Canadian health care, part 2

In yesterday's post I said I was going to write about what the Canadian -- or, more specifically, British Columbian -- health care system was like for me as a diabetic person, but it turned out more to be a factual account of how the system works rather than a personal account. So today I'm going to write a more personal account.

When I'm sick, I go to the doctor. I don't have to ask my HMO if my particular doctor is "approved" by them. I don't have to ask if a particular doctor accepts the kind of insurance I have, because everyone in the province has the same insurance. I either call up my doctor's office and ask to make an appointment, or I go to the nearest walk-in clinic. I tend to use walk-in clinics a lot, actually, because I hate making telephone calls. Regardless, I go to the doctor when I'm sick. I don't sit around worrying about whether I can afford to go to the doctor; I just go. I don't have to pay anything. There is no deductible. There is no co-pay. No bill will show up in the mail.

Three times a year, I go to see my endocrinologist. I get a referral from my GP to go see my endocrinologist; specialists appointments are by referral. You can't just walk in to see a specialist. Specialists don't get paid if there is no referral. But I don't have to pay anything, not even for a specialist. I don't have to ask anyone's approval; I don't have to submit any kind of request to an insurance provider asking if they will "approve" my seeing this doctor. And no, the government doesn't "decide for me" if I can go see the endocrinologist.

My endocrinologist wants particular tests run. They include a hemoglobin A1C and a urinalysis. About a week before my appointment with the endocrinologist, I go to the lab, I give them my medical card, and they run the tests. My endocrinologist will have sent them a request for the tests. Again, I don't pay anything. I don't have to search to find out whether the lab closest to where I live accepts my particular brand of insurance, because as I said, everyone has the same insurance.

It's kind of like everyone in the province has the same HMO, except that for us, the HMO is the government. That's why it's called a "single payer" health system; everyone's health costs are paid for by the same provider, but for us, that provider is the government rather than a private medical insurance company.

Say I was in an accident, or my diabetes care got screwed up somehow and I ended up in DKA (diabetic ketoacidosis), and I had to go to the hospital. No one is going to make me fill out a whole bunch of forms if it's an emergency. No one is going to ask me how I'll be paying for my care. Eventually someone might ask for my MSP (medical services plan) card so that the hospital can bill the government for my care, but that won't be the priority.

Last year I went off disability benefits while I was going to school, and because I'd had a large windfall of money from an income tax refund, I lost my "medical only" income assistance (see yesterday's blog entry for an explanation of medical-only income assistance) and had to pay my own medical premiums. This wasn't a hardship, because I did have enough money. I was just unused to having to pay premiums, having been on either disability benefits or "medical only" assistance for the last ten years. I hadn't had to pay premiums in those ten years. So I forgot about it for awhile, and then I got a letter in the mail reminding me that I hadn't yet paid my premiums.

I had an endocrinologist appointment coming up, and I knew that my payment wouldn't be processed in time for that appointment, so I phoned up the medical services plan call centre and asked if I would still be able to go to that appointment and whether I'd have to pay for the lab tests I'd just had. "Oh, no, that's not a problem," I was assured. "Even if you don't pay your premiums, you still get health care. It's a necessity! We're not going to make you go without."