Wednesday, April 1, 2009

To Clarify

I am loved by a family of bulldogs. Okay, not really. My family is entirely human. But they are quite passionate about protecting each other, and that extends to me and my health. In other words, I've been sensing their frustration with what they see as being Canada's fault. But it's not.

What happened to me - the long and insane hours of pushing, the forceps without episiotomy, the missing the fistula diagnosis, etc. - are all issues related to individual decisions and individual judgment calls. It isn't Canada's fault. If anything, the midwife should have followed a policy of not allowing me to push for more than two hours, and she should have called for help earlier. The Ob/Gyn who used the forceps should have done what she promised and performed an episiotomy. And had I known how this would have ended up, I should have asked for a c-section. All those "shoulds" are related to individuals, not to a country with nationalized healthcare. Those situations could have just as easily happened in the United States.

Right now, I am barred from getting the care I need here in the United States while I'm on holiday simply because of money. It costs too much. And if you had heard the bored and unconcerned tone of the administrative employee who called to tell me that the minimum estimate for this surgery would be $6500, you would know that some in the healthcare system here have lost sight of the original purpose. It's not about money. It's about helping people. The surgeon here gets that. She waved part of her fee at the office visit when she did a procedure that increased our bill by $100 after they'd already told us it was going to be "just" $165. And she was willing to wave her fee for surgery. But not everyone gets that - specifically the insurance companies.

If you want to take a hard look at reforming the medical system here, it must start with the insurance companies. I believe it begins and ends with them. They are the ones who tie the doctor's hands and keep hospitals from getting to focus on healing instead of bookkeeping. And I hope and pray someone does reform this system. I've already seen the horrors of debt that can occur when someone has a serious illness and doesn't have coverage. And I don't want to imagine how my parents are going to get by once my dad retires and gives up his company provided top of the line group plan. Something has to change.

So to those of you Americans who think that my troubles are because I'm in Canada, please know that isn't exactly accurate. My troubles are because I didn't go to medical school and therefore didn't know enough to recognize that some choices were being made that would lead to poor outcomes. If anything, I owe a debt of gratitude to Canadian healthcare. In nine months of care that included one emergency room visit and one emergency ultrasound, I don't owe a dime. In a long hospital stay, three surgical procedures already done and at least one more in my future, I don't and won't owe a dime. The only money out of my pocket has been for pharmacy costs once we are home. And when my husband lost his job when a construction company went defunct, I didn't have to worry about our healthcare plan. It stayed the same, regardless of what our employment status was.

The waiting isn't exactly something I like to do, and I know that some Canadians have had to wait a long time for things that would have greatly increased their quality of life. So it's not perfect. And I wonder if the wait times are more related to the government paying for medical care or to the Canadian doctors who are leaving for the richer pastures of USA medicine. I don't know. But I do know that life and death issues will get you pushed ahead in line, and a good family doctor to advocate for you makes a difference. The wait times could be improved, but really, that's an easier problem than figuring out how to help Americans keep from going bankrupt just so they can be healthy.

So be a bulldog. Keep loving on me. Please don't "should" on me or encourage me to "should" on myself. And if you want to become an activist to somehow improve the system you have here in the land of the free and the brave, know that you have a redheaded cheerleader on your side.


areyoukiddingme said...

Healthcare is mind-boggling and brain-twisting. I don't know if there is a way to make it affordable and reasonable for all parties involved (although doing away with insurance companies who are out to make profits would probably be a good start). I know that it would probably cause a rapid influx of foreign residents in our medical system, but it seems like Canadian healthcare should pay for some treatment when you're out of the country. I imagine that it does, in emergency situations.

But yours is exactly the situation I would fear with socialized medicine. Waiting. I'm not good at it. I hope that your wait will be over soon, and that you will be enjoying your lovely son with no worries.

Thanks for commenting on my insurance musings...

FarmWife said...

I have said (frequently lately) that I fear both systems are fundamentally flawed. Socialized health care takes too many of the decisions out of the hands of the patients (like when to see a specialist) but the private system leaves too many out in the cold with no healt care at all...and the costs of private healt care are simply high way robbery.

I am glad you have the coverage you have in Canada for I fear you would have none at all if you & Henry David were US residents...and where would you be then? Ill, in pain, and thousands & thousands of dollars in debt.

FarmWife said...

And apparently I cannot spell "Health."

Sarah said...

Over here in the UK I think we must have a similar system to Canada.It is, at times, brilliant, and it certainly is great not to have to worry about paying for any of our health care. But the waiting lists and shabby hospitals are not good.Our health service is run by too many managers with too much emphasis on saving money and sticking to budget and too little care and consideration of patient needs.I just hope that you get the care and attention that you need as quickly as possible. Sarah x

Kimberly said...

Amen to all of the above. Hoping the best and speediest of healings for you. ~Hugs~

Anonymous said...

Being a bulldog is a compliment in our family.

Arf! The memory of Albert lives on!

Albert's 2nd Momma! :)