Sunday, August 23, 2009

What if "the commons" didn't end in tragedy? [updated]

Watching the health care debate in the US is nothing so much as frustrating for Canadians (and as far as I can see, Britons, and other) because of the myriad and obscene lies that are being told about the health care systems we live with and access every day.

The two biggest horror stories that American enemies of health care reform seen to be able to hurl at the Canadian system are 1) Canadians go to the US to get health care that is denied them, or to skip waiting lists, and 2) There are appalling delays in Canada for treatment.

As for 1), yeah, a small number of people from Canada go to the US for treatment every year. Bully for them. Through my work, I'm also familiar with Canadians who go to India or Malaysia in any given year for things like Lasik surgery, or cosmetic surgery. Those things aren't covered under Canada's public health care, and are cheaper in those countries, but just as well-done. It's kind of a vacation-cum-surgery retreat. All that means, in fact, is that we have more choice in our health care, if we are able and choose to drop some dinero.

As to 2), in my experience getting access to diagnostic testing has never had a delay attached... seeing a specialist or having the related treatment based on the diagnosis may have a delay of a few weeks. But I've never experienced it, nor has Husband. Nor our extended families. And I've had a lot of experience with the Canadian health care system, bud. I lost count of my surgeries some years back - after they fixed me for good. Back in the early 90s my medical team was jokingly calling me the "million-dollar woman" because that's what they estimated my care had cost to date.

But what Americans seem to miss about Canadian healthcare allocation is that it is urgency-based. I've never ever experienced a delay in getting diagnostic tests nor seeing a specialist nor getting the related treatment because my issues were usually quite urgent.

Elective treatments - such as hip or knee replacements - by far make up the great bulk of delays in the Canadian health care system, regardless of what you've read or heard. And even then, I've never really experienced delays - when I went deaf I was immediately fast-tracked to an ENT who I was told later had a 6-week waiting list. And my hearing wasn't coming back, folks.

As for beaurocrats who deny you coverage... I'm simply baffled by the concept. I mean, I suppose such people may exist. It's just that every decision I've ever made with a doctor or surgeon has taken place in the consulting room, and I am simply unaware of any system whereby someone vets those decisions and says "no". In fact, I would propose that in a country where we worship our health care system, any such denial would result in the patient's family going directly to the media and a firestorm of trouble for the beaurocrats and politicians involved.

Much of the difference in the Canadian system and the way the American media choose to present it is in attitude. The whole system - like Britain's NHS or other developed countries' public health care - is based on a fundamental belief in health care as a shared asset that everyone should have access to, regardless of circumstance. My 79-year-old mother-in-law* has been offered a hip replacement at her leisure. She has chosen not to take it because she feels that that surgery should be performed on someone younger who would get more use out of it. (We disagree, but it's her decision.) I've written before that if given the option of a second implant on the other side, I'd probably turn it down because that money could instead go towards a surgery for a deaf toddler.

I dunno. Mostly I hope that some kind of reform will be stuffed through somehow with a public option so that Americans can start experiencing it, and understanding the great peace and comfort from never having to worry that a catastrophic illness will bankrupt them and their extended family.

*Husband informs me that mother-in-law is 79, not 69 as I originally posted. So much for the "denying care to the elderly" myth.




Blogger Sherwood Harrington said...

... the great peace and comfort from never having to worry that a catastrophic illness will bankrupt them and their extended family.

I can has this? Please?

3:35 a.m.  
Blogger Xtreme English said...

great post. the media corporations are in cahoots with all the other corporations who are out to make as much $$ for themselves as possible. it's no wonder they publish all kinds of horror stories--where do they get them??--to scare boobus americanus into believing "socialized medicine" is the crime of crimes. but these are the same corporations who advertise on programs about vampires and reality shows on things like eating bugs. (and just wait...someone will say "I love [program on vampire] and I'm a grad student.")

you don't have to be paranoid to live in the US of A, but it helps....

5:36 a.m.  
Blogger Mike said...

While there are times when a parliamentary system allows the party in power to run roughshod -- Meech Lake was nearly an example of that, and was largely derailed by the First Nations, a factor outside the parliamentary system. But there are plenty of smaller examples of "tyranny of the majority" to hold up.

However, the great good benefit of that way of doing government is that it keeps politics local. For all the party-line discipline, there remains a bond between the MP and the local riding that tends to keep public opinion from galloping off into cuckooland as it does in the United States. And I think Meech Lake is an example of public opinion galloping off anyway, which was part of what made it so painful for Canadians.

Down here, it would have just been another day at work. Which is why we're still measuring things in pounds and inches and miles, and carrying around paper dollars, while the rest of the world has adopted metric measurement and sensible coinage.

And it's why we're having this insane fight over something the rest of the world has resolved. If the national bloviators were seen as just that, and not as representing some great mass opinion, if our Congressional representatives and senators were more beholden to the guy down the street, we'd have dealt with this much more sensibly.

You can see it in opinion polls about education: Are the schools doing a good job? No, not at all. How about the schools in your neighborhood? Oh, they're fine.

In a parliamentary system, the local knowledge of what is really happening right here carries far more weight than it does in our system, where the Grand Mythos tends to dominate.

7:25 a.m.  
Blogger Nostalgic for the Pleistocene said...

The lies are all a divide-and-conquer strategy and the liars are working hard at it. Thanks for this reality check - it's very good to be able to point people to.

9:52 p.m.  
Anonymous Anonymous said...

While I agree with a lot of what you said, there are instances where my family has had to wait an obscene amount of time to get serious surgery. A friend of the family had a threatening stomach anurism (sp) and had to wait three months before he could get an operation. However, I think these instances are few and far between, and the US would still benefit from a Canadian-style health care system.

6:16 p.m.  

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