Perhaps it's time for us to look with new eyes.



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    Two Women, Two Cancers, Two Healthcare Systems
    By Tom O'Brien
    The San Francisco Chronicle

    Thursday 29 December 2005

    After a long time away, you see with new eyes.

    I moved back to the United States with my Canadian wife and two small
boys after living 15 years in Toronto and Ottawa. US health care now looks
both expensive and scary, leading me to conclude that we'd do better with an
entirely different system.

    Nowhere has this been put in sharper relief than in the story of two
colleagues. Struck in March with cancer, an American colleague worried about
death, insurance loss and bankruptcy. In contrast, a Canadian colleague and
cancer victim had only her disease to fight.

    Susan was on sick leave when I came to work at my new job in August. She
was middle-aged and single with a grown family and well liked in my office.
She was undergoing chemotherapy to treat breast cancer and not able to work.
Our employer supported her beyond the normal period of sick days and
vacation.

    But the scary question for anyone but the rich hit with a catastrophic
illness in the US health-care system is: How long will an employer's support
go on if the battle goes far beyond the time allotted for sickness and
vacation? Susan worried about the loss of health-care coverage and what
ensues - second-rate care, bankruptcy, choosing between timely drug
therapies and even modest necessities. She died this month before those
fears were realized. But had she lived, she and her family would have
confronted the excruciating battle survivors have to fight with insurance
companies, employers and health-care providers over cost, length and quality
of treatment.

    In contrast, my former colleague Kathleen back in Canada was gripped by
uterine cancer, which had spread to her intestines. While she was locked in
a life-and-death battle for 18 months, she didn't have to worry about losing
her health care and choosing which bills to pay. Canadian Medicare covers
everyone for everything in hospitals and doctors' offices, including some
elective procedures. This means no health care-caused bankruptcies. No
fights with insurers. No insurance-driven financial worries. Kathleen could
save her energy for battling her cancer instead. She did recover, and while
her recovery was not necessarily the direct result of differences in care
systems, there is no question that she would have suffered more with the
burden of financial worries related to her health-care needs.

    I hear stories here about Canadians lining up for basic medical care.
But despite plenty of doctor appointments, occasionally bringing my children
to the ER, and having had a heart procedure myself, I didn't witness any
delays for necessary (let alone emergency) care. In survey after survey,
Canadians support public, nonprofit health care by a wide margin.

    And why not? Compared to the United States, Canada has much lower
infant-mortality rates and a longer life expectancy, according to data from
the World Health Organization. Canadian women get just as many mammograms,
for example, as do American women. This is achieved despite spending far
less per person on health care - 10 percent of per capita GDP in Canada goes
to health care versus 15-plus percent in the United States, according to WHO
research.

    After 40 years of private health care in America and 15 years of
Canada's Medicare, I'll take the latter. But of course, I can't; it's not
available here. I love my country but not the private health-care system
that abandons many people and worries even more.

    Few Americans know that every other industrial country in the world has
a health-care system more or less like Canada's. I think even fewer realize
that we do, too - it's called (US) Medicare. The system that boosted the
health of Americans 65 and older is similar to Canada's system for everyone.
They're both "public, not-for-profit, single-payer" systems with low
overhead costs. So why not extend Medicare to every American?

    Our seniors like it. Sure, it will raise the cost of this government
program by billions of dollars, according to even the most conservative
estimates. But it will save money for both individuals and employers who now
purchase private health insurance. After all, it's not how much of your
income you pay, it's how much you keep. You'll keep more under
Medicare-for-all, and every child, woman and man would get the timely health
care they need.

    Give people the opportunity to face and fight their illnesses, not their
insurance companies.

    Tom O'Brien joined the California Nurses Association (www.calnurse.org)
upon moving back to the United States in August.




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