perhaps not needing medications, paramedical services or extended health services, they look for the peace of mind of having personal insurance in place, should they need the extra coverage.” 

Because business leaders grasp the reality that public health care is not free, “Employers provide benefits coverage to look after the health and wellness needs of employees and their families. It not only keeps employees healthy and productive, but it is also a valuable part of a company’s comprehensive compensation package, to attract and retain employees,” she points out. 

No doubt about it. More Calgary area employees and employers are embracing the essential need for additional health care coverage, way beyond the naïve (and risky) shrug about public health care being free, because health care stretches way beyond basic hospital and doctor visits. 

“For a current example, we are seeing many of our employers opt for, and offer employees, an increase in psychology coverage,” she adds. “There are also more specialty drugs (some costing $10,000 or more per year) for rare conditions like autoimmune bowel disorders or autoimmune arthritic conditions and treatments and therapies now available for common conditions like migraines and asthma.” 

The list is long. Virtual care which provides 24/7 telemedicine access for physical and mental care needs has become a very desirable benefit, particularly in the Calgary workplace, helping employees maintain their productivity. 

The Calgary Chamber of Commerce is an active booster for Calgary employees and employers, particularly for Calgary small businesses, to eliminate the “free health care” delusion and be proactive.  

According to Ruhee Ismail-Teja, vice president, Policy and External Affairs with the Calgary Chamber, “The economy does well when people do well, and that means ensuring people can access the health care services they need. Part of the governments responsibility is to provide citizens with quality, accessible and affordable health care services.  

“At the same time, businesses – of all sizes – work hard to take care of their employees and step up to fill any gaps that might exist. As a Chamber, and convenor and catalyst for business, we have seen that many of societys most complex problems have been solved when industry and governments come together to deliver solutions. Employer-paid health care is a great example of that,” she says.  

For many Calgary employers, the Chamber Plan provides in-demand health care benefits to cover services like prescriptions, physiotherapy and other extended medical, counselling and more.  

For employers and employees. The stats and numbers and trends about heal care expenses and coverage are a staggering and urgent reality,  

According to the Canadian Life and Health Insurance Association (CLHIA), the voluntary association whose member companies account for 99 per cent of Canadas life and health insurance business, Canada’s life and health insurers paid out more than $312 million a day, in benefits, Canadians received a record $114 billion in benefits from life and health insurance products (up 10 per cent from 2019), including health insurance claims, life insurance and insurance-based retirement products. 

Among findings in the 2023 edition of CLHIA Facts report, life and health insurers provided coverage for over 29 million people, up nearly two million in the past decade. And the paid out a record $43.9 billion in claims for supplementary health, disability and accident coverage and $14.3 billion in prescription drug claims. 

The trends keep proving it! Health care is definitely not free! 

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