I live in Toronto, Canada.  I immigrated here in 1969
from Ireland.  I moved back there from 97 to 2003, so
got more recent experience of that system.  I have
friends from the US who have given me a perspective on
that system.  Between the three I prefer the Canadian
system.

There have been various commissions on the Canadian
healthcare system over the years.  One of the most
comprehensive was the " Commission on the Future of
Health Care in Canada (Romanow Commission, 2001 to
2002), which is available at:
http://www.hc-sc.gc.ca/hcs-sss/com/fed/index_e.html

It has been some time since I read it but it does have
information comparing the Canadian system with the US
and others.  I seem to remember that there was very
useful comparisons on the costs which showed that the
universal model in Canada is cheaper that the US two
tiered model.

This list has given me a sense of the amount of time
that OTs and other health professionals in the US
spend trying to figure out how to get funding to
provide treatment, or figuring out the rules and
regulations around funding.  We have some funding
challenges but nothing like you have in the US.

I work in mental health, on an ACT team.   I think
that the whole system of mental health is underfunded
in Ontario, especially for client with chronic
psychotic illnesses.   But when I read Pete Earley's
book "Crazy", I got some perspective on the US system.
 I thought that his son's experience of trying to get
help in the US was pretty similar to our system, but
in Canada we don't have insurance companies dictating
length of stay in hospital.  

We have the same problem of too many mentally ill
clients ending up in the jail system.  But again, I
don't think it is quite as bad as that jail in Florida
that he profiled.  In fact, sometimes, it is a relief
when our dual diagnosis clients, (psychotic illness
and crack addiction)  spend a short time in jail as
they are usually detained in the medical section,
where they are given medical help getting off crack. 
Of course they go back on crack as soon as they get
out, but that is another issue.

A major problem in both Canada and the US in terms of
getting treatment for psychotic clients is the "rights
legislation" which allows clients who are psychotic to
refuse treatment, as long as they are not a threat to
themselves or others.  This was so clearly shown in
the US documentary by Susan Smiley "Out of the
Shadow", which shows her family struggle to get
treatment for their mother.  

In my six recent years in Ireland I found there were
more barriers to getting preventive healthcare without
supplementary health insurance.   People who do not
have extra health insurance can wait for years for
some proceedures in Ireland, but rarely die for lack
of treatment.  I made friends with an Irish woman who
was an American citizen but had to return to Ireland
when she got cancer.  She had no health insurance and
would have died as she could not afford the treatment.
 She has remained cancer free to date.

Shortly after I returned to Canada, my husband almost
died and ended up in ICU where he got fantastic care. 
He was unconscious for six days, so I got to talk with
his nurses during that time.  One of them told me that
the daily cost of treating a client in ICU was $10,000
Can.  I was shocked. I was already stressed and the
idea of incurring a $60,000 Can. debt that we could
not pay would have been intolerable.  One of my US
friends who stayed with me for one of the six days,
told me how her father lost his business and home when
he was unable to pay medical bills (in the US).

Regards,

Aine Suttle.

--- Elayne Haley-Ververis <[EMAIL PROTECTED]> wrote:

> Please keep writing on this topic!  I'm an American
> and an OT student.  I live in Nashville, TN, which
> is largely George Bush/right wing country.  I
> desperately want to see universal healthcare of some
> type - any type, at this point - in the United
> States. 
> 
> Michael, you are so right in that universal care is
> more humane - to say the least.
>  I've been in both "lucky" and "unlucky" situations
> here as far as the ability to receive healthcare.
> 
> For example, I was married to a cardiologist for
> years which entitled me to not only excellent
> healthcare, but "professional courtesy" to boot. 
> Once divorced (with three kids), I could not buy
> health insurance.  I was out of the work force for
> 15 years (its incredibly hard to maintain employment
> when your spouse works 70 hours a week.  Also we
> relocated after residency and then after fellowship,
> away from family, etc).
> I couldn't even buy it despite having enough money! 
> I had become depressed over the divorce and took
> medication for two years and so became ineligible. 
> Depression - along with everything else - is
> considered a "pre-existing condition" and so tough
> luck.
> 
> Now I'm a student and can buy student insurance, but
> its not very good.  It only covers up to $10,000 and
> after that I'm on my own.  Believe me, $10,000 would
> not go far here in the US.
> 
> My story would not get much sympathy here where over
> 40 million people are without health insurance......
> many of whom are seriously ill and unable to buy
> needed medication.  So I'm not complaining!  I'm
> only telling my story because many people (here in
> the US, anyway) think that the uninsured are simply
> too lazy to get a job.  Not true.
> 
> So....I would love to hear what you in Canada have
> to say about universal healthcare.  The general view
> here among those against it is that universal
> healthcare means substandard health care.
> -- 
> Options?
> www.otnow.com/mailman/options/otlist_otnow.com
> 
> Archive?
> www.mail-archive.com/[email protected]
> 


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