Monday, July 09, 2007

How I became an American--Sort Of

One of the joy’s of living in Canada is our health care system—depending on the province and your level of income it ranges from free to about $700 per year. It’s not perfect but, when one considers that the number one cause of personal bankruptcy in America is health care costs, the Canadian system is a fine and happy thing to belong to, because that little, throw-away statistic on bankruptcy can’t even begin to convey the horror of suffering from a major illness and knowing that you are the cause of your family losing their home and every other asset you’ve built up during your life-time. I can’t see it helping with the healing process, either.

The Canadian health care system is legally guaranteed by the federal government, but is administered by each province. So I found myself in a bit of a catch-22 recently when I fell into a mad love affair that ended, at least according to Oscar Wilde, badly(we got married). My husband and I conducted our courtship over a separation of almost 2000 miles. This was wildly romantic and very good for our national airline’s share prices, but the time came when one of us had to move. For a variety of reasons, it was me.

Just prior to the move, a thief’s deft fingers liberated my wallet. It was the second time in seven years that I had fallen victim to one of the pickpockets who ply their trade on Vancouver’s crowded city buses. I cancelled my credit cards, notified my bank to be on the lookout for any strange transactions, and then set about the process of getting my i.d. replaced. My passport had recently expired. I don’t have a driver’s license. I wasn’t born in Canada. The very first piece of i.d. I needed to acquire, before I could get anything else, was a Canadian Citizenship card. For some reason, it takes six to nine months to get this card. You might think this is because of renewed security efforts since 9/11. You’d be wrong. When I went through the process last time, it took just as long. The office is in a small city in the Maritimes. I can only imagine that it consists of a sleepy little bureau where half a dozen officials slowly make their way through the paper piles. This delay was to become a major problem.

After three months, my health care number from B.C. was no longer valid, but, because of my lack of identification, I could not apply for an Ontario number. My expired passport was not considered sufficient proof of identity. In vain, I tried arguing that the fact that the government of Canada had just a few years earlier considered me to be myself, and a Canadian citizen to boot, should be enough confirmation of identity to have a health care number issued. The officials were sympathetic but unable to help. And so, there I was, a few months after a major operation, without any health care. Which is how I became an American–sort of.

For that entire period, I lived in terror of any unexplained pain in my body. When the winter arrived and I routinely walked on icy sidewalks for the first time in over 25 years, I moved with the slow care of a brittle woman in her 90’s. I could not afford a broken bone. A bad cold turned into a bronchial infection that I suffered through, praying with each wheezing, painful breath that I wouldn’t develop pneumonia. I chose not to skate on the canal (a seven-mile long ice rink), because my innate clumsiness almost certainly guaranteed at least one good fall and I couldn’t risk a sprained wrist or concussion (both of which injuries my next door neighbour sustained an afternoon skate with her son).

It was the first time in my life that I didn’t have the comforting, background knowledge that, no matter what my financial situation, I could walk into my doctor’s office and be treated without having to choose between my health and the rent. I spent the next five months thinking often of my neighbours to the South. The comments in letters from friends about being stuck in a job they hate because they’ve developed illnesses that will prevent them from getting health insurance if they switch jobs and, hence, their insurance company, suddenly make sense on a visceral level. The spouses that stayed together long after the relationship ended, simply so that they didn’t lose access to health care. The man who risked jail for insurance fraud by giving his health insurance number to his brother after a fall from a ladder that broke his sibling’s back. And the hospitals that operate to make a profit. There is something vile about the idea that a place of healing exists to make money for shareholders; as a corporation, its primary duty is NOT to the patient, but to the shareholder.

There is plenty of room for improvement in Canada’s health care system. But there is also much to be thankful for. And, next winter, I have every intention of lacing up a pair of rented skates and making my faltering way out onto the ice, secure in the knowledge that I can, if not exactly enjoy it, at least afford a broken bone.