Canadian Health Care Information

In my last blog, I described a personal unintended experience in an American hospital. I committed to post the cost of my visit to Emerg for a broken collar bone and a torn shoulder rotator cuff.
The bills arrived and the total was $2,161. While the cost was not cheap, it was not in the realm of the stories we have all heard. What was mindblowing was the storm of paper and phone calls required to manage the bill(s). This was in spite of my immediately and faithfully sending any bill or piece of paper to my Canadian insurance company for handling and payment. And just when I thought that everything was done and paid for (it took 5 months), today I received a call from a collection agency for the phsician bill of $327. This was the second call from such an agency. The first one was a few months earlier regarding a radiology service for $29. For a country that is known for its "good old American know how", it was shocking to witness ongoing across-the-board confusion coupled with multiple redundant circular phone calls. It seems that the hospital costs are separate from the radiology costs and that physician costs are separate from either of these. But nobody communicates or coordinates these facts or these systems. I am beginning to understand why their paper costs and admin costs are so high.

In March, like many Canadian families, we chose to spend Spring Break in a warm and sunny part of the United States. What I didn't plan on was a trip to Emergency. I lunged for a tennis ball and caused a shoulder-on collision with the concrete court.

With the help and kindness of others, I got myself back to the condo, but I knew I needed medical attention. In preparation, I looked for that little paper card with a number to call if we needed medical care outside of the country. Annoyingly, it not there. Not knowing what to expect, my head filled with stereotypes about American hospitals. Would they demand a VISA card? Did I have enough room on my VISA card? Might they refuse to treat me?

Nevertheless, we headed out to the nearest hospital. It turned out to be the Eisenhower Medical Centre and as I later learned, one of the top 100 hospitals in the country. Entering the Emergency department, I found myself in a space that looked more like the lobby of a luxury hotel than a hospital.

Carpets, soft lighting and soft textures invited me in. Multiple small seating arrangements were made up of a sofa and other upholstered chairs as you might find in your living room or mine. The reception desk was a large curving affair with two people sitting behind it. They looked like they were waiting just for me.

"Hi", I said. "I'm a Canadian and I have hurt my shoulder". They asked me 3 things only: Do you have photo id; Are you allergic to anything; and What is the nature of your injury? Then they invited me to sit and wait for the triage nurse.

During my 90 minute stay, I had the assessment (in part with a new temp-taking gadget that is simply wiped across the forehead); the x-ray; the doctor chat with the diagnosis of a broken collar bone; and the prescription for pain meds.

Lastly, a person approached me with a clipboard. "Here it comes", I thought, "the talk about the VISA". Instead, she simply wanted to confirm my home address. Handing me a card, she said, "If you have any kind of travel insurance, just call this number so the invoice can be adjusted". That was it. No talk of VISA. No demand for money. When I get home, I will find the bill. I will let you know what it is.

Oh, and the prescription? It cost 14 dollars. Seemed reasonable to me.

Conclusion on American hospital treatment? It is a polar opposite away from our stereotype. We should update our files.

I used to be an idealist (one who is guided more by ideals than by practical considerations) and an ideologue (an often blindly partisan advocate or adherent of a particular ideology). You see, I used to believe that our healthcare system was providing good care and reasonable access to those who needed it. I am a nurse, so I should know, right? But a few years ago, I attended a house party, and at that party, I learned something what would rattle, uproot and finally demolish my beliefs about the healthcare system.

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The first step towards any solution is the honest appraisal of the situation. Refereshingly, Steven Lewis, a Canadian health policy professor has done just that in his "Afterword" of the recent book, High Performing Healthcare Systems. The book examines excellent healthcare organizations from around the world and includes two such examples from Canada.

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Welcome to the blog.
One of the reasons for this blog and website is to inspire a nationwide discussion by Canadians about healthcare. I hope you will be part of it. I sincerely invite you. I am calling this first blog,“It’s ours, isn't it?”

I am talking about our healthcare system. For more than 20 years, our healthcare system has been going downhill and the wagon is not slowing down. And for most of those same 20 years, Canadians have rated healthcare as our number one concern according to national surveys. Yet nothing changes. How is it that we have this contradiction? I hope you will share your answer. Here is mine:

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