Heavy is the head which wears the crown...

Some of you may have noticed that I haven’t blogged for a while. This is partly due to the concentration a new project demands, but mainly to a series of health setbacks I‘ve faced. It’s been a rough ride, but the health care I have received has been second two none. I am incredibly grateful to the doctors, nurses and my family without whom I would not be here.

We take health, and our bodies, for granted, and outside the sphere of accidents, our illnesses are usually mild and inconvenient, rather than life-threatening. Serious ailments seemingly creep up without our knowledge. Even the heart-attack, sudden and catastrophic, was caused by arterial plaque building slowly over time.

 Which makes the new Corona (Crown) virus, Covid-19, feel such an existential threat. We can see it coming in a way that previous generations simply couldn’t. The last great pandemic, one hundred years ago, the misnamed Spanish ‘Flu of 1918-1919, killed more people than World War I and had a mortality rate (2.3%) that is similar to new virus that is attacking us. But, despite the carnage, some good came from that pandemic all those years ago. The horrific impact of Spanish ‘Flu was a factor that started the ball rolling on the concept universal health care in most of the western world. A concept that came to fruition after the next great calamity, World War II.

I say most, because the great hold out was, of course, the United States of America. The US followed a different path, private insurance paid for by employers. Your health care came with your job. That is still the prevalent system for most US citizens.

Of course, there are exceptions. 

If you are a US veteran, then you get health care provided by state employed doctors in state run hospitals. The closest model to this is the socialized medicine of the United Kingdom’s NHS, the beloved National Health Service.

If you are a senior or on welfare, you are in a single payer model via Medicare or Medicaid. This is reminiscent of Canada’s provincial model. In Ontario we have a single payer solution, OHIP, the Ontario Health Insurance Plan that ensures our health requirements are met without bankrupting us.

For the rest it’s the classic employer/employee model. This is the system that will be stress-tested by the Corona Covid-19 virus for, as the gig-economy bloomed, so the provision of employer health benefits wilted on the vine. Employers, especially new tech companies, are bending over backwards to ensure that as many staff as possible are considered independent contractors and not in receipt of direct benefits including health insurance. Without sick pay those folks can’t afford to self isolate or seek the attention they may need from doctors or at hospital. Even the folks with full benefits, the lucky ones who are fully insured, face potential hardship through co-pays and deductibles (often charged at the departmental level NOT the hospital level) which can add up to thousands.

In contrast, when I was hospitalized in Toronto for five days last October, I paid $0, including for all tests and procedures. The insurance is provided for the common good, and not for profit. My insurance payments were collected as part of my taxation and, because we all pay it, the insurance pool is big enough to ensure everyone is covered. Oh, and it was quick too. From dialing 911 I was in the ICU and had the emergency procedure I needed within an hour. Now I’m in rehab and preventative care, which in our system is a good investment, not an additional cost.

Maybe this is the pandemic that pushes the US towards this kind of universal access to healthcare. The big worry is that taxes will rise. No bones about it, that is likely, but at the expense of the fees that individuals and employers pay in way of insurance premiums and those aforementioned co-pays and deductibles. Overall I would not be surprised if it was cheaper in the short to medium term for families, since these payments, this private taxation, would be rendered unnecessary by the application of universal healthcare.

There is also the hope that private companies would pass on the insurance savings back to their employees in the form of wage rises too, if not, maybe the shareholders will benefit. But not as much as society will, for, with universal coverage, when the next pandemic hits, and it will, all the people will be covered and will be able to get the health attention they need and deserve. That’s on top of the people like me who will be saved on a day to day basis and no longer face the choice between treatment, bankruptcy or… worse.