The argument for cars

So, back to regularly scheduled programing: life without a car.

The day before yesterday, my daughter, H, arrived, laundry in hand and with a stiff neck and aching shoulder. As a hairdresser, sore muscles and joints are cause for concern. She has to do what she can to ensure these issues don't persist. Let's face it, if she can't lift her arm to blow-dry a client's hair, her career could be in trouble.

I encouraged her to get to a doctor and we left on foot to the nearest walk-in clinic -- no pun intended.


It was a 20-minute hike -- no big deal except that she was in pain. When we arrived at 11:20, there was a sign on the door that said they were backlogged and would not be accepting anyone until after 1:00.

Swell.

Since H was scheduled for work at 3:00 and that without a car there was no way she could wait the 100 minutes, be examined and catch a bus in time for her shift.

We opted for another medical centre, a 15-minute walk back toward home. As it turned out, this wasn't a walk-in clinic. Neither was the next one we tried at the IWK Health Centre.

In desperation, we travelled back, past  the first clinic we'd tried en route to the emergency room at the QEII complex. The emergency room has been revamped with a better triage and registration area. We were whisked through to an examination room in minutes. It was 12:50.

We were finally smiling. This was going to be a breeze.


A medical student arrived to give a preliminary exam and then returned for more mobility testing.

And then we waited.

And waited.

At about 2:10, a doctor arrived with the student. As he walked into the room, his cell phone began to buzz and he excused himself. More than an hour later, he returned to a couple of pretty angry faces.

"I had a chest," he offered by way of explanation.

And we got that. We were in emergency after all.

But what a difference that bit of knowledge would have made while we were waiting. We would have understood that he hadn't simply strolled off to take a call but was attending to someone in a worse situation than we.

I realize doctors aren't in the business of client service. They are in the business of healing.

Still, how difficult would it be to recognize that patients who are isolated in closed-off rooms without access to information -- or distractions -- are going to be less cranky if they're given a smidgen of info?

In our case, H -- who had taken two muscle relaxants and was valiantly fighting sleep in order to be coherent when the doctor arrived -- could have napped. I could have gone in search of a magazine or crossword puzzle.

In the end, it was sometime after 4:00 by the time we arrived back home. It had been a five-hour excursion.

In addition to this frustration, was my feeling of impotence at not being able to properly care for my family. That we had to spend so much time walking and walking while my ex had the car that I was, in theory, supposed to be able to access whenever needed. In practice, this doesn't work. I'd have had to be able to somehow get it from him while he was at work. And then there is the fact that we're no longer in touch.

I was in a horribly depressed mood by suppertime.

And then I received a message from an acquaintance of my son's. This guy works at a car rental place and offered to give us the "friends and family" plan that will allow us to take a van for my son's move to Toronto at a savings of $1,000! Plus I can drop it off there for $100 rather than the $1,600 that some companies charge allowing me to avoid the two-day solitary drive home no doubt made while bawling my eyes out over my empty nest.

How sweet can you get?

So, thank you for making my day, Jason.

I still want a car.

Colleen

An Open Letter to Americans

I am begging you to explain your country's fear of universal health care. I do not get this at all.

With the passage of the health-car reform bill in the U.S., it seems the debate is far from over and the crazies are becoming even crazier than before. From Sarah Palin's website that paints cross-hairs over the states that supported the bill to people making threatening phone calls, it all seems surreal.

Even, conservative pundit David Frum was fired from a right-wing think tank for disagreeing with the conservative approach to health-care reform. This is the sort of thing he has said that got him into trouble.

“In a democracy, there are competing teams, and each team has to bring its best game to the table ... health-care reform is here to stay, it isn't going to be repealed, and it was within our grasp to help formulate it and we failed to do so. Instead, we decided to do whatever we could to make Democrats look wicked and evil.”(Today's Globe and Mail)

So he gets fired for being reasonable because that is not the conservative way, apparently.

Why are people so upset about this issue?

The U.S. currently pays more of its GDP for health care than does Canada yet it has worse outcomes. You pay almost twice as much per capita as France, almost 2.5 times as much as Britain. As a matter of fact, the U.S. pays a higher percentage on health care than any other country yet does considerably worse on basic measure of health performance (life expectancy and infant mortality.) As an example, the U.S. has the same infant mortality rates as Malaysia -- a country whose average citizen earns 1/4 that of an average American. Being born into an uninsured household in the U.S. increases the probability of dying before the age of one by about 50 per cent.

It's not that the Canadian system is perfect. It has many flaws. I don't think anyone would disagree with that. I'd like my country to look across the Atlantic to countries like Sweden and France to see how we could improve on ours. But I'd never want to lose what I already have.

Though I am no expert, I have lived with a government-lead system my whole life so I am at least semi-qualified to explain it. Here is the low-down on Canadian health care.

In Canada, no one loses his or her life savings for becoming ill. Our emergency care is second-to-none. If you show up in dire straits and need care, you'll get the best in the world. No one has to approve required tests or procedures. That's between you and your doctor.

If you require palliative care, you get it. If you require a transplant, you go on the list. You don't need to prove that you have $1 million in your bank account to afford the after-care needed before you can go on the list. You get to see your doctor whenever you need to. No one gets to approve or disapprove of your visit. Mammograms, checkups, blood work, etc. It's all covered.

Our health care does not cover prescription drugs however, seniors and those on welfare receive theirs free. Some provinces also have plans for the working poor. Our drugs are cheaper than yours. We can use generic ones which is why American seniors flock to Canada (yes, there are even bus tours for this) to buy their prescriptions.

In Canada, no one tells you which health care provider to see. We choose our own.

It is true that there are caps set on certain government-covered services such as eye exams that are paid for every two years. This doesn't stop anyone from electing to go more frequently. You would just pay out of your own pocket for more regular visits.

Again, no one tells you what you can or can't do.

Like you, we also have privatized coverage. Many employers offer additional coverage to their employees. Costs are often split between employer and employee 50/50. As with your privatized plans, this is where we run into the issue of someone telling us we can't have something because it isn't covered. Still no insurance company can tell us which health-care provider to see.

For anyone who is interested, here is a link to Health Canada. It's not the best website in the world, but it gives you an idea of what is covered.

There are two main downsides to the Canadian system as I can see. The first is cost. Unlike many, I disagree with the statement that we are spending too much. Between 1992 and 2006, spending rose from 10 to 10.3 per cent per capita. That's hardly the spending spiral we've been led to believe.

However, and this leads me to problem #2, we do need to look at better models of health care and avoid looking south of the border when we do. We have to shift our system to one that focuses on prevention and education. Shifting to a community-based model would be wonderful. We all know that if we decrease smoking and obesity, for example, our health outcomes would be better and cost us less. (The same idea as spending money on education decreases spending on prisons.)

So, according to me, the Canadian system needs some creativity applied to improve our delivery and results.

Now it's your turn.

Tell me why the American people are so frightened of having their less-than-stellar system modified? Why are they frightened of taking power away from HMOs and keeping it for themselves? Why don't they want to save a bit of money?

It's time for those of you who want health care reform to get vocal. Write and call your representatives. Make sure that the only voices heard aren't those of the opponents.  

Lucy! You got some 'splaining to do.

Colleen