Other than that, not alot to talk about this weekend. If you haven't noticed, I've taken a momentary step back from the health care issue for the good of my own sanity. This debate is not taking place amongst the rational or genuinely concerned Americans, it has been hijacked by political opportunists, zealots and profiteers. What should be a genuine discussion about the value of health and human life has instead become another ring in the grand media circus that is the lifeblood of America. I have every faith that Obama's foresight, global perspective, and political acumen could lead America in prosperous new directions, but I've grown to have equal faith that the selfish political interests of an entrenched political class backed by an even more entrenched economic class will rule the day. My adding rational discourse to the debate is like trying to get rid of a fruit fly infestation with chopsticks. I'm not through, but I definitely need a break.
To help facilitate a retreat into my inner sanity, I've asked for help from my friend, Thomas, a husband and father of three who has lived in the US, Mexico and Canada and used the health care systems in each place. A couple of weeks ago I asked Thomas to muse on his experiences in each country so that I might share with you, my good readers, a first-hand account of the evils of social medicine. Enjoy...
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Healthy
by Thomas Mical
Disclaimer: I am an American Doctor. I have a Ph.D. in Aesthetics, but since I cannot legally write prescriptions, my in-laws feel I have wasted my time (and theirs). This is my story.
As an American father married to a Mexican wife and blessed with a great many (disobedient) children, we have had the good fortune to experience US, Canadian, and Mexican health care for many years personally. Before we come to the crucial debate over who gets to euthanize my elderly mother, lets go over how to have a baby.
Making a baby in each country is similar, usually involving alcohol. In Chicago, when our little Medium Boy was born, I was unemployed, and paying for a post-employment health care option called COBRA, aptly named for it’s deadly bite. I was actually paying for this, along with my rent, with cash advances from credit cards. You could do this under the glorious Clinton regime, but only for 6 months, because then you needed another full-time job to get fresh health insurance.
I finished my doctoral dissertation on May 18, and the boy, who we were previously told would have severe and inoperable birth defects based on an expensive sonogram I still haven’t paid for, came May 21, after 30+ hours of labor. When he was born he was lavender and lizard-like, but one slap and he was pink and screaming, just like daddy. A large and well-developed baby, his defects healed themselves before birth, which probably resulted from the prayer of all our families. Today he is certified as gifted (in mathematics), and he a chronic hypochondriac - this second trait obviously inherited from my mother. It skipped a generation, as I prefer to follow my father in “walking off” the illnesses I’ve had: bronchitis, pneumonia, bone breaks, and probable cancer from starting smoking at 29 (I quit 3 years ago because of the Canadian sin taxes).
As we were covered under our insurance, my wife got to stay in the hospital for 2 days, got lots of medical attention, the boy got constant nursing attention, and we got a gift basket of diapers and bottles and baby stuff. The women who did not have insurance were usually given their babies, and wheeled to the exit, as recovery rooms were reserved for “paying customers.” That made me a little sad to witness. When it was time to go, I again confirmed my insurance, wrote a check for $4K, and left with the new mouth to feed. When I go back to visit Chicago I always visit that hospital where I nervously smoked and paced for 2 full days, as it was the most intense and stressful time of my life, and it lets me gauge how much I have changed or grown over the years. Now the hospital is shut down, as they refused to treat an uninsured gang member who had been shot and left in the emergency room entrance, which started an investigation, which lead to discovery of financial irregularities, and hence the closing. They were double-billing us for a while, so I think the problem was systemic.
Having a baby in Canada was much easier, for me. 60 days after legally moving to Ontario, we were all magically covered under their OHIP universal health care – you get a card that looks like a Driver’s License with a personal photo on it. At that time, the other provinces didn’t have this long qualification period, but this might have changed now. This card is more desired than an American green card. Anyway, while I was adjusting to my new habitat, my wife decided to go into labor a few weeks AFTER we qualified, so I didn’t have any stress this time. We didn’t know many people in Canada then, so they let us all sleep in an empty hospital room while my wife was in labor. The practice nurses kept trying to draw blood from the baby’s head (it is a teaching hospital, so everyone got a try), and he has a round scar from it, but he’s pretty normal otherwise. They had to do an emergency C-section because the little Canadian had the umbilical cord wrapped around his neck twice (he’s still very wiggly), and then my wife had complications and had to stay in intensive care for 6 days.
I managed to get the other kids home and cleaned and off to school each morning, then I would go to the hospital by bus to play with the baby. I finally got them to release her by constantly asking the nurses what they were doing, and since she could just as easily wait for follow-up tests at home as in a hospital bed. When I went to “check out” and pulled out my checkbook, the nurse said, “You’re from the States, aren’t you? We don’t pay for our babies here!” I was intrigued, and asked if there was a mandated limit like in China or with an HMO, and they laughed. Canada is tough on immigrants, but they love newborn Canadians. Love ‘em … more than puppies. The final tally after 6 days: bus tickets - $18, 6 packs of cigarettes - $72, hospital stay – free, new screaming Canadian poop-machine – priceless (actually I read today it’s $200K/kid to raise them now, unless you can train them to dance for nickels, but that’s not an option because its unionized here).
I have heard rumors that women from Mexico sneak across the border into the US just to give birth to a US citizen, but I’m surprised more American women don’t take a bus to Niagara Falls and hop across pretending to “buy some duty-free souvenirs” and staying. Maybe it’s because the myths in the US about how Orwellian the health care is in Canada, but they have great doctors, and they have strict standards for all the professions, because every cab driver here claims they are a doctor who got in due to their educations, but their credentials weren’t accepted for practice.
Back in Mexico, when you go to the doctor, my wife said you are expected to make a cash donation, kind of like giving a retainer to a lawyer, before treatment, based on the (apparent) difficulty of the treatment. This is a radically privatized system, more so than the US, but with each doctor free to set the market rate based on many factors, both real and imaginary. Hint: speak perfect Spanish for the best rates. Back when Michael Jordan was playing for the Bulls, Chicago Bulls mugs and hats were better than passing out hundred dollar bills! I am told there is formal and expensive health insurance in Mexico, and a good health care infrastructure in big cities, but the impression is that health care is a luxury item for most, and so homeopathic cures are quite common (and sometimes even as effective). As in Canada and the US, common illnesses are solved quite quickly, and most common medicine is significantly cheaper than the US and Canada.
Reality check: when we lived in Oklahoma, our rental home was US $425/month, and the mandatory health insurance policy with my company was approximately US $900/month for a family of 4, with my company only covering my portion. Health insurance was our BIGGEST expense (followed by utilities, then food, then housing, then deductibles for health care). In Ontario, my rent was CAD $1100/month, and the OHIP was free, but now they charge us CAD $750/year for the family on the tax form. We just have to flash the OHIP card whenever you want to go to your family doctor (preferred first stop, but not mandatory), or a walk-in clinic (easy and convenient, usually with decent rotating doctors), or bus to the emergency room (if it looks expensive), and they admit you and process you – we have NEVER had to wait more than 15 minutes to get medical care for ourselves or our kids, and we go for sniffles, coughs, or rashes, because it’s free. We don’t have to call anyone, we don’t panic, and we just go, like running to get eggs from the grocery store.
Some things are a little difficult: CAT scans and other heavy machinery usually take a little longer to schedule than in the US, most tests are fast but results can linger longer, and when the baby broke more than one pair of glasses, we had to use the private health insurance card my company provides to pick up the slack from OHIP. My company covers this private supplement out of my paycheck just like in the US, and it has small deductibles. It works similar to the US except you can also go straight to treatment without calling some switchboard for approval like we always had to do in Oklahoma, even when my son was choking to death and we had to wait for some switchboard monkey at the insurance company to tell us which emergency room we could use. I will always hate HMO’s for that terrifying procedure delay. If Canada went that way, the switchboard would be automated and polite, perhaps “Good day, eh? If you are bleeding profusely from one or more wounds, press 1; if you are incapable of walking to the curb, press 2; if you are unconscious, press 3 …”
Canadians only recently got their universal health care, but they all seem to think it is an essential human right and an essential part of Canadian identity, not the profit-driven elective luxury it should be. Compared to our lifestyle in the American Midwest, Canadians spend more time and money on treatment and prevention, as we noticed my oldest son’s Oklahoma obesity faded after a year of mandatory healthy eating and intensive outdoor exercise required in public school. It was kind of cool to go meet my kids after lunch to go skating on the canal. The teachers had stools and whips like lion tamers, and they made those kids skate!
They like to tax things in Canada, big things, unhealthy things, like those cigarettes I liked. In their passive-aggressive haste they banned smoking everywhere, and they banned foods with trans fats one day, because the second biggest killer after cancer is obesity. I’m not sure what the third is, but there will likely be taxes and laws to stamp it out at the root cause. Note to Canuck activists: I would love to see the Canadian health care system try to stamp out stupidity, but I know that I am a dreamer.
So back to euthanizing grandma ... As the first born son, pulling the plug with my bare hands is my right alone, not some panel of doctors, or some insurance company switchboard operator, or some redneck “death panel”. She had a small head injury a decade ago, which didn’t do too much damage as far as we can tell, but she was blackballed at 55 from any health insurance in the US, due to this “prior condition.” Grandma now has Social Security and Medicare, but this is not enough, so I send her some money each month to cover her food, since she was in the classic “food or medicine?” bind in Wisconsin for a while. Though her prior conditions may or may not be covered if she moved to Canada with us, she thinks those payments won’t work here, and she thinks there are long bleak Soviet-era lines for health care here, and that the ambulances are dogsleds, or some other such nonsense.
Funny how my train trips back to the US bring me in contact with nice older ladies my mother’s age that have duffel bags filled with pills. Because I grew up in Chicago watching the old black-and-white TV show “The Untouchables,” I can imagine a new series where the Feds are cracking down on these modern-day smugglers. I think the pharmaceutical costs and choices would be better across the other border, but I don’t know.
The annual costs of medicine, and our need for health care, has varied significantly from year to year. The USA and Canada have systems that make it possible to budget for these. In Canada, you know the basics are covered, and anything else goes to the private insurance (not everyone has this luxury, either in Canada or the USA). My last job in the USA had an affordable pre-tax option where you got to estimate how much health care money you wanted withheld from your paycheck, as if you could forecast a growing melanoma and budget correctly for it beforehand. I thought it ghoulish, but everyone else at the orientation session said it was a “good deal.” And of course I had to list every named illness I ever had on all this tedious forms, and hope that none of them would get me blackballed like my mom. Imagine the scenario then – you get an illness that usually kills people, you beat the odds and you survive, and your joy turns to despair because now you are the living dead to the insurance companies.
As the living dead, you are on your own against all viruses and medicine-resistant microbes. No wonder my mom has those hand detergents in every room – she buys them by the crate at Sam’s club – because they are now her medical insurance. My mother-in-law used crucifixes in the house much the same way, but in Mexico most homeopathic medicines are collected from the back yard, and boiled into teas.
In conclusion, let us tally up the last 15 years of personal experiences:
- The most affordable health care system for our family, so far: Canada (significantly better).
- The easiest and most flexible health care system for our family to use, so far: Canada.
- The best health care system for newborns so far: Canada (but the USA is just as good, except for all the bills and paperwork).
- The best quality health care for children, so far: Canada, then USA (almost tied).
- The best health care for elderly: maybe Canada, maybe Mexico.
- The health care I would go to for unusual diseases or difficult to diagnose chronic ailments: USA - but using my Canadian health insurance if I could get away with it. If this unusual disease or difficult to diagnose chronic condition occurred in the USA, and my USA HMO were to refuse “non-essential” treatment or downright drop me for getting sick (as they apparently do to keep medicine profitable) I would probably break down and go to Mexico to self-medicate (Tijuana?), get some hand gels, and try the Mexican homeopathic medicines my mother-in-law brews.
