[run4yourlives]

Disclaimer: In Employee Benefits in Canada.

Canada's private health care insurance is very broad, and while you aren't necessarily incorrect about anything you are only giving part of the picture.

The "Employer sponsored" extended health coverage you are referring to is Group Insurance. It is a form of insurance that can be offered to all people aligned to an entity (employer, trust, association, etc) that removes the requirement for personal health questionnaires and medical assessments. The coverage you are offered by your employer as "mandatory" is guaranteed to you so long as you remain connected to the entity in question. There is a huge advantage to this and this is the reason it has become the de-facto standard for private insurance in Canada.

Of course the trade off is that the entity qualifying as a "group" needs to have an overwhelming percentage (often 100% if it is small) participating in the plan to mitigate the risk. Insurance breaks down if the only people buying it are high users.

That said, Private Insurance (i.e. not Group) is most certainly available and affordable in Canada. With private insurance however your rate is going to be based on your own individual heath assessment and life situation. That means that while your Extended Health rates might be lower, as a single 30 year old male your Life Insurance rates will be higher than a Female's, for instance.

Overall, for a majority of people Group Insurance has the benefit of spreading the fluctuating lifetime rates out so that they are predictable and more equitable. You aren't going to be 30 forever, after all.

People can and do waive their employer sponsored insurance all the time (with the exception of participation minimums). In addition, employers have started to introduce "flexible" group insurance that allows limited plan choices, based on fixed credits.

Not much beyond that is fixed in these group plans, so the variance in plans, costs, and overall benefit to the employee from one employer to the next can be huge. It is an effective enticement to have a good benefit plan, hence the interview question. There is also nothing at all forcing an employer to offer any extended coverage.

Personally, I think Canada is right on the money with regards to how we handle private health care services and insurance. Keep in mind that self management also presents a fair amount of improperly covered people. People are simply too ignorant of the situation. At least under an employer sponsored plan a trained professional is designing a plan that meets as many of the needs of the employer's workplace as they feel is required.

[grecy]

Thanks for the detailed and thoughtful reply.

> It is an effective enticement to have a good benefit plan, hence the interview question.

A better enticement is to divorce health coverage and employment 100%. They should have absolutely nothing to do with each other.

Imagine if the employer in Canada dictated where I can live, or what goods I can buy... that's how it feels for me when the employer dictates(or in fact has anything what-so-ever to do with) my health care.

> Keep in mind that self management also presents a fair amount of improperly covered people.

Those people are covered by Canada's public health care, which is exactly what it is there for.

> At least under an employer sponsored plan a trained professional is designing a plan that meets as many of the needs of the employer's workplace as they feel is required.

You are still not even accepting the option of no extended plan at all.

The number of people in Australia that opt for extended private care is small, because the public option is sufficient.

[run4yourlives]

>They should have absolutely nothing to do with each other.

Says the healthy young guy. :-) Many people receive extended benefits at a significant cost advantage through group insurance.

Also most employers pay a significant portion (if not all) of the premium of these benefits! You and I may see a health questionnaire as a simple form where you answer "no" to everything and sign it, but many, many people not much older than you aren't able to do that.

>Imagine if the employer in Canada dictated where I can live, or what goods I can buy...

Um, your employer does dictate where you can live, since most roles expect you to come to a structure of the employer's choosing, and what you can buy through your paycheck. Regardless, there is no dictation here at all. You are being offered benefits, often paid at least in part by the employer as a condition of employment. It's like being offered a cell phone or a car allowance.

>You are still not even accepting the option of no extended plan at all.

As I already stated, this option does exist and IS USED. In almost any company of significant size (i.e. above 10 employees or so) you can refuse all coverage. All you have to do is do so with a written form. You can do so for Health and Dental in ALL cases if you are expected to pay the premium and have coverage elsewhere, inclusive of personal coverage.

Why in god's name you would turn down what in many cases is free money is beyond me, but that is your prerogative. To suggest you are unable to do so in Canada is incorrect.

[grecy]

> It's like being offered a cell phone or a car allowance.

Which reduces your overall salary - you might not be aware of it, and it might not be said in those terms, but it's absolutely true. All "side benefits" or "perks" of employment are just a way for the employer to give you something other than money. Too bad if the last thing you want is a cell phone.

> Why in god's name you would turn down what in many cases is free money is beyond me, but that is your prerogative.

Because it's not free money! My salary is being docked for that expense, as the "benefits overhead" (my company told me to my face it's about 26%). I'm perfectly happy with the public coverage, and want the rest of my salary in my hand, thank you.

[run4yourlives]

At this point though, you are evaluating employers, not health care systems.

It's pretty easy to find an employer in Canada that offers no benefit plan at all, just stay away from larger companies.

Most privately run businesses would be more than happy contracting you at a higher rate and not paying you any additional benefits, or their share of CPP or EI. They are a significant expense to the company. Go get yourself a GST number and have at 'er.

Seriously, if this is that much of an issue for you, you should talk to your boss. I can pretty much guarantee they'd be more than happy to work something out with you.

[grecy]

> you are evaluating employers, not health care systems.

No I'm not. One health care system outright makes that illegal, so it's the health care system defining this, not the employers.

On that note, have you ever lived&worked in a system other than Canada's?

I ask, because you think Canada is "right on the money" with their system... though it makes me think you've not seen how other systems do it.

Don't get me wrong, Canada's system is good, but if I were in a country about to radically overhaul health care, I would by no means adopt Canada's system as-is (or any other single country, for that matter)

> if this is that much of an issue for you

You miss the point here thinking this is about me... The overall effect on society is very interesting and speaks volumes about a given system. Without a doubt, because of this "group plan" idea, Canadians are tied much more strongly to their employer, and that results in employees being treated worse, and overall a "negative" impact on those around me.

I don't like that about Canada's way of doing it.