imperfect
I had some welcome company on my walk around the neighborhood this morning: the pair of squirrels that sometimes scamper along behind me atop the hedges and fences that line the sidewalk. I know them pretty well, so I wasn’t particularly surprised. And the sight of them usually makes me smile. Others, too. I’m sure it looks like I’m taking them for a walk. The Senior Neighbor started feeding the little guys about a year ago when they became orphaned in a high-wire accident. I know you’re not supposed to feed wildlife, but our furry pals know their place. They have learned through trial and error that we humans startle easily and definitely prefer that rodents stay outside.
And they’re extremely cute. When we got home, I pulled out the jar of walnuts I keep in my cabinet for them, and tossed a few onto the lawn. One of the squirrels is stronger than the other, and they often squabble over the food. Usually, one fills up the pouches of its cheeks and sits there eating while the other hastily grabs whatever is left and scuttles away to eat fast before the other is done and decides to bully the last morsels away. I noticed this morning that the squirrel that lost out on all but one of the walnuts is a lot bigger than the other one, and I’m starting to wonder if that’s because we’ll be seeing the next generation coming soon.
When I turned on the TV, it was to see state governors squabbling, too. There are only so many respirators to go around and that number isn’t enough to meet the desperate need imposed by this crisis. New York governor Andrew Cuomo likened his attempts to get personal protective equipment and ventilators to sniping in an online auction. “We all wind up bidding up each other and competing against each other, where you now literally will have a company call you up and say, ‘Well, California just outbid you,’” he told a news conference earlier this week. “It’s like being on eBay with 50 other states, bidding on a ventilator.”
Or like missing out on a shower of walnuts because a faster, stronger squirrel grabs them first. Yes, I hear you. Reducing the fight to save human lives to a battle between rodents is indecent. But so is this situation. There has got to be a better way.
The fight for resources plays out at a personal level, too. With skyrocketing deductibles for the insured — or no insurance at all for the increasing number who find themselves unemployed right now — Americans are routinely forced to choose between necessities like costly medical treatment and food for the family dinner table. Before the U.S. government announced Friday that funding from the Families First Coronavirus Response Act will be used to cover testing and other diagnostic services for the uninsured, just getting a Covid test at a hospital was costing people dearly. Actor Daniel Newman from The Walking Dead reported to CNN that he got a testing invoice for $9,116 from an Atlanta hospital -- and they couldn’t even process his result because they were too busy.
Canadian government officials are also scrambling for supplies – that’s a global problem. But at the personal level, citizens there are able to go to doctors and receive treatment without worrying about the bills.
Instead of America’s costly and uneven patchwork of private and employer provided insurance plans, Canada has a system of that covers citizens’ healthcare costs via inter-jurisdictional transfers of tax money. The single-payer healthcare system has its flaws, but it is a source of national pride for Canadians. And it should be. Especially compared to the U.S., where healthcare is a source of considerable stress for families at the best of times. When my American hairdresser had her baby a few years ago, she was insured under a plan for self-employed workers. Still, when she was discharged from the hospital with her newborn she also got a bill for about $30,000 — including a $600 line-item for a dose of extra-strength Tylenol. Another friend wound up in three years of litigation between insurance companies fighting over who would pay for the $300,000 of the life-saving care she received after she was swiped off her bicycle by an oncoming cyclist who crossed the center line.
That kind of thing used to happen in Canada, too. In 1929, about 60 percent of Canadians were not earning enough to afford adequate health care, according to records from a medical conference that year. There’s a hundred-year-old story in Canada that is repeated so often that it has become a parable. It is about a little boy named Tommy who developed a serious bone infection after taking a fall and injuring his knee. Because his parents couldn’t afford adequate care, he spent 18 months in and out of various treatments and nearly lost a limb. He finally received the surgery that saved his leg when a visiting doctor discovered the needy 10-year-old during rounds of the charity ward and offered treatment for free, as a case study for his students.
The boy’s story is so well-known in Canada because little Tommy Douglas grew up to become the politician now credited as the father of that nation’s universal healthcare system. “I felt that no boy should have to depend either for his leg or his life upon the ability of his parents to raise enough money to bring a first class surgeon to his bedside,” he said later.
About 25 per cent of Americans don’t have access to adequate health insurance today. And with plans largely tied to employment, that number is sure to skyrocket in the coming months. More than 700,000 people lost their jobs in March. Some 6.65 million Americans applied for unemployment insurance in the last week alone.
Today in the United States there are 277,205 cases of this virus; 7,847 deaths. The 14,368 recovered are facing a lot of medical bills.
Taxpayer funded universal health care is a relatively new concept even in Canada. I didn’t realize until I started doing some research this week is that it emerged incrementally over decades of hard-fought municipal, then provincial, and finally federal programs that promised health care for all.
I was in elementary school when the Canada Health Act of 1984 was adopted. I remember there being controversy because my mother takes her voting seriously and the legislation was an election issue. She heavily debated the pros and cons of the latest system overhaul at the dinner table over the course of several passionate months. When the law came into effect, it harmonized national standards, banned extra billing, and established a foundational healthcare framework that guarantees public administration, comprehensiveness, universality, portability, and accessibility. It didn’t come easily – or quickly. And the history of its evolution dates all the way back to the post-war era of the 1940s.
The current system is largely modeled after a provincial plan that Douglas introduced in 1947 to establish universal access to hospital care in Saskatchewan. It was another decade before the federal government launched the Hospital Insurance and Diagnostic Services Act to create a 50/50 national and provincial cost sharing plan and by 1961, all ten provinces opted in to fund inpatient hospital and diagnostic services.
It all sounds harmonious and orderly, but buy-in was far from universal. The Canadian Medical Association was originally opposed to government intervention in the system and when Douglas expanded his provincial health insurance plan to include physicians’ services under the Medical Care Insurance Act of 1962, citizens of his province faced a 23-day doctor’s strike under conditions that history books have since likened to civil war.
Even so, the idea had momentum and a 1965 federal study recommended the implementation of a national healthcare program. The National Medical Care Insurance Act came down in 1966 and came into effect at the federal level in 1968, providing expanded coverage for services received outside of the hospital.
The evolution continues. The system isn’t perfect and administrators don’t always find the right balance between costs and available treatments. But when my mom needed an invasive surgery to remove a mass her doctor discovered on her kidney during a routine checkup a couple of years ago, her care was excellent and immediate. She was in and out of the hospital within a matter of weeks of diagnosis, receiving multiple rounds of testing, the surgery, and several overnights of recovery —and all for the price of a tank of gas to get there and back.
I’ll feed the squirrels again tomorrow. And I’ll toss a few right to the fat one so hopefully she gets what she needs.
It isn’t perfect. But it’s something.
