I was born in the same year that my government adopted socialized healthcare in Canada. I am an educated, middle-class woman and I have never known any kind of healthcare but the kind that is provided by our government-run system. It has been a nightmare for my family and me. The following stories, told in second person and based on my personal experiences with socialized healthcare in Canada, constitute my personal warning to Americans.
Imagine that you and your spouse, and three children under the age of six move to a new city and must find a family doctor. You are told at the local clinic that the doctors there are not accepting any new patients. (Canadian price controls have created shortages of everything when it comes to healthcare). The receptionist suggests that you go through the yellow pages and try to find a physician whose practice is not "full." You spend days, and weeks, doing this, and are repeatedly told "Sorry, we are not accepting new patients." You put your name on several waiting lists and persist in calling doctors' offices.
Finally, a receptionist tells you that, while the doctor is still accepting new patients, he requires a full medical history and an interview with each family member before you can be added to his roster of patients. Based on the questions asked during the interviews, you come to understand that he is screening out sick or potentially sick people. You are all healthy, fortunately, so he takes you on as patients. Others are just out of luck.
There is a chronic shortage of doctors in Canada because price controls on doctors' salaries have resulted in a "brain drain" where the best and brightest practice medicine in the U.S. and elsewhere, after being educated in Canada. In addition, the Canadian government cut medical school enrollment in half in the 1990s as a "cost-cutting measure," making the problem of doctor shortages much worse.
Next, imagine that all of a sudden your six-year-old begins showing what seems to be signs of an appendicitis attack, shortly after recuperating from chicken pox. You take him to a hospital emergency room and carry him in because he is unable to walk. There is no one to help you as you enter the building, so you must lumber along to the reception area. A nurse interviews you for a couple of minutes, asks you for the reason for your visit, and then takes your son's government health card and asks you to fill out paperwork while your son writhes in pain in your lap.
You tell the nurse that your son must be seen by a doctor immediately — it's an emergency! — as his condition is worsening by the minute. The nurse tells you, stone-faced, to go and sit in the waiting room to wait for a triage nurse. Having no choice, you do what you are told and join twenty or so others in line in front of you. You are given nothing to help make your son more comfortable — no damp facecloth, no bedpan for the vomit, nothing.
When a triage nurse finally strolls in a half hour later your son is too weak to respond to her and you begin to panic. Finally, a doctor appears and says it's just a "bug" and that you should not be playing "armchair doctor" by "diagnosing" appendicitis. He orders some time-consuming tests anyway, because you have shown him that you are very, very angry. Six hours later the test results come back positive for appendicitis.
Your son is whisked away for an emergency appendectomy, after which the surgeon tells you that, had the surgery been delayed by another few minutes, he would probably have died. Your son's appendix was gangrenous and on the verge of bursting. It reminds you of reading in the local news of three other people who were sent home from the emergency room, only to have their appendices burst and die. You are grateful that you were much more persistent and ornery than they apparently were.
Our Soviet-style emergency rooms have waiting rooms equipped with hard metal chairs, vending machines that sell junk food, and maybe a television in one corner. There is no access to any medical equipment, beds, or even stretchers. In the emergency room everyone passes through triage and is given a code based on a nurse's cursory evaluation of their affliction. If you are not satisfied with the "care" that is provided there is nowhere else to go, except to an American hospital if you are close enough to the border and can afford to pay cash. Canadians know that if you call an ambulance you can bypass the 1012 hour wait in the emergency room, but this drives up the costs of healthcare even further.
If there ever was a good fight, Americans, this is it. As we say in Canada, "Youse guys just gotta give 'er, eh!
August 11, 2009
Cathy LeBoeuf-Shouten lives in Hudson, Quebec, Canada.