A healthy perspective
Just home from the States, Julie Mason is reminded of how good we have it
By Julie Mason
The Ottawa Citizen
Published: Sunday, September 21, 2008
Every year, after a few weeks of sun and sand at a quaint little beach village south of the border, we contemplate moving to the United States. (This was before the possibility of a gun-toting hockey mom standing only a 71-year-old’s heartbeat away from the presidency.) We imagine an end to eight-foot snow banks, winters that last from October to May, and discussions of national unity.
Then, as always, we have The Conversation.
This time it was over dinner with friends. One is a retired nurse, age 59, who could be a role model for active living and nutritious eating. Slim, fit and healthy, she planned her retirement budget to allow for comfortable living and travel. Then she and her husband moved to California where she suddenly became one of the nation’s millions of “uninsurables.”
The disease that leaves her unable to get health insurance isn’t cancer, heart disease, diabetes or osteoporosis — she has migraines. As a result, no insurer in the state will sell her private health insurance. If she was working, she could get insurance through her employer, but retired and not yet at the Medicare-eligible age, she falls between the cracks.
Luckily for her, California is one of the states that created a backup for patients who have been denied insurance. In a state of 36 million people, only 7,100 Californians can enroll in this “high-risk pool” — there’s a waiting list — and they can stay in the plan for only three years. There’s an annual limit to how much the plan will pay, and many states have a lifetime cap. For this, enrollees pay premiums that can be twice the cost of those paid by other folks. Her insurance costs $12,000 a year.
Our other dinner companion is a successful artist, married to another artist and mom to a nine-year-old boy. They all have normal good health. As self-employed artists, they must buy their own health insurance. While no dollar figure was discussed, she said her monthly premium is more than rent on her small apartment in Manhattan.
They tell us about other friends and relations. One family has a child born with a serious condition requiring extensive surgery and life-long monitoring — the employer’s insurance paid the first seven-figure medical bill; but dad had to change jobs and the new insurance plan is much more restrictive. Now the family worries as much about their ability to pay as they do about their child’s health. Another family lost their longtime pediatrician when the breadwinner changed jobs — going from one plan to a more restrictive managed-care plan that tells them which doctors they must use.
And these are the people who have insurance. Another 47 million aren’t covered at all.
It’s the fundamental American problem: how to make sure you can get and keep affordable insurance that will cover you and your family.
It’s hard for Canadians to imagine the choices Americans must make to ensure health care. Can I take this more interesting job or will I lose coverage? Will I be able to send the kids to camp if my premiums go up? What if my illness isn’t coverage later? What if I get sick while I’m waiting to get insurance?
It’s just as hard for Americans to get it that ordinary Canadians like our health care system.
A few months ago, I was called by a newspaper reporter in St. Petersburg, Florida, doing a story on Canada’s “socialized medicine.” She’d heard I’d spent lots of time with hospitals and doctors. She seemed incredulous when I said my out-of-pocket medical costs for two years of cancer treatments — surgery, chemo and radiation — had been a few hundred dollars for drugs to treat nausea.
She wouldn’t believe me. In her article, she insisted I was one of a few Canadians who like our health care system, and that my experience was “not typical.”
Polls consistently show our health care system is one of the things Canadians value most about our country. With all its warts and flaws, our universally accessible system is as fundamental to defining who we are as a people as the Maple Leaf and beavers.
No system is without problems, and we must identify them to fix them. But it’s easy to forget we have created a health care system that, with all its frustrations, lets each and every one of us get quality care. We can and should work to improve it, but we should never turn our back on its astonishing benefits.
© The Ottawa Citizen 2008