Its Selection Is Not A Choice
I have personal experience with single-payer health care, directly contrasting treatment for the same medical diagnosis under America’s for-profit private insurance formula, with Canada’s single-payer paradigm.
It happened in the late-‘oughts after decades of targeted barbs in the media about Canada’s healthcare system. In retrospect studies found this narrative of long “wait times”, medical “refugees” and substandard, even rationed care to be, simply, propaganda.
But just personally, it has been my lived experience in America as a survivor of several head and neck tumors, to be excluded from any employment not bundled with the benefit of large-group insurance, which accepts preexisting conditions. By necessity of my very existence, my lifelong work experience from the get-go has been limited to enormous institutions with premium insurance contracts, e.g., academia, government. The fiction of “choice” afforded by the free market has quite simply been a permanent, existential, cruel tease.
The fiction of “choice” afforded by the free market has quite simply been a permanent, existential, cruel tease.
In my 40’s I developed neurological problems treated with ganglia blocks and then surgery. And subsequent to this I was diagnosed with a pain syndrome I concluded to be like “phantom limb” syndrome where perception is of a physical reality that does not exist: and there is no way to “fix” what isn’t there. The very real, excruciating pain I experienced was an interpretation, not a reality.
The prognosis is poor and treatment is inexact. Physical therapy with expensive, never-ending copayments appropriated a significant fraction of each session to gathering metrics for the insurance company rather than therapy to address my pain. After one such session devoted entirely to untherapeutic measurements I dragged myself into a stairwell and just sobbed. I could not have explained my anguish to concerned passersby if I tried. I was out of options. And when the insurance company refused to pay for more treatment I agreed that assuming full responsibility for such tenuous care could well be pointless.
Then my husband accepted a sabbatical position in Canada. As a guest of the government his family was entitled to their national insurance coverage. I was inducted into the Canadian medical system following a serious bicycle accident. And when they undertook to treat me for my unrelated, preexisting condition, to my skepticism regarding appropriateness and ROI, they responded: “it does not matter how or when you acquired this problem, the task is to address it.”
In fact, I was lectured with all solemnity, that my responsibility was to work hard, and to miss no appointments because this would displace others in need, thereby contributing to the efficiency of the system. They covered the monetary expense.
In contrast with the American facilities, the Canadian’s was not high tech, without fancy water baths and tape and measuring or exercise equipment. The benefit was derived through my own effort internally using coffee cans and pencils, not received as a magical high-tech gift externally. And it worked. Without personal cost to me beyond that of my responsibilities as citizen and guest.
Under for-profit insurance in my own country, my value is measured in capacity to extract treasure for the corporation, even while my freedom and “choice” is imprisoned within this serf status.
The story of rationed care and unobtainable therapy turned out to be just so much misinformation – variously irrelevant, inappropriate, wrong, deceitful, distracting. Unless resources are literally infinite, constraint is inescapable. Management is achieved internal to the system, minimizing displacement to all; the alternative simply imposes hidden limitations. For example by mandating personal responsibility for treatment, by accepting triage from an independent adjudicator rather than usurping it through one’s personal pocketbook.
Canada gave me my life back. Canada’s single payer healthcare system cared about my physical challenges while a guest in their country. Under for-profit insurance in my own country, my value is measured in capacity to extract treasure for the corporation, even while my freedom and “choice” is imprisoned within this serf status.
I tried earnestly to discuss this with a Canadian friend, to question the tales of Canadians flocking in droves to our northern hospitals, the reported complaints and dubious tales of malaise we were fed in America. My friend simply refused to engage: “You Americans are all crazy. I just don’t want to talk about it; what’s to talk about? Why would anyone willingly choose an expensive, inadequate system? Why choose to pay for what should come to you for free as a right of citizenship? There just isn’t anything more to say; you all are simply crazy.”
On February 19, 2021, California State assembly members Kalra, Lee and Santiago introduced for consideration AB1400, Guaranteed Health Care For All. If you live in California, please contact your state legislators to request their support for this legislation. California’s Governor Newsom must apply to the federal government for waivers to implement the proposal. If it is true that as goes California, the fifth largest economy in the world, so goes the nation, then it is everyone’s prerogative to urge that he do apply for this vital waiver here.
The Los Angeles Education Examiner