It’s time for a truth-and-reality check on conservative crazies in Congress, on Fox, and loose in the country who keep using the Canadian national health system as their example of why they object to making major reforms to America’s medico-insurance complex.
I’ve experienced health care on both sides of the 49th parallel and can tell you that, compared to what happens when you get sick in the US, Canada is utopia.
While films such as Michael Moore’s Sicko and Capitalism: A Love Story and shorts produced by Robert Greenwald’s Brave New Films do much spotlight the problem in bold face terms, the need to change the health care delivery and payment system in the US is essentially the collected nightmare stories of millions of individuals and families.
My sister was one of them.
When my sister and only sibling was diagnosed with cancer in 1999, she and her husband had major battles with their insurance company which fought tooth-and-nail to cancel coverage and deny care at sight of the first claim form.
Because in her original application – roughly 10 or 11 years earlier – the insurer discovered that she forgot to note that, at age eight, she had two sessions with a child psychologist after our family dog died. She had real trouble coping: Tarzan taught her to walk when she was an infant, letting her hang onto his back as he walked her slowly around the house. As a pre-schooler, she’d dress him in outfits for tea parties – the kind little girls have, not Glenn Beck’s monstrosities. When Tarzan died, it was her first experience with losing a loved one and she couldn’t stop crying, even a week later at school.
To the insurance company, which went rummaging through Janice’s past after collecting more than $60,000 in premiums over the years she was a policyholder, that oversight meant she was a scamming liar trying to defraud them. It relented only after being confronted by a series of insistent phone calls from her oncologist and increasingly strong letters from the family lawyer. Nevertheless, the fight took weeks, causing Janice and Steve enormous grief and worry – on top of worrying about Jan’s cancer.
But it didn’t end there.
After being told she was terminal, Janice wanted to die at home in familiar surroundings with her three cats on the bed and her husband of 17 years sitting in the room. Nope, the insurance company ruled. They’d pay for her to stay in a hospital wired to machines and tubes at roughly $2,000 a day or more but the $150 or so it’d cost to have a nurse come each morning to check Jan’s vitals and a health care worker every afternoon to stay while Steve ran errands, bought food and have a few minutes away from his gruesome death watch was verboten.
A Supreme Irony
At first, the company wasn’t willing to pay anything yet when given a chance to reduce its expenses to less than 10% of what they were running, they balked. A bizarre-o world example of what’s wrong with health insurance in the US.
So, there ensued another series of letters between their lawyer and the insurer and, this time, also her employer, threatening legal action and public exposure. Reluctantly, the insurance company backed down. To its credit, the senior vice president of human resources at the large corporation where Janice worked before getting sick phoned to say that he was appalled at learning of the treatment she was receiving and assured Steve that if the insurance company didn’t pay for home care, the employer would.
In a way, Janice and Steve were “lucky.”
Besides having a caring employer, they had the resources and toughness to summon a lawyer to go toe-to-toe with the insurer. And, in the end, her care was covered. But, like Barack Obama’s mother, Jan and Steve spend much of the 11 weeks leading to the end of her life fighting with an enormous insurance company bureaucracy and its “medical advisors” who never clapped eyes on Janice before trying to deny what she’d been paying years to have. Happy to take money from her pay check every month for her share of the premium, the insurance company fought desperately when it was time to meet its end of the deal.
The best system in the world? Only people who never had the misfortune of dealing with it would say so. They must be the people in surveys who say they like their current insurance.
Meanwhile, Up North
Walk across the road where Minnesota meets Ontario and enter an entirely different world of health care.
I’ve lived in Toronto since 1991, during which time my out-of-pocket costs for health care have been zero. Nothing. Nada. Zip. This includes more than a year seeing a psychiatrist for depression and grief after my sister died; she passed away six months after mother and three years following our dad’s death, and I was overwhelmed. It also includes two separate hospitalizations for heart problems, one very minor and one more serious. And I’ve been fighting colon cancer with chemo, radiation, and surgery for four-plus years.
None of my care has cost me anything. I never waited to see a specialist, or to have tests or treatment. When surgery was prescribed, I saw another doctor for a second option and was still on an operating table within two weeks.
Before the right goes all batty and begins yelling I pay for coverage through income tax, I’ll admit that I do. But – and this is a big but, much larger than the butts on the back ends of many of the 9/12-er’s waddling around Washington last weekend – I did the math and my total cost of taxes plus insurance is less than in America.
Yes, my federal and provincial taxes are higher than if I lived in the US. But what I pay includes the cost of government health insurance. So, when I looked at US and Minnesota tax tables – Minnesota being my last state of residence in America before moving here – and added in the average of what friends back home tell me they pay annually in health insurance premiums, I pay about 9% less in Canada than if I lived in the States.
Nine percent less.
My coverage never can be cancelled or denied. I pay no deductible. There’s no such thing as a pre-existing condition. I had coverage the first day I arrived in Toronto after filling out a short, half-page form. I never heard the words “Not in our network” when seeing a physician or specialist.
When I was ill, no one went scrounging through my past to find a reason to deny coverage. When I am discharged from hospital, the only thing I receive is a warm handshake and a sincere, “We’re glad you’re doing so well.”
I did have some out-of-pocket costs. I paid for cable television in my room, a morning newspaper, a vegetarian pizza from a place near the hospital and a few Chinese food deliveries after being taken off the restricted diet list. If I’d had high speed internet in my room, I would have paid for it myself; national health doesn’t cover surfing the net.
Utopia? No. Only when compared to the US health system nightmare. And there are problems with the Canadian system.
For example, Ontario is short of doctors. It’s not because of a brain drain but because of the physicians themselves. The College of Physicians and Surgeons, the licensing board in all of the provinces, for many years made it nearly impossible for immigrating doctors to practice here, a kind of closed shop protectionism.
The rationale – often justified – was that foreign trained physicians and surgeons don’t meet Ontario standards. Fair enough. But then the College required people to start med school all over again, as if they’d never treated a patient.
Most of these physicians readily admit they need additional training when arriving in Canada. But why force them to start a 10-year process of med school, internship and residency all over again? I suspect that human anatomy is the same at a university in, oh, Kenya, Mumbai, or Jamaica as it is at the University of Toronto.
Fortunately, the government stepped in to apply pressure on the Colleges. Now, additional training is handled much more swiftly and the doctor shortage is starting to ease.
Trial lawyers joke that when the facts are against you, argue the law; when the law is against you, argue the facts; and when the law and the facts are against you, then pound the table.
The anti-change artists in the health care debate are left pounding the table because everything is against them. But there’s no talking with most of them because they react like small children: They cover their ears, scream loudly to drown out what’s being said and stamp their feet. It’s their only genuine argument.
The arguments against making major changes to the medico-insurance complex are about as accurate as Glenn Beck’s crowd count. I’m not sure it will do any good but we have to keep trying. For one thing, since I’m uninsurable in the US until I’m eligible for Medicare, I can’t come home until there’s a rational new plan in place.