Monday, November 23, 2009

Pre-Reform Rationing

I've been following the health care reform stuff sporadically. At this point, I'm just praising God I have ANY health insurance at all particularly with the number of checks for co-pays and scripts I've written lately.

However, twice in the last 2 days, we've had to make a call: do we or don't we go to the doctor?

Pojke and I spent 6 hours in our local emergency room Saturday night as a result of him trying to see how far he could push a Polly Pocket shoe up his nose. Initially, DaHubby and I went around and around about whether to head to the ER or not. We tried everything we could think of to NOT have to take him. Because Pojke might be scared and/or traumatized? No, because we can't afford our co-pays and deductibles. Fortunately, due to a strange stream of events, we came out not owing a dime (yet) but DaHubby and I haggled for several minutes trying to assess how in the world we'd pay for it. That sense of financial insecurity and that awful sense of not being able to "provide" for one of the Vikings shakes a momma at her soul.

Then, this morning, I woke up barely able to swallow, feeling like my left eardrum might pop from pressure, my left eyes bloodshot to the point people were staring, and a sinus headache unlike anything I've had in a really long time. I called my regular doc and the whole practice was booked solid this morning. So, I called DaHubby at work to see what our co-pay was for the walk-in clinic. In the meantime, I spent nearly a half hour sitting int he parking lot of the clinic waiting to hear from DaHubs so I could know whether I could go in. If it was the more expensive co-pay, i was very seriously considering not going in and just sucking it up and going home. We just can't afford it with our situation right now and without knowing what any hidden costs may arise from Pojke's visit to ER not 36 hours earlier.

Now, I keep hearing people in the press complaining about the rationing of care under this new plan. If anyone thinks that it isn't already happening, they haven't been in someone's shoes like mine in a while.


Kat Werner said...

There is NOTHING like the health care rationing that will go on under a government program. I lived in Canada under a government program and health care here is amazing compared to there.

In Canada we could not get a family doctor because none could afford to take new patients. There weren't really walk in clinics, you had to go to the E.R. and you had to pay for health care if you went to the doctor or not. One year Jeff paid over $2000 to not go to the doctor.

There are health care problems here, big ones, but nothing compared to what a government take over of health care would be like.

Unashamed said...

I can't even imagine what it would be like to have to stop and decide whether or not to go to the doctor. Having lived under the Canadian system of universal health care all my life (I'm 43) I really can't understand the American resistance to it.

First of all, no one is FORCED to be covered under the government health plan (plans, actually, as each province administers their own program). If you wish to pay for your health care expenses out of pocket, you are entirely free to do so. (For example, the Mennonites in this area do not participate in the program as they are religiously opposed to "insurance" in principle and so they pay for all medical care privately.)

Second of all, the maximum amount that we pay annually for our health plan here in Ontario is $300. That's the MAX that you pay and it is based on income. You can, of course, choose to opt into additional group health plans (ie. through your employer) that cover prescriptions, dental care, travel insurance etc. but again you are not FORCED to take the coverage. Each family makes their own decision based on their needs and if you find that the cost of the premiums will be more than what you would pay for drugs and dental out of pocket, you simply opt out.

It is true that there are some areas that are medically underserviced - the area I live in is one of them. But it has nothing to do with the doctors being able to "afford" taking new patients. Canadian doctors are paid on a fee-per-service basis, ie. more patients = more $$$. However, there are only so many patients a doctor can realistically care for, and in an area like ours where the population is growing at an exponential rate there just aren't enough doctors to go around. The local government provides incentives for doctors to practice in underserviced areas; in our area we are trying to attract another 15 family doctors to ease the burden on the the ER and clinics.

If I had to complain about anything, it would be wait times at the ER. It's not unusual to wait for several hours before a you can get a bed and another few hours before a doctor sees you. This is directly related to our underserviced area - people without doctors must use the ER/clinics for primary care, resulting in long wait times. On the other hand, we had to use the ER in Ottawa once, and we were in and out in 90 minutes, so clearly areas that are fully serviced are not having the same problems.

No one has ever "rationed" our care. When Hope was living with us and we were trying to get to the bottom of her health problems, she was seeing the doctor almost weekly, had specialist appointments, tests and procedures at the hospital and lab an on and on and no one ever said, "Well, you know, we've spent an awful lot of money on you and we're getting no where, so I guess we'll either jack up your premiums or just stop covering you." See if you can get a big US insurance company to do the same. I don't know what we would have done if everytime she needed a test we had to stop and figure out if we could afford it. When you are sick, you certainly don't need the added stress of worrying about money.

I'll tell you this much...we have friends at church who moved here from the US. When their second child was born here in Canada they couldn't stop praising our health care over what they had experienced in the US with their first child.

Sorry if I sound a little testy, I just get tired of hearing Americans slagging on our health care system, which in reality, is one of the best in the world.

Beth/Mom2TwoVikings said...

Kat - I didn't know you had lived in Canada so I'm glad you threw you're two cents in.

Anita - I was hoping you'd pipe in because I feel really torn. Used to be our "employer supplied" insurance was just unbeatable and "gov't" coverage was downright awful.

But, it feels like the scale has tipped somewhere in the last few years. I don't like this feeling and I'm sure that's what Washington is counting on to get support for their plan.

I think Americans look at how awfully our current government health care is run; what an awful state Social Security is in; and how abominably our Veteran Affairs system in run and just can't imagine letting that same federal gov't do our health care.

I really am torn...

Unashamed said...

I think there's a big difference between government RUN healthcare and government FUNDED healthcare. There's a misconception that the Canadian system is "socialized" and that the government calls the shots and manages care. That's not really the case. Yes, the government is involved insofar as they fund providers, hospitals and health services, and yes they do put limits on what is funded (not every service is covered, liposuction, for example lol) but my health care is still between me and my doctor. Doctors still operate their practices, they just get paid by the government instead of an insurance company. I'm not really familiar with what your govt is proposing, but its important to make that run/funded distinction.

Kat Werner said...

Another thing not covered under the Canadian system is medication, you still have to buy that on your own.

And yes, under the government program you MUST get health coverage or you will be fined. I don't need the government telling me if I do or do not need health care.

Again, as I said health care needs a lot of help, but it is MUCH better here than I ever saw in Canada. Not to rip on that system, or anyone that lives under it, but I just would never choose that system over what I have here without insurance.

Unashamed said...

Kat, I'm curious as to what you experienced under the Canadian system that left you with such a bad impression? Can you share specifics?

Unashamed said...

PS my maiden name is Werner...maybe we are related...