Scouting the Unexplored Territory Outside Medicare
By Janet Walker
Some time ago, I became
interested in those Canadians who made the decision to seek medically necessary health care outside of Medicare and/or Canada. Sixty to eighty thousand people a
year do this. Who are they and how can their information and experience inform the rest of us? From our point of view, these people are like scouts who have
traveled to where most Canadians have not been – the unexplored territory outside Medicare.
While they are ordinary Canadians in some sense, they are also heroic figures. Against the background of horror stories about private medical care,
these people took the risks to go and find the health care that they needed which an indifferent and unresponsive system failed to provide. Their stories need
to be told.
I am that storyteller. The story could be called "I Can't Wait: What Ordinary Canadians are Doing to get Health Care". I am conducting interviews and asking questions such as:
The early results of my survey and interviews are both surprising and compelling. For example, these health seekers have used a variety of different countries.
But when asked to compare their health care experiences in Canada and their health care experiences in another country, they consistently used the same few
phrases: "There is no comparison; It was like another planet; They treat you like a person". Over and over I heard these words. What they meant was that
they experienced impressively clean and pleasant facilities, they felt at ease because they were so consistently and well informed; and that all interactions
were marked by kindness and respect. Interestingly enough, one woman from British Columbia needed both hips replaced. While she was on the waiting list here
in Canada, she had one hip done in Bellingham. After a successful procedure and recovery, she returned to Canada and within months had the second hip done
here. Part of the description of her Canadian experience went like this:
- Why did you decide to go outside Medicare?
- How did you know where to go?
- What did you have done?
- How much did it cost?
- Was it worth it?
- Could you afford it?
- What advice do you have for others who are waiting and for Canadian health care planners?
"I went up to the hospital and there was a group of six of us all going in for hips or knees. And they showed us a video. I think there were three employees
involved in that; one to show the video, one to talk to us and one to show us how to get on and off the bed. And when I went in on the morning of my surgery,
I was taken to a room and I was left. Then another woman came in and pushed my bed down the hall where the beds were lined up along the corridor. No one talks
to you. The anesthetist did come. But I never talked to the surgeon. He never came near me. They wheeled me into the operating room and gave me the injection
in the spine. There were nurses running around and a lot going on, but nobody said a word, not a word. Nobody talks to you. In the other place, somebody was
always there. In Bellingham, you are taken care of. Here, you are left". (Mimi)
Common wisdom tells us that only rich people can pay for private health care. In fact, none of my respondents so far describe themselves as rich. The
great majority describe themselves as "ordinary" meaning that they have their RRSPs, their pension plans and some assets that they are continuing to gather
over their working life. They often put it this way "It was either a new car or a new hip. It was an easy choice". But some people are of very modest
means. Shelley, for example, is a single mother of two small children. When her GP told her that the toddler's eyesight was at risk and needed further
assessment and possible treatment, Shelley was not able to access that in or around her Canadian city. Not willing to take a chance, she chose to pay
privately in Detroit. Thankfully, the assessment showed that the child could safely wait for further assessment and possible treatment.
These people are "health care scouts". They have been to the land outside Medicare. They can tell us what it is like. We need to utilize them and their
information as a vehicle for producing the kind of change in the Canadian health care system which the political process has up to this point has found impossible.
I need to hear from many more people who have chosen to find and pay for medically necessary health care. I want to tell their stories. If you or
someone you know has such a story and are willing to share for the purposes of this study and for publication, I would like to hear from you.
Toll Free Telephone 1-866-587-story (8679)
Cell: (604) 862-0922
Copyright: Janet Walker
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