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Sick Sicker Sicko<

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article published on September 22, 2007 in
The Mississauga News
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

I broke down and viewed the Sicko movie. This happened at a time when political candidates and media “experts” are proclaiming themselves as health care policy experts. Some of the points emerging from these debates have the consistency of vomitus. Vomitus is one of those things that gets all over you in a flash, but you can’t just stand there and ignore it for very long. Hence, I wade into the fray, pitting stethoscope against misinformation.

The point I thought was being made in the Sicko movie is that American Health Care is controlled by non-medical insurance company beaurocrats whose allegiance is to their stockholders. They control what tests and treatments patients are entitled to. According to Michael Moore's figures, 80% of Americans fall into this group. The need for care is questioned and problems do arise. It struck me that those U.S. patients appeared very knowledgeable about costs, available choices and alternatives. When they do get health care, it happens quickly and immediately. Waiting 6 months for a necessary test or an appointment with a Specialist is not an option to Americans. They consider it an unacceptable insult. The poorest sector of American Society is provided with free socialized medicaid. Many mock it because patients have to “wait” for care. Sounds familiar? But the waits are often shorter than OHIP and it pays much better.

Many years ago, I treated an American visitor in the Emergency Department with a sprained ankle. I was caught off-guard and dumb-founded when he asked what he owed me. I conferred with a colleague and nervously decided to use the OHIP rate of $17.55. I found later that his entourage left the department laughing in disbelief. Apparently, his tour bus mates had collected almost $400.00 as a down payment for his medical treatment! He even tipped his nurse a $20 US bill. About a week later he was back, this time in my office with his wife. They had endured another seven-hour bus ride, just to see me, and were happy to pay our rates to review all their medical problems. As they left, they inquired if I would be willing to see their American friends. I started to ask a few questions and discovered that they found that it was a bargain to make the trip, see the sights and stay the weekend in Canada rather than use their local health system. But in those times, Ruth Grier, Bob Rae, and the ruling NDP were misleading the public about how over-doctored the province was and, true to form, slashed away at the system. The reality today is that Canadians, world leaders and others routinely travel to the USA to get speedy diagnosis and care. Today, one in four doctors working in Canada is a foreign graduate. We pride ourselves in being world humanitarians and peacekeepers yet continue to steal needed medical expertise from needy countries. I find it a shameful legacy. Canadian medical training is top-notch and world renown. We should be exporters of well-trained doctors.

I pity the poor emergency doctors in Windsor where Moore filmed his accolades to our system. In the Sicko film, a needy American is followed across the border as he sneaks into Canada, and tries to masquerade as a Canadian trying to get health care. Patrons of the emergency department state on camera that the care is free and waiting times can be measured in minutes. Anyone who has ventured into an emergency department in the last ten years knows that visits last hours or days, and empty seats are scarce. Moore forgets to mention that Ontarians pay hefty taxes to afford this system, despite government regulated service fees well below market values.

Only during election time do I hear the rhetoric about “abuse” and user fees. Without venturing into social arguments as to what constitutes “fraud” in a public system, some people still hold on to the notion that greater enforcement is all that’s needed. Nothing is further from the truth. Fraud is a minor problem in an overburdened system. A mother worried to ulcers about her sick child, and sits in emergency all night only to be told it’s a minor cold is not abusing the system. Few people find it convenient to wait months to see one specialist, never mind a second opinion. Doctors are not overworked because the same patients are there every day. As for user fees, we are already paying them, only we refer to them as taxes. People who don’t pay regular taxes would be the first ones exempt from a users fee!

Our system is not the utopia that Sicko portrays it to be. It is overburdened, often inaccessible and full of unimaginable and expanding beaurocracy. We too rely on private insurance to avoid hardship. Despite this, the quality of care when delivered tends to be excellent for the most part. To prevent deterioration, we need to make informed choices. Our life expectancy is not any longer than Americans, but we seem to be full of never-ending patience and tolerance, and perhaps that is the true difference. Rest assured that I am not running in the provincial election.

Related resources:

Canadian Journalists Criticized Michael Moore's Portrayal of Canada's Health Care in 'Sicko' by Lynn Davidson, NewsBusters.

Analysis: 'Sicko' numbers mostly accurate; more context needed from CNN.

'Is this what we'll become?' in PDF. "Michael Moore's latest film is a boundary-pushing, in-your-face journey through American health care. Let it serve as a cautionary tale" by Janice Kennedy.

Canada's health care is "Sicko" blog by Sally Pipes.

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