In the same week that the US Government has shut down ostensibly in a squabble about improving the lot of health care to Americans, I’ve had a couple of painful shutdowns of part of my renal system with a large kidney stone intermittently blocking my left ureter.
I thought I would tell you about my experience this week as a patient in the Canadian health care system, in this case at one of Ontario’s busiest emergency rooms, Brampton Civic Hospital. A lot of effort has been spent in the US vilifying the Canadian healthcare system, so I thought a real-world story might be beneficial to counter some of the misinformation.
I am a 52-year old white male, 6 feet tall, 225 pounds, type II diabetic. I am covered by the Province of Ontario’s health plan. My key to all services is my health card, a photo card I show at every visit to any doctor, lab or hospital. You show the card and they serve you, no questions, no stopping to determine whether or how much you’re covered, no payment ever exchanging hands, no bills forthcoming (there are exceptions but this is true for close to everything).
The total amount I had to pay out of my pocket for this care was zero. It was completely covered by the taxes I pay and the contributions I make. There was no expense for co-pay. There was no expense for needles, tongue depressors, lab work, nothing. The sum total of expenses for the entire week for me was a $15 parking charge.
I chose this hospital because it is close to my home. I would have received the same care at any hospital. I did not have to choose one that belonged to some particular plan. At all stages I was treated professionally and promptly (with consideration to other patients whose urgency exceeded mine).
Here is a breakdown of the care I received. It was all provided via the government plan, with no need for extra insurance coverage.
If there were to be a bill, these might be some of the line items:
Consultation: Emergency room visits: 2 Specialist visit: 1 Family Doctor visit: 1 Lab: Bloodwork: 2 Urine: 2 Imaging: Ultrasound: 1 XRay: 2 CT: 1 Medications: Morphine injection: 1 Morphine IV: 1 Saline Solution IV: 1 Gravol: 1 IV for nausea: 1
The drugs administered at the hospital were all covered. The prescriptions I got were paid for separately and partially covered (80%) by my private drug and dental plan.
Initial Emergency room visit. At 1am, I had some discomfort in the left of my abdomen and blood in my urine. I was triaged through to Ambulatory Care in about 15 minutes, and was in the waiting room there for about 45 minutes until I was moved to an examination room. Was seen about 25 minutes after that, blood and urine were taken, then 1 hour to wait for results. During the hour my pain increased, becoming unbearable and as soon as they were aware, I was given two Percocets, a Gravol and a shot of Morphine in the arm. Once the results came back I was scheduled for a CT scan at 1pm and sent home with prescriptions for Flomax, Naproxen and Percocet, which I filled at the local 24-hour pharmacy, and a referral to my Urologist. Total time from start to finish, 5 hours.
By noon I had talked to my Urologist and had an appointment for 7 days later.
At 1pm I had my CT scan. For the Doctor to see it, I had to be triaged through a now very busy emergency room, and wait for a while at Ambulatory Care. Diagnosis, two 2-3mm stones on the right, one 2mm on the left and one 9mm on the left, 1/3 of the way down the ureter towards the bladder. Total time, 4 hours, mostly waiting comfortably while others were seen who were in distress.
The next Monday I got an appointment with my family doctor to get an extension on the pain medication prescription. He gave me a once-over and grilled me on some details.
The day before I was to go to my specialist, the pain was excessive despite the Percocet, so concerned that some damage might be happening, I went back to emergency. Within an hour I was taken in, blood was taken and I was and seen by the Doctor. I was given an IV of saline and a morphine pack, and later a pack of something for nausea. They took me for an ultrasound and the doctor saw me about 20 minutes later saying it was not clear enough so they were sending me for Xray, which I went to immediately and was seen in short order. The Xray showed it still in the ureter, if a little bit further along. As the symptoms had by that time subsided, the doctor and I decided together that we wouldn’t involve the on-call Urologist but that I would go to my own as scheduled the next day. Total time, less than 4 hours
When I arrived at the Urologist, they tried to get the XRay from the online hospital system, but there were connection problems, so they sent me upstairs to their local lab for another XRay. I was back in 35 minutes with the CD containing the XRay and the Dr gave me my consultation. We decided that due to the invasiveness of the surgical procedure (full anaesthetic, scope up the urethra and ureter, blasting, extraction) I would continue with painkillers and Flomax and if not passed in three weeks reconsider. Total time: 2 hours
Summary to date:
I was seen quickly and efficiently at one of Canada’s busiest emergency rooms three times in one week.
Imaging – I received a CT scan appointment within 10 hours, ultrasound immediately, XRay immediately (twice).
My specialist saw me within a week.
I could have chosen intervention if I cared to at this time. It will be available to me any time should my condition escalate.
At no time did I have to consider the financial implications of this care as there are none.
I understand that the taxes Americans pay for health care (which goes to medicare, government plans including Congress, generally not back to all who pay it) equal or exceed those that we Canadians pay for the care that we all actually receive.
It’s really a mystery why America remains as the only nation who doesn’t get it.