This is in naswer to a posting about the shortcomings of the
Canadian “socialist” health care vis-avis the US system.
No system is perfect and I can only speak from my own
experience.
To give an idea of where I come from I own my house (paid up), a
few other assets, no debts but drive a 13 year old Nissan
pickup with 400,000 plus km on it and still going strong because
I can’t afford to change vehicles that often while this one
still runs. I and many others like me would never have been able
to afford the health care the American way even if we scrimped
on other necessities of a modest middle class lifestyle. I would
remain indebted all my life. Lets say we make the ultimate
sacrifice and buy into a US style health care plan. A major
illness would have wiped us out and leave us uncovered after a
major claim when we most need it. It is alarming that even a
Hollywood notable like Chris Reeve’s benefits ran out after two
years (TV interview, 60 Minutes).
What our socialist health care plan does is to allow us to see a
doctor for the usual colds and sniffles, cuts and bruises which
are what most health problems are without having to worry about
that impacting on our premiums or continued eligibility into a
health care plan. Everyone is automatically enrolled into the
Plan no matter how many health or job related exposure
liabilities one has. There is no prequalification. I can move
from one province to another and get accepted into a similar
health plan without a break in coverage. No need to hunt down a
provider or worry about costs.
And when we do get a whopper of a medical emergency such as a
serious accident, a heart attack or some other disaster for
which immediate medical attention is required there is no wait,
no surprises and no special treatment on the basis of your bank
account. Everyone gets the best services available from the
staff on duty at the time of the emergency. This coverage is
country wide, meaning that my provincial plan will pay for my
emergencythat happened in another province or when out of the
country. I will never get turned away at any hospital because
they couldn’t find my health insurance papers. I don’t get
wiped out financially.
And how many of you on HMOs restrict the size of your family
because of health care costs?
To be sure this is no Cadillac service either. If you have a
serious illness which took a long time to develop which cannot
be fixed overnight even by the most advanced medical technology:
cancer, a heart disease, kidney failure, emphysema, genetic
disorders and the like: there is a long waiting list to get to
the operating table. And if you are elderly where major surgery
is not likely to add much to your life expectations you don’t
get preference to the front of the queue. But everyone gets
there eventually. Your HMOs do very much the same cost benefit
assesments and HMOs are more likely than us to restrict or deny
procedures on lost causes and even cut off coverage.
Our coverage is lifelong and universal. Although there won’t be
any herioc efforts to prolong your life you won’t lose medical
access either or have your premiums jacked up.
Because having the monetary means does not allow a Canadian to
jump the queue they are what you are seeing in the rise in
Canadians going Stateside for medical treatment. If you fear
that something is going to kill you before you get to the
operating table and you have the money, why not go someplace
that will let you pay to get ahead. Money is no good if you are
no longer around to spend it. No quarrel there. But if you
look at the implicit morality of the issue, only the rich get
treatment. The ordinary and the poor have no say. And if you
look from the puiblic health point of view that expenditure
adds very little to the health expectations of the patient. A
year, perhaps two. That same money can treat dozens of lesser
but treatable illnesses to maintain a healthy populace.
With that I am entering into a very contentious debate of
personal health versus public heatlth which will take much more
arguments than time or my knowledge will allow. We have to live
with whatever health systems our countries inherited. Over at
least four US presidential administrations health care costs and
ascessibility had been a serious election issue and the
President and Hilary Clinton’s proposal was as close as the US
got to reform. That went nowhere.
As for Canadians, we have our complaints about our system but
the chief beef is that we are not spending enough, mainly from
those who want immediate and the latest medical procedure when
they have an excuse to draw on the system (doesn’t cost them an
extra cent to demand the best); and from those with vested
interests in generating higher expenditures - to maintain union
jobs and more benefits for example. That talk about the system
running out of money is negotiating tactics to rein in public
health care costs as at no time were essential medical
facilities closed (political sucide). There are planned and
ongoing public hospital closures for sure and practices such as
weeklong stays after a normal birth delivery are no longer
allowed. Stays after major operations have also been curtailed,
cost cutting practices which your HMOs rigorously enforce.
Unless you are a private paying patient like rich Candians in
which case they will max out the stay and your checkbook.
As I mentioned above, we have to live with whatever health
system we inherited. All I can say is that just as you feel so
strongly about your free enterprise medical system, we will
fight to keep ours and proud of it. What I do care most about
from a personal point of view is that payments into our health
care plan and accessibility do not occupy any of my everyday
concerns and I shall receive as good care as anyone else.
That peace of mind no money can buy.
Kelvin Mok (klmok@shaw.wave.ca)
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