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April 11, 2006

Oh, Canada--Adam's Healthcare Woes

(BTW, I am trolling for some comments here. I am bored now that I can't ski or think about skiing every waking moment.)

Last month, I wrote about Adam's issues with getting an MRI on his knee that he injured. Adam lives in Toronto and has been waiting for them to make his appointment for his MRI. Well the results are in.

I've been hounding the poor folks at North York General Hospital for two weeks to get a date for my MRI. After the third call in two weeks, I got the call I had been waiting for.

Previous to getting this call, I had thought a date for sometime in May or June would have been a disaster. It turns out that was wishful thinking. After preceding the date with "are you ready?", she told me my date was July 23rd.

Holy ****. That's in four months.

And what if I need surgery?

My plan right now is this: I have spoken to a couple of people that speak of a magical "cancellation list". I have asked to be put on said list. Whenever someone cancels, people on the list are called sequentially. If you happen to answer the phone, you are in luck. You get an MRI within a day or two. If you don't happen to answer, however, you are simply skipped; the MRI clinic doesn't want to play phone tag at the last minute.

But everyone in Canada has free healthcare. It is free. And everyone has it. So in Canada, I would wait months for my MRI (that is not really free when you see how much they pay in taxes) all so that someone else can have their healthcare also be "free". Everyone is equal. No choice. No option to pay more for better care. No Mayo clinics. Just equality and ubiquity. Guess what, equality is overrated. Waiting months so that everyone has the same healthcare does not sound so good when you have a possible torn ACL that could take a year post-surgery to heal anyway.

I hope Adam gets his MRI shortly and gets healed. I know that I pay through the nose for my HMO that I barely use. But I also know that when my wife needed multiple CT's, Ultrasounds, and MRI's last year, that we never waited more than a day or two. It is expensive and we pay for our insurance, but we have choice. I can't imagine losing a season of skiing because I have to wait four months to get an MRI. Or risking permanent damage. But maybe a torn ACL is not the kind of thing that is considered an "emergency". If your HMO in the US tried to get you to wait four months to get an MRI when you had a torn ACL, trust me, you would be in court before I could say Malpractice Attorney.

Posted by Justin at April 11, 2006 08:34 AM


Thanks for the good wishes. :) I have learned a heck of a lot about our healthcare system through this process. I'm going to blog about this shortly, but here's a few things I've learned that are worth mentioning:

* It turns out there is a formula that is applied which determines when your MRI will be; it is not sequential. From what I understand (and I haven't done a lot of research on this part, it's what others have told me) the doctor fills out a form that outlines your age and severity of injury. For example, I'm probably not ahead of someone who's disc exploded in his back and can't move/is in extreme, writhing pain. Those folks still get MRIs fairly quickly.

* The Ontario government's objective is apparently to cut waiting times down to four weeks. After talking to some other folks who have had MRIs, it turns out four months isn't too bad; I've now spoken to people who had to wait six.

* (Now here is the big revelation) Do you know how much it will cost me to go to Buffalo and get it done? $465 Canadian, $565 Canadian if I need a dye injection. THAT IS A DEAL. $465 for an MRI in something like 24-48 hours from when I say "go". But here's the thing: your doctor needs to fill out a form that outlines your condition/what you need done. Will my doctor be cool with that? I'm not sure, I will find out today. While I've been told most doctors are fine with it, there are some who believe it goes against their ideals. Or this is what I hear, anyway. I guess we'll find out.

Thanks for reading!


Posted by: Adam at April 12, 2006 04:59 AM

It is healthcare rationing. Let's think about this--my personal health has nothing to do with anyone else's. It is not a comparison between me and someone else to have a huge government organization decide which gets priority and who waits six months.

Our insurance (or lack of insurance) system is hugely flawed. But the choice is to pay out of pocket $550 or wait four months.

Our system has choices too--fork over $200-300 per month to purchase health insurance; if you are poor get on medicaid; pay cash for your medical services if you can afford it; or go without healthcare and health insurance. But regardless of which choice you make, you still have immediate access to healthcare, as long as you can pay for the services.

So the tradeoff is choice and speed versus free, slow, and no choice. We have lots of people here who prefer Canada's model, but that is because they have not had to wait four months for an MRI on a possible torn ACL. They just hear free universal healthcare. And that is not to even get into what the system is costing Canada and Canadians in taxes. (See previous article whee Alberta's Premier says 40% of their budget goes to healthcare) Someone has to pay for it.

I feel bad for you, but at least you live close to the US where you can get your MRI for $500. I hope it turns out to be nothing major and you are back 100% quickly. I guess if you are poor, it is better than nothing, but the problem is that in order to provide healthcare to the 40M uninsured in the US, they would have to jack up taxes and mess with the healthcare of the other 270M.

Posted by: Justin B at April 12, 2006 09:47 AM

You got it. People defend healthcare because they think it's part of our national fabric (and I can't say I disagree with that). However, most people (myself included) jump into the debate before they have to experience the real healthcare system. I mean, I thought everything was fine and dandy because all I ever needed was to visit the doctor or go to an emergency room; pretty simple stuff where you get treated well. It's not until you experienec some sort of insane wait that your perspective changes, I think.

It's certainly changed my view on two-tier healthcare.

Posted by: Adam at April 12, 2006 10:13 AM

That is the thing about healthcare. The people most affected by the debate are the poor (who would go without) and the very sick who consume a majority of the services. For folks like us in the middle, we are an afterthought.

The two tier system is not going to help control costs and that is the major issue that is going to handicap Canada shortly. If healthcare costs are rising at a 10% rate (which is approximately what they are projected to rise) and healthcare is already consuming as much as 40% of the budget of several provinces such as Alberta and on top of that Canada is already rationing care and has long waiting lists, either the system has to be improved and more money spent or things are going to get worse.

But you are right. Healthcare is part of the national fabric. It is a sacred cow. But lumped together with government entitlements in general, the days of providing every citizen with top notch care and still being able to fund other priorities and not stifling the economy are over. Now it is tough choices. And most people are not willing to debate tough choices when there is a possibility they might have to give back something they have taken for granted.

Posted by: Justin B at April 12, 2006 10:31 AM

Government and health care do not go together. AND, the FDA has way too much power. Yikes! They are as bad as the mafia...I hope you are able to feel better soon.

Justin, You are so lucky to live in Arizona. Don't you love it?

Posted by: Zsa Zsa at May 3, 2006 09:30 AM

Yes, in the US you have a choice to pay $300 a month for health insurance (plus another $300 paid by your employer) plus $500 for a MRI and you may only have to wait one month to get it. You may also have to wait up to three months to see certain specialist (a friend had to wait two months to see an reumathologist and four to see a gynecologist). No ammount of money of wait will guarentee you an accurate diagnostic though.
FOrtunately, if you have the money you have choices. If you are one of the 40 million people without money, you are out of luck.

Posted by: Justin T at July 5, 2006 08:26 AM

Depends on you employer as to the contribution. And 40M sounds like a lot of people, but let's put it in perspective--that is less than 15% of the population of 300 Million people.

And it is always true that if you pay more, you get more choices, as long as the system allows for you to pay more. Canada does not offer that option. Everyone gets the same quality and same wait times for healthcare. I know that those 40M people are worse off than me, but guess what, those 40M people don't have college educations and good jobs either.

Healthcare is not a right. It is certainly a choice that people make. They choose employers that pay less and have good benefits or opt out of healthcare to get a larger check. Or they work low end jobs that pay very little and offer no benefits because they lack the skills to compete in the job market. But regardless of the reason, the point you made means that 260M people do have healthcare. What about the luck that these folks have? And why do we sacrifice the quality of care for 260M people to provide something for free to the other 40M?

Posted by: Justin B at July 5, 2006 02:56 PM

Well another perspective would be that 40 million people is greater than the entire population of California. And it's rather classist to assume that the 40 million people without health care are stupid and lazy. Some are elderly, some are disabled, some are children. There's any number of legitimate personal reasons why people don't have health insurance, some reasons are avoidable, some are not.

A US male has a 1 in 2 chance of developing some sort of cancer over his lifetime, for a female it's more like 1 in 3. Most cancers are survivable if proper treatment is recieved, but what do you say to the people that don't have health insurance. "Gee that's a bummer, better fill out a will. Hey I'll see you later though; I've got a bit of a sore throat so I'm going to go see a doctor."

America, supposedly the greatest nation in the world, should be capable of a better solution.

Posted by: Anonymous at July 11, 2006 10:11 AM

Elderly and Disabled? Hmmm, if they are either category, they would be on Social Security for the Disabled wouldn't they? Now back to children, if their parents qualify for state healthcare under Medicaid due to their income level or because their parents are unemployed, etc., they would be covered.

You neglect the fact that some people simply do not take advantage of their employer's healthcare coverage offerings so that they do not have the contribution taken out of their paycheck, just like some people do not pay for car insurance and take their chances. Some people consciously choose jobs in industries where there is no coverage because these jobs offer higher pay since they do not offer benefits. America has choice in who you work for. Most jobs without benefits are at the lowest rungs of our society and if we raise taxes or mandate benefits, the folks at these rungs will find their jobs are expendible or will simply be replaced by illegals.

I like your California reference. Try this on for size, there are almost 12M illegal immigrants in this country and by definition, these folks should not or will not be working in legitimate jobs that offer benefits. They can't because immigration will catch their employers. So that is over 25% of your 40M number.

And guess what... people die from cancer. Even those with health insurance. People choose to smoke too. Why not cut healthcare costs by mandating the obesity, smoking, and drinking are illegal since these are what are fueling the rising healthcare costs? Take a look at Europe and the waiting lists and escalating costs of healthcare in France, Germany, etc. Germany and France both have budget deficits that are far exceeding the standards set by the EU for government spending that they agreed to a decade ago and it is getting worse. They are dangerously close to insolvent and it is stagnating their economy to provide the benefits such as healthcare that they do.

It sure sounds nice to have free healthcare for everyone, but when the bill comes and when we are providing it for 12M illegal aliens, I tend to think we need other solutions.

Posted by: Justin B at July 17, 2006 12:46 PM