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Anecdotal evidence isn't much proof of anything, but it's useful to counter other anecdotal evidence.
The tales that USAmericans hear about problems in the Canadian health care system tend to be anecdotal. So feel free to pass my tales around as an antidote. I keep 'em stored, and update them as needed. ;)
In January, I went to my clinic because I was sick of the persistent cough from the virus I'd had twice in the fall. (By choice, I go to a Community Health Centre for my primary care -- a multi-service non-profit community agency funded by the provincial Health Ministry, where doctors, nurse practitioners and social service providers are on salary. There should be more of these centres. Most people go to physicians in private practice for their primary care.) Since then, I have had:
- a chest xray (walk-in basis at a private xray lab, 10 minute wait, no charge to me)
- 4 rounds of blood tests, urinalysis, and an ECG (walk-in basis at a private medical lab, 10 to 20 minute wait, no charge to me)
- 2 rounds of mammograms (waiting room time a few minutes, appointments needed because of slight shortage of technicians -- I could actually have got one at my chest xray walk-in if the technician had been there, but instead was given an apptmt for the next day, there having been a cancellation; for the second one, I had to make an apptment a week in advance; no charge to me)
The mammograms were analyzed and reported on, to my primary care physician, by a radiologist, as was the chest xray; no charge to me.
- 4 visits with my primary care physician (including a Pap smear and the lab report); apptmts made in advance to coincide with receipt of various reports, waiting room time zero each time
- referral to a dermatologist for a non-urgent elective consult; apptmt for 6 weeks from when I saw my doc. I'll be seeing the dermatologist at my own expense, if what I want isn't "medically necessary"; that's to be determined yet, although at present my desire to have lumps removed is considered "cosmetic". (I have grown some lumps on my leg that are undoubtedly not cancerous, but I'm tending to be overcautious because of my dad's melanoma, see below, and my brother being diagnosed with a melanoma last fall, and the pervasive skin cancers in my mother's family. The lumps might, on the other hand, be symptomatic of the genetic cholesterol problem I probably inherit from my dad's side.) If I had supplemental insurance, e.g. through an employer, it would doubtless be covered. My friend had bunion surgery last year under her govt-employee supplemental plan (not covered by the public plan because it's regarded as ineffective).
I need new glasses; since adult eye exams were de-listed by the provincial plan last year, I'll be paying for the exam. Last time I did (when the plan had gone from annual to biannual coverage, and I wanted new glasses in the off year), it was $50; if I call the optometrist tomorrow, I'll have an apptmt this week. If I had supplemental insurance, it would cover both the exam and the glasses. It would also cover dental and prescription drugs, which I also pay for out of pocket. I'm a high earner, but self-employed, and don't have a private plan.
Now let's consider my co-vivant. He was diagnosed with Type II diabetes 4 years ago, in his late 40s. He sees his primary care physician every 3 months, and various specialists (ophthalmologist, audiologist, cardiologist, endocrynologist) whenever she sends him, and they're all covered because they're on her referral; the appointments are not urgent, and usually take 6 weeks or so. He had a chest xray last month; we went together, I went upstairs to the blood lab, he went downstairs to the xray lab, we were out in half an hour. In the two months after his initial diagnosis (when he went to a private walk-in medical office because he was lazy, no charge to him, thinking he had a urinary tract infection, and they diagnosed diabetes and saw him again at 6 pm the same day) he'd seen his doc at the health centre about 4 times, had a full round of tests (blood work, ECG, stress test ...) and had his initial prescription adjusted, and we'd seen a dietician at the clinic and had the option of attending a three-session group counselling/education program.
My mum, who's in her 70s, moved to a small town outside Toronto recently, from a southern Ontario city with some of those world-class medical facilities. Her glaucoma was treated at an internationally renown eye care hospital. She has received treatment by a dermatologist (and sometimes a plastic surgeon) at least every six months for 30 years for skin lesions. On moving, she was able to be referred to a dermatologist and ophthalmologist in her new region with only a few weeks waiting. There *is* a shortage of primary care physicians in that region, a burgeoning bedroom community, but she got signed up with a new one last year when she decided to stop commuting to her old hometown for medical apptmts. When she developed pain in her knee and finally consulted him about it, about six weeks ago, he sent her for xrays, then a second set of xrays at a different lab because he thought the first lab was being ass-coveringly over-cautious, and then to an orthopedic surgeon, who sent her for a bone scan and then an MRI. In fact, she could have had an MRI the same day the ortho called her to schedule it, or the next day, but she decided she needed a week to work up the nerve. All in a little over a month. All at zero charge to her.
My dad had a heart pacemaker installed in the summer of 2002. He was living near a small town about 100 miles from the nearest large centre. He experienced dizziness for a few days, stuck his arm in one of those machines in a drug store in the small town, saw that his BP was okay but his pulse was 34 or something, went straight to a private walk-in medical office, got sent straight to the hospital for an ECG, went back to the medical office for the results, got sent back to the hospital and admitted to the ICU. Three days later he was sent by ambulance the 100 miles to the big internationally renown cardiac care hospital in the big city ... and had to be sent back because he had a staph infection at his IV site. Spent a few more days in hospital, was released under my supervision with meds, and had the pacemaker installed 5 weeks after his initial doctor visit, when they were certain the infection was gone. All at zero charge to him.
At the end of January 2003 he flew home from Florida with pain in his shoulder and hip that had become unbearable, and my sister drove him straight to the regional hospital outside Toronto, on a Saturday. He was examined and given an apptment with an orthopaedic surgeon on the Monday. On the Sunday, his leg pain was extreme and he was afraid it might indicate an embolism, which he had had once before. He went back to the hospital and had a chest xray. They discovered lung cancer. He was then scheduled for a biopsy on the Tuesday, but missed it because my mother got stuck in the elevator in her senior cits' apt building<**> for 2 hours. It was rescheduled to the Thursday, and in the interim he had a bone scan and cancer was diagnosed. After the biopsy, he failed to recover properly, and they admitted him. He was in hospital for 6 weeks while an internist, orthopaedic surgeon and oncologist tried to determine the nature and extent of his disease.
He went to the cancer hospital for radiation therapy on a couple of days' notice, and would have had an MRI on 2 days' notice, except that he had a pacemaker and so could not have it. He was on morphine for pain control, and just deteriorated, although we were given the impression that if his pain could be controlled, he could be released and start chemotherapy and have a few months if not more. He was even scheduled (on a Friday, for Sunday morning surgery) for hip joint surgery, purely for pain relief, but on the day it was determined that he was not a candidate for the surgery (I gather for the anaesthetic -- his blood oxygen levels had simply never got back up). My family decided to take him home for the end; he was sent 30 miles by ambulance to my sister's house, and we were supplied with a fancy inflatable-mattress hospital bed, IV morphine and miscellaneous medical supplies, and a visiting nurse. He died two days later. Of an undiagnosed coronary artery blockage (in response to our queries about his death, the local coroner directed that a post mortem be held) -- the same thing that caused his father's premature death; he'd been on hypertension and cholesterol medication for years, and never had any related symptoms, I guess (still bicycled 10 miles a day at age 72 after getting the pacemaker). All at zero charge to him. And no lifetime limits, btw.
( <**> My mum had no private pension and a monthly payment of under $10 from the Canada Pension Plan -- equivalent to the US's Social Security, a mandatory pay-in scheme -- because she worked outside the home only for a short time. Her income was the minimum that any senior gets: a little under $1000/month, from the universal Old Age Pension and the Guaranteed Income Supplement. She was able to get into a subsidized senior's building after a few months' wait, and then to transfer to one in the small town where my sister is after about a year's wait, at a rent of about 1/3 her income for a small one-bdrm apt., just over $300. On the private market, the cost of a similar apt would vary tremendously by location, but would be at least double that in most cities.)
So ... doncha love a good anecdote?
Yup, there are anecdotes to the contrary. Especially concerning problems with access to MRIs in Quebec and a few other locations, and problems with access to primary care physicians in the last couple of years in some areas of Ontario.
But I, personally, have *never* encountered anyone who has had those problems. I don't claim that they don't exist, far from it. The point is that they are mainly specific to certain areas of medical care and certain geographical areas. And that they are the obvious result of underfunding, not some structural flaw in the system.
And I've never heard anyone in the US report *better* experiences with the health care system, no matter what kind of coverage they had, than the experiences reported here. ;)
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