Late today, but still here. I had the day off, as we had already scheduled weekday morning doctors appointments when I started working. Our first appointment, last month, was a consultation and chat. This one was a physical.
I really like the doctor a lot. So, it looks like I lucked out again. Finding a good doctor was a real concern of mine. Everyone told me it would be hard to find any doctor taking new patients, and then, who knows if you'll like the person who's available? It turned out there were several available doctors in our area, some of whom were female (which I strongly prefer for a family doctor). We chose someone close by, and today, I got a really good feeling about her.
Once again, we see a doctor, there is no charge to us, and we say, This is amazing. Universal health insurance is like a miracle to me.
* * * *
I've learned another difference between health care in the US and Canada. In the US, if you have decent insurance coverage, certain cancer screenings start at age 40 - mammograms for women and prostate checks for men.
It's drummed into your head that you must do this when you turn 40, despite scant and conflicting evidence of the benefits. I've known that there are lots of false positives in mammograms of women under 40 - I had one myself, and that's not something anyone needs to go through. But you always hear you have to do this when you turn 40, your doctor tells you your insurance covers it, and you go.
In Canada, unless there's a risk factor present, such as family history, mammograms start at age 50, and men are screened for prostate cancer beginning at age 50.
There's two ways to look at this.
In the US, it's: more screening is better, early detection is paramount, if there's any chance of benefit, let's do it. Many would look at Health Canada's guidelines and say: scarce resources, rationing, inadequate public system.
In Canada, it's: there's no proven benefit to this, it's wasteful, it causes needless anxiety (from false positives), why run tests just to run them. Many would look at US insurance company guidelines and say: waste, profit, greed.
The fact is, every one of those tests in the US is paid for by someone. And false positives, of course, only lead to more testing. It means more commerce for the health care industry, more business for the insurance companies. But does it mean a healthier population? There's no evidence that it does.
And of course, in the US, not everyone is entitled to these tests. People with decent jobs that include good health insurance are screened at age 40. In Canada, every woman can get a mammogram at age 50.
Growing up American, I was definitely conditioned to think early screening was, by definition, better. As an American woman who's already started having routine mammograms, it feels odd to just stop. Like I was taking care of something that now I'll be neglecting.
But I often wondered if all that cancer screening was just to make us feel better psychologically: I got my mammogram, now I'm safe! A close friend of mine developed very aggressive breast cancer four months after a clean mammogram, so what does annual testing actually do?
Having had a false positive - and six weeks of waiting in between tests (yes, waiting, even with private health insurance in the good ole USA) - and knowing many other women who've had one, and now reading that the benefit of mammograms between ages 40 and 50 hasn't been shown, I'm now more inclined to chalk up all this testing to the profit motive. More testing, more business, more profit. More radiation, too.