Sunday, March 21, 2010

US Health Care -- Some Canuck Answers

Caveat: This post is probably pretty presumptuous, but since I am pretty sure nobody reads my blog, I will continue.

I've been following the healthcare debate in the US pretty closely. Perhaps more closely than is worth the bother, but I have to hand it to Americans, they make politics fun. We can get pretty engaged up here with hating Stephen Harper, but in a parliamentary system, I can't vote for or against the Prime Minister. I have to vote for my member of parliament (MP) and then the party with the most members gets to form the majority and rule the country. The downside of this approach is I would never vote for Harper, but I would vote for Peter MacKay -- the member from my riding/district. So, I either have to make a protest vote and potentially help kick a guy I like out of office, or I have to help Harper hold his position. Tough call -- and probably a big reason why Canada has had minority ruling parties since the "right" merged. Yeah, calling the Conservative Party the right while the Liberal party -- that gutted social programs in the 90s to balance the budget -- gets to be the left is a another post altogether. And since I've lost you all already, I am going to skip right back into the original purpose of this post.

So they may actually pass a healthcare bill in the Senate. Congrats. And it looks like there may be some decent stuff in there for average folks. Although, from a Canadian perspective, this is truly relative. I still think you guys have it bad. Thing is, some of us have it pretty bad too. But anecdotal evidence can be used by all sides to prove all points of view. It's a fact.

I want to tell you what it's like to be an average working Canadian with access to universal health care and a union health plan. I am a school teacher in Nova Scotia, so I feel like I am solidly on the low side of the middle class and a pretty typical guy.

First, taxes. If I make about 45K in a year, I can expect to lose about 8K of it in taxes right off the paycheck. This is not all health care, it's many other things that Americans enjoy as well, but I am not an accountant and I will be rounding a lot here. I do need to hold some details back.

Now, if I proceed to take up woodworking and slice my hand off -- which I almost certainly would -- I can be rushed in a "free" (all uses of free should be considered to be in air quotes for the remainder of this post) ambulance and then some doctor will attempt to save my hand. I will not get a bill for this, but since the best doctors want to become multimillionaires and head to the US, my hand might not be that great after I receive this care, but it should be better than a hook.

I live in a small town. The county I live in has about 40 thousand people. Yeah, laugh it up. By comparison to many US centers, it's a peaceful hamlet. In terms of health care, this means it's not always easy to get a primary care physician (PCP). I should know; I don't have one. So, when I want a prescription filled, I need to go to the walk-in clinic and get in line. This actually can be more convenient than a PCP because I can often see a doctor in 25 minutes -- for free, natch. But forget getting decent care for some long-term, chronic issue. "Hey, doc, I have chest pains." "Well, this is the first time I've seen you so what do you expect me to do about it?" My wife actually had that conversation with a clinic doctor.

Most of us go to the doctor and get a prescription. This is where my extended health care benefits kick in. I have excellent supplementary care as a member of the teachers' union. Almost every workplace can afford to offer something decent because all the critical care stuff is covered by our evil, socialist government. So whether you make $9/hour in a call center or $75K as a principal of a high school, you can get that prescription filled for maybe five bucks. I only have two prescriptions -- neither of which is for cancer, so my medical costs are negligible (outside of what I already paying through my taxes, ya know -- communist etc.)

I mention cancer because there are drugs that slip through the cracks. Let's say you are on government disability and you have cancer. You get a chemo injection prescription that costs $2K . But you are not on old age pension. Let's say you are 58 years old and you make about $1200 month. Guess what? You may be unable to take that injection -- even in communist Canada. Yeah, in this anecdote -- which I have personally witnessed, you may be screwed, komrad.

But let's say you are like me and you have a half-decent job and the union health plan. You can basically get anything (AIDs, cancer, canceraids) and you will be covered. Long term disability, government handouts, massage therapy (no referral), psychotherapy, and all the delicious drugs you can gulp down. As I write this, I realize there are probably thousands of anecdotes that will refute my version of reality. I welcome them. (Aww, who am I kidding? This will never be read by thousands.)

My main point is to outline the experience of a Canadian in a small province with access to universal health care. It is not as glamorous Michael Moore would have you believe -- nor is it communism or Nazism or whatever else Tom Tancredo would have you believe.

I may follow up on this if I get any feedback. In the meantime, I will leave you with this: at CPAC, Glenn Beck said he didn't think access health care was a right. Well, maybe it isn't a right, but it has to be more available to people than a Mercedes E class. As for that avuncular poster boy for the John Galt wannabes, Ron Paul, he said nobody falls through the cracks in the US because of emergency services. Patch 'em up and bill 'em is not a workable policy, Mr. Paul. As an OB/GYN who used to practice his love with the women of America, you know better. But you get a pass because you claim you wouldn't have bailed out AIG either.

IF the health care bill passes and gets some much needed improvements to it over time, I guarantee most of the tea baggers will quietly realize that they were protesting their own well-being all along. Of course, they will forget who dragged them into it and vote for the Beck - Palin ticket in 2012 anyways.


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