Saturday, September 5, 2009

A Perspective On Canadian Health Care

I don't normally post things on my blog that have been written by other people, however, the following email was written by my cousin, who lives in both the US and Canada. So, I feel she has a perspective on the Canadian health care that would be, by my standards, a original source. She's seen it first hand. I think that no matter how you feel about universal health care and that even though the Canadian system is different than the changes being argued in congress, it is worth reading because there is a contingent within our country who still clings to the belief that the system works well there. I also think it's an important part of the discussion because, ultimately, our world is not a just place. As a Christian I am constantly striving for social justice, however, no system in the world outside of God's kingdom -- be it public or private -- is going to
to achieve that. If we naively believe one system can solve all our problems and preclude the need for the church to care for the health and well being of humanity, then we're simply finding our own way to abdicate our responsibility.
There is an awful lot of talk going around about the proposed health plan for this country. Several friends and relatives have sent me e-mails asking me about Canada's national health plan and how it functions. I have finally decided to just relate our experiences with their plan and let you all make your own decisions about whether you think we can afford or even want a government run plan.

We live in a town of 16,000 people. We have four general practitioners, one ob-gyn, and one general surgeon. There is a massive waiting list for those people who wish to have a private doctor. Meanwhile, those who do not have a doctor go to the emergency room. This includes all of the poor and minorities and much of the middle class population of the town. There simply are not enough doctors. They are coming to the US to practice. If a person in our town needs an MRI, there is a 6 month wait, and they must travel 2 1/2 hours to Winnipeg to get it. There is a 10 yr. wait for hip and knee replacements there, a 6 month wait for biopsies after positive mammograms. Colonoscopies are used as a last resort, and mammograms are only done every two years. When a new doctor comes to town, people are called and assigned an appointment time to be "interviewed" by the new doctor. Basically, the docs pic and choose whom they want to bother with. Old, preexisting condition? Forget it. Poor? Forget it. If you cannot keep the appointment, you lose your chance until the next time around. Remember, it was assigned.

There is an 18 month wait in our town for carpal tunnel syndrome surgery. It is done the old fashioned way. If you want the new surgery, as we have in the US, you must wait up to three years to have it done in Winnipeg. In short, elective surgery (even when you are in extreme pain) is wait, wait, wait.

Now, you say, is it this way all over Canada? No. Our province and Manitoba do not permit private health insurance. Many of the others do. Therefore, people in those provinces who can afford private, often come to the US for treatment. Also, there are more doctors who accept private insurance in those provinces. Are the poor and disenfranchised treated any better there? Our understanding is that they are not. In large cities, such as Vancouver, Edmonton, Calgary, Ottawa, Toronto, and Montreal, the care is better and much of it is state of the art. Great, if you live there.

Is treatment paid for? Some. A lot is not, though - eyes, ears, and teeth are another story. Do they pay high taxes? You bet! In Ontario, residents pay national income tax, provincial income tax, and 15% sales tax. That's to finance their "free" medical care.

I've painted a dreary picture of Canadian health care. I'm sorry. It's what we've seen for 19 years. It's dismal compared to what we have. The poor are still going to the ER, the wealthy are still going where the care is good. Nothing is different.

Our system is not perfect in this country, but it is still the best there is. It has some glitches that need to be fixed, but fixing them would be far better than allowing any plan run by our inefficient and costly government.

I welcome any dialogue about this essay, and know that my cousin reads my blog, so am sure she is willing to answer any questions as well.


Amy said...

I have 2 questions for you:

1. How does your cousin live in 2 countries? I mean, does her house straddle the border? Does she live in one country and work in the other? I'm just curious.

2. If there is only 1 ob-gyn in the town, do pregnant women all go there or do some drive to other cities? Does everyone get prenatal care? How does delivering a baby work? No, not THAT part. I know how that part works. lol How far you have to drive to a hospital. Does your ob deliver your baby or just some random doctor? Because it's not like you can get put on a waiting list to get a baby delivered - babies tend to have their own timetable and wouldn't wait for their turn on a list.

Ok I guess that's way more than 2 questions. Sorry! But I enjoyed reading about the Canadian health care system from someone who has actually experienced it. Thanks for sharing this Deb!

Deb said...

Amy, in regards to question number two, I'm surprised that in all your childbirth experience you've never heard of the "canadan cork". It's proven very effective in keeping a woman in labor from delivering for a full 8 or 10 months, until it's her turn in a delivery room.

Just kidding. Obviously.

I forwarded the questions to my cousin. I just couldn't pass up the joke.

Deb said...

Amy, here are responses:

1. How does your cousin live in 2 countries? We have a summer home in Kenora, Ontario where we spend six months of the year. We have used Canadian health care, and then our insurance company has reimbursed us. The hospital in our town is like going back 30 yrs. in the US. Really depressing. I am retired and my husband is semi-retired. I have been there full time, and he flies in and out at will. lol

2. If there is only 1 ob-gyn in the town, do pregnant women all go there or do some drive to other cities?

From what I could glean, the babies are basically delivered by nurse practitioners. The one OB has been on maternity leave for a year, so we didn't even have that. If they need a c-section, they either bring in someone or send the girls 2 1/2 hours away to Winnipeg, Manitoba. Lots of ER visits, too. ER docs tend to rotate in and out.

Robin C. said...

I sat and talked to a nurse friend of mine originally from Nova Scotia (note the Scottish accent I said that with) She lived in Canada and worked in Detroit for 20 years. She said the same thing as your cousin. Many examples of waiting and poor care, few doctors etc in Canada. Her example I can remember is when her 10 year old broke his arm, went to ER and was told the Ortho Doc came on Tuesdays... it was saturday! So she had to wait for anything to be done till he came. Now I assume if it was cutting off circ or something the ER doc would have done something but I'm not sure. She said she could have tried going to the hospital in another (read richer) province but they frown on that because you didn't pay the taxes for this province's hospital so go back to your own!

You may be asking why she didn't just bring him to the US? Well there's custody issues that she deals with and cant bring them over because her x is a... well, mean person. That is all resolved now and has moved here with her kids and would NEVER go back if she didn't have to!!

St said...

I don't know. I've heard anecdotal evidence that goes both ways. I don't know why it matters in this debate since we're not going with the same model. The horror stories Americans tell are what I find more compelling. Stories that sound very similar to the ones told here. Rural communities that don't have clinics at all, etc.

Deb said...

Well, I think it's relevant in that it stimulates discussion over the fact that its not relevant. I agree that it's not what's on the table for our health care reform. However, I'm an e-list where I read people actually telling people to contact their congressmen and pressure them to accept nothing but full fledged universal health care provided by the national government. So, there still are many people unaware of the legislation as well.

However, I also think it testifies to the idea that I put forth in a different entry that the real concern with a nationally run public option is that that option will stink and many employers will want to free themselves of the burden of paying for health care and dump people. Then you've got people paying the government for an inefficiently run system that functions as poorly as medicaid does now.

I do agree that I find the stories from the US more compelling -- when I find legitimate stories. For instance, there has been the recent hullabaloo about the young lady from Miami who recently passed away from what is now being called "not H1N1" because she had no insurance and didn't go to the hospital when she should've. However, I know that she could have cheaply purchased an emergency insurance plan to cover such problems if she had wanted to (or knew about it). I know this because we've purchased said insurance before. So, what the media is putting out as a case of "no insurance by force" is really "no insurance by choice" or "no insurance by lack of knowledge".

What I've directly experienced is things being covered that shouldn't be covered and tax dollars paying for things that probably aren't necessary -- therapies, equipment that doesn't really help anything. I KNOW for a fact that that over diagnosing is very harmful to children that you are trying to raise to be independent and able to conquer the physical world that they live in.

So when I read something like this, what I pick up on is the inefficienty of a national system to 1) administer funds and 2) meet the needs of a particular region.

I think it argues for a need for statewide health care reform with legislation coming from the federal government that protects people from being snookered by either government or private industry and a need for the church to fill in the gap to serve people who have a genuine need.