Universal Health Care and Mental Health Care

By Marvin  Ross

Canadians will be going to the polls in about a month and one of the top issues for every election be it federal or provincial is the state of health care. And the presidential election in the US for later next year has already begun with numerous Democrats fighting for the right to try to take down the Trumpster. Universal health care is another issue that is high on the list of US voters.

Every country in the world with an advanced economy provides some form of universal coverage for its citizens except for the US. Why, I will never really understand but I do hear comments that our system is inefficient, has long wait times, and could benefit from a dose of privatization. An American I know on Facebook recently posted that their insurance premiums come to $730 a month but they have not received any payments from the insurance company despite paying out about $1500 for medical treatment since the beginning of the year.

In this country, right wing politicians and many doctors are trying to bring in some degree of privatization to improve our efficiency – or so they claim. Recently, Dr Bob Bell, an orthopaedic surgeon, former heard of the University Health Network in Toronto and former Deputy Minister of Health in Ontario, discussed his research on the Canadian system versus others with some elements of privatization.

His findings are that there is:

“much evidence to support the argument that private insurance exacerbates problems rather than solves them. Healthcare becomes more expensive, and care for public patients deteriorates when private care is introduced.”

You can read his reasons for that conclusion in the link above where he does state that the British system performs better in mental health than Canada. That is something that I will pursue in the near future.

The US, in 1965, passed the Institutes for Mental Disease  exclusion (IMD) which forbids Medicaid funding for institutes with more than 16 beds that provide residential mental health care. This was an attempt to leave mental health funding to the states but it resulted in many of those facilities shutting down. Consequently, almost half those with mental illnesses in 2013 received no treatment. In contrast, while treatment for the mentally ill in Canada could be  better than it is, we do have free standing hospitals dedicated to treating patients with mental illness and psychiatric wards within general hospitals. Treatment is covered the same as it is for any other disease and social assistance covers medication.

Two years ago, I had what I call a near death experience and wrote about the efficiency of the Canadian system that saved my life in the Huffington Post. This is what I wrote at the time:

For the past number of years, right-wing Americans have continually criticized the Canadian universal health-care system. Sometimes, they are joined by Canadians of similar political leanings who want to see privatization. A couple of years ago, Dr. Danielle Martin, a physician at Women’s College Hospital in Toronto, made a big splash when she appeared before a Congressional committee defending us and, in the process, poking holes in the States’ lack of universality and emphasis on profits. That video has been promoted by U.S. Senator Bernie Sanders

The other week, Canada’s system very efficiently saved my life so that I was released from hospital after only about five days. My experiences should convince skeptics, but first this — for years, I’ve been telling this story to doubting Yanks. It was probably the 1980s when my mother, who suffered from dementia, broke her leg in her nursing home. She was old, she was poor and she was demented, but she was taken by ambulance to one of the major University of Toronto teaching hospitals. The U of T ranks in the top 10 medical schools in the world, and my mother was operated on within 12 hours by the chief of orthopaedic surgery.

I was impressed. But then, to my surprise, the surgeon apologized to me for the 12-hour delay. He said they had major traumas come in that night, and my mother was made to wait under sedation, resting without pain.

Now for my own recent trauma. I had a routine colonoscopy, of which I’ve had many before (but this will be my last one). I had some unusual pain during the procedure, likely due to the air they inject to open up the colon for exploration. That evening I wasn’t feeling well and by morning I was sick and could barely walk. My wife called 911 and within about five minutes, the fire department was standing over me, quickly followed by the paramedics. It pays to live near a fire station.

I had no blood pressure so they got me into the ambulance and tried to find a vein to give me saline but they were unable to. I could hear them talking to the hospital and we quickly took off with lights and sirens. My arrival was like a TV medical show as I was raced into a trauma bay that was waiting for me and fully staffed with doctors and nurses jumping in to do their bit.

I won’t go into the gory details, but at one point I heard a doctor ask if I had family nearby and my wife was told that I was critical. By early evening, I was stable enough to not have to go to intensive care as planned, but to one level down called the medical step down unit. By the next afternoon, I was able to be moved to a regular ward. What exactly happened, no one is sure, but something from the colonoscopy (a common and usually safe procedure) triggered something that put me into organ failure and showed up on the CAT scan as a totally involved inflamed colon.

I was discharged five days later. The competence, dedication and compassion of all the staff amazed me. So, what did it cost? I’ve heard Americans say that nothing is free, so why should free health care be free? It isn’t and it’s not. I will get a bill for the ambulance for $45 — it’s something I’d object to, but I do know that if I were on social assistance, it would be waved. The flat screen TV with cable in the step-down unit was part of the service — no charge. I did have to pay for a personal TV in the other unit and picked the $15-per-day premium package so I could watch the Blue Jays continue to disappoint. My compensation was free WiFi.

My taxes and the taxes of my fellow citizens paid for all else. The 911 line, fire department and probably the paramedics were part of my municipal taxes. All else came out of the Ontario government with infusions from the Canadian government.

But here is another key difference that matters. Our hospitals, unlike in the U.S., are not private corporations intent on making a profit, but are not-for-profit institutions. They are lucky to break even, let alone make money. Here is a question for Americans to mull over: why should a corporation try to make a profit on someone’s misery and misfortune? Making a profit and money is a powerful motivator, but there are some things that should be done for the good of all in society.

The hospital that I was at is part of the Sisters of St. Joseph movement, so their reward is that of serving others, which they consider an honour. However, none of this means that our system and this hospital are not rife with wait times, inefficiencies and overpaid bloated bureaucracies. The health-care system is run by bureaucrats and politicians so the stupid is expected. But at least they are not trying to make a buck on my illness. That can and does compromise service.

In another place I actually was very critical of this hospital for its bureaucrats and their big bucks. The CEO makes about $750,000 a year which, frankly, is way too much. He could reduce his salary significantly so they could hire a few more of the competent nurses I had. They were willing to get down into the muck and bodily fluids which would have ruined the CEO’s fancy suits. He would still make a damn good salary.

If I may, some advice to the United States — Kiefer Sutherland. Let him restructure your health system. Besides saving the American Empire so many times on 24 and now as the Designated Survivor, his maternal grandfather was socialist Tommy Douglas who brought us universal health care. In 2004, almost 18 years after his death, he was voted the Greatest Canadian.

Kiefer, along with his mother, is an active supporter of universal health care, as he pointed out in this message from a few years ago. You may also be interested in a very passionate presentation (Part One) his mother gave on the struggle for and the origins of the Canadian health system. I’m sure, as a tribute to his grandfather, he would be happy to help.

 

5 thoughts on “Universal Health Care and Mental Health Care

  1. You mentioned that we have psychiatric services in our general hospitals. My son was involuntarily hospitalized to a general hospital in 2008 and was just getting better when they wanted to discharge him. I knew that he would quickly decompensate and I would have to call emergency services again and maybe this time he would not go to the same hospital. So I fought to get him to remain until he was well. I think that we need to accept the fact that for the mentally ill there needs to be a system in place that more adequately deals with serious mental illness.

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  2. I agree. Another problem regarding interfering with the needed length of stay is the untimely activities of rights advisors and the lawyers who get in on the act of getting a patient out of hospital before they are stabilized. These lawyer (parasites), allow far too many patients to discharge themselves before they are well enough to cope The lawyers and their malignant influence is plain to see on every main street in Ontario. I have actually had lawyers on review boards acknowledge that they know that the person needs help but they then say that they are only doing their job !

    Until society recognizes that patients who suffer from psychotic illnesses which deprive them of true insight.. need hospital care and protection these deplorable situations will fester on and on in our towns and cities Ill people trapped in a psychosis need appropriate lengths of stay and shelter until they have got their wits about them.

    It is high time to amend the flawed Mental Health Act in Ontario and elsewhere. B.C. may adopt one like that of Ontario soon ! Not a good idea. Agencies can send droves of people to count the homeless but this will not do much to relieve the problem. Treatment in a hospital facility lightens the load for many.

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    1. A good question to ask candidates in this current election is what are they going to do about the current humanitarian crisis of mentally ill homeless and incarcerated people.

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