Started out in paradise
This ain’t no promised land
…Going out with dignity
Going out with style
About five years ago, my ex-wife was facing a serious operation. She was in great pain, but not pain of such seriousness as to get the operation facilitated immediately. I don’t know what level of pain that must be: tearing off your face?
The usual, the waiting.
During 1999 to 2004, I taught cohorts of Chinese nationals who came to the Faculty of Administration at the University of Ottawa (as it was then known). as a group, to study for the M.B.A. degree. They were baffled at Canadian health care, since there had been two tracks in China for many years. Everyone wanted to have enough money to be on the fast track. The idea of compulsory wait times for everyone made no sense to them. When they had health problems, they went back to China for treatment, since the quality and availability of health care was regarded as superior to that of Canada.
I was upset to see my ex-wife in such pain. So I called Messina, New York. Come down next week for an initial consultation, plus operation within a week thereafter, followed by up to three weeks of hospital stay. The cost: $25,000. Seemed like a good deal to me, particularly when appreciating the daily cost of hospitalization, plus the fact that my ex-wife would be seen and operated on by a team of specialists.
What to do? Draw down on the equity in my house. Checked with the bank; no problem, particularly given the circumstances. Went to my ex-wife. She said she would wait through the pain, which she did, for several weeks. Must have been me; generally was.
When my older daughter was born in the early 1980s, I was with the doctor in the delivery room. Before we went in, I asked him what he would make for chldbirth at 3:00 a.m.. He said maybe $350. This was around the same time that Ontario was allowing extra-billing in health care, where doctors were able to bill just like dentists have alway been able to. There is a general insurance plan, and one can bill a bit more, to reflect expertise or whatever. As long as I can remember, the first thing dentists have asked me is whether there was insurance. Treatment prices were a function of the presence or absence of such insurance.
I was upset at how little this doctor, whom I admired very much, was making for bringing our daughter into the world. After the birth, I gave him a cheque. Not small. Do something nice for your family; do something nice for you. When our second daughter was born, I did the same thing. What he was making for the risks he was taking and the expertise he was demonstrating was, to my mind, nothing short of an insult.
Ontario banned extra billing, and the doctors went on strike, in 1986. Largely to no avail. What instead happened was that doctors voted with their feet. The doctor who had delivered both of my daughters is now in the southern United States, and has been there since 1990 or so. The same with virtually every Ontario doctor who treated my children in the 1980s.
I was in Saskatchewan when medicare was introduced. I remember how upset the doctors were. I remember this because the doctor who regularly made house calls expressed his concerns to my parents during the course of one such house call, examining my overheated brother for potential meningitis. House call. You pay for that.
Why can’t the funding model for dentists be applied to health care generally? There really isn’t much of a choice, it seems, and people certainly aren’t jumping up and down to compel dentists to follow the model of socialized medicine. A headline from the Canadian Press, from slightly over a year ago (September 14, 2010): “Patients should pay, OECD says”. Here is an extract from the story:
The OECD says Canadian governments desperately need to clamp down on their health spending, and they should do so by making patients carry some of the costs and by fostering more competition.
…the OECD highlights the long wait times and the shortage of doctors that already undermine patient care.
A summary of the OECD publication, Economic Survey of Canada 2010 , may be found here. Don’t want to leave, but sure want to start the car: