03/23/2010 05:12 am ET Updated May 25, 2011

A System I Can Live With

We've spent a good bit of time in Canada as America debates the future of our failed health care faux-system. So many Big Business types and their hard-line cronies in the U.S. have been shaking fingers (and fists) at Canada that I figured I'd maximize the learning opportunity. No survey was necessary, nor prompting. I just listened to my friends talk about their lives. Not surprisingly, that includes lots of stories of interactions with the system that delivers their health care, ranging from the everyday to the harrowing threshold of death's door.

For example:

Karen returned home from her doctor's appointment at the local clinic, a check-up she'd scheduled several weeks earlier. (Like other towns in the region, primary care physicians work in a clinic setting. They handle routine health concerns and send patients with more serious challenges on to the full-service hospital that now provides specialists and more intensive care to people across the larger district.) Visit satisfactorily completed, Karen went home to resume her day. She says she knew better than to stick her hand into a glass when washing it, but did it anyway. And sure enough, she gouged a nasty big cut into her hand. She makes her living as a massage therapist for bunged up skiers and boarders, so it scared her. Her partner rushed her back to the clinic, hand in bloody towel, where her own doc did a double take as they passed in the hall, she being rushed to the mini-surgery always at the ready for sutures. "Weren't you just here?" he teased. Cost of both visits? Zero.

Marg and Ken's daughter, 35 weeks pregnant and from Alberta, was visiting them in British Columbia when -- surprise!! -- her water broke. An ambulance was called, arrived in short order, and barely half an hour from arriving at the hospital's front door, daughter and over-eager babe were safe and sound in the maternity ward of the district's full-service hospital. The experience was so splendid that the proud grandparents wrote an open letter to their newspaper (below in full). What did it cost the family? "Nothing."

Dan, who owns a lumber yard, was feeling poorly. He went to his local clinic where the docs sent him immediately to their regional hospital. On arrival, the physicians there quickly determined this was a serious cardiac case, more than they were experienced or equipped to handle. So they immediately flew Stan to the heart specialists at the Calgary hospital where his condition was a routine matter for them. Time elapsed from first symptom until he was having the angiogram which led to the replacement of 3 clogged arteries? Less than 12 hours. All of this he reported, standing in his establishment 3 weeks later, hale, hearty and completely covered by the health system into which he has for years made a very modest contribution. The bill for using the system to save his life? What bill? The total cost was his wife having to drive up to the city to pick him up when the drama had reached its happy ending.

A friend on the other side of the country had her regular annual mammogram. A lump was found, biopsied, removed and radiation followed. That was more than five years ago. No recurrence, full remission. And no out of pocket.

Another friend who'd come out of retirement some years back to found a hifalutin' institute at the University of Calgary had completed his task. They were returning home to the States after an half a dozen years as Permanent Residents of Canada. What would they miss? High on the list was the health care they'd received here and how little it cost.

And then we happened on a most unlikely couple. She was visiting from Brazil and spoke no English. Her Canadian companion, Mr. Mateus, however, was eager to exchange pleasantries as we met, ever so casually, in the breakfast room of a motel. On learning we are Americans, he wanted to talk politics -- American politics. It took us by surprise because we constantly encounter Canadians so shocked by the political goings-on "south of the border" during the Bush years that they politely avoid talking about the subject altogether.

Not Mr. Mateus. A former pilot, he specifically wanted to talk about health care reform in the U.S. Why? Because he was appalled and personally offended by what he called the lies being told in the U.S. about the Canadian health delivery system. In fact, he said, he had written to President Obama, offering to be a very public and shining example of just how GOOD the Canadian system is.

He too had had cardiac problems, with escalating complications. Finally, as one thing had led to another, Mr. Mateus had to have open heart surgery where, among other things, they replaced a blown mitral valve. With lots going on to further complicate things, his stay in the hospital was four months long and a longer rehabilitation followed. Out of pocket cost to him? Less than a thousand dollars. Total. Plus, the incalculable value of the chance to live out the fullness of his years.

Yes, the property manager of the place where we were staying is going to have to wait, probably a year, to get repaired the shoulder he'd abused playing golf (badly). He wasn't happy about it. But neither was he willing to go down into the U.S. to pay our retail.

Then it got personal. It was I who needed to see a doctor. So, late on a Tuesday afternoon, I bucked myself up and -- expecting the worst given what I had heard over the course of a lifetime about "socialized medicine" -- I found the local clinic. As there was no line, I rather hesitantly approached the front desk. "I'm an American and, while it is not urgent, I do need to see a doctor. All I know for sure is that I do not qualify for your health care, so I expect to pay for it." Groan.

The kindly woman turned to her appointment book. "Can you be here at 11:30 Thursday morning?" I responded somewhat perplexed, "But today is Tuesday -- do you mean THIS Thursday morning? Thirty-six hours from now?" Yes.

And the cost for this "private patient" visit would be ... ? Approximately 25% BELOW the cost of a routine trip to see a primary care physician in Atlanta. "And if you did live here," she added, "I'm guessing you would pay somewhere around $70 a month for the two of you to have full health care coverage." Seventy dollars a month. For the two of us combined. Full coverage? "Well, that does not include drugs, that's covered under a separate program, but even retail, they're a lot cheaper here than in the States."

Thursday morning arrives. I am greeted -- at 11:30 sharp -- by the doctor who, it worked out, was precisely the one I had wanted. This remarkably accomplished physician gave me her full attention. She provided sound, and appropriately conservative, medical advice mixed with a full dollop of common sense. And in spite of a busy day at the clinic, she spent about as much time with me as my annual physical exam usually takes. Plus, before I left, she reassured me that if my husband also needed care while we were in town, she would be glad to see him, too.

Hmmmmm. This is the kind of care Republicans do not want me to get? Right.

So I took the prescription the doctor had written for me to the local pharmacy. Again, I confounded the locals. The clerk apologized that I would have to pay retail. How much? Significantly less than retail is for the same drug in the U.S.

What's not to like about all this?

Now, I do have to add. The clinic waiting room had not been tarted up by some interior decorator, intent on making it appear to be a her idea of a sultry Tuscan afternoon. No, the doctor did not call in an overqualified attendant to hold the instruments or stand over her shoulder, bored, while I was being examined. After all, this doc had no fear that I would sue her. (We Americans do pay a very high price for our obsession with getting paid off if and or when we are dissatisfied or disgruntled or abused or failed.) And yes, had it been a more serious matter, I'd have had to see a specialist and/or go to another facility. So?

And, yes, other people in other places probably have had other experiences and may have had different outcomes. That is hardly grounds for indicting an entire health care system in a nation so proud to call itself a social democracy.

So ... now that I do not have to take any one's word for it, what's my own assessment of the Canadian health care system I've heard so roundly denounced? Hurry up! Is it perfect? No. Is it better than what Americans have? Yes. This is what I want and we NEED!!

It's far past time for the health and well-being of the American people to take priority over the greed, arrogance and irresponsibility of Big Medicine, Big Insurance, Big Pharma, talk-show buffoons, Republicans and the Big Businesses who profit so handsomely from the current ersatz health care system. The current "system" is manifestly, demonstrably, provably unsustainable. It is making us poor and leaving us sick.

Finally, you might well ask: What do my Canadian friends think when they hear what's being said about them in the 'States? They use very strong "b" words: Baloney. Bogus! Balderdash!! After all, they are Canadians. And true to their reputation, they are polite. But in case you are not Canadian, you might apply another "b" word -- the one my mother so quaintly referred to as "that barnyard word." It also applies.

America's health care "system" is terminally ill. We must ignore the lies, refute them if necessary, and create a system which serves people not profits.


Marg & Ken's letter:

"On August 13th, my husband and I were blessed with our first grandchild, born in the East Kootenay Regional Hospital.   Our daughter, her husband and all four grandparents decided this was the perfect hospital to have a baby.   Here's our story:

"Our daughter, thirty five weeks pregnant, was on holiday at our home in Kimberley when she knew she had to go to the hospital.  Within 35 minutes of arriving at the entrance, she was in a bed in the maternity ward, put on monitors, and visited by the obstetrician, Dr. Huyser, who also made phone calls to Calgary.  

"Not able to get in touch with her doctor, he made the decision, and a half hour later, our grand-daughter was born under the watchful eyes of Dr. Huyser, pediatrician Dr. Brown, many nurses and our son-in-law.   

"During the next six days in hospital, all of us were in awe with the care and caring that were given to our daughter, her  baby and our son-in-law.   A bed was provided for the baby's father, nurses continually checked on our daughter as well as her baby; they taught all the necessary firsts that cause anxiety for a new mom - how to nurse, how to bathe, and how to swaddle.  They spent time just chatting with our daughter to make sure all questions were answered and they gave her time to sleep when she needed it.  All this happened while they were running around looking after at least six other moms and babies.  Never did their cheery disposition falter.   

"Our granddaughter's birth was the fourth that was a surprise to the maternity ward that week.   Keeping in close contact with GPs, the staff has some idea of how many babies will be born at certain times, but they can't predict these surprises like our granddaughter.   None of this had the least effect on the care that we received.

"As a citizen of Kimberley, we were very disappointed when our own hospital closed its doors, but after our experience in the Regional hospital, having specialists like a paediatrician and obstetrician available for our daughter, even on such short notice, was truly a gift.  

"Thank you so much to all the nurses (sorry we can't remember all your names!) who made our stay in the maternity ward such a lovely experience.  Your knowledge, understanding, patience, and gentleness will be recorded in our baby book.  Thank you to Dr. Huyser and Dr. Brown for your decisiveness, professionalism and thoughtful bedside manner.   Last of all, thank you to the housekeeping staff who took such pride in making sure all standards for sterility and cleanliness were met.  All are so important for new families.  What a wonderful way for our kids to start their lives as mom and dad.  Thanks again to all of you.

Marg and Ken Bibby"
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