Monday, November 4, 2013

A Solution Will Be Found for Edie Sundby

Ms. Edie Sundby has a problem, and she wrote a sober but moving account of it in an article that was published on November 4, 2013 in the Wall Street Journal. It has the title: “You Also Can't Keep Your Doctor” and the subtitle: “I had great cancer doctors and health insurance. My plan was canceled. Now I worry how long I'll Live.”

There is no denying that Ms. Sundby has a big problem but there is no reason to believe it will not be solved to her satisfaction before her current plan is canceled at the end of the year. The Affordable Care Act in America is a worthy project, and like all worthy projects it is experiencing some early difficulties in its implementation. But these difficulties will be ironed out before long. I know because we had a similar experience here in Canada almost half a century ago. So let me tell you about our family's experience.

Let me say at the outset that in personal terms, our problem did not compare in any way, shape or form to that of Ms. Sundby. The reason I am recounting it here is to show that implementation – even on a scale as small as Canada's population was in 1964 (Approx. 20 million people) – can go bad, but that the problems it creates are eventually resolved to the satisfaction of everyone.

We arrived in Canada late in 1964 and experienced our first harsh winter in January of 1965. It may have been this change of climate that caused my mother to feel stressed, and so she fell ill. We took her to a clinic where she was seen by several doctors who prescribed the appropriate tests and medication. The Canadian healthcare system was just coming into effect, so we had to pay the clinic and apply to be reimbursed. The amount sounds small now (87 dollars) but that was a lot of money at the time, especially to newly arrived immigrants.

The staff at the clinic gave us forms to fill; we did and went home. A few days later we received two checks in the amount of 87 dollars each. One came from the clinic and the other from the Ontario Health Insurance Plan (OHIP). My father left it to me to deal with the matter, so I called both the clinic and OHIP to ask what to do. Both told me not to cash the check but to send it back to them. I did.

Being new in the country, our first priority was to find a job each, and this is where we turned our attention. By the spring of 1965 we were all working and doing well. The last thing we had on the mind was the money we paid to the clinic, or the checks we were told to return. But then, it was surprise, surprise – in that we received an invoice and a nasty letter from the clinic asking for 87 dollars plus interest or the matter will be handed to a collection agency, which will result in garnisheeing my father's wages.

I went to the bank, withdrew a hundred dollars, put them in my pocket and went to the clinic. I met the woman in charge, and explained to her what happened a few months earlier. She was not surprised, and told me there have been many mix-ups. She opened the books, looked into them, looked at me, smiled, opened a box, leafed through it and pulled a check made out to my father in the amount of 87 dollars. She gave me the check and explained we should have received a notice that OHIP was reimbursing us rather than a notice threatening to call the collection agency.

And you know what? It was all worth it because almost 9 years ago I had a heart attack and went to hospital. I was minutes away from dying when they gave me a shot nicknamed “clot buster” that instantly revived me. That procedure alone cost something like 5,000 dollars. I had a quadruple bypass after that which God knows cost how much.

And every time I undergo a medical procedure, I remember the incident almost half a century ago that ushered Canada into the wonderful plan that is the Canadian healthcare system.

You will too, Edie Sundby, you will come to like the Affordable Care Act when it gets going as it should.