Torontonian/Bostonian

A little space to reflect on life in my tale of two cities...and more

Sunday, April 13, 2008

The Most Quietly Unspoken: Health Care

So by all accounts, a blog that compares US-Canada relations via the towns of Boston and Toronto will have to address health care at some point. When I was first considering moving to the Republic my parents only really had one concern - would my job entitle me to health insurance? Future advice to all Canadians: if the job doesn't include health insurance, don't take it. It is absolutely necessary here in the US, unless you are independently wealthy.

So really there are a number of questions to potentially answer here that are posed on both sides of the border (see if you can match the country to the question):
  • Does the fact that I am covered while so many Americans aren't make me feel guilty?
  • Can the US system be socialized?
  • Does private health care (or semi-privatized) as exists here in the US yield better results for the consumer-patient?
  • Are wait times shorter for many common procedures?
  • Do I pay anything for health care?
  • How do I acquire care?

So some of these questions have more than one answer depending upon which side of the border you are standing on. But its too much to answer in a single blog entry (do I feel a series coming on Sesame Street style: "Jen Goes to the Doctor"). Let me give you some overall impressions.

If you have health insurance here in the US, things aren't that bad at all for a user of the health care system. The key is having insurance - one can purchase a policy on their own, but most make contributions through (and with) their employer. Just as at home, the costs of health care increase exponentially every year in the US leaving many employers attempting to balance costs. However, I cannot imagine living without insurance here. I would have massive amounts of debt. How people manage I do not know. Truly the poor and the working poor are America's forgotten.

Wait times are SIMILAR to those in Canada (believe it or not). There are exceptions. The extreme shortage of doctors and resources in some fields experienced in Canada (like orthopedics) mean that you can get that hip replacement quicker. But I still have to make appointments for medicals or with a dermatologist months in advance.

My insurance plan requires me to pay a 'user fee' when I get a prescription or go to the doctor. And no, I don't mind this. Costs are $10-$15. Its a minimal cost to pay, in addition to my health insurance contributions, for good service.

Paying for care out of my pocket has brought me a better sense of entitlement to services. Because of this, I've gone to the doctor more. I'm paying for it, why not use it?! This has meant I've made and kept annual medical appointments providing me with better overall (and regular) health care.

At home, to be honest, there were times when one is made to feel guilty by going to the doctor except in the most extreme medical situations. The onus on the 'healthy' portion of society not to use limited resources of the health care system in Canada meant I was inscented NOT to go. Doctors are for the really sick, I was led to believe. For that reason I stayed away from an over-burdened system.

Inevitably on either side of the border health care ultimately comes down to the same ideal - use it or lose it.