Ask Tim Carter

Canada Health Care - Part 5

In late September, 2009 I asked my newsletter subscribers that live in Canada to write to me with their positive and negative stories about the Canadian health-care system. Craig Mouldey wrote the following unedited letter:

Hi Tim,

In your recent "Ask the Builder" issue, you asked Canadian subscribers to comment on our health care. I avoid hospitals and doctors like the plague, but here is what I know first hand, second hand and from the news.

Two elections past, the current health care system was an election issue because of the long wait times to get needed treatment. Of course the socialist/liberal sort insist this "universal health care" must be protected at all costs. They even make a big issue about people who can actually afford more private care going to private clinics and hospitals. They view this as a threat to Canada's health care. That is utter nonsense.

If somebody can afford to go to a private hospital or clinic, then that gets them out of the very long line-ups and makes treatment for those who cannot afford to pay out of pocket that much quicker. I had a hernia just above my belly button for years and back in the 1990's decided it was time to get it fixed. I opted to pay extra and go to Shouldice Clinic, which is private and specialized in just hernia operations. The extra cost to me was more than worth it.

I know that in recent years some things are not covered any more. Ambulance service is extra. In some situations, an over night stay is extra and if food is required, that is extra too. Eye exams are no longer covered. Stuff like that. If anyone needed knee replacement surgery, they have to get in line. I'm sure we are talking months if not longer, and nobody gets to see a specialist unless another doctor has referred the person to them. Obviously the entire system is under financial strain. I think the idea of "free" health care caused a lot of people to rush off to the hospital every time they got a sniffle or bump on their head.

There is a bit of history that could be very important in this hour, and I may never know the answer to this question. My mother was born in 1928, the youngest of 5 children. Just in time for the great depression. My grandfather was just an ordinary working blue collar guy. He worked for a company called Taylor Safes which was eventually taken over by a company called Mosler, so he worked for Mosler-Taylor. Then it was Chubb-Mosler-Taylor.

My grandmother was a stay at home mother. From about the age of 3, my mother became quite ill and was in and out of hospitals all through her childhood and teen years. She had major surgery on her spine. She contacted spinal meningitis at some point and another bone disease called osteomelitis. I remember this flaring up from time to time and causing her great pain.

My point? How did a single wage-earning man in a blue collar job, before medicare, during the great depression, with 5 children manage to have his one child go through all this surgery and hospital care and not go into the ditch financially? Something must have been different about how things were run then but I don't know what it was. It seems to have worked. This is my mother in hospital as a little girl. (Craig included a photo of a child sitting on what appears to be a hospital bed. The smiling child has a plate of food in her lap.)

Universal health care sounds so lovely and "Christian". But it only sounds that way. Socialists use "Christian" terminology to make their aims appeal to the unsuspecting. Having the government run much isn't a good idea in my view. It always means they take more control over our lives and leaves us with fewer and fewer choices and less and less of our hard earned money. I read an article recently that put the blame for high drug prices squarely on the FDA and their meddling. Remove government involvement and prices will go down.

I think you are fighting the right fight Tim. I hope for all of us that you and your countrymen prevail and the country doesn't progress any further down this insane path your leaders are taking you. Meanwhile, I am working on my own government and flapping my gums to others every chance I can. My latest to the government is:When will I be able to stop playing pretend, and really own my home? I pay "property tax". What is this if not rent? If I don't pay it, they eventually come and take away my home. So, how then can it be said that I "own" my house and property?

P.S.

Tim, I forgot to mention this about our health care. We moved to a much smaller community in early June, to Port Colborne. It has a hospital that had it all: Emergency room, surgery, critical care. You have a heart attack, you go there, minutes away. Recently the Ontario Government has changed things. You can go there if you have a broken bone or need stitches or things like that. If it is something urgent and serious, you have to go to a hospital in Welland or St. Catherines. So, basically this hospital has become an over sized walk in clinic!

Addendum:

On October 16, 2009 I received an email from Bud O'Reilly, a retired news reporter. I've not confirmed the following, but have every reason to suspect this is 100 percent true:

"Your #5 e-mail response from a Canadian regarding Canada's universal health care mentioned the Port Colborne Ontario hospital cutting back on services. I am familiar with the hospitals in that area. What your corespondent has noticed is a streamlining of the Ontario hospital system, eliminating duplication of services in the region. I point out that the Welland hospital is only about eight miles away from Port Colborne and going there for relatively serious surgery is not a hardship. The Ontario Government has also established "Trauma Centres", hospitals that are especially equipped for emergency treatments. Both changes are what makes the system financially viable for taxpayers."

Canada Health Care - Part 4

In late September, 2009 I asked my newsletter subscribers that live in Canada to write to me with their positive and negative stories about the Canadian health-care system. Christy Herman wrote the following unedited letter:

Dear Tim,

Even though I live in Greece, and my last 30 years were spent as an Italian Citizen living in Italy. I follow your column. I was born and educated in the US, more precisely, in California and Colorado. I began keeping up with your column and newletters when I needed information that you so kindly provided on how to find the pigments for coloring cement - about a year ago.

Concerning National Health Care, my first reply to anyone who tries to convince me that it will work in the US, is, how long to you wait in the waiting room to see your GP? Can you get an appointment, well, I can't, I just have to walk in, take a number, and wait, and wait, and wait. Which is the same process you have to go through when you go for the visits to specialists as well. I usually have to wait over an hour for any visit to my GP - who of course has to refer me for anything else that I need; god forbid should I forget to ask something and need to go back, my Doctor does not take phone calls....

Granted, in the last 5 years I have seen vast improvements in the system in Italy. But I always say, US citizens would never put up with what Italians do to get their health care. And, forget it if you think you are going to pick who does surgery on you. On a lower level, for everyday health care it works to a level acceptable to Italians , but for more serious things such that you might want to make your own choice, it does not allow for personal choice and the quality is not what you find in private care. period.

And, who decides what treatments you are going to get if you get cancer? It won't be you. When the state takes over, it does just that and you, and everyone else all fall into a big pot and are as one, you all get the same equal treatment. How many Americans will put up with this? Well in Italy now they are promoting INSURANCE, yes, and those who can, take it especially for "catastrophic" health problems, or, with a high deductable and for major problems - this is what I have now.

I still use the normal health care when I am back in Italy, and I am willing to work with the system. However, we now pay a high "ticket"for all our exams such as blood work, so, it is no longer the "free" health care of 10 years ago.

Maybe a form of goverment subsidized care should exist as elective care for lower income people and those who are destitute, how? I have to admit, I can't help there. But, for all of middle America and above, I am fairly certain that one month in Italy on the system there would convince them that it is not for the American public, we just plain have a different mentality, we are, as of yet, not a socialist country. I am not currently following closely what is going on there in the US, I have my hands full here, so , possibly there are proposals that somehow skirt these problems in the systems here.

My husband is English. His is a long and interesting story of working with in the health care system. To give all the details would be a fairly long email. If you are interested, I will give you some prime examples of the pros and cons of the system there, which at a high level, is of very good quality, but how long does it take to get your operation? Could take FOUR years...you might be crippled or dead by then....Again, we as a country of free thinking, free spirited people (at least I think we still are) do we really think we can live with someone telling us how to take care of ourselves? Choice goes out the window with socialized health care.

Regards,
Christy

Canada Health Care - Part 3

In late September, 2009 I asked my newsletter subscribers that live in Canada to write to me with their positive and negative stories about the Canadian health-care system. Diana Craig wrote the following unedited letter:

Hi Tim,

I'm a proud 16th generation Canadian living in the Vancouver area of British Columbia. My retired Dad had quadruple bypass surgery on Christmas Eve in Vancouver, and we were extremely pleased with the response from the health care system. In total my Dad spent 3 weeks waiting for the surgery (in the hospital). He's 75 and has type 2 diabetes (which is very well controlled due to diet and exercise) but due to possible complications and his previous heart surgeries they didn't want to send him home to wait.

He was transported to the major Vancouver heart surgery hospital from our suburban hospital a few days before the surgery. He received excellent care from a cutting edge surgical team and the after care was extremely comprehensive.

There were complications due to the diabetes and he was back in the hospital a couple more times until everything was fine. Total cost to my Dad $0. His medication is covered 80% by Pharmacare (a BC government plan) up to $1000 and 100% after $1000 (per year). His hospital care including multiple transports was covered by Medical Services Plan of BC (another provincial government plan).

Because my parents are retired and on a reduced income the normal monthly cost of health care insurance ($37 per person) is free. They do own their own home (valued at $650K with no mortgage), but it's their income that is the factor.

I also have Type 2 diabetes and because I work full time, my employer covers my family's basic monthly cost ($37 per person) and extended medical and dental insurance is also covered by my employer. For example, I pay 20% of the cost of my glucometer strips up to $1000 annually and then they are free as Pharmacare then takes over but the tests for diabetes and the doctor's visits were free. My family's eyeglasses are also covered up to $400 per year (frame and prescription) and the exam is covered up to $70 per year. There are many more benefits too numerous to mention.

We can also deduct our medical/dental expenses at income tax time.

I spent a few years of my life as a single parent on welfare with two small children and everything was covered by the provincial medical plan except my youngest daughter's ortho work but the orthodontist (who was one of the top doctors in Vancouver) allowed me to pay monthly with no interest at a reduced cost. Once I became employed the orthodontic work was covered by my employer up to 80%.

There are no deductions from my paycheque for my family's health coverage and I am not in a management position or in a union.

There are lots of complaints about wait times in the media here but personally I would trade waiting a little longer for affordability and health care access for all any time. I wish you all the best with your health care reform. We love our American family members and neighbours!

PS. Love your AsktheBuilder website and your newsletter. We just bought a 1941 house and are undergoing major renovations. We've gotten lots of helpful advice from you.

Cheers,
Diana

Canada Health Care - Part 2

In late September, 2009 I asked my newsletter subscribers that live in Canada to write to me with their positive and negative stories about the Canadian health-care system. Leslie Fauvel wrote the following unedited letter:

Hi Tim:
I am a Canadian plus I work in the health-care industry serving urological cancer patients.

Referrals are made to our office from a general practicioner - Family Dr. so the urgency is known from the initial time of referral. It may take from 2 hrs to 2 weeks to get that patient into our office depending upon the urgency of the problem. I can tell you that many patients postpone a week or two as they have commitments to deal which they prioritize. Surgery can also be very prompt (within 2 weeks), depending upon the significance of the problem - and here again, some patients defer surgery a month or two due to other life priorities.

The "worried well" have to wait when it comes to elective surgery, but the "proven sick" and the cancer patients get priority attention. There is no stress over paying bills, insurance claims, etc. There is no need to consider refinancing a home.
Many of our patients' ailments are detected early as our system is structured to welcome medical check-ups. Patients have an annual physical through their family doctors, and don't need to rationalize whether or not they'll visit their physician due to a cost concern.

There are services which are not covered by our health-care system, which include plastic surgery, elective adult circumcisions, and vasectomy reversals. Also, 3rd party requests for medical services (from insurance companies, lawyers, for elderly driver's licensing, or pilots, etc.)

There is much to be said about being in the same boat and having a collective system which is continually evolving with the needs of the population. Our patients are served by medical need, no matter who they are - which makes the system fair and efficient.
While you may fret about the upcoming reform for health care in your country, consider those who are not as successful & wealthy as you are. All the other prosperous nations in the world do this, and have a better system than yours in that they serve people's medical needs without bankrupting them, and without generating huge profits to insurance agencies.

It is true that the Canadian system is being stretched at present with the aging population, including baby boomers, and with the growing carcinogenic diagnoses, but these ebbs & flows are normal in a vibrant democracy. We have our challenges, but with caring physicians at the helm, we tend to roll with the bumps quite smoothly. I can tell you that hundreds of our patients have expressed their delight to me at how quickly and efficiently their treatment is booked & delivered. Regrettably, the contented are not as likely to make headlines and don't have the sensationalism that most media pick up!

Take Care & when you're finished with Obama, please send him north..

Leslie Fauvel,
Edmonton, Alberta, T5W 4N9
Canada

Canada Health Care - Part 1

In late September, 2009 I asked my newsletter subscribers that live in Canada to write to me with their positive and negative stories about the Canadian health-care system. Timothy Rigby wrote the following unedited letter:

You requested that your Canadian subscribers let you know what they thought of our medical system, and so I am responding to that request, and have taken the liberty of adding my two cents worth to your discussion occurring in the USA.

Let me start by saying that I am more than a little familiar with the politics and life in our great neighbour to the south. I have a brother who is an American citizen. He lives in Florida. I have two nephews (dual Canadian/American citizens) who are, or were educated in the US (one now pursuing a post graduate degree in California, the other completing medical studies back in Canada, and a daughter who is in ‘pre med’ in a small college in New York State. It is therefore with warm regard and respect that my following comments are directed to those who are involved in the health care debate taking place in your country.

It is my belief that your citizens are being subjected to the same self interested hyperbole and denial of facts that was waged by the tobacco companies when their product was put into question. The medical insurance industry in the US with their HMOs and denial of service is very aware that a “Canadian” style medical insurance system would cost them billions if not trillions of dollars in lost revenue. The US insurance industry is therefore are waging a campaign of lies (I use that word advisedly because I understand the strength of such an accusation) about the quality of care received by Canadians. They find a small unrepresentative number of

Canadians who are willing to get their “15 minutes of fame” by relating stories about how the system has failed them, but never seem to notice the tens of thousands, indeed millions of Canadians, who are alive and well today because of our health care system (check out the comparative statistics for morbidity, longevity and quality of life – you don’t have to take my word for it). To quote sage in the building industry from whom I receive a news letter; “is our current health care system perfect? Heck no. “ I would add for the Canadian system; but it’s kind of like democracy – the worst system in the world except for every other system. You will no doubt get some stories of frustration and failure of the Canadian system, but I think that with 45 million uninsured Americans (larger than the whole population of Canada) there are probably a few heartbreaking stories to be found in your own backyard.

As for stories of failure/success in Canada, let me address for example, the issue of wait times. Because our citizens have come to expect great things from our health-care system they sometimes clog the emergency departments with health issues that could wait for a walk-in clinic or a family physician’s care at a later time. Those people do not get great care in the emergency department and often must wait for several hours before being seen by medical staff. Similarly non-urgent surgery can wait – but you do get the surgery (and still own your home afterward).

What are the medical staff doing while ‘ignoring’ the non-life threatening patients. I can tell you from personal experience that when a surgery or situation needs immediate attention that is what they are doing. I experienced a personal injury – hockey warrior at 50+?? - with a punctured lung from a broken rib and a separated shoulder – I was seen by a specialist and had shoulder repair surgery with in days because although it was not life threatening it was urgent to repair the joint.

Similarly a friend of mine is undergoing his third heart valve replacement. When he walked into the emergency department in distress the triage nurse dropped what she was doing (triaging less urgent patients but still aware of her department) and whisked him into the patient care area where he was admitted immediately for care. In spite of the fact that his body keeps rejecting the valve replacements his 'insurance company' didn’t reject him for care (because the Canadian system is based on need not usage) and the doctors have tried different solutions to his persistent and expensive health problem. He still owns his own home, his children are cared for, his wife is not a widow and he will soon be able to return to work.

Listen up Tim – don’t use the failures of the Canadian medical system to reject making changes in America, which will benefit millions of your citizens who are without health care today. Remember that millions of Canadians are permitted to use the US system anytime they choose but the numbers doing so number only in the thousands or less. That alone speaks to the perceived ‘failure’ of the Canadian system.

In spite of the many accomplishments of your great republic, health care is an area where you are failing your citizens, not because of lack of capacity, obviously, but because you believe the scare mongering of self interested groups who are willing to put their profits ahead of the well being of their fellow citizens. Your system needn’t look like the Canadian system but it certainly doesn’t need to let millions of Americans experience the heartbreak and hardship of your current system. Americans are noted world wide for their generosity toward others, and in spite of the current economic difficulties America remains the wealthiest nation on earth; how about looking for a way to be more generous to your own fellow Americans!

With respect
Tim R.

Ps. I have included links you may be interested in. This video is from a current affairs program in Ontario and presents a more balanced view. You will no doubt find some of the guests support your viewpoint but some also provide a counter point in the discussion. It is an hour long, but well worth the time, especially if you wish to refer to Canada as part of your discussion.

The ‘sick for profit’ link is part of the discussion from your country and contains some strong views in favour of health care reform.