Sunday, May 20, 2007

An Unwanted Journey: Day 0542 - Cancer and Canadian Health Care

My wife and I have often wondered what would have happened to our family if Canada didn't have a universal health care system and if we both didn't have benefit packages to provide an economic buffer for a serious illness. As it turned out, from late November 2005 until just recently, the Canadian health care system paid for most of the following direct medical costs (mostly, in our case, the Ontario Health Insurance Plan or OHIP):

  • 2 colonoscopies and 2 sigmoidoscopies
  • 2 MRIs and 2 CT scans
  • several X-rays and 2 PICC lines
  • daily radiation treatment for almost 6 weeks (prior to surgery)
  • daily chemotherapy treatment for 6 weeks (prior to surgery)
  • bi-weekly chemotherapy for about 14 weeks (after surgery)
  • a low anterior resection surgery
  • twice weekly (at least) visits from nurses providing home care services
  • a total of about 30 days of hospitalization
  • various in-patient tests and procedures including implantation of an inferior vena cava filter, sonograms, medications, x-rays, and private intensive cardiac care for several days

In addition, my employer's benefit package provided semi-private room coverage, short-term and long-term disability coverage, and the flexibility to apply sick days and vacation days to the period of my hospitalization to recoup loss of salary. My employer also deserves praise for accepting travel to and from our regional cancer care centre while I continued work (admittedly with a significantly reduced productivity rate for most of 2006). We were also beneficiaries of a federal drug plan to recover the costs of oxaliplatin during my chemotherapy.

A nationally mandated health care program dispensed through provincial and regional institutions and a culture in Canada supporting universal health care made it possible for us to get through this period without suffering serious financial losses (although, I should hasten to add that there were financial implications despite what our country and employers offered in the way of protection).

If we had lived in the United States, things might have been very different. True, given that we are a fairly average, middle-class family of four, we both would likely have purchased private health insurance with an HMO. But as Michael Moore's most recent film, Sicko, reportedly demonstrates, that might not have been enough (see Time's review or Salon's movie review).

Donna and Larry Smith, both in their 50's just like us, had HMO plans, but when she had cancer and heart trouble, their health bills accumulated so quickly that they had to sell their home, move into their daughter's basement in Denver, and use all their life savings to pay for treatment and medication. The documentary doesn't deal with the 50 million Americans who don't even have health care, nor the 18,000 or so that will die each year in the United States because they have been denied health care (about 4 times the number of American soldiers already killed in the Iraq war). It deals with average Americans whose medical insurance plans don't protect them adequately just when a serious illness strikes. Far better to be a prisoner. Even detainees at Guantanamo get better health coverage than most American citizens, including free colonoscopies and nutrition counseling.

Until and unless you've been in a similar health care crunch, you may never fully appreciate how wonderful it is to be a Canadian citizen.

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