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Canadian Universal Health vs The Great American Gamble

The day my twins were born, my son developed an infection in his leg. It was an excruciating ailment, one that came on without warning and left him unable to walk or even move. It was also a big mystery; doctors weren’t exactly sure what it was, or how to treat it.

My husband spent the next eight days shuttling him back and forth to the hospital. While I tended to our newborns at home, they logged hours on the pediatric floor. Each day brought a different round of testing for our young son. His little body was put through it all: x-rays, ultrasounds, MRIs, and bloodwork.

That was a draining week for all of us. Most days, we struggled just to keep him comfortable. The hospital had every test result back within 12 hours each day. But waiting isn’t easy – especially for a hormonal mother who can’t stay off Google. I spent sleepless nights worrying about sprains, Lyme disease, even cancer. WebMD became my best friend and worst nightmare. My insane penchant to already hop worlds and realities were already compiling a list of unreal threats and my tired brain harnessed the absurd rather efficiently.

One thing that never crossed my mind, was the cost of all that testing, and how I would pay.

Canada is among the 32 developed countries with universal health care. Under our publicly-funded system, we don’t pay upfront for trips to the doctor or hospital. Provincial health cards are golden tickets, providing access to testing, medication (when administered in a medical setting), and most surgeries. Many use private insurance to supplement the cost of out-of-pocket expenses. These include prescriptions, dental, eyecare, and paramedical services.

Our system isn’t without flaws. Long wait times can have people sitting in emergency rooms for hours. Unless you’re critically ill, it can take months to see a specialist. And since resources are first directed to the most populated regions, rural areas don’t have the access to the same quality of care. Nevertheless, our health care is a point of national pride for many Canadians. It’s one of the biggest things that sets us apart from our southern neighbour.

By contrast, the American system is a patchwork of various programs. The government funds Medicaid, Medicare, and the Children’s Health Insurance Program. These plans offer coverage for elderly, low income, and youth populations. Those outside of these groups often rely on private policies through their employers. Some even use a combination of private and public options.

Unfortunately, many don’t qualify for any insurance at all. Last year, about 3.2 million Americans were uninsured. To combat this, the Patient Protection and Affordable Care Act (ACA or affectionately called Obamacare) was introduced in 2010. Its goal was not only to ensure everyone had access to health insurance, but also to lower the general cost of care. It is important to note that, with the rise of the new administration in 2017, the ACA is currently under repeal.

A recent study found that medical bills are a large source of debt for Americans. Despite being covered under private insurance, many struggle to pay off large balances consisting of high deductibles and copayments.

My husband once had an American colleague who stressed over registering his kids for recreational soccer. Even with insurance, a simple broken bone would set him back quite a bit. Our son’s infection coincided with the birth of my twins. As American citizens, that week would have landed us deep in debt.

We never saw the bill, but the testing he went through racked up thousands. Hospitals bill the government well over $1,200 for an MRI alone, and we had multiple tests. By day three, the infection spread from one leg to the other, and doctors were bewildered. They repeated each test and ordered new ones. Everything they were looking for came back negative.

After a week, my son woke up and was walking as if nothing was ever wrong. The infection left as quickly as it came. Without definitive answers, it was named a virus that just had to run its course. We were so relieved to see him running around again. But seven months later, I still can’t shake the feeling of helplessness I had. It’s awful to watch your child scream in pain without being able to help. It would have been worse with a hefty medical bill hanging over our heads.

What would we have done without OHIP (Ontario Health Insurance Plan, our provincial coverage)? Would we have exhausted all of our resources on diagnosis, leaving nothing for treatment? Gone into debt paying for both? Or would we have chosen just a few tests, only to be consumed by thoughts of What if we’re missing something? What do we do if he gets sick again? Does he have cancer?

None of these options are ideal. But it’s reality for many people in the US who don’t have adequate health insurance. For refugees and immigrants, it’s yet another hurdle to navigate in a country that isn’t theirs. Exorbitant costs combined with language barriers are enough to prevent them from seeking care altogether.

When my siblings and I were younger, my mother was quick to rush us to a clinic whenever somebody was unwell. If we didn’t see our usual doctor, they would ask, “Do you have insurance?” before writing up a prescription. As obvious minorities, it was assumed we couldn’t afford much.

Without hesitation, her answer was always the same. In broken English she would reply,
“Yes, we do. Give us the best medicine, please.”

At the time, I didn’t understand the weight of those interactions, what wasn’t being said. When people talk about providing for a family, it’s always food on the table and a roof over heads. But survival also rests on staying healthy and recovering from illness. Thanks to the Canadian government and a generous company insurance plan, my parents always had the resources for us to thrive.

A couple months ago, the province of Ontario began offering free medication for youth under 25. For the most part, physicians don’t have to consider insurance when treating children anymore. Nevertheless, those conversations between Mom and the doctor ring loudly in my head whenever my kids get sick. I would do anything, go broke even, in exchange for their health.

Luckily, in Canada, I don’t have to.

Donna Luangmany, dluangmany@gmail.com

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