What Americanization of health care really means ( Kathy Eisner and Ish Theilheimer )
from http://www.straightgoods.ca/ViewFeature5.cfm?REF=601
What actually matters in election campaigns can get obscured by all the hubbub.
Our family got a frightening view of what, for us, is a highly motivating political issue as we watched Kathy’s sister Peggy lose a two-year struggle with the US health care system and colon cancer at Christmastime last year. Dying of cancer was bad enough, but the inhumanity and downright cruelty of the American system was infuriating and shocking to us, as it would have been for most Canadians.
Most Canadians are not aware of how bad it is in the States. In America, the bottom line of the insurance companies is truly the driving force in health care. It drives everything from diagnostics to treatment to palliative care. At every point, the companies squeeze patients and doctors in ways Canadians would find incomprehensible.
We were appalled at Peggy’s treatment, despite her having a decent health plan and living in a rich state, California. Important things that we, as Canadians, take for granted were non-existent. The different doctors appeared to function as private operators who don’t communicate, with Peggy left to work as go-between among the doctors and other health care workers. Case conferences among health care professionals were non-existent. Who would pay for them?
Although the Canadian system is justifiably criticized for wait times ˜ much longer now than before the current Prime Minister’s tenure as budget-cutting Finance Minister ˜ Peggy experienced lengthy waits in California for consultations, referrals, appointments, diagnostics and, most critically, approval for all these things from the insurance companies. The delay in approvals often led to setbacks in her treatment and great pain. The doctors and hospitals clearly passed off less lucrative procedures to one another. Certain hospitals would only do certain procedures. American hospitals, we learned, give priority to patients with higher-price insurance premiums.
Unlike in Canada, there was no homecare available for Peggy except from cancer society volunteers. Courses of treatment that ran counter to the insurance company’s ability to save money were vetoed.
The last chemotherapy drug Peggy was on was really helping and made her feel better, but when the company decided the test numbers didn’t look right, they stopped it because they said it wasn’t going to cure her. She went into immediate decline. The treatment was entirely dictated by the insurance company and what it would pay. It is doubtful that treatment would have been denied her in Canada.
When the disease reached the final stages, Peggy was hesitant to go on palliative care because she was told they wouldn’t cover anything that would help prolong her life, even things that would give her relief like getting fluids drained from her lungs and abdomen. Had she chosen too soon to go on palliative care, she knew it would mean if a new drug were approved there would be a waiting period before she could get on it. And the palliative care they offer is dismal, volunteers and the occasional nurse ˜ she couldn’t even get a morphine pump. The insurance companies controlled that.
The short-sighted, profit-oriented approach to health care applies to prevention and diagnostics. Our US family members have far less access to screening. Colonoscopies are routine for family members of colon cancer victims in Canada, but Peggy’s adult daughter cannot afford the thousands of dollars one would cost because she doesn’t have insurance. Our (Peggy’s and Kathy’s) 57-year old brother, who has a “gold-plated” insurance plan, was only able to get a colonoscopy because two of their first-degree relatives had had colon cancer. If it had only been one, they wouldn’t have paid. In Canada, any doctor can order one for anyone over 50. (After Peggy’s diagnosis, I [Kathy] got a colonoscopy in Canada in a matter of weeks. It took our brother months.)
We were struck, when we began to research Peggy’s condition, by advice from her local branch of the American Cancer Society. They supplied a list of “useful organizations” to cancer patients. Topping the list were food banks. The implication was Americans with cancer likely need to choose between medicine and food.
It is important for Canadians to understand the full dimensions of “Americanization of health care” ˜ the way our family now does. As private clinics and treatment centres are allowed in Canada, the next step will be private health insurance. As money flows into the private system, the public one will become less and less capable. Before long, if this happens, many families will experience the kind of heartache ours has.
We don’t believe the Canadian system would have saved Peggy; her cancer was discovered too late for that. The cruelty and inhumanity of the American system and how poorly it served her will always be with us. Our experience will always inspire us to warn other Canadians and to work towards the improvement of our public health care system ˜ the one we have fought to have in Canada and that, in many ways, defines us.
Please pass this on to others who actually do care.
Kathy Eisner teaches Kindergarten in Eganvillle, Ontario, and is married to Straight Goods publisher Ish Theilheimer. They are thankful to live in Golden Lake, Ontario.