A Question About Healthcare, And My Answer

In light of my all-too-many experiences with the healthcare system over the last couple of years, I was asked to comment on whether I’m happy with the Canadian healthcare that I’m getting, or if I’d be happier with American healthcare.

That’s a bit of a loaded question, because as I understand it, the main problem with American healthcare is not so much the quality of the healthcare but the issues of class inequality and the fact that a significant percentage of people do not have proper access to healthcare. So as a reasonably well-off individual, I’d assume that under the US system I’d be well insured, and thus get excellent health care, the best in the world by some accounts, and quite likely better than I’m getting now. However, I don’t think that fact necessarily means that it’s a better system. Also, I do know wealthy Americans, self-employed folks in general, who skimp on paying for medical insurance and as a result find themselves in very unpleasant circumstances when things go wrong — so even the well off can be failed by the US system.

Here in Canada I’ve always had easy and completely free access to my family doctor, often many times a month. If I want an appointment, I usually have it the next day or at most two or three days off, and I can always go to any number of walk-in clinics as well who provide similar service with only a few hours wait (also covered by government healthcare). Emergency room service is acceptably fast, although if you go in for something that’s not emergency, you can find yourself waiting for a few hours or sometimes more, but that’s not really an issue of who’s paying, that’s more of a procedural decision at the hospital that’s difficult to find objective fault with. Most things — all the doctors visits and all the testing — are free, but I do have to pay for prescriptions (which can add up), eye care, and dental. These things are covered by employers for the majority of people with regular jobs, but I’m not in that category and never have been.

The problem that you have in Canada, that I’ve experienced to some extent, is that when you find yourself in a position where something less normal is going on, and you need to see experts, that you can at times have significant wait times — a few months or more — to see a specialist. This is more because we just don’t have enough qualified experts — the system itself does its best to get you in as quickly as possible — than because of some sort of “rationing” conspiracy that’s keeping you from seeing doctors. That said, I’m sure that the amount of specialists is influenced by there being less money in the system in general than there is in the US. Because the conditions that I’m personally dealing with are often excruciatingly physically painful, these wait times are very difficult to cope with, and I have sometimes wondered whether I’d be better off in a country where money can give you unfair treatment. Objectively I don’t like the idea that a wealthier person gets preferential healthcare, because I really feel that healthcare must be egalitarian, but on a subjective level it’s harder to believe in those ideals when you’re personally affected.

I’d love to see more money in Canada invested in healthcare — more technology, and more doctors — but in terms of the system itself, I’ve been happy with my experiences with it, all things considered. As to whether I think the US should switch to a universal system, of course I feel that it’s the duty of all nations to ensure the health of their citizens, but I think it’s important that the US not sacrifice the significant lead that it has in many categories to achieve this.

incision

I don’t know anything yet about the results of my most recent surgery, which was done to try and figure out why my muscles are breaking down seemingly without explanation, but the incision that was left by the surgeon was beautifully closed and I expect I will have little to no scar — unlike the brutal gash left from the last two surgeries, that healed to about a half an inch wide scar with many stitch-marks from the staples that held it closed. Of course that’s a photo of it above, at one week old. I’m going with the assumption that the clean work and attention to detail on the incision is a sign that the work that was done internally is of similar quality.

Other than that, we’ve been having fun until school starts — last night we strapped flashlights to the RC cars and took them to the park for night races, and this week I should have most of the parts I need to get the Sterling on the road (the new exhaust went on today), so hopefully that actually happens before the snow falls this year. All-in-all though during this period where there’s no school or summer camp I’m pretty wiped out by day’s end so I haven’t been too motivated to write here. Nefarious is off at the CNE today with her grandmother, her second time this week, having just seen the amazing two-plus minute underwater escape act by Kristen Johnson (one of the most intense escape artists in the world) with an old friend. Might do another road trip next week, at least a short one, in part to get away from the night time noise, as my neighbor’s band has a big concert coming up so they’ve been putting a lot of work into practicing lately. Since I’m here alone, I finally watched Suicide Club (Jisatsu s√Ękuru), which I really enjoyed and recommend you check out, if you can find a torrent site that isn’t getting pushed offline…

*RING*

Interrupted by the doorbell, I just got a great surprise delivery of some homemade preserves and a conversation with a friend, which is a nice piece of synchronicity, as just an hour or two earlier there was another ring at the doorbell which contained a box of books, many of which were books on how to make such preserves that I’d ordered for Caitlin as a present.

I also got some sailing books in that shipment, so I think I’ll now read them in the bath and pretend I’ve achieved that dream. I continue to more and more seriously eyeball a nice big live-aboard catamaran on which I can spend a few years sailing around the world…

12 Comments

  1. Edurus_Fas wrote:

    The thing that puts a flag up for me about the U.S. healthcare, is that the senate is exempt from inclusion with the health care. I feel the old addage “What’s good for the goose is good for the gander” is appropriate.

    I hope your leg heals up very quickly, and they can find an easy, simple, way to repair your condition.

    Wednesday, August 26, 2009 at 3:10 pm | Permalink
  2. Predator wrote:

    The Danish health care system is very similar to the Canadian model, and I think that’s what all countries should be offering their citizens – although I have never needed to go to the hospital myself.

    Btw, nice of them not to cut through your tattoo haha!

    Wednesday, August 26, 2009 at 4:54 pm | Permalink
  3. Twwly wrote:

    It takes 3-6 months for us to get an appointment with a GP here. Everyone is referred to emerg, where waits are OBSCENE.

    Many rural areas are suffering from similar doctor shortages and the incentive packages that towns put together to lure new doctors are pretty… crazy. It’s a battle of big business, big bucks in some places.

    Our system is pretty messed up out here.

    Wednesday, August 26, 2009 at 7:42 pm | Permalink
  4. Nathan wrote:

    Living in the US, I can only offer a small slice of alternative perspective. I took a friend with a history of liver issues (fat metabolism problems) in for what appeared to be extreme dehydration. We were subsequently forced to wait over 8 hours in the tiny waiting room, and he was directed to not drink anything at all even though he had not even been glanced at by a doctor (or nurse). The reception girl just said that “if whatever is wrong with him requires surgery, he can’t have drank nothin.” When I explained that he appeared to be dehydrated, she said, “I’m sorry sir, there is nothing that I can do.” 8 hours later, they hooked him up to a saline drip or something and then sent him home with the advice of “try to drink lots of water.” God bless the USA.

    Wednesday, August 26, 2009 at 9:39 pm | Permalink
  5. Em wrote:

    I think for me, more troublesome than the issue of money just to afford healthcare is the way insurance companies weasel out of providing support for healthcare, whether by claiming it to be a pre-existing condition or not in the coverage plan, etc. it’s a nightmare that happens all too often for people who can afford insurance and pay their premiums.

    idunno, I’m in Japan now with Japanese national heath care and it’s awful. My monthly premiums are slightly more expensive than what I was paying in the states, the co-pay is about the same and the care is far, far worse. While it covers dental (good), it does not cover routine check-ups, teeth cleaning, or pregnancy, which goes I think more to explaining the low birth rate here than anything.

    However, everyone is covered as a requirement and fees work on a sliding scale based on wages earned. It`s not the greatest care, but if you`re seriously hurt you will be taken care of.

    And if anyone reading wants to rebut with anything about why the Japanese are so healthy: they are hypochondriacs. They go to the doctor if they have a cold, if that says anything.

    Wednesday, August 26, 2009 at 11:19 pm | Permalink
  6. Scienkoptic wrote:

    The American health care sucks in part because of the legal system here.
    Open up a Yellow Pages book. What are there more of? Lawyers or Doctors? As long as the potential of legalized extortion exists in America, Health Insurance will continue to be an unattainable mirage.
    Cost of health care here is in part driven up by our(US) litigious nature.

    That coupled with the gaming of the public health care system here by medical device and supply companies. Ever seen the guy selling the crappy mobility scooters on TV? He’ll give you one for free if Medicare or Medicaid doesn’t pay 100% of it’s cost.

    Thursday, August 27, 2009 at 4:28 am | Permalink
  7. Shannon wrote:

    Twwly, that’s BRUTAL. I needed to see my doctor yesterday, and I got an appointment 30 minutes later, and that’s fairly typical if I ask for it…

    Thursday, August 27, 2009 at 4:35 am | Permalink
  8. Twwly wrote:

    I’m actually one of the luckier ones, since I actually have a GP. There are thousands of “orphan” patients, Scott included. That is a REAL mess.

    Getting Maggie treated for her pneumonia this spring was totally nuts. The only reason I managed to get her in to see my GP was because I actually staged a sit in at the nurses station. As in, ‘I am not leaving here until you see my sick baby.” Our appointments then with our GP were on his LUNCH BREAK. (And I have been with my GP since I was a little girl).

    Most people don’t do that, aren’t that aggressive and don’t want to face the 6+ hour emerg waits. (I have gone in with the kids to see EVERY chair full and just turned around and walked out). In some ways, maybe it’s good, less kids and people on ABX, getting resistant, etc. But there will be a lot of conditions going untreated that DO require care. And that’s pathetic.

    I still really want to contribute to your dirtydocs site, I just haven’t had the time to start composing. I don’t know where to start, there’s been so many horrible experiences!

    Thursday, August 27, 2009 at 7:21 am | Permalink
  9. Alyssa H wrote:

    I’ve alwasy had health insurance here in the USA, and shit gets weird. They sort of pick and chose, oddly, when and what they will help pay for. Every three months I have a birth control injection, and now and then I’ll get a bill, or I won’t, for the $10 injection fee.

    I had the flu so bad a few years back that I went to the ER. I waited for four hours and decided that if I was going to die it would be at home. That’s usually how it goes. Another time I couldn’t talk because of strep, and the triage nurse wouldn’t allow my own mother to give him my information because it had to come from me. It’s all very stupid.

    Last month my grandparents went to Canada on vacation, and mt grandfather had a nasty fall. They were in, taken care of, and out of your Canadian ER in under an hour.

    Thursday, August 27, 2009 at 2:04 pm | Permalink
  10. starbadger wrote:

    There are a number of sectors we spend too much on – war and medicare are the top two.

    Things where we spend too little – education and the care of children.

    Friday, August 28, 2009 at 5:21 am | Permalink
  11. peteD3 wrote:

    i live in the USA and it usually only takes me a few days to see my GP. emergency room waiting times can be a bitch tho…depending on the day/hospital

    Friday, August 28, 2009 at 11:11 am | Permalink
  12. Danielle wrote:

    Nathan,
    #1 – dehydration does not = lack of water. It is actually an electrolyte imbalance which may or may not be improved by fluid intake. Fluid defecit is a lack of fluids – please learn the difference prior to making comments such as yours. Secondly, if in fact your friend had been given water and then required surgery, he/she would have had to wait another 8 hours without water (or anything else by mouth) prior to receiving any anesthesia or surgery. Thirdly, if people who did not have to pay for their healthcare and receive it free of charge (courtesy of you, me and other hard-working, tax-paying citizens of this country you mock so freely) didn’t bog down Emergency Rooms with sore throats, stuffy noses and other nonsense, maybe those of us actually in need of medical attention could get it in a more timely manner. If they were required to work or pay for their healthcare, perhaps they would go to a PCP for non-emergent issues and your friend wouldn’t have to wait so long to be seen in the ED. In any case, 8 hours in the ED waiting room is certainly better than 8 months waiting to see a PCP under socialized healthcare. GOD BLESS AMERICA!

    Saturday, August 29, 2009 at 3:37 pm | Permalink
Wow Shannon, that's really annoying! What is it, 1997 on Geocities? Retroweb is NOT cool!

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