A Senior Moment
'Medicare Muddle'
by Rev. Bob Johnston

April 2, 2017

New Perspectives

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Wanda Wickizer lives in Norfolk, Virginia. If she had lived in Norfolk County, Ontario---or anywhere else in Canada, her story would have ended on a far happier note.

 A 51 year old widowed mother of two teenaged boys, Ms. Wickizer had the misfortune to fall seriously ill on Christmas Day, 2013. In a featured critique of the American health care system, (March 29, 2017) New York Times reporter Elizabeth Rosenthal has documented how this single mother’s misfortunes only worsened once she returned from her three week hospital stay.

Before her husband’s death in 2006, the family’s medical bills were mostly covered through his employer-provided insurance. That coverage was extended by the policy agreement until 2009. Ms. Wickizer then attempted to secure private coverage for her family. Because she had a prior, minor medical condition, she was deemed to be high risk. Insurance premiums would have cost $800 per month with a $5,000 deductible. That was far beyond the family’s modest income.

Desperate to protect her children from huge medical bills, , Ms. Wickizer left her job so that their now-reduced income would make the two boys---but not herself--- eligible for Medicaid coverage. Then, on December 25, three years ago, she was suddenly felled by a life-threatening brain hemorrhage.

After she was she sent home to recover, the medical bills began to arrive in the mail. The NYT article details how the US health care system siphons 25% of its $3 trillion budget into administration of the programme. An impossibly complex code is used to define each medical condition and specific treatment. Lengthy invoices spell out each procedure to be billed. (Ms. Wickizer received one detailed invoice that was 66 pages long.) Specialists in coding and billing are needed to navigate the system. The multitude of insurers negotiate and battle with hospitals and practitioners over assessed costs. By contrast, Canada allocates only 12% of its health care budget for administration.

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Wanda Wickizer’s billing included $50,000 for an air ambulance, $16,000 from the local hospital, $78,000 physician costs and $356,884.42 from a second, specialized hospital. This last invoice generously offered a 20% discount because she wasn’t an insured patient. Needless to say, her recovery suffered a psychological and emotional setback. Eventually, concerned outside resources intervened on her behalf and a more realistic cost assessment reached. Terms were not to be revealed.

In Washington this week the circus continued. President Trump has openly attacked the so-called Freedom Caucus, a coterie of conservative Republicans, previously his ideological allies who successfully fought against his proposed legislation to repeal and replace Obamacare.

I never really understood the rationale behind the American aversion to single payer (Federal Government) universal coverage health care, common to every other Western democracy. Late one sleepless night , I found part of the answer when listening to an American, right wing phone-in radio programme. One outraged caller angrily asked why he “---should have to pay for his neighbour’s surgery?”

This was the American ethic of “rugged individualism,” where any attempt at a collective approach to health care services for its general population is quickly branded and rejected as “creeping socialism.” Canadians who have never heard the Biblical story of Cain and Abel (Genesis 4) nevertheless practice its central message: “I am my brother’s keeper.” Through taxes, we contribute to Government revenues, a percentage of which is then transferred to Provinces to help cover their costs of providing health services to citizens.

I have never heard anyone in Canada complain about paying for someone’s necessary surgery, hospital stay or rehabilitation. We understand that someday, it may be our turn. The American health care system leads the world in quality of care for those who can afford it. Compared with many other developed countries, we remain stuck with excessively lengthy waiting times for many medical procedures.

Yet, I would not wish for a moment to trade places with Wanda Wickizer and many others like her, entangled in that confusing labyrinth called the American Health Care system.

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