As I’ve mentioned in some of my recent posts, I’m recovering from a serious illness. Now, I’m not a person who heads for the doc at the slightest discomfort. In fact, I don’t have a family doctor precisely because I rarely will go to one.
The last time I had contact with the medical system was about seven years ago, I had a swollen lymph node back then, easily dealt with. This time was a serious infection that required being hospitalized.
I hear lots of complaining and even horror stories about our medical system. Sometimes I’ve wondered if some of those stories come from unrealistic expectations, lack of communication with health providers or if the problems are indeed real. Like most people, we find out when we experience the system.
Some Background on the System
Canada is a single payer system, or universal health care. Most medical care for all is paid through taxes. While the system is federal, each province administers the system in their own manner in compliance with federal and provincial laws.
When OHIP (Ontario Hospital Insurance Program) was first introduced a credit card size red and white card was issued to every qualified Ontario resident to prove we were insured. When we went for medical care, we presented the card and OHIP was billed. The card didn’t have an expiry date.
Back in the late nineties the government decided to go to a new system where the cards carried a photo of the resident and had to be renewed every three years. There is no charge for the card, just the nuisance of having to renew them.
I Held Onto My Red & White Card
I had received letters asking me to go in and get the new card. It told me what ID was required and one of them even told me if I didn’t get the new card, they might cancel my red and white card.
I put the letters aside. Since I didn’t have a current need for medical care and I had other things to do, the letters just never got onto my ‘must do now’ list. They were set aside for my ‘should get around to it’ list. You know, like when I actually need it.
The Need Arrived and I Try to Get the New Card
In mid-May I started experiencing an illness. Me, being me, I just kept on doing what I normally do and considered any sick time to be a nuisance that would pass. It did however nudge me into thinking about that health card change and I visited Service Ontario to get it looked after.
I quickly learned that my card had in fact been cancelled back in April 2016. I also couldn’t get the new card without having a birth certificate for ID. I would have to go home and place an order for my birth certificate online and it would cost me to get it. So, off I went, knowing I didn’t have health care coverage.
Getting Sicker and No Health Coverage
So, I placed the order for the certificate and would have to wait for it to be processed. The message on the order informed me it may take longer because some info like my parents birth dates were not supplied by me.
I thought I might actually be getting over what I thought was a bug so I decided I’d just wait for the birth certificate to arrive and then maybe see if I could get checked out to be sure.
I looked around online to try to get an idea of what would happen if I needed medical care and had no coverage. I found a few reports of people losing their coverage for not getting the new card but nothing about the outcome.
Early in June, I started getting worse. I was having considerable difficulty keeping food and drink down. I anxiously watched my mail. I reached a point where I was vomiting every few minutes. There was no choice now, I needed to get to the hospital.
Off to the Hospital I Go
I called 911 and had the ambulance take me to the hospital as I not only wasn’t really fit to drive but had I had someone take me to the hospital, I wasn’t sure I could actually get into emergency when I got there. The ambulance took me directly in.
During the ambulance ride, I was asked if I had my OHIP card. I replied yes, but, it wasn’t valid and explained what had happened. I was surprised when the response was, ‘not to worry, it can be dealt with later’. I was too sick at that point to ask how or when or even to care.
My expectation was that I’d receive bills for the care received and would have to then go to OHIP to argue that they should cover them as it was them who had cancelled the card without further notice. I’d deal with that when I had the strength.
Taken Into Emergency
We arrive at emerg and I hear the paramedic advise the desk that the my card is invalid. Nothing is said, I’m quickly taken into a treatment area and before long a doctor appears to examine me. I’m sent over for a catscan and intravenous is setup to hydrate me and to try to settle the vomiting.
After some time the emergency doctor tells me there is a large cyst like mass in my stomach cavity and he’s called in a surgeon to decide on treatment. The mass is causing pressure on my stomach and causing the vomiting.
The surgeon advises me that there is a partially embedded stone in the wall of my kidney. She’s asked a few doctors to have a look at the images from the catscan and they are not fully in agreement about the role of the kidney stone but they do agree, the mass is infection and it needs to be drained.
Arrangements are made for a drain to be inserted in my stomach the next morning as it was getting late in the day. I spent the night in emerg because no beds were available upstairs. I learned the next day that there was eleven people in emerg awaiting beds and twelve over capacity upstairs.
I’m Admitted for Care
After the drain was inserted, I was taken upstairs to a bed that had become available. A person from admissions appeared briefly in my room and asked to see my health card because the number was showing as invalid. I confirmed to her that was correct and told her what had happened.
Nothing further was said. Treatment continued, medications were administered. I was transported to another hospital for a procedure and returned to the first hospital. The doctor saw me on a regular basis. The care was excellent, I couldn’t complain about how I was treated. The communication with the staff was good and I knew what was going every step of the way.
Discharged to Home
After ten days, I was discharged. Because I didn’t have a primary care physician, the surgeon advised me she would stay involved in order to make sure that followups were done with herself, the urologist and anyone else I needed to see.
Home care was arranged to look after the drain that was still draining my stomach cavity. Nurses came to the house at first daily and then every few days until the drain was removed.
I had to return to the hospital for outpatient appointments for another catscan, xrays and to see both the urologist and a lung specialist when fluid was found on my lung that needed draining.
At no time was I denied any care even though my card wasn’t valid.
Getting the OHIP Card Sorted Out
It was almost two weeks after I was home before I was strong enough to even try a trip into the local Service Ontario office to take the birth certificate in to get my OHIP card back in place.
When I mentioned to the lady on the counter that I had just been hospitalized for ten days without benefit of a card. Her response was “Oh, we’ll cover that. You are a valid resident of Ontario.”
She explained to me that once my card was reactivated, which it would be as soon as she entered everything, I should call the hospital and find out if they have done any billing. If not, I was to provide them with the updated card info and they could then bill OHIP.
I asked what would happen if they have billed me. She told me that I should take the bill that arrives and take it to a ‘full service’ Service Ontario which was about 20 miles away and they would sort it out for me.
So, just like that, my coverage was fixed and the bills for the care I received, while not actually covered, was covered. So, I’m not inclined to complain about the care I’ve received. When there was an urgency for me to receive a test, it was done and when less urgent, the time between the doctor wanting it and me receiving it was not very long.
Well, there is two bills I had to pay, $45 for the ambulance trip to the hospital and $80 for the antibiotics I had to take when I left the hospital. All the meds I received during the hospital stay were billed to OHIP.
I’m thankful for our system. It’s not perfect but for the most part, it works.
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Interesting! Thansk for sharing your experience. I recently got citizenship so I've been curious about this.
congratulations on becoming a Canadian citizen. There is going to be a citizenship ceremony take place in my community on Friday. Looking forward to observing it.
That is a super story you are sharing with us! And I think the system you have I really like. I'm from the Netherlands and we introduced a state health system as well years ago. Although we have private companies handling the insurance side of things. They offer basic packages that must include everything the state defines as mandatory. On top of that they sell extras. I think we need a system like you have in Canada to be honest, since our system is overly complex. BUT, the good thing is, everybody is insured in my country as well. As long as one is a country citizen, healthcare will be given. I dont have that much experience with the system, but when I use it, I never had any issues. On the extras I sometimes have to debate with the insurance companies, but that has nothing to do with real medical care and payment for it, since that is part of the basic insurance. Extras are anything like, teeth bleaching, or using taxi service across the country to some remote hospital. Although I like states without to many rules, I love the socialistic approach to healthcare; One for All, all for One (oww, I love those movies as well, The Three Musketeers).
Wow. That is pretty much how healthcare should work. Aside from the waiting for a bed...but that happens even here in the US. We have "virtual beds" which is just a bed in the hallway where the really sick people wait while another bed is made available. The I tell you...stories like this make me want to move to Canada. My wife is Canadian and she'll jump at the chance to go back. Also, I'm in Florida...and I hate the heat.
I wasn't laying in a hallway waiting. They did move me from an active treatment bay to another room that had been setup for the overflow and it wasn't too bad trying to sleep.
The system isn't perfect but I appreciate that it is there.
What's the elective surgeries like?
Cosmetic surgery would be an example of an elective surgery. It's not medically necessary.
I've heard that elective surgery are what's hard to get...but if it's elective and not life threatening...I don't see the big deal in waiting for a while.
I'm telling you, if I ever make it big with STEEMIT...I'm leaving the USA for Canada :-)
Very interesting, appreciate your sharing of this experience.
Very Interesting. Thank you for sharing @shadowspub.
I am glad you are recovering and good to have you back around the hallways of SteemIt.
Thank you @whatsup, good to be back in action again.
I'm so happy they sorted that out for you. And thank you so much for sharing this experience with us.
While I'd never wish for an illness and a ten day hospital stay, I'm jealous of your medical care. If my wife and I got sick with what you just had, it would completely ruin us financially. We're both self-employed at the moment, which means uninsured. Actually it means we're fined over $1000 a year for the fact that we can't afford health insurance.
When I was working for a corporation, we paid close to $30,000 for care we never used, because the deductibles were too high, and any visit to a doctor's office would run at least $400.
Recently we had to pay an ambulance to move my grandfather from one nursing home to another. The cost? $5000.
We hear a lot of propaganda about how backwards and incapable the Canadian health care system is, but clearly it's all from a bloated insurance industry that doesn't want to see their cash-cow taken away.
I've always found it astounding how much our neighbours to the south pay for medical insurance and then pay on top of that out of pocket. It is no wonder that insurance industry fights hard against a single payer system and spreads propaganda about the Canadian system. It is far from perfect but the costs are way less than to the south.
That $30k for insurance would be a person's annual wage up here.. low income but still a wage. As a self-employed person, what would insurance run you a year?
It's extremely complex, as the companies have endless plans to sell. Then there's the state-welfare type plans, which vary state by state. When my niece was working for a farm and making next to nothing, she qualified for our state's most generous plan. She was paying around $200/month but could actually get checkups and medication with low co-pays. Then she got a job at Starbucks and was required to get their health plan, which costs her more and has high deductibles, so she goes to the doctor far less.
That $30k was the total I spent over eight years, so about $3750/year, with my employer paying a lot more than that. When I left that job I was sent an offer to stay on the health plan for $1600/month if I wanted to pay it myself.
That was the private plan with the $400 deductible, and it only covered 80% of expenses after that. A ten day hospital stay is around $20,000, and the cost of, say, kidney stone removal could easily add another $30,000.
Without insurance, I'd be out $50,000 easily for what you just had. With my old insurer's plan I'd still owe $10,400.
The worst thing about "Obamacare" was that it required employers to offer insurance to all full-time employees. Sounds fair, right? Well, as soon as it went through, my company got rid of all full time positions except for managers. And if we scheduled a part-timer to work over 20 hours a week, we'd be fired.
I was worried about what the costs would be had OHIP not covered them and could easily have envisioned $50k or more. While I was in hospital there was also the 3 or 4 catscans i had and the transfer to the other hospital for a procedure and back again that could have been billed separately.
Since I left hospital there has been appointments with a lung specialist and a urologist, 3 xrays, 2 more catscans (another scheduled this week) and fluid drained off my lung.
The cost you quoted for the removal of a kidney stone was of interest. One thing that was discovered in the course of all this is that I have a kidney stone partially embedded in my kidney that has been there for some time without me knowing about it.
It has rendered the kidney pretty much without function and later this fall the kidney will be removed. So, that will be more time in hospital.
Seems that Obamacare needed to address some of the loopholes that had an unintended effect. From up here, it all seemed pretty complicated to understand but I got the sense that it was being seen as a first step towards a universal system which would sure get the insurance industry riled up pretty good.
Sorry to hear about all those complications. It sounds like you're having a rough year! But I'm so glad you have access to the care you need.
It's hard not to despair of ever seeing a single-payer system here in the US. The current system generates so much money for corrupt interests, all of which have too much lobbying power. So it's hard to see them letting that go. Billing and Insurance Related expenses are half a trillion dollars a year. That's political-assassination type money.
It has been a rough 2-3 months with more coming BUT the good news is, it is something I should heal from and carry on. Considering that I had seven years of zero medical needs, I'm pretty grateful it's not worse.
I tend to be aware of what I eat and try to stay away from foods that are processed, contain a lot of sugar and even flour. I think a lot of our health is driven by what we consume. I know I should exercise more, but, I really hate that. Although I am working on doing more walking around and doing things to increase my steps daily.
I have noticed more discussion by my American acquaintances about a single payer system. It seems as though the efforts to repeal Obamacare is generating that discussion. With your current government, I suspect you are correct, there is no hope of moving to a single-payer system. It may become a future issue though.
There are efforts by mainly conservative types to bring more private, profit driven health care into Canada. I suspect a lot of that is the US insurance industry looking for new markets. I will support governments that stand against that effort. I believe there are improvements that can be made to the system but not by privatizing and giving the insurance industry a foothold.
Stay healthy and keep fighting, for sure!
Private health care is like an infection and once it gets in it can spread out of control.
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