A Tale of Two Doctors

I've seen a few medical professionals lately. I pretend it has nothing to do with getting older. In fact, it doesn't; it has to do with having checkups.

Tuesday, I went to a physician's office. I flashed my health card and was ushered in to talk with the physician. When we were done, I made an appointment for my physical and left with an order for routine blood tests. No money exchanged hands. I had no co-payment. I will not receive a bill for 20% of the charge up to some amount.

This is the kind of health care Canadians like to talk about, and with good reason. When you're sick, you get care. However, when you're healthy, as I am, and you live in an area where family physicians are scarce, as I do, getting regular medical care requires jumping through hoops. Still, I get by with a little help from friends...and now I have a doctor.

Wednesday, I saw the dentist. At the end of the appointment, I went to the desk and made an appointment for a repeat in 9 months. I also received a photocopy of the form they're submitting to my insurance provider. When the insurance company pays for everything it pays for, there will be a balance left to pay, and I will be expected to pay it.

If this process sounds familiar to you Americans, it should. Routine preventive dentistry is exempt from the "free" medical care. So are routine hearing health and routine eye exams. For those health professionals, you need deep wallets or insurance. And insurance determines what treatments are covered (fluoride is not) and how often I get cleanings (every 9 months; other insurance I've had allows cleanings every 6 months).

Some issues with hearing, vision, or teeth are considered "medical" and therefore would be covered. If you suddenly lose hearing and see your physician, she may order a test from the audiologist to determine what hearing is lost and refer you to an ENT specialist or neurologist. Those kinds of problems are deemed to be "medical."

But if you're losing hearing and it looks like routine aging, you're outta luck. What about the fact that if you can't hear what your physician says, you won't follow instructions? Maybe you take two pills at bedtime instead of one pill at a time, 12 hours apart? And if you have a mouthful of decayed teeth, your overall health is at risk. That stuff isn't addressed as well up here.

Medications are also not covered. So, for example, your pharmaceutical insurance might allow you to receive chemotherapy at home. Or it might not. It might defray 80% of the cost of some drugs, and leave you on the hook for the full price of others.

Of course, that state of affairs is "normal" in the U.S. Hearing aids are expensive; many boomers should have them and can't afford them. Your insurance may not cover an experimental chemotherapy, even though your participation may benefit not only you but the entire population who has the same cancer.

When I was having my teeth x-rayed, I heard a young woman talking with a hygienist. She said, "When you don't have dental insurance, you're obsessive with the floss." I would submit that those of us who do have dental insurance can also be obsessive with the floss, and that floss isn't the answer to all dental problems. Of course, her point is that not all medical care is free even on this "socialist" side of the border.

And as I have said before, medical systems are systems, with emphasis on the word system. No system is perfect.

But this system has advantages, I have to say. I really wish Americans weren't so afraid of it.