We recently launched a series on Diabetes Around the Globe because while diabetes doesn’t discriminate, life with diabetes looks very different depending on where you are in the world. We started off with Mike, a British ex-pat living in Spain, followed by Anke from Germany. Today we bring you Jamie, from the Great White North a.k.a. Canada!
Jamie Naessens lives in a small town in Ontario, and works in Toronto. She’s the mom of a twentysomething and is married to an American ex-pat. Jamie has lived with type 1 diabetes for 21 years and has been pumping for the last four. Buckle up as she takes us on a brief tour of what it’s like to live with diabetes in Canada…
A Guest Post by Jamie Naessens
So, Canadians are almost the same as Americans, aren’t they? Except they have free health care, right?
Hanging around in a town like Petawawa, you might hear:
“So, how is it going, eh?” (So, how’zitgoin’ay?)
“If ya got one, I need a … loonie ($1 coin, named for the loon engraved on it) for that parking meter, or a toonie ($2 coin, rhyming nicely with the loonie) if we’re going to be waiting here any longer for that endo appointment.”
“Let’s go to Timmies (Tim Horton’s – Starbucks of Canada) afterwards for a double double to go” (coffee, double cream, double sugar).
And finally, who can’t love a country that has places with names like Spread Eagle, Conception Bay, and Dildo. Really! I kid you not.
Well, now that I hopefully have your attention, let’s get back to the question of free health care. It’s a nice idea, and it is indeed tax-supported, but alas, it’s no free ride.
Most people who have been touched by diabetes already know that Canada is the birthplace of insulin and its discoverer, Dr. Frederick Banting, so shouldn’t diabetes care be a shining jewel? Well perhaps there’s a little tarnish on that crown.
One might reasonably ask, what is covered by the health care system, notwithstanding provincial differences? Visits to physicians and specialists, hospitalization, most lab and other diagnostic tests are covered. A few provinces (not many) will pay for insulin pumps and supplies. If one is lucky enough to have insurance benefits through their employers, they are likely to be covered for prescriptions, dental and other such “perks.” But that’s not a given in this economy. In the provinces that don’t cover pumps, insurance companies may pick up the tab for pumps and supplies.
Health Canada governs health care, and divvies up federal funding to the provinces and territories. Now, imagine two levels of government involvement before care gets handed to the health providers and patients — bureaucrazy (spelling intended!).
Because decisions about coverage are made in each province and territory, coverage is rather uneven across the country. Each province or territory covers what it deems necessary, driven by its own agenda and legislators. For example, what is covered in Ontario may not necessarily be covered in Quebec. Also, due to doctor shortages in some areas, wait times to see specialists can exceed 6 months. In other areas where wait times to get a family physician can be 2 years or longer, visits to walk in clinics are the norm. Needless to say diabetes self-management is essential.
So what about new technology? It comes slowly and manufacturers must jump through hoops to get it approved; both federal and provincial approvals are needed, and labeling must be in French and English to comply with our language legislation. It can certainly be daunting.
Availability of diabetes technology in Canada has lagged behind the US. It hasn’t been until the last few years that pumps have become more common, but their use is far from the norm. Continuous glucose monitor use lags even further behind. Provincial plans do not cover them. Insurance companies are slow in accepting them, and very few of the more progressive plans will cover them. If pumps are the new kid on the block, CGMs are virtually absent.
What it comes down to, is that those who want them must pay out-of-pocket. Under the current system, it could be years before CGMs are allowed to become a must-have for Canadians. What is most alarming is the simple fact that devices which could ultimately prevent a health care drain down the road are likely to remain off limits for all but the most fortunate Canadians.
As in the US, changes need to happen in Canada. However, Canadians tend to let the system drive the bus. That’s not to say that there aren’t people already doing some great advocacy work. They are out there, slogging through the bureaucratic slush and system iciness.
Although Canada is a little larger than the US in geographical size, its population is smaller than that of California. With the population spread out as it is, and the different provincial coverages, those few brave advocating souls must somehow make themselves heard — certainly a logistical challenge to coordinate efforts to dispel the diabetes myths and initiate change in a country often averse to such change.
Our neighbors south of the border have got advocacy right. Kudos to the DOC in the work they’ve done to organize a united voice, making a difference in the diabetes community. In addition to our own advocacy efforts, I can only hope that changes taking place in the US will spill over the border, making a positive difference in Canada.
And now you know some basics about health care in Canada. If any lesson is to be learned, it is from Canadian Tommy Douglas, the father of Canadian Medicare:
“Courage, my friends; ‘tis not too late to build a better world.”
~ Tommy Douglas (1904-1986), Leader of the New Democratic Party and 7th Premier of Saskatchewan
Are you one of the ‘Mine’s international readers? We’d love to feature you and your country! Please drop us a note at info@diabetesmine.com. Thanks!
Well done Jamie, you got my attention. I have an American friend who’s been living in Vancouver for 20 years working as a nurse at a hospital. She also has type 2 diabetes. She says the big problem with the Canadian health care system is the time lag waiting for appointments for any type of doctor or procedure. I’m curious – is there an active LC-DOC? Loonie Canadian Diabetes Online Community? riva
WOW. I am proudly Canadian and this post sums it up OH SO nicely. Thank you so much for putting that out there.
I’d also like to add that without health benefits through employment there is nothing. I have had no health benefits for 15 months so NOTHING tangible is covered. Strips, Insulin, medications etc. As well, there is virtually NO insurance company that will insure me privately because of my diabetes.
I am going to share this post, It was really awesome! EH!!!!
»Courage, my friends; ‘tis not too late to build a better world.«
What a great quote. Thx for your insight. The more I learn about diabetes around the world, the more I am shocked to see how many levels of survival there are, and that quite simply being able to afford your disease, gives you much better chances.
If I owe one thing to diabetes: It has made me a much more humble person.
I have a friend who suffers from diabetes he says the big problem with the Canadian health system is the lag time waiting for quotes for any type of physician or procedure. Well you can do is to wait it best and congratulations on your achievement.
It’s really great getting the perspective of people living outside the U.S. Thanks, Jamie and DiabetesMine!
Another, proud Canadian here; this is a very insightful post.
“Canadians tend to let the system drive the bus.” This statement is very True and the root of the issue. Personally my experiences have differed. I had a family doctor within a month of moving from Washington DC to Vancouver and meet with an endocrinologist that same month. My mom also went from mammography to seeing a doctor at the BC Cancer Agency in a week.
I guess moving from the USA a little bit of the “American advocate for you” had been inherited. I did not let the system drive the bus I worked really, really hard on coordinating health care both for myself and my mom.
Nicely summarized take on our health care system. I am orignally from ontario, moved to Alberta 7 yrs ago, and in the interim have had two of my 5 kids diagnosed with Type one, I am payin out of pocket for two pumps, but have coverage for sets thru the job perks you mentioned above. I have written to the Alberta Minister of Health, and get a letter back, telling me much better Alberta is compared to other provinces, I cause that depends on your diagnoses. I eagerly awaiting change, and am pretty vocal about getting better universal coverage for all Canadians. Time will tell I guess.
Cheers to the great post!!
Great post! All you folks who are unfortunately mistaken about “free” healthcare, aka ObamaCare need to really take a good read on this. And then read it again.
Government run healthcare has never, is not now, and will never, ever come close to a free market driven system.
Ours is far from perfect of course, and needs to change. But read this post closely. As a type 1 diabetic for 34 years, and a healthcare provider who has worked in the US Veterans Administration system, I am so scared about this not because of what all the politicians say, but because I’ve seen it up close.
The people that work in government healthcare are great, wonderful, altruistic, intelligent providers in large part. However, as the author writes, the “bureaucrazy” is always there and inevitably significantly and negatively effects the care you recieve. Service is HORRIBLE. Those of you who think it is bad now, you can’t imagine.
Please think more about this and what you need to be healthy. Everyone always says Canada has it, we should too, etc etc. They are ALL subpar to the US Healthcare system. The rediculous bureaucracy is already here and it is rough and yes, there are many who go without. But it would just bring down the standard so many many more would go without and those who did get care would get worse care. Let’s hope and pray we can keep the “bureaucrazy” out of the United States of America!!!!
Wow! Thanks for the great comments – & lol re the LC DOC comment, Riva! We should form a ‘special’ chapter of the DOC, with a loon mascot!
Perhaps I didn’t say it in the post, but what I do really appreciate is that at least everyone gets health care here – even if sometimes slow or inadequate, and sometimes annoying. There are indeed problems, and sometimes we can’t get what we want, or when we want it, but it’s available for everyone.
Great post Jamie – thank you!
Sam, I wonder if you are actually from an insurance company because they have spent millions to scare us away from universal health care. I am fortunate to have health insurance but have to wait four months to get to my endo, so I’m used to that hassle. I had to fight like crazy to get my pump, adequate number of blood check strips. etc. etc. With 47 years living with type 1 diabetes, always with health insurance, I have had plenty of fights with the insurance companies – and I am so sad for those who don’t have insurance. We have left those unemployed, underemployed in the gutter. Universal health care is the only moral answer and is much more important than lining the pockets of the insurance company executives and shareholder and the politicians who get lots of bucks from the insurance companies. At least with universal health care, everyone could share in the burden as well as get some sort of care. Right now, if you are seriously ill you get banged terribly with co-payments and, in NYS, a 9.73% surcharge of medical bills – so you’re only taxed if you are sick. this is disgusting.
An interesting point about advocating for yourself. When my husband moved to Canada, he has noticed that Canadians seem almost shocked when he calls to address something akin to advocacy. He is no stranger to advocating for himself and others (he had a disabled son) and is no stranger to bureaucracy on both sides of the border. He has been amazed at the Canadians’ love of writing a ‘strongly worded letter’ and believing that it alone is enough to make change happen (although I say it’s not a bad start!).