Monday, 23 February 2015

On Health Care, Personal Experience, and Reasonable Arguments

I have people I love and respect in the USA who have objections to "Obamacare" and those objections are based on really reasonable arguments.  There's a component of US constitutional law that is in direct conflict with a "universal" healthcare system in the USA, and constitutional law is the highest form of law.  The constitution of the USA is equivalent to the Charter of Rights and Freedoms in Canada, roughly (emphasis roughly) and people in Canada get pretty pissed off when they feel that their charter rights are being violated.  When the Supreme Court ruled on the legality of "Obamacare" it neglected to respond to the constitutional challenge.  It's still a problem.  So far as I can tell people on both sides of this debate are sensible people applying reasonable arguments - just very different reasonable arguments.  Personally, I'd say that if you can't see the sense in why someone disagrees about something like universal healthcare in the USA and you don't understand why, you should look deeper.  You don't have to agree on conclusions to believe that someone is rational, sensible, and basing their ideas on sound and reasoned thinking.

Having said that...  I was sick and scared and opted to just go back to Canada to see a doctor rather than risk some kind of exception in the States that an insurance provider would have used to deny coverage.  It's illegal in Canada to charge money for a medically necessary test or procedure.  We have had universal healthcare for quite some time, and I'm a fan of it.  I like it better than the alternative that I see in the United States.

While it follows the same rules as the rest of Canada broadly speaking, Quebec as a province is a bit different than the rest of Canada.  That's true in lots of ways and specifically it's true with the medical system.  If you have a non-emergency issue that requires urgent care but not a visit to the hospital's emergency room, it's like you're trying to pull one over on the medical system... as in (literally) you've gotta get up pretty damn early in the morning.

Walk-in clinics in Quebec are mostly government run.  They only take 12 walk-in patients in a day.  They open at 8am.  To reliably get in and see a doctor you have to show up 90 minutes before they open (6:30am) and sit on the steps.  If a mother with a child is in line before you, that counts as 2 people.  If you're person #13 it sucks to be you - either go to the emergency room or wake up earlier tomorrow and try again.  I imagine during flu season you have to wake up even earlier. 

So, that was me.  Once I actually got to see a medical professional I was treated very well.  They asked a lot of good questions, they were more conversational and more curious than any doctor in BC has been in a long time and I felt like they were really paying attention to what was happening for me.  I was queued up for a couple of simple tests and reassured that it was probably just a cold or flu that took a long time to go away.  It took me (in total) from 6:30am when I lined up until 11:00am just to see a doctor. 

I know I would've seen a doctor much more quickly in the US if I'd chosen to access my travel insurance, and I suspect the care would've been just as good or better, so the advantages of a totally privatized health care system were clear at 11:00am when I finally stepped away from that whole medical process... but removing the chance that my medical expenses would've been paid out-of-pocket on the off chance that an insurance company denied me coverage made the whole thing seem a lot more bearable.

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