Originally posted in July, 2009
In the current health-care melee, we hear much alarmist talk and Canada-bashing, aimed at their single-payer health system.
A few days back, I had an unexpected chance to observe the Canadian system up close. What I saw was very instructive.
Here’s what happened: on the last evening of a Toronto visit, I was invited to dinner by a young couple – let’s call them Hank and Sue, for privacy.
Driving there, my cell buzzed. It was Hank, just home from work as a bicycle messenger: Sue was at the emergency room with Teddy, their seven year-old. He had broken his elbow in a playground fall. Hank was headed there; dinner was off.
Not so fast, said I. Let me pick you up and tag along. I could be moral support; and I had some bread, cheese and blueberries in a bag which might come in handy.
In fact, these snacks became our dinner. After relieving Sue, who took their fussy baby daughter home, Hank and I settled in with Teddy, to wait.
Waiting – that’s one of the big knocks on Canadian health care. Teddy, arm in a makeshift sling, grimaced with pain but bore up bravely, watching a Harry Potter DVD. Hank and I grazed and caught up, and wondered what was taking so long.
Turned out there were two factors.
The first emerged when the chaplain dropped in. A Quebecer, we were just starting to chat about my favorite Canadian topic, Anglo-French issues, when her beeper chirped.
Glancing down at it, she frowned. “Sorry, got to go.” Then, out of Teddy’s earshot, “A child may be about to die.” She hurried out.
So. Reason Number One was that ER basic: triage. Teddy was hurt and hurting, but in no danger. Life-and-death cases properly came first.
And we weren’t just left in limbo. A pediatric social worker came in several times, both to keep us posted and to distract Teddy when an IV was put in. She was, I noted, very good at both.
Reason Number Two became clear about nine o’clock, when finally it was show time: to reassemble Teddy’s elbow involved a team of six, including an orthopedist, an anesthetist, a physician, X-ray tech, nurse and the social worker. In a big, busy hospital, getting this much expertise into the same room at the same time, ad hoc, was a challenge.
Once there, though, they made quick work of it, cast and all. Then it was only a matter of monitoring Teddy’s recovery from the anesthetic. It was near four AM when I dropped them off; but it was done.
With four kids, I’ve had my share of ER visits. What did this unplanned field reconnaissance in the Canadian version reveal?
Two things above all:
First, I saw Teddy receive excellent, family-sensitive care.
And second, I observed how a personal injury did not become a family financial disaster.
Hank’s messenger job is a no-frills, tough times gig: no sick days or bennies. In the US, that would mean no health insurance.
In Toronto, their out of pocket cost was zero. Here, his son’s ordeal would have set off jingling cash registers at every step: ambulance, ka-ching; ER visit, ka-ching; IV, X-rays, sedation, ka-ching, ka-ching, ka-ching. Not to mention the social worker and orthopedist: ka-double-ching!
In the US, when Hank got home, he would have carried not only his sleepy son, but a hospital bill of many thousands, likely five figures.
Hank and Sue are seriously thrifty folks: no mortgage, no car, no credit card balances. But down here, Teddy’s accident would have crushed their discipline under a pile of medical debt.
Of Buy neoral course, there’s no free lunch. Hank and Canadians pay for their care with higher taxes than here; I’m told that their wealthy even pay more.
That’s what I witnessed.
So now, all you Canada-bashers, please line up to the right. And tell me again just how such a system is a godless socialist plot to destroy civilization.
Have at it. After all, who am I supposed to believe – you, or my lying eyes?