Monday, November 10, 2008

I'm Brandy the Ex-Pat

The election is over. Those of us who have been holding our breath, waiting for change to come, can finally exhale. There's so much promise in what has happened, and even yesterday, as I was watching the kids play, it dawned on me that the first president they will remember will be a young black man named Barack Obama. That is our world now--certainly not the same world I grew up in, where I myself was teased because of the color of my skin, because my mother was someone different from the rest of the small town, being Vietnamese and Buddhist. This is a new world.

Yet this realization is coupled with another that I had last week. As I sat here in Canada, listening to everything going on south of the border and in particular, the debate over the health care system, I had so many emotions. There was even one woman being interviewed on CNN, who was a cancer survivor, saying that she opposes universal health care. Her fear was that if health care were available to everyone, then she wouldn't be able to get treatment and other appointments for her cancer because everyone would be flooding doctor's offices. I was so angry hearing this woman say this that I wanted to throw something at the tv. But then again, I didn't want to bust my tv, so I didn't. And then I just felt sad--very very sad--that because of corporation and government interests and greed, that people have come to believe such utter nonsense about health care access. So I thought about this a lot--I've been thinking about that woman and about the other common folk whom I've seen on tv, their eyes wide with fear of a "government-run health care system," their mouths saying that *they* want to have control over their health care. All the while, no one in the U.S. has control over the health care because insurance companies have such a death grip on the situation. And so then I think about myself, my situation, my story, my experiences both here in Canada and in the U.S.--and it dawned on me so very clearly: I can never go back to my motherland to live.

We heard this phrase a lot during the election: "pre-existing condition." We don't say words like that here in Canada. You get sick, you're diagnosed, you get treatment. It's true that it's many times not as clear cut and simple as that--the diagnosis part is the hurdle because health care professionals here just can't send everyone who's sick to get an MRI, x-ray, ultrasound, etc. That's the consequence of having health care for everyone--unless it's clear you need urgent care, you have to wait your turn. But soon enough, your turn will come, and you will get care and not have to worry about where the money to pay for it is coming from.

When I was diagnosed, my treatment at the cancer agency started almost immediately. When my white blood cell count dropped to dangerously low levels during chemo, I was put on Neupogen, a $200 injection that I gave myself every other day. If we had not had the extended health coverage that we do through my husband's employer, there was assistance in helping to pay for that injection, so that in any case, we never had to pay anything for that prescription. Never. Granted, we do have what is called the Cadillac of extended health coverage here (there are two kinds of coverage; the basic coverage which is granted to everyone, but which doesn't cover all medical costs, depending on the level of necessity of treatment; and extended health care, which employers can give out as a benefit, and which will cover many of the costs the basic doesn't take care of). But even without the extended, we wouldn't have had to pay for much. Our basic coverage took care of the surgery entirely, and my entire hospital stay was $500, but only because I opted for a private room. And even then, our extended health care picked up the tab.

So here I am in Canada--and while people are suffering in the U.S., struggling to get the care they need, I don't. People often ask us why we chose to live here instead of going back to LA. The choice was clear once I was diagnosed--we wouldn't be able to afford living in the U.S. with my cancer. And now, with my pre-existing condition, we can never go back to live there. There's no insurance company in the world that would take me on. No freakin' way.

So this is what universal health care is, folks. People get to live. Simple as that. This system is not some scary entity that takes over your life and tells you what to do with your health and takes away your say in the matter. We get to choose doctors like anyone else. We get to have our prescriptions that heal us; we get to have the surgeries we need. But we don't have to worry about not being able to pay for that. Those of you living in the U.S.--can you imagine that? If you can't, ask me about it, and don't listen to all this bullshit about how the government will control your lives through your health care.

I have so many friends and family in the U.S. who have had at one point or another suffered because of how things are, whether they be small struggles or large ones. It's just inhumane and not right.

The next time you think about your health care or you hear someone say something about universal health care access being dangerous, think of me. If you haven't experienced it, it's just an abstract. I've experienced it all--it's all real to me. What's scary is how things are now, and how much worse they could become if things don't change.

Don't get me wrong--I love living here. I feel so fortunate that when we had to make this decision, that living here in a Canada was a real option for us. We never had to stress about my treatment; all our focus was on me getting better so I can be here for my family, so I can be here for my children most of all. In the U.S., this is a luxury. In Canada, this is a basic human right. To be able to live and not worry about how to pay for living.


tammy said...

hey b... i work for a death-gripping health insurance company and i agree with you %100. i can't tell you how many hurdles and hoops i have to jump through to get my members/patients "benefit exceptions". and the ones that get the shittiest end are the marginal ones that have more than the destitute but don't have enough for commercial insurance. they're the ones that really get screwed and it really sucks... and heaven-forbid if they're legal immigrants that haven't been in the counrty for more than 5 years...that's a whole other giant ball of red tape to get them needed coverage. it blows... and even those of us that are in here, grinding away at the system, get that it blows.

Jeff said...

gawd, I couldn't agree more. it's soooo broken, but there just isn't an easy solution. the socialist part of US medicine (medicaid, medicare) is broken (government constantly under-reimbursing docs and hospitals) and the capitalist part of US medicine (private health insurance) is totally broken too (something like medicine shouldn't be for profit - the "right" thing to do just isn't cost-effective).

my last paying job btw (for 6 yrs) was working as a data analyst in the field of "health economics" - mostly researching the real costs of treatments to justify their coverage by medicaid/medicare/private health insurance. helped me understand how difficult a problem it is, and how tricky it will be to improve it, never mind fix it.

-Deirdre (can't get my login to work)

Victoria said...

well said!

linana said...

could not have said it better myself! A basic human right is exactly what it is. I pity workers like Tammy who get it and I'm sure most do. The guilt must be incredible. I know I wouldn't be able to do a job day after day, where I had to justify to myself that I wasn't able to extend benefits to everyone that needed them. How can you deny treatment to someone based on what kind of coverage they qualify for? The only qaulifying criteria should be need. We had a technician here (northern Alberta) who was found guilty of fudging results so that more people would qualify for a free treatment. It wasn't that people were being denied treatment - just that there had to be a starting point - in this case how severe was their breathing problem- before they would be considered to benefit from this particular treatment. When his case went to court most people saw him as a hero not as someone who did something bad. It seems as though the insurance companies in the US are operating on the oposite principle. Lets hope things change and soon.

Unknown said...



Steve and Amy

Sandy C said...

I don't disagree with you. I do, however, see another side. I'm an insurance agent. I can't tell you how many times I go to people's houses. People who have no insurance for their children. No pre-existing conditions. Could easily get coverage for their entire family for about $400/month.

I walk up the driveway past their two brand new cars and beautifully landscaped house. I walk in their front door and see their big screen tv and brand new appliances and all the bells and whistles you can imagine. They greet me in their Abercrombie and Fitch attire with their very expensive glasses on and their $1000 dog yapping at my feet. Why can they buy all this? Because taxes are wayyy lower down here because there's no "universal health care".

I then present the health insurance plan and they tell me "I can't afford it".

Sometimes it's about choices. I moved from Canada to the States because the taxes were so much less. I liked having choices about my healthcare.

I really, really agree with you that something needs to be done and that there is a lot of need in the US but I also wanted you to be aware that some people are just making bad choices. Hopefully someone will come up with a good plan I just don't know what it will be. said...

Hi Sandy,

I'm reading what you're saying about people who can't afford insurance, yet can "afford" their lifestyle. Well, can they really? I'm going to go out on a limb here and yes, judge them--doesn't seem like they make a good choice.

Now I've been to both land of choices (grew up there), and land of high taxes. So I suppose it is a matter of what you prefer--how you want to live your life, what kind of life you want to live. But even with "good" medical insurance--my husband and I were employed at UCLA, so we had plenty of options for "good" insurance--basic health care was a pain in the ass because of the insurance companies, plain and simple. I could give you boring examples of what I had do to get birth control, to more exciting examples of what my brother-in-law had to do when he was alive, to get what he needed to live with lung cancer (and yes, he also had "good" insurance). I've seen it ALL, Sandy, and I KNOW that even with without such a range of "choices" here in Canada, there's no comparison in the type of coverage I receive, and the peace of mind I have because of that.

So I wish you well, Sandy, and I appreciate your thoughts, but I do have pretty strong feelings against insurance companies in the U.S. because in my experience it's been about greed, greed, greed. (My sister works for Blue Cross, but anyway, that's another story.)