Sunday, October 12, 2008

There are some good things about being on this side of the Border

I was asked by Jane to write something about our Canadian Health Care. I’ve been thinking about that for a while, especially since we watched the documentary “Sicko” by Michael Moore (worth it if you haven’t seen it yet).

Until I started travelling to the States (in the mid-eighties) it never dawn on me that some people had to pay to see a doctor. I guess I took that for granted. I have to say it was somewhat of a foreign concept to me to think that, when sick in the States, not everyone can get medical treatment. This is so weird to me. All my life, whenever I felt sick we would go to the emergency or to a walk-in clinic. Medical care is a social service in Canada. Each province has its own basic rules and regulations, but every Canadian is covered. As long as I had my Medicare card, which is issued by our province, it was all-good.

The card would get “shlick-shlick” (how the doctors get paid by the government); I would wait and eventually would see a doctor and get treated.
Because I’ve been thinking about this, I’m realising that I, alone, would probably have ruined my parents if they’d have to pay for all the care I’ve received before I became an adult. I had my tonsils removed at age five, so a few visits before because of sore throat, a hospital stay of a few days, surgery and subsequent visits. Then I had appendicitis, at age twelve, which involved many visits to the emergency before they actually found out what was wrong, then surgery, etc. Then at seventeen, I broke both my wrists… We never paid for any of these, we presented my card, and that was that. I even had many dentist visits covered as well, until age 12.

Granted what we don’t pay in money, we often pay in time sitting in the waiting room of the ER. I remember squirming in desperation when my mother would tell me we had to go to the hospital; I hated going there because I knew we would sit and wait. Whenever we would see a doctor within an hour, we were so pleased. That didn’t happen too often, unfortunately. The waiting time in Québec is a known and expected thing when seeing a doctor. They created CLSC, which are little community centre where one can see any type of doctors (from psy to ob/gyn), nurses etc. They do blood tests and such and supposedly cut a lot of patients from the ER. I say “supposedly” because no matter where you go, you do wait. Waiting, I think was and always will be part of the medical experience, because after all, the name says it; “patient”, it’s not by shear luck it is called that.

I consider myself lucky. We are lucky to be Canadian, despite our cold winters; I think we have it good. Last year when my MIL was doing her chemo, each treatment she was getting was costing over $1,500./injection, and that’s not counting the pills and all the other things she had to take. She was hospitalised for almost nine months. Luckily everything was covered by the RAMQ (Régie Assurance Maladie du Québec). I can only imagine the cost of the surgeries both Hubby and myself have had like his hip replacement, my multiple knee surgeries, my hysterectomy to name a few… For all of these, we were lucky; between the times we started seeing a doctor for a problem, the diagnostic and the scheduling of the surgeries it only took a few months. Like everywhere else, we have great doctors and some quacks. Some really do care about the patient, and others just treat a number. Many people want to turn our medical social services into a public private partnership, which would mean that those who could afford it would see a doctor faster than those who couldn’t. Naturally, those will little income are strongly against it, and want to remain social.

I’ve heard horror stories about people not seeing doctors before months. Our system currently suffers because our doctors and nurses (schooled and trained here) go to the States for monetary reasons and for the opportunity to work with better equipment and environment. Our family doctor told us that he no longer takes new patients, and is often contacted when one of his patients dies. People are trying to get in anyway they can, by asking: “Now that Mrs. Soandso is gone, will you take me as a patient?” We are lucky enough to have a family doctor. Whenever we need to see him, we call him and get to see him within a week or two.

I believe, like in every other aspect of my life, that it is our own responsibility to be aware and pro-active when it comes to dealing with the medical system. Yes the hospitals do need more nurses and more doctors, but if each of us would stop running to the hospital for every little booboo we have, maybe we would waste less time in the waiting room. I have see many abusing the system, in different ways. It creates jams for the people who are really sick and in need of some attention. It’s not unusual to have to wait for more than three hours after triage. That is the real ugly part of our system. But the real beautiful part is the fact that no matter where or who you are, you will get treatment. That is a comforting thought. …At least, to me it is!


jane said...

Personally, I'm for socialized healthcare here in the U.S.
I've heard such nightmarish stories about Canadian healthcare:
Having to wait years to see a doctor. (when you wrote there is a waiting time, I was shocked that you were referring to HOURS)
I've heard that if you are elderly they will simply deny you medical aid & let you die.

We had a friend that worked at a school district & had no insurance, so when he got sick he'd go to the pet store & buy pet antibiotics!

One has a different view of socialized medicine if you've been without healthcare for years.

Thanks for taking the time & writing this.

Marius said...

The Conservatives in this country have made a demon out of the idea of socialized health care. They act like the very concept is similar to sharia law. Of course it goes hand in hand with their other boogey man, higher taxes. The so-called downside to socialized medicine is higher taxes to pay for it. I don't know why paying out of pocket for insurance is better than paying higher taxes so everyone can see a doctor, but then I'm just a country hating Liberal. If my wife and I didn't hate cold weather so much I think I'd try to move up there.

Anonymous said...

I think our healthcare system sucks, but I am not sure that the Canadian system is the answer. I do not think people could go from what they have now to what you have described here.

The healthcare system is outrageous. I suggest reform begin with insurance companies.

I saw and enjoyed "Sicko," but I think it was overstated. America's streets are not lined with the sick and dying. The poorest people are covered by the government, middle-class people and above are covered by their employers. The people hit by this problem the most are the working poor.

I live in liberal Wisconsin. We have state healthcare for the uninsured. The problem is, few doctors take it, so it is hard for those covered by BadgerCare to get treatment. I fear if we went to fully nationalized healthcare, we would create a two tier system, those who had to go to govt healthcare, and those who could afford to pay for healthcare.

I cannot imagine Donald Trump etal is going to be willing to wait three hours to get healthcare. I worry a govt run system would marginalize too many of the population

flurrious said...

I think you've hit on the biggest barrier to national health care in the U.S. Doctors here make more money than doctors anywhere else in the world, and they are not willing to make less. The health care industry and the health insurance industry like to talk a lot about the rising cost of health care, but it's not the cost that's the problem. It's the price. It's a problem they've created and which they are profiting from. My health insurance premiums have increased more than 300% in the last six years. My mom's Medicare premiums (Medicare is a government health insurance program for retirees) have increased more than 200% in three years -- which is even more outrageous when you consider that this is a system she paid into all of her working life.

As for waiting times and the ability to even get in to see a doctor? It's not any better here. When I was looking for a new primary care physician a couple of years ago, I had to call at least 15 doctors before I found one who was taking new patients. And I have excellent insurance. People without insurance or with Medicare or Medicaid are often SOL. Once you find a doctor who'll take new patients, you can wait weeks for an appointment (unless you have some really obvious problem, like a lump in your breast or an axe in your head, in which case you'll only wait 2 to 4 days) and once you actually have an appointment, you'll still wait. Many doctors stack appointments; they'll give, for example, a 2:00 appointment to six different people. The patient is required to check in at 2:00, but may not actually see the doctor until 5:00. My doctor doesn't do this; she staggers appointments in 15 minute intervals ... which means that she will spend no more than 15 minutes with me. God help me if I ever have a problem that requires more than 15 minutes of medical care.

lizgwiz said...

Flurrious is right--there's no guarantee of seeing a doctor quickly here, even if you have great insurance.

My current doctor is GREAT about saving a few slots each day for people who need to be seen quickly, but that's certainly not the rule.

My uncle was diagnosed with melanoma a couple of years ago, and it was about 4 months from the time his regular doctor made the initial diagnosis until he could get in to see a specialist for confirmation. Talk about being on pins and needles!

Annake said...

I too agree with Flurrious. I remember an appointment I had with my old primary care physician years ago when I had strep throat. I showed up at the time they scheduled for me and sat in the waiting room with chills and fever for TWO HOURS while I watched sales reps being ushered in and out. The only thing that kept me there was knowing that I'd have an even longer wait at the emergency room. Luckily, my current doctor doesn't make me wait more than 15 minutes but you don't get to spend much time with him. I guess it's a trade-off. :-(

PinkPiddyPaws said...

It's interesting because I think about how many in the US don't have health care because they can't afford it.

Which is worse?
Not having it or having it but having to wait? Hmmm....

Nicotine Jones said...

Thanks for sharing. Very interesting stuff. As a drug rep, I see the system up close (in the U.S.). I know there's probably a better way, but I'm not sure what it is. There are some docs who charge a lot to be exclusive to a small group of people but they only take on those patients. I don't think that's the answer. It's a mess, though.

Stinkypaw said...

jane: Thank you for asking! I don't know where you've heard about the elderly, but it's not what I've seen. The system has it's bad sides, but it's not horrific. Delays vary from hours, to weeks, to months (for some specialists) but not years.

marius: We are VERY highly taxed here, that's for sure, and it's cold! ;-)

monkey: What I described is my perception/experience of our health care, and I'm not even trying to suggest it's the way to go, far from it. It's not perfect. And you're right, like for many things, the hit class is often the working poor.

flurrious: Our system are similar. Our doctor schedules people at 15 min. interval but takes as long as he needs - he always talks computer with Hubby - which is great once you're in but VERY frustrating when sitting in the waiting room!

lizgwiz: There's no garantee anywhere, but here people thinkn that because now that there's a few paying clinics around and they're effecient that it is the way to go... That must have been hell for your uncle.

annake: I understand what you're saying. I've experienced that as well, being really sick and waiting is hell!

pppaws: Both are bad, but for me not having it would be worst.

nicotine: A real BIG mess, indeed, no matter which side of the border!

cinnamon girl said...

We have Medicare in Australia. Thus, we have a two-tier system where some pay for private and some go public. The hospitals are underfunded but it is still much better than not having Medicare. Yes, you may wait three days in emergency for a bed after being triaged if your case isn't urgent. But I know people who would not be eligable for insurance even if they could afford it, who would be forking out hundreds of dollars per week for medication or thousands of dollars for treatment. I have friends who would be dead without Medicare because they cannot afford treatment. I would much prefer our system any day to the one in the US (we tend to think it's barbaric that a so-called first world country has no universal health care).