American Retired Seniors

David Bly, For The Calgary Herald, November 25, 2008

In Canada, when discussion turns to reforming the health-care system you often hear, “But we don’t want an American system.”  Since moving to the U. S. about two years ago, I have often heard, in discussions about health-care reform, “But we don’t want a Canadian system.”Among my acquaintances here in Nevada, understanding of Canadian health care is polarized. Some shudder in horror at socialized medicine and quickly change the subject to less frightening topics. Others have a more positive, if somewhat hazy, understanding, gleaned mostly from Michael Moore’s Sicko, a documentary that paints a rosy picture of health care in Canada but does not delve into such mundane details as waiting lists, doctor shortages and rising costs.

We often visit with an elderly couple who have a multitude of health problems. She’s a retired surgical nurse and the mere mention of Canadian health care elicits a fierce response.

“Socialized medicine!” she will hiss. “We don’t want any of that.”

It turns out her feelings are based on experiences with a veterans’ hospital run by the U. S. government. She has tales of horror about substandard care, cost-cutting to the point of rationing oxygen to patients, and uncaring administrators. Attempts to explain that things are not always like that in Canada are to no avail. She’s determined to stay as far away from “socialized medicine” as possible.

Yet, she and her husband depend on Medicare, basic medical insurance for seniors which is paid for by taxes, my Medicare tax is $600 annually. As a retired nurse, she also has insurance as part of her retirement benefits.

Medicare and supplemental insurance don’t cover everything. Once a year, they travel to Mexico to get their prescriptions filled for about a third of what it would cost north of the border. If they need treatment, they go to a hospital in Utah, 64 kilometres away. Her insurance company does not deal with the local hospital.

My wife works for a doctor who has a full-time employee who does nothing but deal with health insurance companies. He has contracts with about two dozen companies and deals with scores more on a case-by-case basis.

A man in his 80s came in with a persistent nosebleed, serious if it couldn’t be stopped. The office had to get special permission to treat him, as the doctor was “out of network,” according to his insurance company’s rules. At first the insurance company wanted to send him to Las Vegas, 150 kilometres away, but because the man couldn’t travel, the local doctor was grudgingly given permission to treat him.

That was not his only health-care worry: his wife had two heart attacks during the summer and, as a result, they are $200,000 in debt for the care components the company wouldn’t cover. It’s a debt they will never be able to discharge.

In another case, an elderly man was taken to the hospital for injuries sustained in a mi-nor accident. He developed complications and was in the hospital for 30 days before he died. Insurance covered 80 per

cent of the costs, but his widow was still left with bills totalling nearly $250,000. In her 70s, she has mortgaged her home to pay the medical bills.

A colleague of mine went to the emergency room after a gastro-intestinal infection left him severely dehydrated. He was treated and released. He has no insurance, so hospital personnel called him later to arrange payment. At first, they said the hospital cost (the doctor’s fees were extra) was about $400, then called back to say they had miscalculated and he actually owed $1,300.

We have what is considered a decent insurance plan through my employers, for which we pay nearly $3,000 a year. But even good policies come with co-pays and deductibles. My wife underwent a colonoscopy, which would normally be covered 100 per cent because it’s preventive, but when a few polyps were removed, it became surgery. We had to pay the $750 deductible, plus another $200 as our 20 per cent share of the cost.

A three-year-old girl in our town suffered a serious head injury in a home accident and has been undergoing treatment and therapy for several months. Friends of the family have conducted several fundraising events to help defray the huge costs not covered by the family’s insurance. That kind of fundraiser occurs on a regular basis here.

Medical bankruptcies happen all too frequently, and not just to the uninsured. Benefits run out and insurance companies are quick to find loopholes.

People with pre-existing conditions can’t get insurance, or it is horribly expensive. I know people with serious health problems who go untreated because they fear the cost of seeking medical care. The American Association of Retired Persons, which is pushing for massive health-care reforms, says most Americans are one serious illness away from financial disaster.

As one doctor said to me, “Health insurance is another name for organized crime. It’s not a health-care system, but a health-care jungle in the home of the brave and the land of the fee.”

But for the comfort of my conservative friends, at least it’s not socialized medicine.

David Bly, a former Calgary Herald journalist, is now editor and general manager of the Desert Valley Times in Mesquite, Nevada.

Filed under: Senior Health Care