Socialized medicine?

It's probably a bad idea to start writing a post when I have to head out soon, but here goes. ;-)

Ever since Pres. Obama won the election, there's been a lot of talk about his health care reform ideas. I'm not sure what he's actually proposing, since it all seems rather vague, but that doesn't stop the media on both sides of the issue from drawing their own conclusions.

The loudest opponents to health care reform in the US decry "socialized medicine," usually by slagging Canada's medicare system in the process, using it as an example of how terrible the very idea of socialized medicine will become. Based on their descriptions, our medical system is a complete failure, and people are dying left, right and centre, while waiting for necessary surgeries - unless they're willing to fork over cash and get their procedures done in the US.

Now, I absolutely admit that our system has its flaws. There's a bloated bureaucracy, with staggering amounts of waste (which is true of pretty much all government run systems). Yes, there are waiting lists, and yes, sometimes people die while on them. Yes, there is sometimes a lack of available technology. Yes, there are times when technology sits idle, due to a lack of budget or some other reason, preventing them from being used more often and reducing those waiting lists. Yes, there are problems that need to be fixed.

For all it's problems, however, most of the anti-Canadian-style socialized medicine opponents are spouting drivel, greatly exaggerating the flaws while completely ignoring the benefits.

So here are a few things to clarify.

First, it's important to know that our "free" health care system isn't free. It's paid for through our taxes, and some provinces also monthly payments required, just like any other insurance, with amount based on how many family members there are. The amount is pretty nominal - a little over $100 for a family of four, if I remember correctly. Most of the time, those are deducted off paychecks, so few people have to pay them directly. BC has them and, both times we lived there, we never saw a bill.

Second: our medicare system is a provincial responsibility, and not everything is covered. The federal government re-directs tax dollars to the provinces, but it's the provinces that decide what is or isn't covered. The basics are covered everywhere: you'll never have to pay for an emergency room visit. If you have a heart attack, a broken leg or just need a few stitches, you're taken care of. Need a CT scan? MRI? Broncoscopy? Specialized blood tests? Xrays? In my family, we've had all of those done, and never once had to worry about how to pay for it.

There are those that complain that politicians or other power brokers get preferential treatment. This claim was made quite publicly when our former Governor General got a pacemaker in only a few hours. Yet I know this isn't true because my own father, a retired farmer living in the middle of nowhere, got his pacemaker even faster than she did. This, even taking into account the time it took for 1) my brother to drive him to the nearest medical centre in another town 2) for the medical centre to have my father transported by ambulance to a health sciences centre in the city, which was between 1 and 1/2 hours drive, and 3) for the city hospital to gather a surgical team, prep my father for surgery, and take care of all those niggling little details that need to be taken to get someone into surgery. Even with all that, he got his pacemaker about an hour faster than our former GG did.

My father also has had at least 5 strokes that we know of. The third one left him paralyzed on one side and required physiotherapy for months. He regained most of the use of that side, thanks to the excellent care he received, plus his own stubborn determination.

For all this, the only thing my parents have to pay for is my dad's prescription medication and, since they live in Manitoba, which has a pharmacare programme, my dad only has to pay the deductible.

Whether it's my parents, on their retirement income, or my husband, with is medical mysteries, we've never, ever, had to worry about paying for care. Some prescriptions, sure, but even then, doctors can often give samples for free. Only his CPAP is no longer covered in our current province, but his insurance through work covered 80%. He's with a new company now, we we still don't know what the new insurance will cover.

Our system can use improvement. Personally, I am ok with a "two tier" system, though we already do have one to a certain extent. When I had my breast reduction surgery, it was considered a medical necessity and paid for by medicare, while performed by a doctor with a private practice. Medicare paid for what was necessary. If I wanted liposuction to get rid of the "flaps" that would result under my arms, I'd have to pay for it myself (which I chose not to). I can see this sort of private/public partnership being successfully extended to cover other procedures as well.

Other concerns about a public system are that, if the government has control of the purse strings, the government can decide who does or doesn't get treated. Seeing what's happening in the UK, I can completely understand that concern. Canada's system is not the same as the UK, however, and so far we've managed to avoid the pitfalls of our publicly funded system becoming a sort of lifestyle police.

There are people and groups calling for certain "undesirable" patients to be either refused treatment, or forced to pay. (These include smokers, drug users, and those with what people consider "lifestyle" health issues. Most often this includes fat people (like me and my parents), even though it's been shown time and again that fat people don't actually have lifestyles any different than thin people, and the it's people in the "overweight" category of the BMI that have the longest life spans, recover the fastest from illness, and have the best outcomes after surgery. My dad probably wouldn't have survived the recovery period of his 3rd stroke if he hadn't had all that "extra" weight to loose.) Others, however, include activity related illness or injury. These calls are especially loud after stories of a rescue operation for lost snowboarders, for example, hits the news. If boarders go out of bounds and get lost or injured, the complainants say, they should be responsible for the cost of the search and rescue, as well as the cost of their treatment.

While I can understand the emotion behind such claims, I am glad our system has so far resisted calls to restrict treatment to those who live "approved" lifestyles.

With all our moves and different medical needs, we've never had to worry about how to pay our medical needs. We've been free to go to whichever doctors we choose, not just ones from a list approved by an insurance company. We've never had our treatment restricted for financial reasons. With a few individual exceptions, we've received excellent and mostly prompt care. Whether we were working, between jobs, on medical leave, it didn't matter. We were always covered, if we needed it. We never had financial stresses added to our medical concerns.

For all its flaws, I'll take our "socialized" medical system over what the US has any day, and am grateful that we have it.