Thursday, April 05, 2007

Mama Bear speaks

On Tuesday, I wrote a bit about where we are in terms of getting Scooter evaluated. And then I made a reference, almost in passing, to the private clinic we have begun to consult. I wrote from the perspective of a mother who has struggled to get any recognition from medical professionals that her son needs extra help.

I guess I’d gotten used to thinking of myself as a very small, out-of-the-way blogger with an audience made up primarily of some local women I have met in the flesh along with a handful of others, mostly other readers of Bub and Pie and a few other bloggers who I found through comments. So far, the only “anonymous” comments I’ve received have been of the spam variety. So I was a bit surprised to find this remark from Anonymous* on Wednesday morning:

Why was it a shock that dishing out dough for something that should cost nothing will get you in there as fast as you want? I understand wanting to do everything you can for your son, trust me, I do, but I worry that trusting private clinics to do the job simply means that some other kid will fall through the cracks.

But then again, you are American. Paying for something that Canada offers for free must feel natural.

My initial instinct was to reply in the comments. The first comment would have been less than courteous; that was never written. I started on another one, but decided it was too long. I figured Trillian would pop in with something—or maybe ‘pop off’ would be the correct term. But she decided that she wouldn’t be able to stay within the bounds of common decency, so she and I just talked about it.

Luckily some of my usual readers, women who have followed my blog long enough to understand my intent, stopped by and said a bit of what I wanted to. So my first point has pretty much been made. This is what I call the Mama Bear response—instinctive protectiveness, you could get your face chewed off, etc. OK, so there are really two points here.

  1. I will go out of my way to do what I think is best for my son. It is my job. I don’t even see this as giving my son an unfair advantage, as I expect that’s what most mothers are doing.
  2. Back the fuck off. Seriously. Mama Bear has calmed down for now. But it is wise not to poke the bear.

That said, let me say a few more things. I doubt I’ll get to absolutely everything I have intended to say, but I will make a valiant effort. I generally avoid criticizing Canada. Part of this is out of respect for my online friends and readers from Canada; I have met some of you in real life and have conversed enough with others to feel I know you pretty well, and I see no reason to go out of my way to criticize your country. I also recognize that many of my little complaints—and they mostly are little—are Toronto- or Ontario-specific. Or, as I’ve become increasingly aware, city-specific; the two areas Trillian and I have our sights set on are basically towns, not densely populated at all. Even my main complaint is Ontario-specific. And that would be health care.

I have not made it a secret that I detest the university health plan. Technically, it is equivalent to OHIP. Technically. They cover all the same things. But they place a dollar limit on how much they will cover for each procedure. And not every office will accept UHIP or requires payment up front; none of them are supposed to turn someone with UHIP away, but they can make it nearly impossible for a person to fulfill their up-front requirements. I was set to have a midwife and deliver at Mt. Sinai only because I was willing to push through the bureaucracy from the beginning. And yes, because Trillian and I have enough saved that we could afford the difference between UHIP’s coverage and actual costs at Mt. Sinai.

I also found out while doing my research a couple months ago that UHIP is entirely funded by members’ premiums. And so every service I seek through my insurance is charged against that amount and, ultimately, determines how much my out-of-pocket cost will increase. And then we pay extra for some sort of supplemental insurance to cover dental, vision, and prescriptions (reimbursement only with strict yearly limits). That is why our premiums increased about 90% between my first and second year; we are now paying two to three times what we did in the US for insurance premiums. And this is despite the fact that Trillian is paying taxes on her income in Canada—several thousand dollars. Similarly, international students who work are paying taxes that go in part towards OHIP but receive no benefit from that. It also means that I am well aware that every cost I incur means higher costs not just for me (since we can afford it), but also for all of those cash-strapped students who have come from around the world for this opportunity.

Then there is also the issue that the particular combination of services and philosophy of treatment we will be getting at the private clinic is not available through provincial services, at least not as far as we can tell. Speech therapy (which is a provincial service outside of health care) and occupational therapy (through a non-UHIP provider) are a piece of the whole puzzle—and we will be getting those through official channels. The developmental pediatrician might suggest some additional therapy and coordinate the treatment. But the sensory processing piece, what we think is the biggest piece, is not generally addressed by any of those. And no, Scooter is not so bad off that he simply cannot function. He is not in the same position as some of the kids we saw at the clinic this week. My heart goes out to them—and to their Canadian parents who have also decided to work outside Ontario’s system. Because these are not services available for free through that system.

Mad Hatter’s comment addresses the other topic I could say quite a bit on, but I will restrain myself to some quick remarks only since I’ve gone on so long already. The system is broken. This certainly seems to be the case in Ontario. And the health care system is a big part of why we’re thinking of leaving Canada before my program is complete. Trillian and I are both at risk for certain types of cancer, and as we move along in our 30s, we can’t help but be concerned about what would happen if we needed treatment. Both of the cancers we’re staring at have been profiled in recent articles. Chemotherapy is not covered by OHIP or UHIP. It’s considered a prescription, so we would get 80% reimbursement up to our yearly limit, which is a few thousand dollars—not much in cancer terms. In addition, wait times for treatment are horrendous. And the province’s goal for reduced wait times—their goal, not what they actually are or are likely to be anytime soon—is considered medically unacceptable. My goal is to avoid the cancer altogether, but I’ve decided it’s best to be someplace where I can get the care I need when I need it.

I will stop there. Not because I’m done, but because I’ve calmed down a bit. And would really like to settle in for at least a few hours of hibernation.

* I should point out that I can easily match ISP addresses to comments via StatCounter. Maybe I don’t have your name—though I could probably figure that out if I really wanted to. But it is important to remember that there is no true anonymity on the internet.


Suz said...

I'm at the same point. It has taken three weeks...going on four and the public service has not even called to schedule the appointment to get the twins evaluted for developmental delays.

We're going private.

But I don't see how that allows another kid to fall through the cracks, as your commenter said. Maybe I'm just being dense here, or maybe this is one of the differences between the American system and the Canadian (although I don't think that the American system is any less broken).

I agree with you. I have to do what is best for my children, especially as I'm not quite sure how it affects others.

Mad Hatter said...

I went to a birthday party for one of Miss M's friends a couple of months back. All the families in attendence were International students. Talk turned to health care and the way our system treats International students. It was shameful to hear their stories. Shameful.

Lisa b said...

I was completely appalled by the drug plan the university offered Canadian grad students so I cannot even imagine the problems with UHIP.

cinnamon gurl said...

You're so right.

The first thing I thought when reading your first post was what if Swee'pea needs services like that and he's considered in the normal range? I felt fear until I got to the private clinic, hoping there would be an alternative.

The system IS broken. I think you'd be hard-pressed to find a Canadian who doesn't agree with that.

bubandpie said...

In all honesty, I don't see the logic of how your decision to pay for services adversely affects anyone else, much less the child of parents who can't afford to pay. If anything, you're freeing up space on the waiting list.

Mouse said...

Lisa b- Our supplemental insurance is through the grad student union, so it's most likely the same thing you're talking about.

And I'm with everyone else on not seeing how using the private clinic will cause another kid to fall through the cracks. I don't doubt that there are kids falling through the cracks. I also don't doubt that, were there no private clinics, more kids would lack the services they need. And I do recognize how lucky we are to be able to afford to go this route. And I think it's awful that other kids are waiting, but this is an area where I won't pursue what I can based on the principle that not everyone can do it. As Trillian said to me at one point: "I'm not going to quit going to the dentist because some people can't afford it." Doesn't mean I'm not incensed that dental care can be so hard to get, but my not going won't solve the problem.

And there I go on one of the points that didn't quite make the original post.

kgirl said...

Just catching up after being away for a few days.

I'm sorry that the system wasn't working for you, as it doesn't for so many others. Whatever your view on public vs. private healthcare, no one could deny the importance - and drive - to do every single thing you can to help your child. Don't worry too much about the comment. You certainly don't need to defend yourself.

Aliki2006 said...

Chiming in late to offer my support as well. We had to turn to a private service, after many struggles with our son's school (he has OCD and many sensory integration issues but because he has not been diagnosed with anything terribly out of the "norm" it's hard to get his school to do anything) and we really can't afford it but have to scrape by, obviously. When it comes to evaluations, it's often the case that it's imperative to act as quickly as possible--for the sanity/well-being of both parent and child. Nobody can offer criticism for a parent doing above and beyond what they need to do--you are the only one who knows best what you need to do for your child and questions of private vs. public become moot.