9.01.2019

my experience with bc (and small town) health care so far

So far, my experience with health care in our small BC town has been excellent. Limited sample size, anecdotal, non-scientific, yes. I'm just reporting on what I've experienced and observed in the past nine months, plus a few facts about funding.

Port Hardy

Our town of about 4,200 people has a primary health centre and a hospital. It's a regional hub for many tiny communities on the North Island. (There are also two other health units in neighbouring towns.)

The health centre is a bright, clean, thoroughly modern facility. The signs are all in English and Kwak'wala, the local Indigenous language. There is a big, affirming, trans-positive sign on the washroom.

I haven't been able to get a family doctor yet; all the doctors' rosters are full. However, we are always able to see a doctor, either whoever is on duty that day, or you can request an appointment with a specific doctor. So even though I don't have a family doctor, I make appointments with a doctor that I like, and everything goes in my health record -- so it's practically the same thing.

Routine lab work is done at the hospital next door, on a walk-in basis. You might have to wait 10 minutes.

In Ontario, lab services are almost all privatized -- so they're understaffed, overcrowded, and frustrating to deal with, as the for-profit, corporate providers try to squeeze every dollar for their shareholders.

In BC, lab work is part of the public system. I don't know what the facilities are like in cities like Vancouver or Nanaimo. But here, they are fast and efficient, staffed with competent union health workers.

One downside to living in a remote town: most specialists are three hours away, in the town of Campbell River. It's time-consuming and inconvenient. Some specialists visit the health centre on a regular basis, but most people who need specialists end up traveling to Campbell River. If you have good supplemental insurance through an employer, your costs may be reimbursable, and if not, they are tax-deductible. There is some public assistance specifically for medical-related travel.

Our health centre has a registered dietitian and a diabetes educator on staff. There are also prenatal and neonatal classes. Ontario has this, too. Hopefully all the provinces do.

BC has Pharmacare

The province of British Columbia has public Pharmacare! There's a means-tested deductible, after which all your drug costs are covered. The deductible is quite high, and if you have benefits through your employer, that is one of the things your insurance will pick up.

The current Pharmacare formula is controversial, and whether it's fair or progressive is a matter of public debate that I won't get into now. Here's the Canadian Centre for Policy Alternatives' analysis. My point is this exists.

Monthly premiums are ending

Right now in BC, every resident pays a monthly premium for health insurance -- and everyone pays the same amount, regardless of income. Like all flat-tax schemes, this is inequitable and regressive. The monthly fee doubled under the last Liberal government, rising to $125/month per person, or $250/month per family.

Monthly premiums will end in January 2020, thanks to our NDP government. The Province will fund the difference with a payroll tax, which includes a small-business exemption. If BCers are paying attention, this should guarantee our NDP government at least one more election.

In our household, our health care premiums are paid by our employer-paid benefits, so we personally won't notice the change. But for everyone without supplemental benefits, it will make a huge difference.

Public health care is worth fighting for

Recently I had some questions about my blood-test results, and the primary doctor suggested I see the registered dietitian on staff. The dietitian was awesome -- super knowledgeable and progressive. She gave me a full hour appointment (and we ran over) and booked a follow-up. Free. Covered by our public health insurance.

Why would the Province pay for consultations with a dietitian? Because prevention. When health care is a shared public resource, prevention is key, and prevention begins with education. When health care is for profit, there's a disincentive for prevention, because more health care means more profit.

It's very simple, really. Tommy Douglas explained it to Canada and now we can explain it to you. Health care costs x number of dollars. Health care plus profit costs x+profit dollars. Get rid of profit and you lower costs.

12 comments:

allan said...

And, at this point in our evolution, proper health care should be a basic right of being alive.

Amy said...

Very interesting. I will never understand why so many here in the US are so afraid of a single payer system.

laura k said...

And, at this point in our evolution, proper health care should be a basic right of being alive.

And a roof over their head.

Amy, same here. It is SO great. Convenient, efficient (usually), and just plain healthy.

Jim said...

Good stuff. You'll recall that I asked about this a while ago. Ironically, I got a letter from my GP last week saying she was retiring in Dec. so I'll be in the wind. Who wants a 72-yr old male with claw toes? Kingston is notorious for wait lists, fortunately the nearby clinics have a good rep. One already told me that they can renew existing meds R/X with a visit/check-up. I'll take it from there.
I've had my GP since returning to Canada in 92, she's only 55 and from past conversations with her, I'd bet that dealing with OHIP drove her away. I see a few specialists regularly, I don't think I'm on anybody's "pain in the ass" list, so we'll see.

laura k said...

Hey Jim, yes, I did remember. Losing the family doctor, that sucks. As long as the walk-in clinics can keep your record, that will (hopefully) work.

Friggin OHIP.

I was definitely concerned about access here -- and a bit concerned about quality. Total city bias.

allan said...

I will never understand why so many here in the US are so afraid of a single payer system.

A lifetime of hearing propaganda. ... When we decided to move to Canada, I was more attuned to coverage of Canada. And in those almost two years, every single story The New York Times did on the Canadian healthcare system was the exact opposite of reality. 180 degrees. Every story. Every fact. Every time. That is not an accident. It's deliberate. And that's what people hear - decade after decade - so they believe it.

Jim said...

The NYT. I really don't know why I still pay to subscribe. It's been at least 10 years and I still can't get over the number of times there's an op-ed with a religious bent. It's like they're obsessed with it. Two things I was told as a kid. Never ask anyone what church they go to or who they vote for. The NYT is addicted to both.

Amy said...

Yep---and the whole fear of government and love of capitalism that have always been two cultural foundational values here.

impudent strumpet said...

I never knew lab services were privatized! That would explain why they have ridiculous waiting room times 100% of the time. (Other medical services I've used have ridiculous waiting room times a portion of the time, and little to no wait a portion of the time)

laura k said...

I thought Amy's comment was meant rhetorically. 🙂

Re propaganda, a wise Canadian wmtc reader told me a long time ago, if you want to know how Canadian health care works, ask a Canadian.

100% of what you see from US sources is lies. Same for the NHS in the UK.

laura k said...

Jim, I also subscribe still, and don't completely know why. I like reading the book reviews and some essays.

laura k said...

Lifelabs. Private company. I never realized it either, until a friend had some messed up results and her doctor sent her to a hospital to have them re-done through the public system.