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Full coverage doesn’t mean quality care
As a Canadian immigrant to Enumclaw I want to inform your readers about the realities of socialized medicine in the province of British Columbia (health care plans are run by the provinces, not the federal government). I am going to focus on the problems because people only seem to be aware of the perceived advantages.
First, how it’s paid for: efficiencies from the single- payer system, lawsuits are rare. However, when we moved here in 1999 the top income tax bracket started at $60,000; 14 percent tax on most goods and services; near nonexistant military where we can’t contribute significantly to international crises, we won’t be able to cope with a major natural disaster on our own soil and quite frankly expect the American military to save us. Two top-selling Canadian books, “Whose War Is It?” and “While Canada Slept,” both based on the Canadian government’s own internal reviews, state these exact concerns.
Access and coverage. Yes, we are all covered from the day we are born or from establishing residency of about six months regardless of income or employment status, but coverage does not mean you get care. Currently, the ambulance drivers/paramedics are on strike – have been for months. All nurses are government employees; when they have a major contract problem, they also go on strike and your surgery gets cancelled for an unspecified amount of time. The NDP government controlled costs by putting a cap on reimbursing doctors, regardless of the number of patients they saw. In other words, doctors and their office staff were expected to work for free. So the doctors went on strike. Being Canadians, they were civilized about it; every January your doctor office preschedualed their strike days for the following year. These strikes are not localized, they are provincewide. Yes, the government is certainly paying less per patient per year. Pretty easy to do when the offices are closed. But hey, we’re all covered.
Yes, you’re covered in B.C., but does coverage equal access when you are on a waiting list for tests, surgery and treatment? I can name very specific friends and family members who have and are suffering in serious pain with their condition worsening while they wait: six to 10 months for an MRI; three months for a specialist; from the onset of illness to specialist to surgery date, two years. When interviewed, the former head of the Canadian Medical Association said that Canada’s biggest health care problem is lack of access and that the system is in crisis. But hey, we’re all covered.
How did the B.C. government follow through on it’s promises not to go into further debt and control health care costs? British Columbians are not shocked when a new hospital wing is built, but the beds stay closed for another five years because there is no money available to actually staff it. Or when the emergency room budgets are frozen and a family member, an ambulance driver, advises you not to call 911 because paramedics get turned away and are forced to more distant hospitals while “walk ins” are required by law to be accepted. As a side note, when you register for the maternity ward, they send home a list of supplies you have to bring yourself, down to the sanitary napkins, because the government doesn’t budget for that anymore. But hey, we’re all covered.
Americans get upset when big, powerful corporations have no oversight. Well, in B.C. the provincial government owns, operates and regulates every hosptial. So when the B.C. government recently trimmed it’s budget for sanitation, who is going say “no” except the scandal that gets created on the evening news? But hey, we’re all covered.
How do British Col-umbians cope with these problems? In addition to our taxes, higher cost of living and quarterly health care premiums to the government, our employers pay for supplemental health insurance. I know a Vancouver City police officer and sole income provider for his family who buys private American health insurance in addition to our government plan so that his family can cross the border for care. Other people I know, in addition to all the up front costs, borrow thousands of dollars to get treatment in Bellingham, Tacoma and Seattle because the pain is so unbearable and they can’t wait through yet another cancelled surgery. Another family member simply paid the $600 out of pocket so she could get a quicker diagnosis with the hope of starting treatment sooner. Something tells me that the statistics showing the lower costs per person for Canadian medicine probably don’t include what comes out of our pockets after our taxes and premiums are paid. But hey, we’re all covered.
Recent headlines in Canada have included the concern that if the U.S. adopts a single-payer system Canadians will no longer have the option of going to the States for care. But hey, we’re all covered.
I’m not saying that the current system in the U.S. isn’t messed up. It is. And in Canada, for all our problems, I’ve had friends and relatives get wonderfully good care.
I remember being suspicious of American immigrants to Canada expressing their dismay at the lack of access. I believed that only the rich in America got health care and yet those I met were of pretty basic to ordinary means. What are they talking about? Lack of access? They must be kidding, coming from the land of sorry, you have a pre-existing condition. Now that I have lived here 10 years, I finally get it.
Being covered, possessing a CareCard and never having to file for medical bankruptcy doesn’t mean you actually receive the care you need when you actually need it.