9.05.2008

keep canada canada, part 2: thank you, tommy douglas

"The personal is political."

That feminist axiom sums up the overall theme of this blog, and of all the activism I've ever participated in. Abortion, sexual assault, violence against women, war resisters: these are all events in people's personal lives that must also be seen in a larger social context. In our political work, we should never forget the personal, human side. And when we comfort and help people, we should always keep the political context in view.

Perhaps nowhere is "the personal is political" more obvious than in the realm of health care. When we suffer through an accident or an illness, it can't get more personal. Our bodies, the stuff we're made of, the shells that hold our selves, are hurting or in danger. Pain is frightening. It's debilitating. It hurts.

When we have health problems, our entire world changes. It changes us mentally, emotionally and socially; it changes family dynamics. No matter how well we cope, we are still forced to cope. Even if we deny and avoid health issues, we're still expending energy denying and avoiding, and eventually, inevitably, the body will win.

But what about financially? What if we simply can't afford to get sick?

What happens to people who can't afford health care? What happens to a society that allows people to go without health care? We know the answers. Lack of access to affordable health care one of the principal reasons the United States is falling apart.

* * * *

As you may know, we recently had a frightening bout with illness. Allan was in extreme pain, and we had no idea what was going on.

It turned out to be a kidney stone. I was relieved it was nothing life-threatening. He was relieved when his pain was treated! But the attack itself was enough to deal with. We didn't have to worry about how we would pay for it, or fight a bureaucracy to get treatment.

Here's a recap and update.

1. Emergency department treatment, pain management, plan for follow-up, prescriptions and instructions. (Waiting time: zero.)

2. Appointment with specialist. (Waiting time: five days, including a Sunday and holiday.)

3. Consultation with urologist, including on-the-spot x-rays. He thinks the stone has passed!

For those who like more information: The emergency-department CT scan showed the stone in the bladder. The severe pain was probably the stone entering the bladder. The doctor said that is the narrowest point; if the stone makes it into the bladder, it can make it into the urethra and out of the body with no problem. Good news!

4. Urologist orders some follow-up blood work and pee samples, to make sure all is well, and to make sure the stone was not a sign of underlying issues. Recommends follow-up with family doctor.

5. Out-of-pocket cost to us: $0. We have already paid for this with our taxes.

Thank you, Tommy Douglas! Thank you, Canada.

* * * *

Some months back, I noted to Allan that no matter how long he sleeps, no matter how late he wakes up, he always has a lot of trouble waking up, and always seems exhausted. We started talking about how tired he is, nearly all the time.

Allan has clinical depression and takes anti-depressants, and I was concerned this might be a return of symptoms. But he said it felt different than that.

My blog-friend M. Yass, in a different context, mentioned he had sleep apnea. I wondered if Allan might have it, too.

M. Yass wrote me a detailed email about his diagnosis, and how his life changed after getting help. It really resonated with Allan. I recalled how reading a personal essay about depression helped us recognize Allan's own depression, and began a life-changing process. Maybe this would be a similar process.

So:

1. Appointment with family doctor. (Waiting time: maybe a week, trying to schedule a convenient appointment.) Allan tells her he is always tired. She does a physical, orders blood work to rule out other possibilities, and suggests a sleep study.

2. Blood work normal, Allan does overnight sleep study. (Waiting time: a few weeks, with earlier appointments being offered, but declined for scheduling convenience.)

3. Another appointment with family doctor. (Waiting time: until test results were in.) Diagnosis: obstructive sleep apnea. Treatment: C-PAP machine used overnight to increase oxygen flow to brain. This seems like a really good thing to me - non-invasive, no medication with potential side effects.

While this is happening, of course we discover that many of our friends have sleep apnea and use C-PAP machines. Most of them attest to excellent results. Allan has also gotten some good information through sleep apnea forums online.

4. Appointment with specialist from sleep clinic, who explains the options. (Waiting time: negligible.)

5. Second overnight appointment, to test one type of machine and to determine the proper level he needs. Depending on the results, this may be repeated.

Cost to us so far: $0.

Our provincial health insurance will cover a certain amount of the purchase of the machine. Depending on the price, that may be about two-thirds. Since we are fortunate to have supplemental health insurance through Allan's job, that will pay the remainder. If we didn't have that, it would cost a few hundred dollars.

This amazes us. It thrills us.

We pay our taxes. We receive health care. We pay our taxes, others receive health care. And we receive the same health care as people who earn much more than us and people who don't earn as much.

Last summer, I was unemployed for the first time in my adult life. I still received health care.

If you freelance (as I do) or own your own business or work part-time (as I also do) or work without benefits, you still have health care.

Thank you, Tommy Douglas! Thank you, Canada.

* * * *

I realize that not every Canadian has had as positive experiences with their provincial health insurance as we have. People are waiting for hip replacements and MRIs, they can't find a family doctor, they want treatments that Health Canada considers experimental and won't fund. (I must note that if you do not have a family doctor, you can use walk-in clinics, which are easy to find, and free. Not as good as a family doctor, but you do have access to care.)

It is certainly not a perfect system. I can't imagine that such a thing exists.

But it's a very good system. It's sane, rational. It's egalitarian and accessible. It's responsive. It focuses on prevention. It focuses on patients. It costs less than health care in the United States because it runs without financial profit. The only profit is fostering health, because healthy people strengthen our society.

Canadians are always discussing and debating how to improve the health care system. And no matter how much the Fraser Institute tries to convince us otherwise, any politician who talks about dismantling the public health system is committing political suicide.

I'm not writing this because I fear Stephen Harper's Conservatives will destroy public health care. But the system is a very good one. We need more of it. More funding, more programs to attract doctors, more access, more upgrades. The system needs more public funds, and it needs protection from people who believe otherwise.

24 comments:

redsock said...

Having been in the US for roughly 42 of my 45 years, I still find this system amazing, although I don't feel like I'm skipping out on paying my bill at the front desk anymore.

The second sleep study was last night and while I never like being woken up at 6 AM, I think I do feel less tired than usual today. That may be wishful thinking; I assume I will need to use a machine for many weeks before I can tell for sure.

Now I have to choose a company/supplier from a lengthy list provided by the clinic. They all do pretty much the same thing, so it may come down to location in determining which one I pick. I also want to call a few and see what extra benefits they provide to customers (follow-up appointments to answer questions, machine adjustments, etc.).

I will tell the sleep clinic who I chose and they will send my recent results to them (so the quicker I decide, the quicker I'll get a machine). They will start me out with a one-month loaner. I assume it will be something similar to what I used last night, which felt alright and was something I got used to pretty quick. I definitely slept better with the thing on my face last night than I did without it on the first night (back in July).

After the one-month trial period, then I guess I order a machine. I think they run about $1,500 (according to the cashier at the 24-hour grocery store I stopped into on the way home for rice cakes and who stared at my head and then pointed out the goop on my head ("Do you know you have leaves or something in your hair, sir?") and nodded knowingly when I said I had just come from a sleep study and that was the electrode glue residue and then he said he has been using a C-PAP machine for about eight years and "they work, they really work").

I also have a morning appointment at the sleep clinic scheduled for mid-October. I can't recall what it is for, though. Maybe a follow-up to see how everything is going. So you have not heard the last of this story!

M@ said...

One of the most telling things about how good the health care system is that Canadians have a hard time believing a system like the American one exists.

Most people take the Canadian system for granted, I'm sure. I'm glad we have a system worth taking for granted.

Good luck with the C-PAP machine, Allan!

john said...

My family has a history of obstructive sleep apnea. I've been using a C-PAP for the last seven years. Thanks to a combination of public and private health insurance, I paid nothing.

I share your contempt for the Fraser Institute. The Fraser valley in BC is a beautiful place, and the Institute shouldn't be allowed to steal its name. :-)

L-girl said...

Most people take the Canadian system for granted, I'm sure.

It does seem that way. That's why I feel so frustrated when I hear co-workers say they'd rather live in the US - because they can buy cheaper crap there.

ErinOrtlund said...

I'm so grateful for universal healthcare. I wonder why so many people in the US fear it, when we accept government funded education, etc?

James said...

One of the most telling things about how good the health care system is that Canadians have a hard time believing a system like the American one exists.

I've mentioned a couple of stories I've gotten from US friends to Canadian friends, and I almost always get either a "But why didn't they just do X?", to which I have to explain that "X" isn't an option in the US; or a "How could the HMO do Y? Surely that's illegal!", to which I have to explain that "Y" is often not only legal, but pretty much mandated.

L-girl said...

I wonder why so many people in the US fear it, when we accept government funded education, etc?

I take your point, but if they funded health care the way they fund education, it might not be an improvement over what they have now.

L-girl said...

I've mentioned a couple of stories I've gotten from US friends to Canadian friends, and I almost always get either a "But why didn't they just do X?", to which I have to explain that "X" isn't an option in the US; or a "How could the HMO do Y? Surely that's illegal!", to which I have to explain that "Y" is often not only legal, but pretty much mandated.

Yes, it's quite unbelievable. For many people, it is literally unbelievable.

James said...

I wonder why so many people in the US fear it, when we accept government funded education, etc?

A lot of people in the states are against public education, too.

I take your point, but if they funded health care the way they fund education, it might not be an improvement over what they have now.

Another "hard time believing it" scenario I run into is talking about US education. People up here have a hard time with the idea that it's largely funded at the municipal level. "But wouldn't that mean that poor towns get the worst schools?" Well, yes -- and they do.

L-girl said...

A lot of people in the states are against public education, too.

Right! Although those are usually people without kids in the system. "Why should I have to pay for..."

Another "hard time believing it" scenario I run into is talking about US education. People up here have a hard time with the idea that it's largely funded at the municipal level. "But wouldn't that mean that poor towns get the worst schools?" Well, yes -- and they do.

There was a landmark court ruling in NY State which said the funding differences among districts was discriminatory - that the state had to spend the same money per student on every student in NYS.

This was the product of years and years of struggle and work, to get the lawsuit pushed up through the courts, by activists and good NYC elected officials.

They won - and it's been completely ignored, like it never happened.

L-girl said...

In case anyone is interested in that case, brought by the Campaign for Fiscal Equity: some info here.

James said...

Right! Although those are usually people without kids in the system. "Why should I have to pay for..."

Don't forget all the homeschoolers who don't want the evil government teaching their kids un-Christian things like evolution or racial equality!

L-girl said...

Don't forget all the homeschoolers who don't want the evil government teaching their kids un-Christian things like evolution or racial equality!

You know, a lot of USians homeschool because their school districts have been taken over by those people. Lots of progressive/liberal people, gay families - and just generally smart families - have had to take their kids of out of the school systems in order to teach tolerance. And science!

john said...

Here's a fact for those Americans who think Canadians are taxed too heavily: I am a single man, making a bit above the national average income. My effective tax rate last year (amount payable divided by total income) was 20.3%

Now, how much extra do I pay for my universal health care? Zip. It comes out of the taxes. When I moved to my current province of residence, all I had to do was send in a form to the government. I got a health card in the mail a short time later. When I go to my doctor or the hospital, I give them the number on that card, and I pay nothing.

I've given money to a hospital billing department once in my life. I had to stay overnight after having my gall bladder removed. Health care covered a semiprivate room. I wasn't feeling sociable, so I upgraded to private. It cost me ten bucks.

Charles said...

Last night in McCain's acceptance speech, he said, to boos from his kool-aid drinking audience, how Obama will force people into "government-run" health care where there is a bureaucrat between you and your doctor. It's just such a big fat lie on so many levels.

Right now there is already a bureaucrat between me and my doctor. It's a private sector bureaucrat who works for an insurance company. This bureaucrat's job is to find a loophole to wiggle out of paying benefits, so as to benefit the shareholders of the insurance company, which is the top priority of any publicly traded company no matter what they say.

Second, I've already lived under a single payer system in the UK, so I know better. Compared to here in the U.S. it was notable for its lack of bureaucracy. On my one visit to the emergency room there, I was seen right away and all they did was to ask me who my GP was. That is in stark contrast to waiting hours at a hospital here in DC, and having to fill out insurance forms on admission which I could hardly see because of an eye injury which was the reason I was there. In the UK, no money changed hands, no insurance forms were filled out. Likewise, there was neither exchange of money nor form filling when I went to see my doctor in the UK.

Third, if only it were true that Obama were supporting "government-run health care". Alas, he is not.

M@ said...

For many people, it is literally unbelievable.

Damn, I missed one!

But the idea of defunding public schools is quite literally unbelievable to me. I cannot conceive of how that would work. I guess children just pay their own way if their parents can't?

But obviously, when election time rolls around (is that soon, there? I haven't heard), the most important question is whether the candidate seems like someone you'd like to have a beer with.

The question stops being "why did you leave?" and becomes "why didn't you leave sooner!?"

James said...

You know, a lot of USians homeschool because their school districts have been taken over by those people.

I was refering to those specific homeschoolers, not homeschoolers in general.

deang said...

Yeah, guaranteed health care is such an obvious good that people from outside the US often can't imagine that the US really doesn't have it.

I've taught ESL in the US off and on over the years, and an important component of the lesson plan is devoted to the medical and health care terminology they'll need to get by. This inevitably leads to personal stories of how difficult it is to obtain even basic care in the US, even when compared to countries like Mexico and Nicaragua. Cuban students, with their internationally recognized health care system, have been especially baffled by the US non-system. Just like with the Canadians, they could not even imagine that a country would be without something so obviously beneficial.

When I worked at an American university, a visiting instructor from India told me that she periodically flew back home for routine medical stuff because the US system is so unworkable. She would say, "It doesn't even work for Americans themselves, so why do Americans defend it so much?!"

L-girl said...

I was refering to those specific homeschoolers, not homeschoolers in general.

Right. I mentioned it because I had been surprised to learn this. I thought homeschoolers were all reactionary creationists - until I met young adults who were homeschooled for exactly the opposite reasons.

It was good for them, but where does it leave the kids whose parents are both working and don't have time and/or skills to take it on?

L-girl said...

John and Charles, thank you both for the excellent comments.

Third, if only it were true that Obama were supporting "government-run health care". Alas, he is not.

So many Canadians believe Obama is running on an end-the-war / bring-healthcare ticket. But sadly, he is a Democrat.

L-girl said...

The question stops being "why did you leave?" and becomes "why didn't you leave sooner!?"

Just wanted to highlight this. :)

L-girl said...

She would say, "It doesn't even work for Americans themselves, so why do Americans defend it so much?!"

That's a "whole nother" (grr) story.

For many Americans, the US cannot be criticized - and no other country can be praised! If you compare the US favourably to any other country, on any score, then you are lying, you are a traitor, why don't you just leave, etc. etc.

I used to blog about this a lot when I was first becoming part of Canada. Canadians feel free to criticize Canada, and to complain about things they don't like, without their loyalty and patriotism being called into question. For many (certainly not all) Americans, it's an all-or-nothing proposition. It's the TGNOTFOTE, or fuck you.

It always reminds me of something my father used to do. One of us kids would come home from a party or a playdate at a classmate's house, talking about how big or beautiful the house was. We meant this in a nice way: wow, my friend is so cool, she has such a cool house.

My father would get angry. "You live in a perfectly nice house. What do you lack? You have everything you need!" and so on. Later I came to realize he was insecure and defensive. He heard praise of anyone else as criticism of him.

The parallel is obvious. You can't even generate meaingful discussion of an issue if a good portion of the population and politicians put their fingers in their ears.

James said...

Canadians feel free to criticize Canada, and to complain about things they don't like, without their loyalty and patriotism being called into question.

I'd question the patriotism of anyone who didn't complain! "What's the matter? Don't you respect our traditions of grousing about stuff?" :)

john said...

I'd question the patriotism of anyone who didn't complain! "What's the matter? Don't you respect our traditions of grousing about stuff?" :)

Tell it brother! When I catch people giving Canada too much praise, I run up to them and shout, "Criticize it or leave it!" ;-)