How lucky we Canadians are - From the Cluttered Desk with Keith Roulston

It was shocking enough to hear that Brian Thompson, CEO of UnitedHealthcare, was assassinated on a New York street last week. It was even more surprising/disturbing to read that thousands of commentators on the internet were cheering because they were so upset by the actions of healthcare companies in the U.S.

 

The controversy was stirred up after it was reported that the words “deny”, “defend”, “depose” were written on shell casings of the bullets left at the scene by the shooter; the words often used by healthcare companies in the U.S. to deny coverage to people who thought they had protection through health insurance.

 

For a Canadian, who has been covered by our universal health insurance since I was a young man, the mystery of U.S. health insurance coverage has been obvious.

 

Recently I saw an interview on television with Julia Louis-Dreyfus, one of the stars of the historic television situation comedy Seinfeld, in which she revealed to the interviewer that she had been “scared” when she had cancer, even though she had insurance coverage. I could identify, even though we have universal healthcare, because the prostate cancer I’m infected with is frightening even when there are no bills to pay. To be an American with fear of being sick and concern about how you are going to pay the enormous cost (we Canadians aren’t even aware of what the costs are) is too much to contemplate.

 

Given this, it’s hard to support some provincial governments, like ours in Ontario, that seem ready to accept, if not encourage, private participation in our healthcare system. Private clinics are being allowed in some fields with the supposition that they can provide service that a scarcity of doctors and nurses, which has been in the news a lot lately, can’t. 

 

There has long been conflict between federal governments, dating back to when Prime Minister Lester Pearson introduced federal health coverage, and provincial governments like Ontario’s, that resisted. It’s understandable when you realize that the cost of medical coverage has just kept increasing since Pearson introduced the system.  A recent Ontario budget totalled $214.5 billion for all programs, including $85 billion in health spending.

 

When I took over as editor of the Clinton News-Record in 1970, we hired a financial advisor who had previously worked for a health care co-operative which had provided medical insurance coverage for local residents. With government intervention, that co-op was put out of business.

 

Doctors back then were often unhappy with the system which enacted controls on how much they could charge for various services. It took years for them to realize that there were cost savings with the new system because they didn’t have to chase patients to get them to pay, simply sending their claims to the provincial government for payment.

 

Installing the system was messy, but I’m sure few of us today would want to get rid of it, even if the thought is tempting to some Premiers who are well off enough that they’d never fear the cost of medical bills themselves. 

 

Still, the U.S. system is attractive to some doctors. A few years ago, I needed replacement of a heart valve, the long-term effect of a case of rheumatic fever when I was a child. My surgery was postponed for months by my surgeon, the top of his class in London, because, I found out later, he was taking time off to visit officials at a California hospital. Eventually, he moved (no doubt at a considerable increase in his already lucrative salary) and my case was passed on to another surgeon, who moved me to the top of his priority list because I needed quick treatment. I have been so grateful to him ever since.

 

But though he moved to California just before the COVID-19 pandemic shut down the medical system, my original surgeon was following many in moving to the U.S. For many who work in the system, doctors, nurses and medical officials, the American system is rewarding. Brian Thompson, the medical insurance company CEO who was killed in New York, made a salary of $10 million. That’s what matters, not that medical coverage is universal in other countries from Canada and Great Britain to most European democracies. 

 

While people working within the system that provides medical service to Americans are rewarded, people who depend on these professionals don’t fare as well. Some don’t have any insurance coverage and face huge bills if they have something that requires them to go to hospital. Others have insurance to give them some help, but, as the alleged motivation behind Thompson’s death reveals, insurance companies use all sorts of excuses to reduce their costs.

 

As a Canadian who has had a lifetime of paying government health insurance, I’m so glad, as a senior citizen, that we have government health coverage!