There are few things as sacred to Canadian identity as a universal and free health care system. Most Canadians would probably agree that it is socially mandatory to sing the praises of our socialized health care. Criticism of this system is not just an awkward faux pas, it is downright treachery. It ranks right up there with deserting from the front line in time of war.
The doctor might also be right about the other thing, that cronyism is natural and universal. Perhaps everyone prefers to provide services for their friends and family, and will bump such people to the front of the line whenever possible. But here's the problem with Canada: in a country where there is no private health care, we have no other line to stand in. We are all forced to stand in the same public line, so when some people get bumped ahead due to connections, everyone else gets bumped down.
If I lived in the U.S., I wouldn't care so much that some doctor prefers to service his or her family. So what? I would just go to another doctor who was more available, because I can shop for doctors there. Actually, fee-paying clients might speak more loudly than even family connections in the end - I wonder how many doctors would be so quick to prioritize their family and friends if they were depending on income from their patients, rather than from the state?
But here, I can't buy faster service on the market. The only way to speed up service (or sometimes, to get it at all) is through connections. People die while waiting for specialists here. People also die because they were seen by specialists far too late, when their illnesses had progressed beyond curable. Who wants to take that chance?
This is the real way that we have a multi-tiered health care system here in Canada. New immigrants and lower income persons are mostly out of luck because they lack the right connections. I used to be one of those people, and I feel their outrage. The middle class gets lucky some of the time, as has happened to us. But the upper crust (and that includes many doctors themselves) lives in a different world of fast and friendly service by friends and friends of friends. No wonder there is so little will among our leaders to change this system.
Margaret Wente has written about this problem in relation to her hip replacement. She is a well-known columnist for a national newspaper, and she herself got to jump the queue when getting treatment. In fact, she managed to get access to a novel treatment that was not even being offered at the time to most Canadians. Here is how she described it:
What I got was first-tier medicine in a multi-tier system. Access to first-tier medicine isn't about money. It's about knowing people who are willing to help you get in to see a specialist in days or weeks instead of months or years. I found shortcuts. I asked for favours. I used courtesy and charm, which seemed to help, and also tears. (Believe me, the tears were real.)
At first, I felt guilty. But I was in pain, and the pain was destroying my life. If I had relied on the system to take its languid course, I would probably be in a wheelchair right now, still waiting for a consultation with a specialist who would probably recommend a type of surgery that is not as good for me as what I got.
So for all those Canadians who are wondering how to get faster service, here is the secret: being friends with a doctor, or having a doctor in the family, can literally save your life. Not because of what they can do, but because of whom they might know.
What will I do about it in my personal life? I am undecided. We have taken advantage of connections in the past, and frankly, we might do so again in the future. Although I strongly prefer a just system, in Canada playing fair might mean ending up dead. That is the sad truth. How is that for an ethical Catch 22?
Photo: salimfadhley via photopin cc