04 My Experience in the Canadian Health Care System

As I’ve mentioned in some of my recent posts, I’m recovering from a serious illness. Now, I’m not a person who heads for the doc at the slightest discomfort. In fact, I don’t have a family doctor precisely because I rarely will go to one.

The last time I had contact with the medical system was about seven years ago, I had a swollen lymph node back then, easily dealt with. This time was a serious infection that required being hospitalized.

I hear lots of complaining and even horror stories about our medical system. Sometimes I’ve wondered if some of those stories come from unrealistic expectations, lack of communication with health providers or if the problems are indeed real. Like most people, we find out when we experience the system.

Some Background on the System

Canada is a single payer system, or universal health care. Most medical care for all is paid through taxes. While the system is federal, each province administers the system in their own manner in compliance with federal and provincial laws.

When OHIP (Ontario Hospital Insurance Program) was first introduced a credit card size red and white card was issued to every qualified Ontario resident to prove we were insured. When we went for medical care, we presented the card and OHIP was billed. The card didn’t have an expiry date.

Back in the late nineties the government decided to go to a new system where the cards carried a photo of the resident and had to be renewed every three years. There is no charge for the card, just the nuisance of having to renew them.

I Held Onto My Red & White Card

I had received letters asking me to go in and get the new card. It told me what ID was required and one of them even told me if I didn’t get the new card, they might cancel my red and white card.

I put the letters aside. Since I didn’t have a current need for medical care and I had other things to do, the letters just never got onto my ‘must do now’ list. They were set aside for my ‘should get around to it’ list. You know, like when I actually need it.

The Need Arrived and I Try to Get the New Card

In mid-May I started experiencing an illness. Me, being me, I just kept on doing what I normally do and considered any sick time to be a nuisance that would pass. It did however nudge me into thinking about that health card change and I visited Service Ontario to get it looked after.

I quickly learned that my card had in fact been cancelled back in April 2016. I also couldn’t get the new card without having a birth certificate for ID. I would have to go home and place an order for my birth certificate online and it would cost me to get it. So, off I went, knowing I didn’t have health care coverage.

Getting Sicker and No Health Coverage

So, I placed the order for the certificate and would have to wait for it to be processed. The message on the order informed me it may take longer because some info like my parents birth dates were not supplied by me.

I thought I might actually be getting over what I thought was a bug so I decided I’d just wait for the birth certificate to arrive and then maybe see if I could get checked out to be sure.

I looked around online to try to get an idea of what would happen if I needed medical care and had no coverage. I found a few reports of people losing their coverage for not getting the new card but nothing about the outcome.

Early in June, I started getting worse. I was having considerable difficulty keeping food and drink down. I anxiously watched my mail. I reached a point where I was vomiting every few minutes. There was no choice now, I needed to get to the hospital.

Off to the Hospital I Go

I called 911 and had the ambulance take me to the hospital as I not only wasn’t really fit to drive but had I had someone take me to the hospital, I wasn’t sure I could actually get into emergency when I got there. The ambulance took me directly in.

During the ambulance ride, I was asked if I had my OHIP card. I replied yes, but, it wasn’t valid and explained what had happened. I was surprised when the response was, ‘not to worry, it can be dealt with later’. I was too sick at that point to ask how or when or even to care.

My expectation was that I’d receive bills for the care received and would have to then go to OHIP to argue that they should cover them as it was them who had cancelled the card without further notice. I’d deal with that when I had the strength.

Taken Into Emergency

We arrive at emerg and I hear the paramedic advise the desk that the my card is invalid. Nothing is said, I’m quickly taken into a treatment area and before long a doctor appears to examine me. I’m sent over for a catscan and intravenous is setup to hydrate me and to try to settle the vomiting.

After some time the emergency doctor tells me there is a large cyst like mass in my stomach cavity and he’s called in a surgeon to decide on treatment. The mass is causing pressure on my stomach and causing the vomiting.

The surgeon advises me that there is a partially embedded stone in the wall of my kidney. She’s asked a few doctors to have a look at the images from the catscan and they are not fully in agreement about the role of the kidney stone but they do agree, the mass is infection and it needs to be drained.

Arrangements are made for a drain to be inserted in my stomach the next morning as it was getting late in the day. I spent the night in emerg because no beds were available upstairs. I learned the next day that there was eleven people in emerg awaiting beds and twelve over capacity upstairs.

I’m Admitted for Care

After the drain was inserted, I was taken upstairs to a bed that had become available. A person from admissions appeared briefly in my room and asked to see my health card because the number was showing as invalid. I confirmed to her that was correct and told her what had happened.

Nothing further was said. Treatment continued, medications were administered. I was transported to another hospital for a procedure and returned to the first hospital. The doctor saw me on a regular basis. The care was excellent, I couldn’t complain about how I was treated. The communication with the staff was good and I knew what was going every step of the way.

Discharged to Home

After ten days, I was discharged. Because I didn’t have a primary care physician, the surgeon advised me she would stay involved in order to make sure that followups were done with herself, the urologist and anyone else I needed to see.

Home care was arranged to look after the drain that was still draining my stomach cavity. Nurses came to the house at first daily and then every few days until the drain was removed.

I had to return to the hospital for outpatient appointments for another catscan, xrays and to see both the urologist and a lung specialist when fluid was found on my lung that needed draining.

At no time was I denied any care even though my card wasn’t valid.

Getting the OHIP Card Sorted Out

It was almost two weeks after I was home before I was strong enough to even try a trip into the local Service Ontario office to take the birth certificate in to get my OHIP card back in place.

When I mentioned to the lady on the counter that I had just been hospitalized for ten days without benefit of a card. Her response was “Oh, we’ll cover that. You are a valid resident of Ontario.”

She explained to me that once my card was reactivated, which it would be as soon as she entered everything, I should call the hospital and find out if they have done any billing. If not, I was to provide them with the updated card info and they could then bill OHIP.

I asked what would happen if they have billed me. She told me that I should take the bill that arrives and take it to a ‘full service’ Service Ontario which was about 20 miles away and they would sort it out for me.

So, just like that, my coverage was fixed and the bills for the care I received, while not actually covered, was covered. So, I’m not inclined to complain about the care I’ve received. When there was an urgency for me to receive a test, it was done and when less urgent, the time between the doctor wanting it and me receiving it was not very long.

Well, there is two bills I had to pay, $45 for the ambulance trip to the hospital and $80 for the antibiotics I had to take when I left the hospital. All the meds I received during the hospital stay were billed to OHIP.

I’m thankful for our system. It’s not perfect but for the most part, it works.

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