The one horror story that’s missing when Canadians talk about health care

[marmar]

August 27th, 2012 11:11 AM

The one horror story that’s missing when Canadians talk about health care
By Dr. Jen Gunter


I just spent a week in Canada. Most days were spent enjoying the glory that is a Manitoba summer on the sandy shores of lake Winnipeg, the kids playing in the water and building sandcastles while the parents chatted.

As often happens, when people find out that I’m a doctor, the conversation turns to medicine. I don’t think this is because I’m special somehow, but since everyone requires health care and almost always has a friend or family member struggling with some health issue it’s a common ground. People are eager for insider information. Unfortunately, most of the times people recount horror stories, although I suspect if I were a pilot conversation would veer to the travel industry and we’d all talk about the longest time we sat on the tarmac or the worst flight we ever endured.

I heard a story about a young woman, age 42, who felt she had to bully her doctor into an annual mammogram instead of every two years. She had no specific risk factors for breast cancer, but wanted a yearly screen. She was successful, and at her yearly mammogram a cancer was diagnosed (fortunately stage 1). Unfortunately, she was going to need chemo and radiation, but thankful it was caught and that she had advocated for herself. I have heard very similar stories south of the border as well.

.....(snip).....

I heard nothing about co-pays, nothing about fighting with an insurance company to get a drug or procedure approved, and nothing about limits to the allowed number of physical therapy visits a year.

Money was startlingly absent from every conversation about health care. ...............(more)

The complete piece is at: http://www.michaelmoore.com/words/mike-friends-blog/one-horror-story-s-missing-when-canadians-talk-about-health-care

[xchrom]

1. Du rec. Nt

[rfranklin]

2. People hear one anecdote about delayed or denied care and they use that to tar the entire system...

I have heard the same anecdotal garbage about the British health system and the Veterans Administration. Yet most of the people who are in those systems would not give them up for a fistful of vouchers.

[gkhouston]

3. Which is ironic, considering that our system is rife with examples of delayed/denied care. n/t

[kestrel91316]

42. And stories of NO care - never forget the many millions with no medical insurance

who, if they get seriously ill, simply resign themselves to die.

[gkhouston]

44. Believe me, I know -- I have no insurance. n/t

[Curtland1015]

4. It's like people who refuse to wear seatbelts because they "heard of a guy..."

who died because he wore his/lived because he didn't.

Using the one in a million case (that may never have actually happened) to justify bad choices.

[kurtzapril4]

28. Well, I personally knew 3 people

who burned alive because they couldn't get out of their seat belts. A whole family. Had to be identified by their dental records. I went to their memorial service.

[KitSileya]

38. Which is horrible, and you have my sympathies for your loss,

but that doesn't negate the fact that you are far, far more likely to die in a car crash because you are not wearing your seatbelt, than because you are, and at this point, it becomes a statistical game. We will never manage to eradicate car crashes, and because we know we cannot, we choose to recommend, yes, even mandate seat belt use, because that will save so many more lives that even the cost to the car manufacturers (and consequently the car buyers) makes it worth it.

The same goes for single payer health care systems vs health care insurance systems - there are cases of people not getting proper health care in all systems, but there are fewer of them in Canada, the UK, and other countries with "socialized medicine", than there are in the US. When the price is cheaper to boot - well, that's when you have to ask yourself cui bono to realize why the US still has such a sucky system.

[leftyohiolib]

5. the "i know a guy who " stories. i occasionally hear from people who dont like unions they'll say

stuff like "i know a guy in a union who didnothing but slept all day and the company tried to fire him and the union stopped it so that's why i hate unions"

[rickford66]

7. I hear these stories too

Next time we should all ask for names and places. When the FOX whores say "Some people ..." the reply should be "What people?"

[xtraxritical]

17. What kind of bogus is this post? The headline, "Horror story", is absured. Please go away.

I don't care to kick this thing but I feel I must comment. If I could I would move to Canada in a heartbeat - civilized people there.

[marmar]

19. Did you actually read the story?

Seems like you missed the point by about 1,000 miles.

[xtraxritical]

51. There's thousands of doctors in Canada, if one did not want to do the exam she would have no

trouble going to one who would. Horror story? lol

[marmar]

57. The "horror story" the headline is referring to......

....... is having to deal with insurance companies, denial of benefits and other drama in a for-profit health system. The headline is saying that's a "horror story" Canadians will never have to deal with. It's really not that cryptic.

[Proud Liberal Dem]

24. +1

People can always find a "horror story" about anything. However, of course, that doesn't mean that we just ditch something that works well otherwise, nor does it mean that it isn't a good/better system to adopt- like teabaggers/regressives would have us believe.

[byeya]

6. I live in the south. ALL the veterans complain about the VA medical system and NOT ONE has gone

or would go anywhere else for treatment. I a couple of dozen vets.

And, most of these who benefit from socialized medicine gladly vote to deny the same to their fellow citizens.

[raccoon]

10. Some people on Medicare don't want their fellow citizens to have it.Greed and selfishness, purely.nt

[Victor_c3]

12. Personally, I love the VA

However, your note is funny.

It's kind of like where I work. Everyone hates working for my organization and constantly complains about how bad of a place it is to work in a recent employee survey. But the funny thing is nobody leaves. Something like 2% of the employees who work here have been here for a year or less and turnover is almost non existant. If it sucks so much, why have you been working here for 20 years? Is it because nowhere else can you make the money you make here, have a low-stress job, and have the closest thing anyone has to absolute job security anymore?

The same with the VA.

Personally, I have nothing but good things to say about the VA. It is a big organization and it is easy to get lost in the system, but that happens with any excessively large organization. I fully believe that the care providers are sincere and really want the best for veterans like me. I show up a complete mental wreck (I have a lot of pretty severe PTSD issues) and they help me with every aspect of my life. I have relationship problems, a social worker helps me out with that. I lost my job, another person helps me find work and helps me write a resume. I'm going crazy bouncing off the walls and someone else will just sit and listen to me rant. When I'm having good days and I bring my kids by, everyone stops and to talk or play with them. The VA is full of good people and has provided me nothing but awesome care. They have done so much for my life.

I lived in Germany for a number of years where they have socialized medicine and I never heard anyone say anything negative about it. I know there is a lot of propaganda out there from the health insurance industry, but I don't how people can't see the numbers and realize that our healthcare system is crap. We pay more per capita on healthcare than anyone else in the world and have a lower life expectancy than most other industrialized nations. I just don't get it. Our for profit healthcare system obviously isn't working as well as it should.

Another thing that I find funny is look at how, relatively speaking, successful and strong the German economy has been in the last several years. They have things like socialized medicine, environmental controls, and fair labor practices - all things that conservatives claim kill the economy. They currently have an unemployment rate of 6.8% (if I recall correctly) and are the second most exporting country in the world after China.

[xtraxritical]

18. All the Democratic Socialist countries of Europe are ahead of the USA in every measurement

except, of course, for defense spending. Our obscene defense spending is exactly why the USA is behind in everything that really matters. Bring the troops home, close down 180 military golf courses around the world. Vote Democratic.

[Victor_c3]

25. but but but

(sarcasm)But what about the glory of war and combat?(/sarcasm) (I've been there, you don't have to convince me that there is no glory in war)

There's no glory is having a healthy and educated society, at least not in the minds of the conservatives.

[Lars39]

36. They have strong unions.

If I remember correctly, their strong unions were given a large part of the credit for the country doing so well during this last financial crisis.

[Brewinblue]

8. So

where's the fucking "horror story?"

[MoonRiver]

13. The horror story is that women with breast cancer might not catch it soon enough

due to the two year wait for a mammogram. A lot of people get very aggressive cancers that, unchecked, can kill you in that amount of time.

[marmar]

14. What the author is referring to by the missing "horror story" ......

....... is the horror of having to deal with insurance companies and denials and extraordinary out-of-pocket expenses. That's "missing" in Canada because Canadians would never have to deal with that crap under their health system.

[MoonRiver]

16. Yes, I know those horror stories happen, but I didn't experience any problems with insurance.

I was lucky in that regard. But I think I could easily have been Stage IV if I hadn't gotten the 2011 mammo. THAT'S a horror story, to me at least. But other than this I believe the Canadian health care system is far better than ours.

[laundry_queen]

32. A 2 year wait for a mammogram?

LOL. Never happens here. I even lived in a very remote area where they had a 'travelling' mammogram that came every month or so.

I have NEVER heard of a 2 year wait for that.

ETA: you got the 2 year 'recommendation' as a 2 year WAIT from the article? Reading comprehension is important.

[MoonRiver]

47. From the story I deduce that mammos are covered by the national health insurance only 2 years.

I don't know what you mean by WAIT. Asshole.

[TrogL]

48. You can have a mammogram whenever the doctor thinks you need one

The two year recommendation may have something to do with radiation exposure.

Right in the article, it says the patient was able to talk her doctor into one. She did not have to pay for it.

[Lunabelle]

9. United Healthcare denied me a medicine once.

I was having bleeding in my eye and a certain medicine was not on their "formulary"even though it was recommended by my doctor as the drug of choice. (eyeball injections, I shudder as I remember) My wonderful doctor had some extra from previous procedures that he kindly used on me and charged the insurance company for their cheaper choice. United Healthcare would rather I go blind than to pay for the correct medicine because it was a little more expensive.

[JayhawkSD]

27. I have been on United Healthcare for fifteen years

and have never had a single problem with them. I have had one hell of a lot of medical procedures in that time, too, what with having had 12 strokes, two heart attacks, two hospitalizations for emphysema, treatment for Parkinson's Disease, and two surgeries.

Several times I've been prescribed with medications not on their formulary, and each time their representative has called me on the phone and advised me precisely who to have my doctor call to get a waiver, which was accomplished. Once I was administered a procedure without the required preapproval, and they worked it out with the doctor to do the approval retroactively and pay for the procedure.

Yes, sometimes I have to make a phone call to straighten things out, they don't do everything I want automatically, but every time I have called them the person I've talked to has been pleasant and clearly has been concerned with taking care of my needs, and I've come away satisfied with the result.

The only problem I have with them right now is that they have some nurse that is mildly annoying me by calling repeatedly to "discuss the programs and benefits that are available to me under my health care plan."

[truth2power]

41. About the nurse who calls you repeatedly. That's part of the insurance companies' scam

under the ACA.

I've said that before, and there was an article posted to DU from CommonDreams that explains it. Most didn't believe me when I said it. Some here made excuses how it couldn't be true.

I'm willing to be patient and wait for it to shake out.

I'll try to find the article. I can't remember the name of the author, but she was a nurse.

* * * *

Edit> The author's name is Donna Smith. I found the article over at Smirking Chimp after I did a Google search:

Be Not Fooled, Insurance Companies Still Gaming the System

Link: http://www.smirkingchimp.com/thread/donna-smith/44641/be-not-fooled-insurance-companies-still-gaming-the-system

So, if required to provide more actual care that might reduce actual profits, what’s a good health insurance executive to do? Well, go to work changing what qualifies as actual healthcare under the new rules and then find ways to make even more money by providing that while denying more real healthcare services. And that’s exactly what is being done to you and to me.

Wellness and disease management programs now qualify under the ACA as part of what insurance companies can call “medical loss” for purposes of meeting the criteria required to be spent on healthcare. Having that nurse or other insurance company employee call you and me monthly and recount which medications we take and for what conditions and then set an appointment to do it again every month is considered spending on health care. That’s right.

Read the entire article at the link.

[Lunabelle]

60. Well how nice for you

Not so much for me. I didn't have time for a waiver, I was going blind by the minute and the doctor had to stop the bleeding stat. United didn't want to pay for my sight saving medicine. End of story.

[gollygee]

56. This is standard in my experience with UHC

For me, and for one of my kids. The kids' medicine was more expensive in her case, so they required her to take an adult medicine and for me to take the capsule apart and sprinkle the insides on something for her to ingest it. And they've forced me to change from one medicine to a different one that was not quite right but cheaper a few times.

[MoonRiver]

11. My cancer was missed on the mammo in 2010, but found in 2011.

Doctors say it had been there for years. I also was early stage, low grade. I shudder to think where I would be if I hadn't had that mammogram in 2011, but had been required to wait until 2012. Now done with lumpectomy, radiation and reconstruction. Just taking a hormonal, and, God willing, will never deal with this again. I definitely believe mammograms should be offered every year. They are imperfect, as my 2010 results, done at the same NCI facility as the second one btw, attest, but they do often catch cancer.

[SheilaT]

50. Isn't there some kind of evidence

that the radiation from frequent mammograms can trigger breast cancer?

[MoonRiver]

52. Not that I know of.

[kcred]

61. Dear Friend

The doctors are covering their behinds, and I will tell you why. If you had a mammogram and the doctors missed it, it is a lawsuit. Contact me I have a horror story that is unbelievable. kcred

[Egalitarian Thug]

15. K&R Generally, people that "love their insurance company" have never been really ill.

As long as they can get a scrip for their anti-biotic when they have a bug, or get Suzy's arm set when she fell off her bike, they think everything is and will be fine. By the time they learn the truth, it's too late.

[JayhawkSD]

29. See post #27

I've had 12 strokes, two heart attacks, two hospitalizations for emphysema, treatment for Parkinson's Disease, and two surgeries.

[Egalitarian Thug]

43. Generally. First word I wrote.

I too have had a lot of dealings with health care insurance companies, and I too get good results, but I know more about the science than most people and do not accept what I'm told on faith. I've also been really fortunate to have had enormous amounts of time which I could devote to research and working my way through the bureaucratic mazes and finding out who knows what they're talking about and who's just generating revenue.

Unfortunately, there are way more people that have not got the good results that we have. And most of those that live don't even know they're not getting what they need.

[blake87]

20. The fact is the life expectancy is longer in these countries than the U.S.

They must be doing something right.

U.K.: 80.5
Canada: 80.7
U.S.: 78.2



http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

[Victor_c3]

26. Don't forget to compare the per-capita costs

US: $7,960
Canada: $4,363
UK: $3,487

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

(copy and paste the entire above link. The hypertext got messed up when I tried to post it)

It makes it even more apparent that we are doing something wrong with our healthcare.

[MrSlayer]

21. The people I know in Canada say the primary care is great, everything else sucks.

It's great if you get the flu or break an ankle or have an emergency or whatever but sucks when you need an MRI or a hip replacement or something. You will be doing some waiting.

[ieoeja]

33. As opposed to here.

Where we just have to wait awhile.

[laundry_queen]

34. Where do the people you know live in Canada?

My large extended family, that spans 5 provinces, has never 'waited' for anything for any extended length of time. What do you consider a 'waiting' period? A week? 6 months?

[MrSlayer]

46. London, Ontario.

The woman I speak to from there says you're waiting three months for an MRI, much longer for a hip replacement. She also said her doctor couldn't sell her practice at all. Had to give it away and moved here to make more money.

My other friend lives in very rural New Brunswick. He gives me similar information.

This is what they tell me and I have no reason to doubt them. Perhaps experiences vary.

[Gabi Hayes]

53. wow! worked hard for

that huge demographic

great work!

[MrSlayer]

54. Hey, whatever.

I'm just repeating what people tell me. I don't really care what you think.

[Canuckistanian]

39. Not my experience

My wife got a hip replacement - and she didn't have to wait years. Only 3 months.

And MRI's are backed up, that's for sure. It is one thing that needs attention.

And I have heard NOBODY in my life who says that our health care "sucks" in general. And we sure as HELL don't want anything even CLOSE to the American system.

[SmileyRose]

55. My husband's American "cadillac insurance" Hip replacement took 6 months wait time

Not necessarily to you but to the DU world in general...... by contrast our American experience with a GOOD insurance plan.

A piece of the socket cracked off and got stuck in the joint so he had a very narrow range of motion. Was wheelchair bound pretty much instantly.

From the ER visit to the actual surgery date took 6 months.

3 weeks until we could get in to see primary care for the referral to orthopedic
2 weeks for insurance to process the referral
7 weeks to get in at orthopedic
3 weeks to wait for an MRI because no one asked for that during the 7 weeks we waiting for the initial ortho appt.
another 2 weeks for MRI follow up with Ortho
About 7 weeks before surgeon had room in his surgical schedule for the surgery.
2 months of physical therapy with limited results
A 2nd Or visit to "crack out" the scar tissue in the joint to get him full movement.
2 more months of therapy.

Our total out of pocket for the entire thing, medicine, co-pays, deductables etc about $8800.
Plus almost a full year out of work.

[Did I Just Type This]

22. BUT, i thought the u.s. had the bestest health care anywhere?

I am pretty sure someone said that, so it must be true. Rush Limbaugh said we have the bestest health care in the world! He surely wouldn't lie about such a magnanimous statement would he?

[bvar22]

45. WE do.....

...but ONLY for the very, VERY RICH.

[Historic NY]

23. The first question here is who is paying for this or who is responsible for paying for the treatment

must fill out and sign those forms .

[bakpakr]

30. Another take on Healthcare

People in the vast majority of countries other than the US. When they get sick don't worry about whether they have insurance or not, can afford treatment or not. Thus they seek care for ailments sooner. As a direct result the companies they work for are more productive and profitable.

Now here in the good ole USA. They have to worry if they have insurance, can afford the treatments. Thus they will wait until the ailment becomes so bad that they must seek treatment. They go to work sick, they infect their coworkers. Their productivity suffers as a consequence of their illness. Their coworkers productivity suffers as well due to their being infected by their coworker. The companies productivity and profitability surfers as a consequence.

[midnight]

31. k&R...

[truth2power]

35. All of my family of origin are Canadian citizens. My cousin (by marriage)

died of mesothelioma in 2003. He suffered for several years and was in and out of the hospital, with the attendant boatload of medications etc. etc. He received excellent care during the entire course of his illness.

His widow is still living in their very comfortable home. She wasn't forced into bankruptcy because of medical bills and made to sell their home and live on the street for the rest of her life.

I am sick unto death of hearing people bash the Canadian health care system, on the basis of nothing more than propaganda spewed from the a**holes of the likes of Limpbaugh and others of his ilk.

My Canadian family of origin was quite large (most have passed on at this point). NONE were ever reduced to penury because they couldn't afford healthcare. Americans should be so lucky to have a system such as theirs. And, no, ACA isn't it; we WILL see that.

Thank you, marmar, for posting this.

[mysuzuki2]

37. Waiting time for procedures in the US can be horrendous too.

My 40 something son had a ruptured lumbar disc. He has decent insurance. He was in terrible pain. It took several weks to get an MRI, and several more weeks to talk to the Dr about the results. Getting the surgery he needed took almost another 6 months to schedule. So much for the argument that lengthy waits are a problem only in socialized medicine.

[Aristus]

40. As many DU-ers know, I'm a Physician Assistant practicing in the clinical medicine setting.

I can't tell you how often I have to arm-wrestle the insurance companies best two-out-of-three just to get my patient a certain medication or an MRI. I wish the prior authorization forms had just one check-box with the notation: "BECAUSE I SAID SO!"

The American health insurance system stinks. It makes it so hard to practice good medicine. I wish I could tell those brain-dead, dipshit insurance execs: "I'll practice the medicine; you pay the bills. Capice?"

[TrogL]

49. My wife is in kidney failure

Hence, as you can well imagine, I'm intimately familiar with the Canadian health care system.

My biggest health care expense is their overpriced parking and the crap they sell from the vending machines at 4 a.m. A couple of times I've had to put down a $10 deposit on expensive medical gear like a Holter heart monitor.

Delays are a valid criticism of the Canadian health care system. I've had to wait 10 hours in Emergency with a serious problem (breathing) because that was the day there were 5 serious multi-vehicle accidents in a row. Even then, I got seen by a nurse and they parked me somewhere with an oxygen tank and checked up on my regularly until the doctors finally got out of surgery.

Due to a shortage of nephrologists (sp?) in my area, it took awhile to get my wife in for her first appointments and get her surgery for her dialysis tubes.

There's a known shortage of MRI's but if you need one (eg. head trauma) you get one.

[Cleita]

59. Your complaint about a long wait in the ER is pretty standard here.

I waited for hours one time to get stitches on a cut and bleeding hand for the same reason that there were accident victims who needed help sooner than I did. The big difference is that I got slapped with a big, expensive ER bill afterwards. I don't think you did.

My husband died of kidney failure too and our experiences with our system weren't much different than a Canadian friend of mine who was going through the same thing with her husband. We had met at a resort and kept in contact with each other by mail so we were able to compare notes. She complained about the same thing you did, but frankly I had the same problem. There just aren't a lot of nephrologists and renal specialists around. Fortunately, our government system does pay for dialysis and most of the expense of kidney failure because our private insurance system won't pay for end stage renal disease at all.

[Cleita]

58. Gee whiz. She had to bully the system for an extra mammogram?

Many women here in the US get no mammogram because they can't afford it. Now it will get even worse with the Repuke attack on Planned Parenthood. I have also heard stories about Canadians having to badger the system at times for services not covered or maybe delayed, and surprise, surprise, the system caves in and lets them have the extra care.

I am allowed a mammogram a year under Medicare, a government program. The mammogram center wanted me to come back in six months because they wanted to follow up on something they were concerned about, however, Medicare wasn't willing to pay and I couldn't, so I will be going in next week for my yearly mammogram. I didn't even have the luxury of bullying the system.

I think the following comment on your link by drummer tells the true story:

I'm an American living in Canada. I've spent about half my life as an expat. So I have experienced both systems.

The downside of Canadian healthcare is you have to be a bit patient sometimes WHEN IT'S NOT LIFE THREATENING. For example, I had to have a colonoscopy as a routine procedure. My brother in the US, who has super deluxe health insurance through his employer, had the same. His waiting time was about 1 month. Mine was originally 3. I decided to switch doctors because a relative really liked a particular other doctor. He was very busy, so my wait increased to 6 months to see him. At the end of the day, both procedures got done and it was all good.

Now, the upside. 2 examples: My mother has a degenerative illness. She gets world-class care by the best experts in their field. Every avenue for her comfort and care is explored and never are we told "We don't do that". My father had taken seriously ill at one point. He spent 2 1/2 weeks in hospital, got every test you could imagine (scans, MRIs, bloodwork), was assessed by a team of experts, and was made better. I checked him out of the hospital. At the end of his stay, there were 2 bills that needed to be paid. 1) He splurged on the premium cable TV and phone package for his entire stay. Total cost $260 for 2 1/2 weeks. 2) There's a nominal fee for ambulance transport $55. Not once was he 'rationed' care, denied tests, or was otherwise worse off for being in universal care.

I LV CDN HLTHCARE!!

btw I'm grateful I can get the yearly mammogram. I'm not complaining.