You may pay for our Canadian System With Years of Your Life

Chapter Five: How is Mr. LD doing now?

First the bad news; Mr. LD has spent approximately 300,000 dollars to date for medical treatments south of the Canadian border. He has been inconvenienced considerably by having surgery in a foreign country, staying in hotels, being apart from his family during these stressful times, and of course, enduring the pain and discomforts of his surgeries. He is being maintained on 4 mgms. of Zemeta intravenously once a month and 30mgms. of Depo-Sandostatin intramuscularly once a month administered by myself and a home care nurse. He occasionally takes some ordinary acetaminophen or Advil for a slight ache in his left arm residual from a bone met. that was previously radiated but is not progressing. He has two other small bone mets. that have showed up on scanning in the past six months but also do not seem to be progressing. He continues to visit the MDAnderson Cancer Center every three months for scans and follow ups that likely will set him back some additional dollars.
Now for the good news; He is free of 99% 0f his tumor load and since this has been identified as a slow growing malignancy, likely will still have another four or five years of life expectancy. He is basically pain free and symptom free, walks one to two miles everyday, and continues to run his many businesses, paying in excess of 300,000 dollars in income tax every year. I’ve listed the tax as a good thing since it is better than his demise in which case, tax would not be a problem for him. Basically he continues to enjoy his normal good quality of life. I find it quite ironic that he supports our health care system with his considerable tax dollars, but the system certainly did not support him.
So what went wrong for this man at one of our more “advanced” cancer centers in Canada? Some of you will say it was a failing on the part of the physician surgeon, but it is my understanding that this particular physician is one of the most respected at the Center. Perhaps we do not have the technology to determine that he had 50% more liver than necessary to survive the surgery. If this is the case, why not refer to a center that has more accurate CT scanners and the necessary technologies. For that matter, why was not a second opinion/referral given when the patient specifically asked for that information? The cliché that “we all read the same medical journals” certainly was of no help to my patient. Or are we, in the medical profession so pressed for time that such a time and effort commitment is only made when there is the potential for a cure, not simply for additional years of life. Even more frightening is the question: “Are we as physicians prioritizing what we do to save the system costs”? We do know that our transplant teams are given annual budgets and patients are selected as to “who will benefit the most”? Has this become a “Modus Operendi” for major surgeries in general?
So once again the question needs to be asked “What is a year of good quality life worth to you. If Mr. LD lives another four years he will have gotten at least five additional years that he would not have had by accepting his “fate” in our healthcare system. That will work out to about 60 to 70 thousand dollars per year of life, a figure that he feels is a bargain. But do you and I have those resources, and why is private insurance banned in Canada. The Supreme Court of Canada ruled in the Chaoulli case that the law was unconstitutional. Why haven’t provincial governments in Canada responded, or is the constitution for the protection of Quebecers only? After all, the average Joe doesn’t have the deep pockets of my Mr. LD, and insurance was designed to protect us low income folks from unforeseen major costs. What I would like to know is whether, as a Canadian citizen, I could take out insurance in the U.S.A to cover second opinions and delays in access to our healthcare system. It may be something to consider.