I thought I was dying. It felt surreal. I was at the mall, for god's sake. Who dies at the mall? There was the big "Atlantic Superstore!" sign shining brightly, there were the people bustling around with their groceries, and there were the little coin-operated grocery store gumball machines. Normal. Banal. Ordinary.Except that my abdomen was on fire. My roommate looked at me with ill-concealed panic. Ever realize that YOU are in bad shape because of the way someone else looks? Yeah. It was like that.
This is a diary about what happened to me that day, and on other days when I used the Canadian healthcare system. Considering that the Dems control Congress, and (as scott jones notes in his diary) there are serious single-payer plans on the floor, it seems like a good time to get beyond the Republican propaganda. No statistics or deep analysis here, just personal experiences, warts and all. In this diary, I want to share my own Canadian healthcare experiences, and invite you to share yours. If you have been treated in Canada or another country with universal coverage, please tell us about it: good, bad, and indifferent.
So, yeah, back to the dying.
I couldn't walk, every breath was torture. I was almost floating because of the pain. I didn't feel like I was in my body–actually, I hoped I wasn't. Somehow I staggered (and actually crawled) to the exit and got into the back seat of my roommate's boyfriend's car. He tried to drive fast, yet smoothly. Poor soul. Every bump made me long to pass out, but somehow I didn't. I remember singing incoherently to myself, trying to concentrate on making up tunes in order to forget the godawful searing pain just below my stomach. I seem to recall throwing up on the steps of the hospital. Somebody got me a wheelchair and then I went into the ER. By that point, I not only thought I was dying, I wanted to die.
The ER wasn't too crowded. I slapped my MSI (Nova Scotia health card) down and gasped out my doctor's name. The admitting person took down my information in about 5 minutes. I huddled over a stuffed animal that my roommate had brought me from home. For some reason I can still remember that it was a Wishbone doll. Poor Wishbone; I think I nearly squeezed him in half trying not to pass out. 10 more minutes of agony. I saw a nurse who took me to an exam "room" (really one of those doohickeys where they swish the curtains around to create a room.) She was calm and soothing as I gasped out my story and symptoms. She helped me to a bathroom for the inevitable urine sample. Someone took my blood. There were exams, pregnancy tests, blood tests, and god-knows-what tests.
I saw a doctor about half an hour later. He had red hair (I have no idea why I remember that) and a South African accent. He talked to me about what might have happened. He was fairly certain that I'd had an ovarian cyst, which had burst. Fun fact: Ovaries are as sensitive as testicles, kids! It's just that usually they don't get injured. When they do (or when a cyst develops and bursts, as happened to me), it's awful, nauseating, dreadful pain. But thank heavens, it started to get a bit better. I got a shot and a prescription for pain, orders to rest, and a discharge. Two days later I saw my regular physician, and we followed up the problem which had, by then, subsided.
I didn't die. But there had been an ER visit, tests, pain shot, follow-ups with my doctor. What did that cost me? I hate to think what it would cost me now, living here in my DEEEEP South state, even with my health insurance.
But in Nova Scotia, it cost me nothing. Rien. Nada. I was billed for nothing.
I was a poor grad student at the time. My first year in Canada, I had to buy health insurance from my university, as a foreigner. After that year, I was able to be covered by the provincial plan. (It's not really correct to talk about "Canadian health care"; each province administers its own plan.) I picked my own physician; when I needed a second opinion, I got it. I flashed my card, I got care. There were some issues finding a physician in rural areas; during the summers I had to travel an hour from the small town I lived in to see a doctor. But never, never, never was a physician "assigned" to me, nor was I forced to keep seeing a physician I did not like.
I liked the doctor I settled on, and our typical visit was 15-20 minutes. She took her time and got to know me. When I came in to talk to her about a depression I was going through, she ordered blood tests, talked about nutrition, my life situation, and more. None of that cost me a cent. I had some experience with medical emergencies not my own while living under MSI. When one of my roommates' heart developed a flutter one night, it was VERY scary. We called the ambulance. But we didn't worry about how to pay for it. Just when she would get better. She spent weeks in the hospital. She didn't have a private room, but she did have a bill of exactly 0$ when she got out.
Let me talk downsides. I had no dental, nor vision coverage. (Those coverages vary from province to province, btw; bear in mind I only have personal experience with MSI). I was in 3 different hospitals during my time, and they ranged from very nice to awful-looking. Not Stalinesque, mind you, just run-down. Definitely not the 17th-century bloodletting facilities some Republican scaremongers claim are common.
My physicians in the States have nicer offices in terms of decor and stuff like that (if those are things that matter to you–myself I'm happy with the old waiting room and the stacks of magazines. I don't need CNN in the doctor's office). My roommate who had a chronic condition (anorexia) did experience some serious access issues. The closest clinic suitable for her particular condition (she really needed live-in treatment) was in Ontario, and she spent a year on the waitlist to get in; there was a lot of complicated paperwork trying to get her MSI to cover the Ontario treatment. Wheelchairs, crutches, hearing aids and glasses were not covered in Nova Scotia (I emphasize that every province is a little different in what is covered); nor were alternative treatments like massage and acupuncture. Psychological care was not covered. Employers may offer supplemental insurance; my university offered some supplemental insurance and services for students; limited amounts of counseling, for example, were available free from the university. Some of these insurance plans cover the extra cost of a private hospital room.
The system is not perfect. But it is good. Based on my personal experiences in both countries, I would change back in a heartbeat. I have "good" insurance now; it costs me about 90$ a month in premiums. My annual deductible is 300$, with office visit co-pays of 20$. The time that I get with my physician is 10 minutes. At least I have insurance now; I briefly had to go without, and unfortunately had an emergency visit at that time. The total cost of seven stitches? $1400. I never know what something is going to cost up front; one simple procedure my result in three different bills (my physician, the lab, the lab personnel). I worry a lot about financing. There have been times, frankly, when I've put things off because I was unwilling to put them on credit cards and I had no way to pay at that time, even with insurance. $300 is a lot to get hit with all at once when you're paying off debts, insurance, rent, etc. What good are all these marvelous medical breakthroughs if I can't pay for them?
I'm not that kind of a doctor, but I'm willing to bet that all the stress isn't healthy. And yet I should really shut up. I can't complain, because I am insured.
This is a diary about the micro, not the macro. I can't pretend to know the ins and outs of any system, but I hope you will bear my experiences in mind next time someone tries to convince you that the Canadian system is so terrible. You might also look at pale's experiences with the British Columbia system. Several pregnancies a broken toe and more...all with nothing more than the cost in her taxes. Don't miss the comments either, as there's great info o issues such as funding.. Snakes on a White House also had a lot of great comments in this diary in which Canadians and Europeans answered some questions about their experiences. I've also asked some Kossack Canadians to share their own experiences in diary at The Next Agenda and I got some very honest comments about the ups and downs of personal experiences.
If you have an experience to share, please do so.
And one final thought. In 2004, CBC television ran a contest asking for votes for the "Greatest Canadian." While hardly a scientific poll, the contests results are still revealing: the "Greatest Canadian" was voted to be not a prime minister (nor a hockey player, but
Tommy Douglas, the Saskatchewan premier credited with founding Canada's universal health system.
We've been hearing a lot from the Republican noise machines about how much Canadians hate their healthcare system, moving the Overton window ever-rightward with statements like: 'Well of course we don't want what they have in Canada.' Why ever not? From where I sit, it looks like Canadians are pretty proud of their healthcare system. Whether its implemented at a national or a state levelI want one that I can be proud of too. Don't you?
All images in the public domain except for portrait of Tommy Douglas, which is owned by the Saskatchewan government, and is under Crown copyright. It is believed that the use of this photograph to illustrate the person in question, where the image is unrepeatable, (i.e. a free image could not be created to replace it) qualifies as fair use under United States copyright law.