Thursday, August 20, 2009

My brain and the Ontario health-care system

Special guest post by Paul E. Barber

Ed. note: The following was written by a friend and colleague of mine here in Toronto. It is a response to the various right-wing attacks on Canada's, including Ontario's, health-care system -- one in which there is a real "public option," one in which basic government-funded coverage is universal. Supplementary private coverage can be provided through one's employment or otherwise acquired in the market, but there isn't a two- or multi-tier system that divides us based on how much money we have. There is choice -- I selected my family doctor, for example -- but we all go to the same hospitals. At the very least, there is health care for all. And excellent health care, as Paul explains in this very personal piece. I encourage you to read it in full. -- MJWS


You may have seen the stories about the television ad with first person testimony from a woman who claims she had a brain tumour and was unhappy about her care in the Ontario health-care system, part of the ongoing assault on "Obamacare." Five years ago, I actually had a brain tumour and dealt with the Ontario health-care system. The truth about our system is much different than the misinformation spewing forth over the Internet and the airwaves. This is my story.

I am not the type of person who would be described as a hypochondriac. I am more likely to dismiss aches and pains as of no consequence. Thus when I developed some peculiar head and neck symptoms in early 2004, I did not pay much attention to them at first.

Even when I called for an appointment with my GP in March, I was asked by the receptionist if it was urgent and I said no. The GP said he was puzzled by my condition and referred me to a neurologist. I saw him in early April. His assessment included some physical tests, all of which I passed with flying colours. This is perhaps not surprising, as throughout this period I was regularly
Scottish country dancing, a physically and mentally demanding form of exercise that no doubt kept me in decent shape.

I did have some blood pressure abnormality. The neurologist concluded, not inappropriately, that I should see a cardiologist and said he would recommend that my GP refer me. Shortly thereafter, I had an appointment for early May.

A week or so later, we were invited by close friends to a delightful Saturday evening dinner. I didn't think I had drunk too much wine, but my wife was driving, so it didn't matter. When I woke up the next morning -- it was Sunday, April 17 -- and felt quite sick with a headache – I thought I had a hangover.

However, unlike all previous hangovers, this one did not disappear by Sunday afternoon – I remained very ill and in bed. By the afternoon of Wednesday, April 21, we finally concluded, after consulting my GP on the phone, that I should seek emergency treatment the next day if I showed no improvement.

Late that night, unable to sleep because of a splitting headache, I got up to take some strong headache medication. The last thing I remember was reaching up to the cabinet containing the pills. My wife then heard a crash as I hit the floor. I had collapsed and gone into a convulsion.

This is the point where we discovered just how fast and effective our health system could be. The complaints you hear directed at Canada's health system about waiting times for treatment are simply without foundation. As you will see from what happened next, my experience says quite the opposite.

The next thing I recall I was being carried downstairs by some fire fighters who responded to the 911 call and had made it to our house ahead of the ambulance. I was taken immediately in the ambulance to the Mount Sinai Hospital emergency. I drifted in and out of consciousness and don't remember much from that period, but a CAT scan done in the wee hours of Thursday, April 22 revealed a large mass in my brain.

A few hours later, I was admitted to the Toronto Western Hospital neurology ward (which has an
international reputation for excellence). I had a brain tumour and needed surgery. The doctors were optimistic that what they didn't get with surgery could be dealt with by chemotherapy and radiation. They assumed I had brain cancer, but they said it would be a few weeks after surgery before tests could determine the exact nature of the tumour. The medical staff could scarcely believe that I had actually been at work the previous Friday.

Hooked up to an IV and rehydrated, I began to feel a little better. However, I discovered that I had lost considerable sensation on my right side. I could not hold a cup of water without dropping it, a very distressing discovery.

Early the next morning, Friday, April 23, I had an MRI. This marvellous machine provided a precise three dimensional portrait of the tumour. That evening, my neurosurgeon,
Dr. Taufik Valiante, came by the hospital room to discuss my case. He felt I needed surgery in the near future, although not necessarily right away (he thought I might have to wait a week). However, he cheerfully went off to check on the availability of the space and personnel needed to do the surgery, and found we could do it the next day.

Just 60 hours or so after my collapse, on Saturday, April 24, , I underwent five and a half hours of surgery to remove a large brain tumour. The surgery left a large scar running across the top of my head, now just barely visible through my thinning hair. Twinges in my right hand and stiffness in my lower right leg are the only long-term consequences of my experience. I have an MRI every couple of years (I just had one) to check that the tumour has not returned.

Despite the extensive nature of the surgery, it was performed so skillfully that I felt able to leave the hospital and go home the following Tuesday – April 27. And the next day, Dr. Valiante called with the news that the tumour was benign, a slow-growing
pilocytic astrocytoma, generally thought of as a brain tumour one sees in children. I would not need any further treatment. In less than a week, the system had me on the road to full recovery. My wife recalls this period as a blur of unfolding events.

By the way, I did see the cardiologist a week or two later while still recovering from surgery. She did a few tests and pronounced me fine.

As you can see from my story, the delays encountered in my care were entirely of my own making, not wait times in the health-care system. Once it kicked into gear, I received incredibly fast, world-class health care. Apart from my initial ride in the ambulance and my hospital phone, the only other cost to me was the rental of the hospital TV set. A couple of days after the surgery, I remember watching a Toronto Blue Jays - Minnesota Twins game, featuring a first-rate performance by then Blue Jays starter Ted Lilly. Full value for my money spent on the TV and full value for my tax dollars that pay for our health-care system.

Our experience with Canada's health care system has been first-rate. This includes the cancer care my wife is currently receiving, which has included a sophisticated procedure whereby she successfully received a transplant of her own stem cells at the wonderful
Princess Margaret Hospital in Toronto. She did not have to wait for that complex operation either: it was performed upon completion of the essential preliminary treatment.

On another occasion, my son dislocated his shoulder playing a pick-up game of ice hockey. He called me at work to help him get to the hospital. When we entered emergency, the triage nurse gave Alex a quick inspection and then instantly whisked him away for treatment. Once again, no waiting.

I think our experience with health care is comparable to that of most Canadians. Our system may not be perfect, but we are more than happy with how it has treated us, and,
like other Canadians, we would not trade it for the American system.

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  • We're in BC and our experiences -- though not nearly so dramatic -- are much the same.
    Because my GP was on the ball, I got an early diagnosis of hyperparathyroidism and had surgery to correct the condition within a month. The only symptoms I had were tiredness and mild depression. Left untreated I could have developed kidney stones, osteoporosis, and a host of other unpleasant problems. I'm so grateful to have a doctor who pays attention! (We live in a rural area not a big city.)

    I have no complaints about the system though I'm sure there are lots of areas in which improvements could be made.

    By the way, I am a US citizen living in Canada for the past five years and I am thoroughly familiar with the US "system" and I won't go back to that under any circumstances.

    By Blogger Sharon, at 12:45 PM  

  • Thanks for posting Paul's story, Michael.

    Like Sharon, I am also in British Columbia.

    Awhile ago I got so frustrated reading the "Socialized Medicine Sucks" posts that are found easily through google all over the web, that in response and to make sure people searching the web for confirmation that Socialized Medicine Sucks would find another example of reality in the Canadian Health System, I wrote about an experience of my own of having a kidney removed for the whopping cost of $18.00, with the satirical title Socialized Medicine Sucks:

    No one wants the U.S. to be a backward third world country like Canada, do they?

    In Canada they have long, long, long waiting lists and people just up and die waiting, right? Just ask the villagers, they'll tell you.

    I live in Vancouver, BC. Canada's medical system is a single payer system as many of you know. The monthly premium for a single person is $54. Read all of it here...

    By Anonymous Anonymous, at 1:08 PM  

  • I've lived in Ontario for 39 years. I've experienced excellent healthcare for that whole time.

    When I broke my wrist in a fall, the entire package, including setting the bones, cast, visit to the doctor for progress evaluation, taking cast off and several visits for rehab, was NINE dollars. For parking.

    By Blogger jeff house, at 5:23 PM  

  • All your comments are in line with what I hear from my wife's many Canadian relatives and not too much different from what I hear from my British relatives.

    It's too bad that the amplitude and repetition of a few dubious stories regularly drown out the truth in this proudly ignorant land.

    By Blogger Capt. Fogg, at 5:50 PM  

  • I once visited an emergency clinic because my elbow was swelling in a weird way. They couldn't tell me what was wrong, but happened to notice in the x-ray a bone chip in my elbow and they called an orthopedic surgeon that was in my insurance network and arranged my appointment for me. I saw the surgeon and he took another x-ray because he insisted the first x-ray wasn't good enough. I decided that surgery wasn't necessary for such a stupid thing that wasn't causing me any problems, and so I did nothing about it. I still have the bone chip in my elbow.

    A month later, I find out that while that surgeon's office was in-network, the particular doctor I saw wasn't, and I therefore had to pay for the complete cost of that office visit: $220. Not a lot of money, but more than I wanted to pay, as none of this was my fault. I called my insurance and was told that they'd pay for it. But two years passed before I could actually get them to do so. In the meantime, the surgeon's office insisted that this was my liability and kept pestering me and being rude, until they finally sent me to a collection agency. I paid the bill. Finally, the insurance company paid the doctor's office, but the doctor's office insisted for several more months that they hadn't been paid and kept being rude to me. Finally, they reimbursed me the amount I paid them, minus the $40 collection fee.

    So on top of my normal co-pay, I got a two year problem, tons of rudeness and lies, a $40 fee to collect an amount I didn't owe, and I still have the bone chip. Yeah, that's MUCH better than Socialized Medicine.

    By Blogger Doctor Biobrain, at 6:12 PM  

  • Part of the problem with Republicans is that they do not believe health care is a right.

    We need to just move over them and get health care reform done.

    By Anonymous Anonymous, at 9:04 AM  

  • Paul, thank you for this article ...

    I too am Canadian, and I wouldn't live anywhere else. I live with a chronic illness and my medical care has been, for the most part, excellent. My own physician practices in a community clinic 40 minutes from where I live ... but his care is worth the drive. He's been my doc for 20 years; everyone at his practice is top-notch.

    I have my occasional complaints, as anyone would have ... but overall, when it truly counts -- acute injury, serious illness -- our medical system is there for us, and triage at a hospital doesn't include someone hanging over your head demanding to know if you can pay for treatment.

    Mental health and psychiatric services remain a thorn in the side ... Services are backlogged and there are too few enlightened options. But basic physical care is never in doubt -- that's been my experience.

    I was in the US on holiday in 2000; after an ocean swim, one of my ears was clogged. My host took me to his doctor, who tried to syringe the ear twice. No luck. The ear remained plugged. I started to leave the clinic, and was called back by the receptionist, who told me that the charge for this miniscule visit and failed procedure was $95.00. I was stunned. I shudder to think of what a serious injury or illness would cost ...

    By Blogger Alexa , at 3:58 PM  

  • The Canadians have done the right thing for their citizens I am an American, and I think our system of for profit medicine is a shame, a disgrace, and is broken beyond repair, but we won't repair it because our elites don't want it-it would cost them too much money. The other thing preventing any reform is the divisions of race and class that exist in the United States. A small group of senators from small states and angry mobs heated up by astroturf (fake grassroots) groups and ignorant talk show hosts are able to help stifle any reform even though the ordinary people belonging to the mobs would benefit from much-needed reform. Sadly, I think we Americans stand as a prime example of what not to do.

    By Blogger khughes1963, at 10:39 PM  

  • Great story, I too am sick of the republicans treating our system like #$!@. It really bothers me to hear all these made up stories about how people had to wait for years to get a surgery. It's clearly not true. I'm sure there is a mishap somewhere once in a while, but that's al they talk about and make it seem that the one in a million mistake is a common thing to happen. That's just not right...


    By Anonymous Life Insurance in Canada, at 10:15 AM  

  • It is interesting when you actually measure things like 5 year survival rates for Cancer, America leads all other countries. If universal health care is so amazing, why does it fall behind in cancer treatment?

    This person saw a neurologist who pronounced him fine, then he collapsed in convulsions a week later. You sure he wasn't just trying to push you out of the office so he could get his daily quota faster and go home?

    The price of medicine is somewhat misleading. Yea, you paid 8 dollars for parking, but how much were you taxed last year?

    And finally we get to another major point. Without health care markets would CAT scans and MRI's even exist?

    By Blogger nates, at 4:13 PM  

  • In reply to Nates a 4:13 PM

    1. Canada is behind US in cancer treatment
    - The US is behind Canada in general mortality rates, infant mortality rates, life expectancy, cost, circulatory disease death rates, child maltreatment rates, digestive disease death rates, Intestinal disease death rates, respiratory disease death rates, heart disease death rates, HIV death rates and probability in reaching age 60 among other things.
    -Basically, you have a point, Canada is behind the US in cancer treatment, but you're picking through and finding a very specific example. When you look at the overall statistics, not just in very specific cases, the US is doing much worse.

    2. Your example with the neurologist
    -It was made up. You cited no source, provided no names or any evidence that this occurred. So you're trying to prove your point but you aren't giving me any factual basis.
    -Also, your point is once again a very specific case, one that cannot truly be applied in the big picture. Bad things do happen with the Candian system, but they happen just as often in the American one.

    3. Tax issue
    -The Canadian tax is $54 dollars a month for one person, $96 for family of two, and $108 for a family of three. My family of four pays $542 per month for health care. That's with a $5,000 deductible.

    4. Without Health Care markets...
    - CAT scans and MRI's most certainly would exist. Funding most projects like that is to expensive and risky for a private corporation to pay for themselves, so guess who provides it. The Government. Guess what that's called. Socialism. Don't get the wrong idea, I'm not saying America is entirely Socialist, just that we have Socialist elements, and we always have.
    -The only reason the Health Care "market" even had anything to do with such developments is that they wanted to mark them up and sell them to make money. Hosital's needed these scanners, private corporations beg for funding from anyone (typically this ends up coming from a very large corporation [which receives tax breaks for this kind of stuff], non-profits [Gov. funded], or straight from te government) THEN they go ahead and build the thing. Only once they have gotten what they need from the Government. Which gets it's money from taxpayers. So the market wasn't the catalyst for those MRI's or the CAT Scanners

    By Blogger Alex Kimble, at 11:14 PM  

  • Robert.
    3. Health care is more than $54/month. That sounds like the Ontario health care premium which was just the most clear tax hike, and has only existed since the current Ontario government took power.
    Most health care funding comes from general government revenue, so it is well hidden how much we actually pay. However looking at per capita health spending and we see it's thousands more than the $600/yr you suggest.

    By Anonymous Matt, at 7:03 AM  

  • Matt

    I'll have to re-check but that's what I was finding wherever I looked.

    But the point isn't whether it just started a while ago, the point is it's there.

    I'll re-check.

    By Blogger Alex Kimble, at 9:51 AM  

  • I was a Canadian (Ontario resident) who moved to the US. I have a HMO plan thru my employer. Besides paying ~$200 a month for medical insurance for my family, every time I visit the doctor, I have a $25 copay. If I want to see a specialist, I have to go to my doctor to get a referal - $25 to my doctor and another $25 to the specialist.

    I live in California and although my tax bracket is lower than what it was in Ontario, my disposable income is almost the same as it was in Ontario. I attribute this to higher cost of living (housing costs primarily).

    So, I support Obama in every way on health care.

    By Anonymous Anonymous, at 2:01 PM  

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