The Gem in Canada's Crown

One of the best things Canadians have ever done, was to follow the lead of a former 'commie' preacher from the west and set-up a national medicare system. Tommy Douglas was the leader of the Canadian Commonwealth Federation - a cover for 'the communists' - during the 50's and 60's.  He had the notion that one of the things every Canadian should be able to afford was to look after their health. For a long time that wasn't the case, doctors and medicine were private enterprises to which those who could afford subscribed and the rest borrowed when it was absolutely necessary. Doctors 'built' their own patient lists and sold their practices to new-comers as sort of a retirement gratuity. Doctor Fred Banting, the discoverer of insulin, failed in business as a GP and was only saved from a different career by a lab assistant's job at the University of Toronto. Doctors and their patients, both had it rough.

The Government of Canada passed legislation to set up the national medicare plan in the early sixties. But the government left the administration of the plan to each province. Each province set up its own bureaucracy to administer the plan. Hospitals were socialized.  Doctors joined the plan as private corporations contracted  at fixed rates for service, or opted out, as they wished. Each individual was registered with the plan and issued a membership card and could be assigned a doctor if they didn't have one. Individuals paid for the plan at one of two rates, through their employers. Those unable to pay were registered for free. As time passed, many employers subsumed all, or part of the insurance costs  as fringe benefits. Provincial governments allocated other funds to healthcare as well. There were disparities between some provinces, but essentially most common medical and surgical services were 'covered'. Dentists, and some specialists like specialized clinics and opthalmologists exempted themselves and required private arrangements.

As time went on, drug benefit plans were added to insurance coverage paid by individuals, or as fringe benefits. Public coverage of some medications was extended to the unemployed, aged and needy. Some drug abuse treatment and mental health programs became part of the medical establishment. Hospitals and clinics were built in many areas where there had previously been none. Doctors were educated, or imported, often at public expense, to meet needs. Canada has perhaps one of the most wide-spread medical care in the world.  Regional Health Centres to address high-tech treatments, or unique services e.g. oncology, were developed in the 80's  and 'families' of hospitals refer patients for specialized or intensive treatment. Costs were beginning to be concerning in the 80's and 90's and cost savings, as well as increased payments, were instituted.  Some aspects became payable e.g. testing, disposable materials, prosthetics and appliances, private rooms, and there were cutbacks in others e.g. nursing staff reductions. Multi-doctor clinics and nurse-practitioners are becoming more common, to ease pressure on  medical facilities and deal with trivial complaints. Prescription by pharmacists is also being considered to ease the cost of doctor visits.

So where does this leave us all to-day? We're still in good shape.

If you become ill and call an ambulance, there is a paid public service that will have EMS personnel pick you up, treat you as necessary and transport you to an ER. You will be seen by a nurse and physician in order depending on the severity of your problem,  eg chest pains are seen at once and monitoring started. Should you require emergency surgery, that will be done within 24 hours either 'on site' or, if necessary, after transfer to a regional center by land or air ambulance. Other surgery will be done within 26 to 48 hours if required, non-essential procedures will be scheduled at anything from two weeks to three months. Such might involve screening, or evaluatory visits to specialists. Stays in hospital are covered at 'ward rates', private rooms are available at an extra daily cost. All meals and most in hospital treaments, drugs and materials are covered. You will be released when full body function is restored, provided there is safe care for you. Some people are placed in nursing facilities for recovery, at their own cost. Some visiting nurse activity can be arranged at low or no cost. What we only rarely find out in all this is the cost of such treatment. From time to time the plan auditors will send out reports of treatments received and costs involved for corroboration by patients. It is at that time Canadians can appreciate what a gift we have in our healthcare system. For whatever the cost, it could only be increased if there were somebody's 'profit margin'. A payment out of pocket, for a visit to a top-rate opthalmologist, say, is a real 'eye opener', when one gets a glimpse of what 'quality private care' costs.

When  somebody says most Americans are one disease away from bankruptcy,  that's not hard to believe.

I was hospitalized for 5 days due to an aneurism. It was my first real trip to 'the shop'. I signed in, under my own steam, after a day spent with the lab people, the anaesthiologist, heart eval. monitor, x ray, Cat Scan, etc. I was tagged and gowned and swabbed for C Diff. etc. I walked up the hall to the surgical suite, was checked, taken into a theatre, introduced to the 'gang'  present, greeted by my doctors - the surgeon and my GP, there to assist. I was sedated and awoke some 3 hours later in the ICU where I spent the next two full days as there was no room for me on the ward. I had been given a spinal analgesic,  had my abdomen opened and my aorta opened and patched with dacron, the incision had been stapled closed and dressed.

The spinal analgesia was miraculous until I displaced the shunt flopping around in bed. I had the 'trots' due to a preexisting condition that caused almost-constant use of the bedpan and, later, the commode. My nurses deserve a service medal for putting up with my foul output.

Hospital food is crap. I think it a total waste of time and money. Most of it, I would bet, goes into the garbage. That is an area of potential cost saving. Either make a deal with a mass-manufacturer for something like TV dinners, or leave it for the family to provide. Nobody is in hospital long enough to get sick, or well,  from the food. Nutrition should not be a problem, or a hospital department, unless someone is starving.

I noticed that the folks who had come in with me - for some equally-serious surgery - and who had been placed in a ward  (4 to 6 beds) were discharged a full day before I was from my 'private ' room. I found out later that my insurance didn't cover a private room. That was when I got the bill for $600.00. I had a few squawks about that private room, as, the first day I was there, they put somebody in the next room to die. They 'closed' my side of the bathroom door with a paper notice saying that I couldn't use it. Whatever he had required biohazard dress from the staff, one of whom stayed with him every night. She coughed constantly and I could hear her through my side of the common bathroom to which she kept her door open. He also seemed to be visited by members of the staff, with their  kids, well after visiting hours. I know tough times are often lightened by levity, but at one point I had to ask them to take their 'laffs' down the hall to the lounge rather than outside my door. That was close to midnight.  The moribund chap was still in residence when I left.

When I called the hospital business office about my tab, I was told I was getting a "one-time amnesty" on the bill and my insurance coverage was being changed to note 'no private coverage'.

On some floors there are no wards, in that case there is no charge for a private room. Likewise if you get 'bumped up'.  I have feeling, however, that,  if you have insurance coverage, your insurer gets billed. A little 'money-maker' for the hospital, like the parking lot.

 Since then,  it's been back to see the surgeon once, to have the staples out. To see my GP on a number of occasions related to the surgery. All at no cost to dear old retired me. Except for a medicare surcharge on my annual taxable income ($400) . Since I turned 65, my prescriptions cost me $6.88 each, in co-payments, covered by my  family medical insurance.

 Canadian medicare is great.

 Changes may be in the wind but I'd bet Canadians would give up their military and politicians before they'll give up 'socialized' medicine.

.

Frost is in the Air

The first cool evenings are telling us that summertime is all done. If it was down south the catfish would be stoppin' the jumping and the cotton would be high ( all 2.5 feet of it). But this is Ontario and the pot is the only thing that's high right now, as summer corn season's over, and the only things jumping are the 'pollyticians' trying to get themselves another 4 year sinecure on-the-way-to-a-pension.

The Ontario election is in full swing and the BIG issue, to distract us from the important stuff, is education. Not the soaring cost of college or university, mind you, but the minds and hearts of our 'little ones'. This time it's about extending the school system to accommodate the polyglot panalopy of multicultures that is Ontario. Not the watered-down, politically correct no-child-is-an-asshole and we are all together Public School System (although that is the currently touted 'option'), but the notion of letting parents, and the other ratepayers who support their views, pay to educate their kids in the Ontario curriculum plus the other things the 'politically correct' would like them to do on Saturdays. The PC candidate , whom I personally think rates up there with the non-juvenile assholes, wants to extend funding to what are now private schools. I'm OK with that, but that's only part of his agenda, and the rest of it spooks me.

What he has succeeded in doing, is whetting the appetites of those who think a one-size (theirs) fits-all solution is the best one. From the beginning, the protestant ascendancy in Ontario was forced to make allowances for Catholics - because the reverse was required in Quebec. They did it grudgingly. So grudgingly in fact, that full and equitable funding to Catholic schools took more than a century to arrive, and even then a significant amount of taxes (corporate taxes) were reserved, in the main, to the public system. The recent takeover of school funding taxation by the provincial government, as opposed to school boards, has leveled the playing field even more.

There are 4 'public' school systems in Ontario at present - English and French Catholic and Public Systems. These are funded from Government revenues - taxes. Taxes are paid by 'Francophone' and 'Anglophone' (a new Ontario wrinkle) Catholic , or other, taxpayers. Catholics may designate the 'education' portion of realty taxes to Catholic school support, or otherwise, ditto for French- speaking Catholics. Everybody else, by law, has to support the 'public systems. Non-Catholics can't support the Catholic systems. The proposed change would allow taxpayers to allocate their taxes to support the schools of their choice.

That's not how others see it. They cry out that "public money" will be taken from Peter to pay Paul - forgetting where that 'public' money comes from. They say that having kids learning other than the humanist values-based system of majority-rules morality will cause the fracture of society. That hasn't happened, even given more than a century of schoolyard banter and shenanigans, because WE didn't want it to happen. They seem to think that the 'public schools' somehow embody what Ontario is all about. They're good, but they're not all they're cracked up to be. There are some 'modern' values they teach and espouse that fly in the face of all that some people hold sacred. Put on a cost-effectiveness scale, it might be better to, scrap the public and go with one Catholic system as they've been raised to 'do more with less'. They teach the same curriculum, plus religion and they manage to accommodate cultural sensitivity and awareness - it is a universal Church, you know?

Meanwhile other, more important issues slide by the wayside. Healthcare in Ontario sucks. Even given the massive infusion of a per capita health tax waiting times are intolerable and medical 'service' is declining. The root problems have not been solved by giving doctors a raise.

Right now gasoline sells for 2005 prices, even given the fact that world oil hit $100 per barrel. The price of gas, I believe, is being held down so that it's not an election issue. After the election watch it soar, and with it the revenues of the newly-elected government.

The economy is booming. But the dollar hit par with the US to-day and other than water, Ontario has little to sell other than its manufactures. A readjustment is overdue, and it could be just around the corner. No Ontario government has been able to stop big business from cutting losses by cutting Ontario jobs - even given millions in public incentives, loans and investment.

The liberals, crying the poor mouth when elected, have found themselves on the nice end of the checkbook. Pay down the deficit? Eliminate some of the Hydro debt? Reduce the Health tax? Hell no! Build some community resources for immigrant groups - that's the ticket. A casino for the Canadians, but if you've just stepped into Canada from wherever, the Trillium fund will help you build a retirement home for your aged Granny. That Temple you want to put up can get a couple of million if there's a 'community centre'attached . Horse pellets! It's called pandering.

There was a minor scandal about this, now forgotten, where, for instance, a lawn bowling club asked for $40 thousand and were given a million and a half by a government cultural agency with more money to give away than horse sense. They weren't asked to return the money - just spend it on something worthwhile. Nuts!

So it looks like I'm not voting, or if I do, I'll be voting the local rep, or writing in a name. There is no party that clearly wants what I want. We'd need a new one - ' the Sensible Party' or the thoroughly Stupid one.