Health Costs

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A dominant topic today is the opening of the Obamacare exchange, and many people are promoting how important health insurance is even to the young and healthy. Being Canadian, I’ve had health insurance from the day I was born (thanks to – and I’m not joking – Keifer Sutherland’s grandfather), but it’s not perfect in its providing of care.

Comparisons are constantly made between universal public health insurance and free market alternatives where we don’t all have to put our names sequentially on the same waiting list – those who want to pay more should get more! There are differences from province to province in how health care is funded and administered and these systems are always being evaluated and compared to each other with different pros and cons across the country. There are differences in what is covered under public health care and what comes out of the patient’s pocket, or a private “extended health” insurance provider. Yes, we too in Canada need to buy health insurance as well.

Over the course of less than three years I went on four ambulance rides. Ambulance rides are not publicly insured. I had bills mailed to me that totalled over $1500 for those four rides, and all but one had to come out of my pocket. I only had insurance for the last ride I took because either I was unemployed, underemployed, or new (as in three days in) to a job so benefits hadn’t yet kicked in.

Most of these times I would’ve preferred to not have an ambulance called, but I wasn’t in a position to voice that preference and since three of these four were in the workplace I doubt they would ever take that advice for next time. I would’ve saved myself some money and the precious resources of paramedics and hospital emergency rooms. I was not injured, and only needed a short time to recover back to normal functioning. I knew how the process would go but other people around me wouldn’t take the risk not to call. I didn’t consider myself to be in need of emergency care, but even if you’re in your 20s and apparently healthy, on your behalf people will err on the safe side and that may cost you.

I’m a young able-bodied Canadian and I’ve needed health insurance. All Americans need to get their asses covered if anything like this happens to them.

Prescription drug prices are more regulated in Canada, especially where I live as the big buzz industry of 10-12 years ago here was online pharmacies. They’re better contained and where I live you can apply for the province to pay for 100% of your prescription costs past a deductible based on your income two years prior. Last year, when I had 80% of my meds covered by private insurance through my employer at the time, my public deductible was only $100 as two years earlier I was entirely unemployed. I barely spent anything. This year (going April – March) it’s much higher since I did work in 2011, but low enough that I will reach the deductible in a few months. This is useful to me, because as I’ve changed jobs I won’t be insured again for six months and medication is expensive. This isn’t overmarketed superfluous medication either – most of it is for a lifelong condition, and the rest is to prevent the conditions of another life. It’s meant to prevent more of those ambulance rides, albeit at a price that equals one of those bills every three or four months.

I’ve seen multiple sides of this reality. My use of the healthcare system stands alone from what’s universally free and I take only what’s reasonably needed, if that. (My family doctor wants to put cold metal objects into my vagina more frequently than I let her.) I’ve paid in cash and I’ve paid insurance premiums, or had an employer pay insurance premiums on my behalf, and I know that neither health nore health care are things to be taken for granted. Get insurance; first thing’s first. Once you have insurance, demand that at least part of the coverage be just a given, be universal, be single payer, be public. I still have to pay or be insured for things because of cost-containing measures in public policy and the prevention of overuse/abuse. But even without that insurance I’ve always been able to see my doctor, be referred to a specialist, have diagnostic procedures done, and non-elective surgery performed without me or my parents paying a penny beyond parking spots (which are expensive enough) and I see that as a right in a society that with merely moderate sacrifice can afford it.

Not all health is created equal.

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