ABC’s and PhD’s: A health care perspective from the Great White North

Health care is on the minds of Canadians these days, just as it is at the forefront of discussions in the United States. However, our fight is by comparison much easier than that which U.S. citizens face. We’re simply trying to keep our existing universal coverage strong and well funded since cuts to health care are the first things politicians go for when there are budget shortfalls. Here in Canada most of my friends and I used to take for granted our universal health coverage, but increasingly with the U.S. arguments over health care heating up I overhear conversations among Canadians where they express disbelief over the fact that many in the U.S. lack basic health coverage or that applicants can be denied health insurance because of pre-existing conditions. We’re a little naïve up here, perhaps, but these circumstances sound almost barbaric. The arguments many U.S. politicians make against government-supported health care are baffling, especially when they throw in misinformed criticism of the Canadian system to make their point. Inspired by Rosemarie Emanuele’s call for stories of our experiences with health care, here I tell of my own experiences in the U.S. and in Canada.

As a graduate student at the University of Washington, I felt fortunate to have a powerful graduate student lobby that fought and secured a benefits package that included not only medical coverage, but dental, vision, and drug plans as well. Early in my PhD program my student health services doctor referred me to a migraine specialist. Because this specialist’s services were not part of the university health system, my graduate student insurance covered only a portion of his expensive consultation fees, and I paid $30 out of pocket every time I saw him, plus the co-pays for medication, blood work, and the CT scan he prescribed. (To his credit, this doctor was very sympathetic to the fact that I was a low-income graduate student and often gave me bags of free samples of my medications.) Despite a wonderful insurance plan, the out-of-pocket costs from co-pays were not insignificant on a TA’s salary and added up over time. Still, I wonder how I would have made it without the coverage I had. My migraines were debilitating and made it difficult to work. I thought about taking time off from graduate school at one point, but fears about what would happen to my health care coverage made me stick it out.

After graduate school, I moved to Halifax, Nova Scotia, where my husband had a faculty position. I’d been living there for two years when my son was born. To appreciate the value of even the most basic Canadian coverage (Nova Scotia is one of the poorest provinces in Canada), I compared my pregnancy expenses with those of a friend whose husband was a post-doc at a large research institution in the U.S. They accrued over two thousand dollars in debt from basic maternity services and co-pays not covered under the family benefits of her spouse’s post-doc health care plan. By contrast, we paid nothing for my maternity care in Canada, except for my private hospital room, which was partly covered by the supplemental insurance plan my husband received through his university faculty benefits. (Our private insurance covers dental, vision, medications, ambulance costs, and semi-private hospital rooms, among other services that vary with the employer’s particular plan.) For every blood test, ultra-sound, doctor’s visit, and hospital admission I simply showed my provincial health care card, which linked me to a computer database that contains information about my address, age, allergies, and family doctor (but not personal details about medical history). And the cost of pregnancy and delivery was the same a few years later when my daughter was born in Vancouver, nothing (there wasn’t a private room available, so our supplemental insurance paid the full cost of the room).

Critics of universal health care often cite Canada’s long wait-lists for procedures or waiting periods to see specialists. Indeed this is often the case in non-emergency situations. However, with my recent health scare I was impressed to see how quickly things moved when there was a sense of urgency. A few hours after I’d been brought to the emergency room by ambulance, I was able to consult with a neurologist about my stroke-like symptoms. He was able to see the results of two CT scans taken within ten minutes and two hours after I’d arrived at the ER. A few days after my time in the ER (I was not admitted to hospital then) the neurologist’s office called me to come in for a follow-up exam. When my neurologist later suspected I might have viral encephalitis, I was sent for blood work, a lumbar puncture, an MRI, and then hospital admission all within a few hours of an abnormal EEG. And again, for all of these hospital procedures and the many consultations in-patient and out-patient with a specialist, I paid nothing. With every visit I simply showed my health care card (the 911 dispatcher reminded my husband to have my card ready for the paramedics), with no excessive forms to fill out or detailed questions to answer about my insurance coverage. We later received an $80 bill for the ambulance, but our supplemental insurance plan covered that.

Although our system is far from perfect, publicly funded health care is something we value very highly in Canada. The Canadian Broadcasting Corporation (CBC), our public radio and television broadcaster, conducted a poll a few years ago where listeners and viewers were asked to submit their votes for the greatest Canadian of all time. The results were indicative of the importance placed on health care and other social services in Canada. After a few weeks of discussion and debate, the person chosen was Tommy Douglas, a politician known as the “father of Medicare.” While Premiere of Saskatchewan, he pushed through a government funded health care system in that province in 1962, despite opposition from the province’s doctors. The Saskatchewan model caught on nationally, and the Canadian parliament created a national health care program in 1966.

In our small Mama PhD blogging community alone we have stories about how access to good quality health care has been so critical in our lives, and I’m inspired by the experiences some of my blogging colleagues have related about their own health crises. The U.S. health care debate has raised our awareness of how fortunate we are in Canada to have publicly funded health care, even with our system’s flaws and imperfections. Frankly, the U.S. really needs this too, or some form of health care that doesn’t leave anyone out. It’s really not such a bad thing.