Thursday, July 12, 2007


I am well aware of the fact that I am a guest in this lovely country that lies just to the south of my own. A happily employed, gratefully health-insured alien of a guest.

Yeah, I'm officially an "alien". If you look up alien in the dictionary, the first entry (at least in the dotcom version) explains that alien is simply the opposite of citizen. Nevertheless, it still makes me giggle.

But yes: a guest. And as such, I try to be discreet about my feelings regarding the country in which I reside.

Oh yeah - there is no longer any confusion about my status as a non-resident-for-tax-purposes versus my incredibly incorrect ignorance regarding my status as a resident-for-immigration-purposes. I am a full-on, legitimate resident of the U.S. now: taxes, customs, immigration, health, body, mind, soul and vehicular warranty limitations. (Uh, hey GM - 36k miles is way less than 60k km, you know. For the record.) The good news: no more getting yelled at by angry customs officers who are obviously just bitter about being stuck in the basement of the Dallas-Fort Worth airport signing off on weary through-travellers' customs forms rather than getting to work the Mexico border in Laredo where the tequila confiscation is much easier to accomplish.

I so digress.

Right. Where was I? Oh yeah. I'm a guest, and I try not to diss this country too often, at least not so much in this public-forum-stylish place. But sometimes I just can't help myself.

I think it is fair of me to estimate that the majority of you are Canadians (after all, I have a site-meter... shhh... don't tell), and my main message here is for you: I want you to stop complaining about the health system in Canada. I know it has flaws, but... well...

Oh just read on.

Last week while eating my lunch in the break room of the hangar, one of guys who works there asked me about my status as a Canadian and how it affects my health insurance while I'm working in the U.S., and did I actually have insurance here?

At the risk of sounding like Dwight Schrute:

Fact. No Canadian is allowed to set foot in the U.S. on a legitimate visa without American health insurance.
Fact. For two years we kept our Ontario health cards active, because, well... it made us feel good.
Fact. We allowed our Ontario health cards to laspe because we are trying to cut our residential ties with Canada because... um. Well, we're tired of paying for health insurance in two countries, when we really only live in one.
Fact. If we moved back to Canada, our Canadian health coverage would kick in after three months. I have no idea what we would have to do in the interim. That is only slightly disturbing, but it seems that my instinctive response to not knowing something that may or may not be important is to hope and pray that it won't be important.

I tend to avoid worrying about things that may never need to be worried about. I find I can worry about those just fine if and when the time to worry ever comes. I know I know... can't add hairs to your head... yeah yeah.

Wow, I digress.

I replied to the break room question that yes, I need to have health insurance here, and that yes, I'm with Kaiser (Permanente - for those of you who have seen Sicko, and I'm afraid I haven't yet, I believe that Michael Moore discusses Kaiser as the big bad wolf of HMOs. Oh goody for us.) Kaiser is one of the four health care options that we have at my workplace. The options, as laid out, were as follows:

option 1) Cigna premium. You want good health care? Okay. Give us your firstborn.

option 2) Cigna middle-of-the-road. You want decent health care with a nice name? Okay. Give us half of your firstborn.

option 3) Cigna worst-case-scenario. You want to pay for everything until you've paid $5000? And then we'll pay the rest, even though you've already run back to your home country 'cause WOW things got bad. Okay. Give us $5, and then go away until you've reached your deductible.

option 4) Kaiser's just-under-middle-of-the-road. You want decent health care? You want to constantly see commercials on TV telling you how good your health care provider is? Okay. Give us 1/4 of your firstborn.

And so we're with Kaiser. (Option 3 would be good if we could actually afford $5000/year in the event of a tragedy, but that's too risky for us.)

The little break room question turned into a little discussion on American versus Canadian health care blah blah blah, and at the end of the conversation I realized why I fundamentally despise private health systems:

Health insurance companies are businesses. Their goal? Make a profit. Even if Canadians paid more money for their health care (hidden in their taxes, rather than overtly stripped from their paychecks every two weeks) than Americans, which, according to many sources, they don't, then at least they wouldn't be helping some stuffed-shirt CEO of some hideous very-much-for-profit company get even more filthy rich.

Right now I'm resisting an urge to change my last sentence to use the word "paycheques".

I, personally, would much rather give my money to a government institution (flawed though it may be) and have said institution dole out said money for my medical treatment than hand over the same money to a company whose main concerns are to (a) keep their shareholders happy and (b) stay in business.

Not the health and well-being of their customers?


Unfortunately, I don't have a choice, living where I am, and I am forced to pay into a Kaiser health insurance plan to the tune of ~$180/mo.

Have I had issues getting something covered with them? Umm... yes, but fortunately, it doesn't involve life or death, and it doesn't involve something that has already happened, and thus needs to be paid for by someone. Something like this incredibly well-written, but oh-man-I-feel-her-pain story. I know. It's a long read, and I've already blabbered on for a good 10 minutes, but especially for you Canadians I think it's good for you to understand just how good you've got it.


Kate said...

I recently had dinner with a high school friend who I hadn't seen for many years. She is an ER nurse in our local hospital. The whole public vs. private healthcare topic came up during our dinner. She said she likes the fact that if she accidentally drops something on the floor she doesn't have to charge it to somewhere, since we aren't private. However, apparently there are many drugs that work better than generic, cheaper drugs, that they'd like to give people in the hospital, but they are forced to go through the cheaper options first. Usually they end up using the more expensive drugs in the end anyways. Now I'm not sure of the cost to taxpayers of adding up the cheaper options vs. just giving the expensive ones but it sort of scares me that we are not given the best treatment option due to the cost.
A few years back I had to go to the emergency room with what we thought was appendicitis. After waiting 7 hours in a disgusting grey room with blood stained walls I was given a prescription for a problem which I did not have. A take this and go away solution I guess. I had to follow up with my family dr. a few days later as I was still in a lot of pain. She looked at my bloodwork and couldn't believe the ER doc has prescribed what he had because clearly I was not suffering from a bladder infection. What a waste of my time (and taxpayers money). I would have preferred to have paid to see someone who actually took their time to diagnose what was wrong with me, rather than writing me a prescription for something that I did not suffer from. I realize not ALL docs would have done that but it left a real sour taste in my mouth.
Guess I've ranted enough...

meg & critch said...

I don't mind paying higher taxes for good health care. If. If. I knew that the money actually got there. Sometimes it feels that our taxes just end up in someone pocket, and doesn't actually get to the hospitals. (can you say corruption?)

The only thing about private health care is, I think the care is better quality. If you can afford it.

My dad was on the verge of having a heart attack (sweating,pain up his arm, dizzy.) and they sent him home. Because they only do stress tests once a week. That was a Monday, they told him to come back Thursday. (budget cut backs)

He went home and had a massive heart attack, and his heart stopped in the ambulance for three minutes. Against all odds they got him back.

I've heard too many stories like this to think that our health care system is good. I think in theory it is - but how it actually is implemented in reality, is flawed.

Anonymous said...

we are trying to improve our image of not being a country of whiners, so therefore we are going to thank God that we have health care, and recognize that sometimes systems as well as people fail.

Jenn said...

okay, so, i'm rather touchy on this particular subject and happen to have very strong views so please excuse me while i get up on my little soap box...

i work in our everso fabulous healthcare system at the major trauma/cardiac centre for the region. i work on the post-surgical cardiac floor (open hearts - bypass and valves) and my husband works on the trauma/surgery floor. as well, i have spend a good deal of time working in our emergency department.

for those of you who are for private health care please feel free to move to another country. if we were to institute private healthcare it would only cause problems. the private industry would offer higher wages and in return demand staff with the best experience. this would lead to the best qualified staff working at private clinics and hospitals and leave the not-so-experienced, junior and just plain unsafe workers working in the public system. the private sector would drain the public of the best staff and they would offer shorter wait times for those that could pay for it and the poor would be left with the leftovers - old equipment and junior, inexperienced staff. try visiting a local community hospital in an underprivledged area of the usa - maybe pick downtown detroit - and then tell me you want privatized healthcare. sure, if you have the money you're all set - get your mri without waiting, get surgery faster, etc., etc. but what if you're not rich? what if you're homeless? what kind of care do you think you're going to get then? or even, consider that you're middle class and have a decent job like becky. you pay your required monthly insurance and carry on hoping that nothing major happens. but what if, say, you need bypass surgery? many HMOs have extremely strict guidelines (no matter your coverage) that you can only go to X hospital and you must choose from these 3 surgeons (all of whom, after you check the offical physicians and surgeons licensing website, have terrible records and have killed several people due to carelessness and negligence and yet are still practicing). then how would you feel? still excited for privitized healthcare?

try canada. maybe you wait longer for tests, appointments and procedures (and trust me i've been here - several months for an mri, almost a year for a specialist appointment), but you know, that no matter what, no matter your income, your race, your religion, you will get the healthcare you need and you will get access to the best care that is available in your area.

yes, everywhere there are stories like meg's where her dad had a massive MI and that is sad but if you live in an area with a smaller population and a community-type hospital that can often happen - everywhere there are cutbacks - not enough equipment, not enough doctors (and especially not enough nurses). if this kind of thing really freaks you out move to an area with a larger population and better hospitals because underserviced areas are not going to get better anytime soon. even the major centres are feeling the squeeze.

and yet, with all of the things that can go wrong i see a lot of miracles every day where i work. matt and i both take care of people who shouldn't be here anymore - little walking miracles all over the place. and there are a lot of days that we come home and complain about what a bad day we had since we were 2 or 3 or even sometimes 4 nurses short so you had to work like a slave for 12 hours and hardly even sat down. but you know what, i wouldn't change it for anything. canada has a great healthcare system - equal access and opportunity for everyone - and we're lucky to have the access to the care that we have.

so those of you who are for private healthcare - talk to the widow of that middle class american who had to have the butcher surgeon do his bypass surgery because that is the only surgeon that his hmo would cover him for and then complain - go ahead, tell me how much our healthcare system sucks i dare you.

meg & critch said...

It's funny that Jenn mentions if the healthcare in your area- like ours in a small northish town is not good- go to a bigger centre.

That's what we have started doing. When something major comes up, such as Christian had a serious accident involving his sight - so he drove to a hospital in TO to get care. Because the emerg doctors here didn't know how to handle it. Lack of resources.

My dad thought he was having a second heart attack, so my mom drove him to New Market immediately, where he got better care.

Although in emerg. they were a little surprised when they find out how far you drove to get there.

My own GP is working very hard to get improve the care available at the local hospitals.

Kate said...

I live in the Newmarket area Meg and we've frequently had to drive to Toronto to get better care. Sad that those who cannot drive have don't have the choice of which hospital to go to.

Shannon said...

Jenn - I agree completely - you couldn't have said it better :)

I have also had to wait for things like surgery and specialist appointments, but really, when push comes to shove, I would rather be able to pick my surgeon and my specialist than to have to try and coordinate my HMO with what surgeons and specialists I *may* require in the future.

And yes, I think it is awful that people in smaller centres suffer - everyone in Canada should be able to get the same treatment no matter where they live.

The thing about healthcare (in Canada anyways) is that you can't always predict accurately how many people are going to get sick and require treatment... and it is not feasible to pay healthcare workers to sit around and wait for people to get sick. So, we play catch-up. As best we can.

The best advice I have for people is to learn how to make the system work for you - drive to a major centre if you think you have a major problem... be informed about your own health... ask questions - it's your body - would you just blindly let someone fix your car or your house without doing a little research?


While I agree that our system is not perfect and there is plenty of room for improvement, I am glad for what I have :)

My two cents ;)

Gunfighter said...

An American perspective (at least, that of one American)...

Despite the fact that there are some drawbacks in the
canadian system, I find it admirable that everyone in your country has health care.

When I was much younger (I'm 43) I spent 8 years hoping that nothing bad would happen to me, because I didn't have health insurance. It's a scary place to be.



Beck said...

Thank God for the public healthcare system in Canada - I've known far too many Americans to be financially ruined by a medical emergency.