Aunt Betty's Hip

I'm going to start this by saying that we, like every family in the United States, have seen our health insurance premiums continue to increase year after year, regardless of what medical adventures have passed us by or caught us up. Fortunately, with thanks to God, we can afford health insurance -- even with high monthly premiums and high deductibles.

That said, I envy the medical system in Canada. I cannot imagine what a blessing it would be to know that I and my family would be able, as Canadian residents, to receive good quality care without the very real possibility of losing everything we own. The stress of health care costs, I honestly believe, creates illness and despair; ill health or injury still visits people, but what a burden would be lifted if, when sick, all we had to deal with was the illness and its treatment, not the enormously high cost of simply getting to a doctor with some sort of coverage. Canadians agree, and most wouldn't change their system -- designed, believe it or not, by the actor Kiefer Sutherland's grandfather -- to save their lives. And I mean that literally: Lives are lost, many thousands of them, when access to medical care is denied or made too expensive.

And yet, there's always Aunt Betty.

Aunt Betty, or my cousin's husband, or the neighbor's friend's chiropractor's husband, gets trotted out as an example of the purportedly dreadful care in Canada that requires her to wait six months for her hip replacement while demanding that my cousin's husband wait three weeks for his diabetes test. I don't mean to be flip. All of us want to be able to go to a doctor, be taken seriously, be treated well and be treated as quickly as possible, and as someone who's twice had to wait even a few days for biopsy results (both negative), it's a painful process, physically and emotionally.

But the debate about Aunt Betty's hip replacement delay in Canada misses a larger point, albeit a point only important to those who believe that the "rightness" of a system isn't based solely on how they're benefiting from it. The complaint of Aunt Betty and the neighbor's friend's chiropractor's husband, valid as they are, are the complaints of a relative affluence and security unknown to millions in this country. Millions of hard-working women and men, and millions of children with no economic or political power, can't imagine having to wait six months for a non-immediate procedure. They can't empathize with someone who sweats out a week of waiting for test results, and they can't fathom the anger directed at a system that prioritizes patient care based solely on one's medical condition, resulting, often and necessarily, in a delay in some treatment -- like Betty's worn-out hip -- so that others, like the migraine sufferer who suddenly experiences stroke-like symptoms, can receive immediate diagnostic care and treatment. For a family that can't even afford to take their child, themselves, or even their own hip-stricken Aunt Betty to the doctor, period, these complaints seem utterly foreign.

And they are. The United States has a deplorable health care system that disenfranchises the already disenfranchised, leaving them to languish without care until they're often too sick to be cured. It prioritizes care on the worst possible basis, morally and medically, by making access to medical treatment as closely aligned with financial resources as by immediacy of need. The hypothetical six-month wait for necessary but not immediate care is not hypothetical to the uninsured poor, for whom a six-month wait pales next to the lifelong, and often life-taking, denial of even basic care. A delay in guaranteed, quality, available treatment has as its primary feature the delay. For the poor, a delay in treatment has no qualifiers, no "guaranteed," no "quality," and no "availability." You have to have medical care to complain about its faults, and those complaints, while significant, must be part of a system available to all.

The system doesn't work terribly well for me and my family, but it's designed to work at least better for us than for most. That's what's wrong with it, not what's right with it.