Opinion: Canadian health system works
By Miriam Schubert
Marin Independent Journal
08/16/2009
CANADIANS have voted Tommy Douglas, known as the father of the Canadian Medicare system, the greatest Canadian of all time. Canadians may complain, but they love their system, which provides lifelong medical care for everyone. There are private clinics but everyone pays Medicare taxes.
I am a Canadian and had breast cancer while living in Montreal. Last year, while living in California, the cancer recurred. Where do we get these myths about Canadian health care?
In Canada I was able to choose my surgeon, oncologist and radiologist from all the doctors in Montreal. I also chose a McGill University hospital for my surgery. After the operation, my oncologist prescribed all the needed tests, including a bone scan and an MRI, which were all done immediately.
I then started chemotherapy. At every appointment I had blood tests, my tumor markers were monitored, I saw my oncologist and had a breast exam. I saw my surgeon every three months. Throughout, my treatment was orchestrated by all the doctors who worked consistently as a team. After chemo I had a PET scan. Results were good, and I continued to see my oncologist and surgeon yearly.
Because my team thought ultrasounds the best diagnostic tool for my dense breasts, I had those every six months as well as annual mammogram and breast MRI. The radiologist also examined me at every imaging appointment.
Here, we are covered by Kaiser. Tumor markers are not routinely followed at Kaiser, but my oncologist did agreed to test them last year. They were high. I continued to have tests every six months. The markers kept rising and I requested a PET scan. My oncologist said he could not justify it. Not justify it! This was a phrase I had never heard in Canada.
Finally, I broke a rib and that was enough to justify a PET scan. It revealed boney metastases and I got radiation therapy. I am now on a drug treatment regime recommended by my Canadian doctor, to which my Kaiser doctor has agreed.
My markers are low and I am feeling very well. But Kaiser has refused to do ultrasounds or MRIs. I get a mammogram every two years. I have never seen the radiologist who has decided mammograms provide adequate testing. My oncologist, whom I see regularly, has not examined my breast in 18 months.
Where is the rationing? I never had to argue to get treatment in Canada. I never had to know so much about my illness or to be such an advocate for my own case. I used to get calls, from my physicians in Canada, suggesting treatment. Not here.
I worked almost 40 years as a physical therapist in Montreal. I have treated thousands of patients with hip and knee replacements. There is no rationing, by age or anything else, and anyone who needs a joint replacement gets it. The medical team makes the decision. The waiting period, in Quebec, for a hips and knees is now three months. Furthermore, ceramic hips are considered the most durable kind of prosthesis and they are used regularly in Canada. My son is an orthopaedist in Iowa and bemoans the fact that ceramic, total hip replacements are not available in the USA.
I have had good care here, but the care in Quebec was better. Everything was done to get me healthy. And here, the out of pocket cost is much higher than the Medicare taxes I was paying in Canada.
There, when I was earning a high salary I paid high taxes. When I became ill and could not work, I paid nothing. Here, as I get older and sicker, my costs rise. What an unconscionable system, completely counter to what one expects of a civilized society. Civil society means caring for one another, the healthy caring for the sick and the young for the old.
How did this idea get lost in the USA?
Miriam Schubert lives in San Rafael. She was a lifelong resident of Quebec until she married an American and moved here three years ago.