I Found Canadian Healthcare!

Finally.

After waiting sixty days for my Personal Health Number to arrive (and be valid), then sitting on the BC family physician waitlist for ninety days (and counting), then trying to get into a walk-in clinic (you have to call in for an appointment these days) and failing, I finally, finally, saw a doctor.

Granted, I only saw them virtually. I’m still on the GP waitlist, and I’ve yet to set foot inside a walk-in clinic. But I spoke with a real, BC-licensed doctor, got a real prescription, and had it filled at a local pharmacy.

Thank goodness.

Don’t get me wrong, I’m in general good health (post-Covid). I’ve managed to dodge the family diabetes so far (touch wood), I don’t have any mobility issues, and my asthma has actually gotten better since moving to BC (cleaner air than the States). But I’ve had an issue for the last few months that I wanted to get checked out, because it didn’t seem to be getting better on its own.

Luckily, one of my friends at work (that also lives in BC), recommended I checkout Maple, a tele-health company operating in Canada. I was skeptical, but out of options, so I signed up, and was pleasantly surprised to find out they had BC-licensed doctors, which meant my consultation (their word) would be covered by my provincial health insurance.

Not everything is covered, mind you. They have dermatologists and other specialists available, but those are not covered by provincial health insurance (yet), so they charge for those. And you have to select BC GP (not the normal GP button!) in order to get covered care.

Which is only available certain times of day, of course. And while their estimated wait time is an hour, I spent close to two hours keeping tabs on my laptop’s screen, waiting for a GP to pop in.

But they did, eventually, show up! And one look at the pictures I uploaded (ahead of time, while waiting for the GP) was all they needed to diagnose exactly what was wrong, soothe my worries about it being serious, and issue a prescription to fix it.

I was expecting a video call, but it was just chat at first (I guess that’s simpler to implement, and is why they have you upload pictures). They surprised me by calling me at the end of the text chat, just to see if I had any other questions about the diagnosis or the medicine.

They surprised me again by being…well…very Canadian! That is, professional but not rushed, willing to chat a bit and earnestly interested in my well-being. I know: “They’re a doctor, they’re all interested in your well-being,” but that has not been my experience in the States. So it was nice to once again have the experience of encountering not bureaucracy, but people, in this Canadian system.

After the call, Maple sent my Rx direct to the pharmacy I chose, after a few button clicks online. And that was that!

I know this wasn’t a life-threatening condition, but it was such a relief to finally get access to healthcare after being in limbo for so long. To know that it can be there when I need it, and free.

Hope wherever you are, that you can get the help you need, when you need it, whatever form of help that might be.

Canadian Covid

Haven’t posted in the last two weeks, because I finally caught Covid-19 (or it finally caught up with me).

Went to a small D&D session on the 10th. There were just five of us, and we’d all been triple vaccinated (one person had already gotten their second booster, in fact), and we all were homebodies who masked up in public.

And yet we all got sick.

I seem to have gotten hit the earliest and the hardest, which is good because two of the other folks have other medical issues that would make anything more than a mild case potentially life-threatening. We all seem to be pulling through, however, which is about as good as we could hope for.

I learned a few more things about living in Canada, along the way, that I’d like to share:

No Testing

Trying to be a good citizen, I went to the BC CDC site to see about getting an official test. I know that case counts are inaccurate because not as many folks are getting tested in a way that’s reported back to the government, so I wanted to have my infection, at least (if it was Covid), count.

Unfortunately, the official advice for someone like me — triple vaccinated, relatively mild symptoms — is not to get tested.

I didn’t have any home tests, either, so a friend volunteered to look around at local pharmacies and see if any of them would deliver to me. The answer was a resounding: Nope.

So, technically, I don’t know for certain that I had Covid-19. Everyone at the gathering that tested (using a home rapid test) did come back positive, which is fairly compelling. But I wasn’t able to get tested.

No Contact

The BC CDC does recommend self-isolating, even if you don’t get tested. They say five days is all you need, but I’ve also heard ten days, so I decided to wait two weeks, to be safe. That meant not leaving the apartment to check my mail, etc (which meant I had a package stolen from the mailroom downstairs, but that’s a different story). And it meant I needed to find another way to get groceries.

Not just groceries. I was totally unprepared for being sick, it turned out. I didn’t have any Nyquil, no Advil or Tylenol, no cough drops, no extra tissues, nothing. I had some soup, but not nearly enough for two weeks. So I needed food and sick supplies.

Thankfully, there’s a couple of Save On Foods near me, and their delivery program is simply fantastic. Everything I worried about turned out to be easy. I picked out my groceries, set a delivery time, left instructions for the callbox, and that was it. No texting me in the middle of me trying to get some sleep to ask if a substitution was okay (they had me indicate in advance if subs were okay or not, and I said “no” to most of them). No multiple notices about shopping starting, stopping, checking out, etc. Just an emailed final receipt and a single phone call to let me know they were ten minutes out.

My one big worry, though, was the callbox. I’ve had many a Skip delivery go awry because they can’t figure out how to use the callbox so I can buzz them in. If the grocery delivery had the same issue, I wasn’t sure what I’d do. Even if I could physically make it downstairs, how many people would I infect along the way?

Turns out I needn’t have worried. The delivery driver — who I gather works directly for Save-On — had no problem using the callbox, and brought everything up to the apartment door using a little delivery cart. No contact, no issues, just the food and medical supplies I needed.

No Doctors

I’ve mentioned this before, but I’ll say it again, because it was the scariest part of being sick: What if I needed to see a doctor? How would I get in to a clinic in time to be of use? If I had to call 911, would anyone answer? Would there be anywhere in the hospital for me to go?

Thankfully it didn’t come to that. Though I monitored by Blood Oxygen levels using my Apple Watch (for however accurate it is), it never fell below 90%, so despite being miserable for most of a week and a lingering cough, I’ve been ok.

Going Forward

So one of the first things I did this weekend — my first time outside the apartment since the 10th — is go pick up a home testing kit.

I was already masking up indoors, which I’m going to continue doing. And I’m going to start testing on a regular basis, before doing things like meeting friends for dinner or getting a haircut (for which I’m also masked).

I know I was lucky enough to get a mild case, but having Covid was miserable. I don’t want to catch it again. I don’t want to give it to anyone else. And I hope wherever you are, that you’re staying as safe as possible.

Which Country Has the World’s Best Health Care? by Ezekiel J Emanuel

Today, the US healthcare system occupies a place very like US beer did in the 1990s.

See back then, US beer was a joke to liberals, or anyone that took beer seriously, and a point of patriotic pride to conservatives.

These days, after decades of shifting regulations that allowed the market for craft beer to first find a foothold, then blossom, US craft beer is world-renowned. Numerous pubs in other countries proclaim they serve “American-style craft beer.” People across the political spectrum can take pride in their local brewers, no snobbery or jingoism required.

Our healthcare system has not experienced anything close to that kind of renaissance. Conservatives refuse to countenance any critique of the system, while liberals use it as a tired punching bag. We’re warned of the dangers of “socialist medicine,” all the while my mother-in-law is constantly harassed about a $4,000 bill she doesn’t owe (the hospital filed it wrong with her insurance), doctors and nurses are overworked, and millions go without any sort of insurance.

And, frankly, Medicare for All sounds great, but it scares the bejeezus out of anyone to the right of Bernie Sanders. Not to mention it’s sort of vague on details, and seems to require a rather large leap to get from here to there.

So I was primed for a retread of the old arguments in Which Country Has the World’s Best Healthcare?. US healthcare is terrible, Canada’s is great, etc etc.

Thankfully, that’s not what I got at all. Instead, I found the missing manual, a way to evaluate different healthcare systems around the globe. Along with a proper sense of the history and workings of eleven of them.

Emanuel describes a set of axes along which to measure a healthcare system. Things like patient wait times, or costs at the point of service, or choice of doctors. Then he proceeds to examine each country’s system in turn, looking at the things it does well, the challenges it faces, and — most importantly — how and why it does those things well or badly.

True, the US performs terribly on basically every axis. That’s not news. What is news is that multiple countries manage to provide better coverage, better care, and cheaper care, without giving up private practices, or even — in some cases — letting go of private insurance!

Reading this, I felt both relieved and angry.

Relieved, because with so many different systems out there, no one’s got a monopoly on the “right” way to do things.

Angry, because for so long the debate in the US has been framed as single payer or status quo. When the truth is that we can do a lot to improve our system without letting go of the basic free market nature of it.

How much further would we liberals have gotten, if we’d argued for a regulation of drug prices, instead of single-payer? Or insisted that insurance coverage for children be provided for free, as part of any policy, like it is in other countries with well-regulated markets?

We don’t have to have the government take over as the single payer for everyone. We don’t need to radically overhaul the system. We need to properly regulate it, to get the outcomes we want: patients being able to choose their doctor, use their insurance to help pay for their care, and not go broke obtaining the prescriptions they need.

Framed as the proper regulation of a free market, what could the conservative response have been? I suppose they could argue that Greed is Good, and everyone that has to choose between paying the rent and buying their blood pressure meds deserves it, so the CEO of some corp can enjoy a multi-million dollar bonus.

But that doesn’t have quite the same ring as “death panels,” does it?

So ultimately, I’m grateful that Emanuel and his team chose to write this book, and publish it now. It’s high time we brought a more nuanced, useful debate, to the argument over healthcare.