Envy of the World

The following events did not take place in the Soviet Union. Cuba and Venezuela are also in the clear. None of this inhumanity was a figment of my imagination. It all took place in front of my eyes, and I’m narrating the details without the aid of the slightest hyperbole.

Gather all your compassionate, equality-minded, social justice pals for a ride through one amazingly affordable health care system. The one Obama and other notable liberals paint as the “envy of the world”. See how quickly you can figure out where this envy of the world dwells.

Got your seat belt on? This liberal utopia is a bit bumpy.

To kick this saga off, you’ll need to enter a hospital emergency room. But not before you’ve suffered two months of abysmal pain, unable to do any type of basic task or even straighten out, sit or lie down. You’ve forgotten what a shower feels like. You look and move like the Hunchback of Notre Dame. You’re debilitated 24/7 with no reprieve and you cry out from continuous piercing pain that permeates every few seconds. When one of your legs isn’t totally numb from hip to toe, you experience sharp stabbing sensations that make you want to slit your wrists.

Yet you do exactly what your nation’s one tier medical system instructs you to do; you visit a family doctor who routinely suggests an MRI, an imaging exam before which he is unable to provide even a hint of a diagnosis. And since you live in the proud lap of liberalism which ensures the all-inclusive equity of suffering, you quickly get told that your MRI appointment is a mere twelve months away. A referral to a back & spine clinic was provided, wait time to be seen? A teensy-weensy six months. But lucky for you, a generous dose of an opioid was prescribed in the interim. The 60 Oxycontin pills (the most addictive opioid on the market with a street value of $60/pill) were augmented with 270 pills of Gabapentin, a drug designed to deceive your brain into thinking that you are not in pain. You walk away a guaranteed addict with a pocket full of mind-altering chemicals. None of this really shocks you, you’ve lived in this country’s health care nightmare long enough to expect little more.

At this point, you should be entirely consoled and comforted by the idea that many are in the same boat, experiencing the same wonderful egalitarianism with respect to the twelve months of waiting and consequent suffering. In fact, in our country, the very thought of equitable misery is expected to work as an instant pain reliever. This very philosophy is at the crust of the liberally-installed public health care system and barbaric government policies that criminalize and outlaw private care as part of a two-tier offering in this country.

This is how my friend’s journey through the cartel of socialist policies began. No one could’ve predicted what was to come.

As Amy (let’s call her that), tried to figure out how to take her next breath without screaming, she decided that a 12-month wait is simply inhumane. So she did what most of her countrymen (correction: country people!) do with affluent means; she got an immediate private MRI, which provided a diagnosis of bulging spinal discs pressing and impeding nerves in the lower spine, pain further compounded by broken off bone fragments that aggravate the nerves and surrounding tissue. She was now $692 poorer, even though her tax dollars guarantee health care when she needed it. And they certainly do if she doesn’t mind croaking from pain first.

In fact, in Amy’s country, an average annual income of $60,900 pays a health care tax bill of $5,516 for the privilege of this “free“ perk. In 2016, an average family earned $83,105 and forked out $35,283 in taxes, that’s 42.5% straight to government coffers out of which health care funding is allocated. But if you find yourself in the top 10% of country’s income earners, you would pay up to $37,361 annually (in taxes vis-à-vis health care) for your shot at the “free” emergency room queues, MRI waits, and specialist appointments.

Sound good?

In Amy’s country, more is spent on taxes by households than anything else. And out of the aggregate taxes, more is spent on public health care than on anything else. This exuberant tax payers’ funding of the faux health care utopia known as the “envy of the world” is today Bernie Sanders’ and Kamala Harris’ main advocacy platform all the way to 2020.

Amy’s journey continues…

After the devastating MRI results, came the immediate realization that all she would have at her disposal are addictive and mind-altering pharmaceutical chemicals. No back specialist appointments were on the horizon. Not even close.

After a several days of continued suffering, with no relief from prescribed opioids (the same ones causing a crisis throughout the United States) Amy, now in a wheelchair I’m pushing, heads to the nearest emergency room. Official wait time is recorded as two hours on the website. In reality, the two-hour wait was simply the time needed to get through the three-point admission. Efficiency as always. Three different staff asking a very pained individual the same questions because the bureaucracy requires it. Ultimately, Amy enters a second waiting room which begins her real waiting time. After 3 more hours, a triage nurse takes Amy into a draped-off room where she simply asks her more questions and tells her to wait some more. Ten hours later, loaded with more addicting opioids (this time Hydromorphine and Tramdol) and a referral for a back injection that can “tie” her over for a couple of months before the pain returned. No other treatment plans were proposed. An average wait time to see a back surgeon is between 18-24 months.

Next came 2 more visits to hospital emergency rooms out of sheer desperation and helplessness. Amy is seasoned enough to know that these emergency rooms rarely do more than prescribe drugs and lend a sympathetic ear. But when you have no other choices, you seek relief even where you know there isn’t any.

Time and time again, doctor after doctor, Amy was prescribed more and more addictive medications and told that she just had to learn to manage her pain. Amy understood that “managing pain” is code for “living with pain”. Continuing this regime of ineffective addictive pill therapy is, likewise, synonymous with, “there are no ideas, no resources, no treatments, but you’re welcome to become a drug addict and not waste our time ever again.”

After spending three days in three different hospitals, Amy returned home with more opioids in her purse than she went in with. Amy proceeded to take every drug prescribed in different variations. Nothing worked.

Next came the difficult challenge of trying to arrange a cortisone shot, something Amy expected to get in the hospital but was told they don’t have the ability to administer. After days of trying to figure a way to get a referral for this shot, Amy finally had a scheduled appointment.

I wheeled my friend into a clinic with high hopes for cortisone magic. Her pain was especially intolerable that day. As we settled into the waiting room, I assembled four chairs so my friend could lie down on her side to get some relief. The relief lasted but a few seconds.

At last Amy got the shot, her last shred of hope for pain relief as a temporary measure. Disaster struck; the shot failed to work. Amy was wheeled out of the appointment room in greater pain than she went in with.

After the failed cortisone injection, I asked the nurse, “Have you ever seen anyone in this much pain? Should one live like this? What’s the solution?”

The man replied, “Yes, I have and it’s terrible. Solution is pain management through drugs.”

I couldn’t contain myself, “No solutions other than to hook a person on opioids for life?”

He shrugged his shoulders, “As you know, waiting time for surgery in this country is up to three years.”

As if hit by lightening, I realized that private health care surgery may be the only relevant subject for discussion. It was the end of the line. We had to take control of the situation and control of Amy’s health, regardless of public system’s incompetence, lack of resources and foreboding advice.

A few days later – another trip to an emergency room. Amy called an ambulance. Out of the three hospitals available in the city, only one has a spinal unit. Amy requested the ambulance to drive her to that facility. They refused. She was informed that she had only the option of being driven to the closest hospital facility, the one without any resources to help her. Amy explained that she’d already visited that facility to no avail. None of that mattered; EMS (ambulance) staff had their protocol. Amy’s pleas fell on deaf ears.

Amy is wheeled once again into the emergency waiting area of a familiar hospital. This time she’s on an ambulance stretcher with EMS staff by her side. For four long hours she groaned from crippling pain, waiting for emergency room bed to be made available. Very generously she was offered more opioids for ingestion, but opted for Tylenol and Advil to take the edge off the pain. She was swiftly told that EMS does not carry anything but Oxycontin, the opioid. Opioids are free and ample, a common pain killer is not. Let that sink in…

Another two agonizing hours go by for a total of six. Amy is now in a waiting room. No buzzer, no attending nurse. Nature calls and Amy needs the girls’ room. She begins to holler. No one hears, no one responds. My friend decides she can wait no longer; she removes a thin blanket off herself and throws it to the floor, gets down on all fours and proceeds to crawl out of the room towards the bathroom. An intern sees her and inquires what she was up to, yet continues to work on the computer without any offered assistance. Finally, a nurse heard the commotion and lifted Amy off the floor and brought her back into the waiting room. A few seconds later, the nurse returns with a commode (a portable toilet) and a male nurse. The female nurse departs, leaving Amy to use the commode with the male nurse present. The same nurse later assisted Amy back into bed while she screamed from pain.

It wasn’t until the clock struck 03:00 AM when a doctor finally showed up. Exactly eight hours since Amy was delivered by ambulance. In that horrid stretch of time, no tests were done, no medical assistance was provided.

After making an appearance at Amy’s bedside, the good doctor on duty simply uttered, “There’s nothing we can do for you here” and then whispered in Amy’s ear “You should’ve gone to the other hospital with the spinal unit, we don’t have any orthopedic specialists here, but don’t tell anyone I told you.”

Predictably, Amy’s visit to the hospital ends with a fresh new prescription of heavy duty muscle relaxants, anti-inflammatory drugs and, of course, a refill for more opioids. She was sent home as before; no treatment, no plan for treatment and certainly not even a hint of the word “surgery”.

The next morning, Amy’s pain got worse, if that was even possible. This time, Amy’s husband drove her to the hospital with the spinal unit, the one EMS service refused to take her to. Hoping for different results, she once again waited for three hours in the waiting area. Another nine in the spinal unit itself, for a total of twelve excruciating hours. Let’s re-read; twelve hours of waiting merely to be seen…

And what was done this time?

Aside from a urine test and a portable ultrasound – absolutely nothing. And since my friend spent the entire day waiting, she requested food. She was delivered a small sandwich at 7 pm. When the neurosurgeon arrived he offered this, “Sorry, we don’t do surgery for your condition. I’m happy to put you on a waiting list to see a back specialist. If you’re lucky the average 9-12 month wait to see him might expedite to a 3-month wait. I’ll see what I can do.”

Amy clearly explained that no medication, no matter how strong, gives her any relief. To which the neurosurgeon replied, “You’re just going to have to figure out how to manage your pain. All we can do for you is give you meds.”

My friend sobbed, “I can’t go home like this. I’m bedridden and in tears from pain continuously. I will ‘off’ myself if I have to live like this much longer.”

“We will send in a social worker to speak with you”, was the reply.

The social worker came along with brochures on half-way houses for folks suffering from chronic pain. In these desolate, last-resort facilities one is taught how to go to the bathroom in pain, how to dress in pain, how to eat in pain, how to sleep in pain, etc. There are only two such facilities in existence with nine beds between them in a city of 1.5 million.

A few hours later, a new doctor came on the scene who had no knowledge of the previous doctor’s directive to see a back specialist in the not-so-distant nine months. He proceeded to page that neurosurgeon. The latter left the building earlier with no instruction on my friend’s file.

This final visit to the hell of public health care ends with Amy receiving a walker. And once again she goes home completely paralyzed by pain and bedridden. More helplessness, more crying and desperation, more crawling to the bathroom in perpetuity.

It was during this time that I recalled about a friend who recently had back surgery by private means in Florida. I quickly dialed Lyndon. Five minutes later I relayed the information to Amy. Lyndon had had the same diagnosis, gone through the same degree of pain and faced the same level of public health care’s incompetence. Lyndon enlightened me about the most advanced type of one-hour laser surgery that gave him his life back by way of a private clinic just a few hours south of the border. He raved about the results, the efficiency, and before & after care. Since his own experience, Lyndon had sent four other friends/neighbors/employees to the same Florida clinic for the same fantastic results. Amy was now sufficiently convinced that a private surgery route was her only option for survival.

As it turned out, Amy was able to find a local doctor who performed surgeries in the highly underground, shunned, and unadvertised private medical clinic in another city only one hour of flight away. Since the flight to Florida presented Amy with ten unbearable hours of sitting, a one-hour flight to the private clinic in a city next door was much more feasible. The cost was identical; about $20,000 when all was said and done.

From the time Amy found the private practice of Dr. Moe (not his real name) to actual surgery, only four days had passed. Four days! Not nine months, not two years.

Amy and I were promptly on a plane to spinal surgery to rid her of this torment once and for all. To watch my friend struggle with pain on a one-hour flight is a vision difficult to describe or forget. At times she was on the floor and on her knees tucking her face into the seat.

Amy’s surgery proceeded as scheduled and the very next day we were discovering markets and beaches of a beautiful city. She remembered how to walk after two months of confinement. She remembered how to smile and crack jokes as she routinely did before. It was a rebirth.

Dr. Moe explained that Amy’s nerves were completely mangled by the bulging discs and he was not at all surprised at the level of pain she was suffering. He also admitted that she should’ve unequivocally been admitted for surgery had the system worked, and that this type of pain cannot be just “managed”.

In case it’s not clear yet; the local spine surgeon had to fly to the adjacent city (as Amy did) to perform this surgery in a private clinic. With draconian restrictions on private care, he had no way of doing it locally where both he and his patient reside.

Although still in recovery, Amy is able to walk today. Able to sit. Able to speak without moaning out of pain. She’s on the mend.

But Amy’s story doesn’t quite end here. For lack of any other alternatives, this very Canadian (there you have it!) public health care mess, more than charitably fed Amy all sorts of opioids. Her room is a pharmacy with every choice drug on the planet.

Yesterday my courageous friend read an article about the dangers of opioid addiction. She promptly decided to stop the use of Tramadol. Today she took none and experienced the most frightening withdrawal symptoms she could’ve ever imagined: a terrible migraine, severe achiness in joints, inability to function or think, pounding and pulsating temples and forehead, flatulence, drowsiness to the point of total muscle weakness, and all the common flu symptoms. No medical professional prescribing and handing out this chemistry ever mentioned opioid addiction, opioid withdrawal and proper way to manage and eliminate this poisonous dependency.

Unless you live in Canada and have the dubious pleasure of experiencing the one tier system of finding a family doctor, wait times in hospitals, wait times for imagery exams, wait times to see specialists and wait times to discuss possible treatment or surgery, you can’t really appreciate the true meaning of the word “affordable” in Canada’s very affordable public health care.

If affordability and equity are your goals for suffering and right to die in pain, then the Canadian public health care system has your name on it. And you should move here immediately. If on the other hand you understand the tragic jeopardy of government controls on what you should and should not spend your money on, and the inherent inability of government to run anything efficiently and effectively, let alone your health…than it is probably best to fight for a two-tier system with everything you’ve got. It will save your life one day.

It is extraordinary that those adamantly against the existence of private health care do not compute one simple concept: if you alleviate the backlog in the public system by moving patients (with means) into the private sector, you help everyone. By providing a private health care option, which every Canadian should have a birthright to access, you move patients up through the public queue ever so much more expeditiously. And by providing a decent private alternative, you just may retain your best medical staff, instead of perpetuating the talent drain to south of the border. To boot, income taxes lower as it becomes less onerous on government to provide healthcare for all. Everyone wins, right?

Alas! Liberal governments lose! What will they do without such a vote-ensuring government co-dependency?

In the nirvana known as the Canadian “free” public health sector, two things are a complete lie. First, the system is certainly not free – this is no free lunch. Canada is one of the most overtaxed nations in the world with a hefty portion of the tax bill feeding the “free” healthcare model. Second: it is hardly a public system when you wait for up to two years to see a specialist, up to three for surgery, and don’t have any hope in hell to get through emergency room queues.

Hard to believe but this very flawed and inefficient universal health care is a source of collective pride in Canada. Yet expensive dental, ambulance and other services (chiropractic, physical therapy, mental health services, etc.), as well as specific prescription medications must be paid for out of pocket. Eye exams and eye care after age of adulthood? On your dime, thank you very much. Only 2/3 of all Canadians have insurance coverage for these types of expenses. Incidentally, Amy just got a $385 bill in the mail for her scenic ride in the ambulance.

The Commonwealth Fund (a U.S. think tank) ranked Canada 10th out of 11 wealthy nations in terms of health care. The report placed Canada last in timeliness of care. Long wait times and bureaucratic roadblocks are not justifiable even if you believe a system of equal suffering is all the rage. European countries that use a hybrid of private and public models have shorter wait times and are ranked higher overall.

Bottom line; if Canadian government mandates that you can’t spend your hard earned money on your health, then you will spend your hard earned money on your health south of the border. American hospitals are full of Canadians. 63,459 Canadians sought medical treatment outside of Canada in 2016, a 40% percent jump from the previous year (Fraser Institute report). This is affectionately known as “medical touring”.

Canada’s single-payer public healthcare system forced over one million patients to wait for necessary medical treatments last year. An all-time record. The only thing Canadians are guaranteed is a spot on a waitlist.

Unless you plan on the flu or a headache, don’t get sick in Canada. And remember, the only trouble with free is that it’s so expensive.

About the Author
Valerie Sobel is an Economist, writer, philanthropist, and a pianist living in Canada.