The Tale of the One-Dollar Q-Tip

An AmeriCanadian Perspective on U.S. Health Care Reform

I’m no politician—which means I can sit back in front of the TV with a cool raspberry popsicle and something like detachment as I watch both supporters and critics of the Democrats’ health care reform proposal turn American town halls into The Jerry Springer Show. I say “something like detachment” because although I am Canadian, I will be moving back to Iowa again this autumn, at which time I will be eligible for U.S. health insurance. Whee.

Come on. You have to admit it. The system’s a mess right now, as parties on both sides of the fence will attest.

But don’t worry, just because I’m Canadian doesn’t mean I’m going to whip out my Robert Owen T-shirt and start reciting the Socialist Manifesto (if there is such a thing). I’ll be the first to admit the failings of Canada’s health care system—chief among them, those pesky waiting lists for specialists and surgeons. Still, as someone who’s had direct experience with health care on both sides of the border, let me offer you a quiet, little-known story. It is the Tale of the One-Dollar Q-Tip.

Back in 1994, when I was blithely racking up what would eventually become a $50,000 post-secondary education loan in Iowa, I became inundated with some serious sinus blockage (sexy time!), for which I required surgery.

“Do you have insurance?” asked the receptionist in the otolaryngologist’s office, as I booked my appointment for a nasal endoscopy (the unceremonious reaming out of one’s sinuses via snaky laser scope). I mumbled something about having coverage through my father, who lived in Canada. She whipped out a piece of paper, I signed the dotted line and a few short weeks later, I was in a recovery room at the University of Iowa Hospitals and Clinics barfing up blood like something from The Exorcist (swallowing buckets ‘o hemoglobin was an unfortunate incidental of the operation).

Turns out, the worst was yet to come. A few weeks after the surgery, which was only day surgery and only partially successful, my father received a bill for $22,000. His insurance company, Sun Life, chipped in and paid O.H.I.P.’s (Ontario Health Insurance Plan) going rates for the procedure, from anesthesia through recovery room: $4,500. The remaining $17,500 was to come from Papa’s pocket. Dad called to dispute the bill, but my surgeon was vacationing in the Bahamas.

It’s funny how inanimate objects can lodge themselves in a family’s lore and come to stand as near-mythic icons of a particular incident (such as my operation), or paradigm (such as the U.S. health care industry). For our family, it was the $1 Q-Tip item charge on that hospital bill. I don’t know what the going rate for Q-Tips was in the early ’90s, but today a pack of 750 will set you back about four bucks. That’s a little over $0.005, or half a cent, each. Which means the Q-Tip was marked up, oh, 200 times or 20,000%. How much, then, was the surgeon’s rate hiked up?

In the Schrum household, the One-Dollar Q-Tip has come to symbolize the failings of the U.S.’s capitalist system of health care, at least, as it runs currently—e.g. relatively unchecked by the government. The sky’s the limit on what hospitals and physicians can charge, and therefore insurance companies are free to follow suit. Little surprise, then, that Americans spend more money, per capita, on health care than in any other nation in the world. Moreover, medical debt is the primary cause of bankruptcy in the United States. Why then, are Americans frothing with fear about the dangers of a government-run public health plan, which would exist alongside private insurance companies to keep them in check? Sounds like the best of both Socialist and Capitalist thinking to me.

Why is it that the mere mention of the word “Socialism” strikes fear into the hearts of Americans? Yes it’s true, Canadians dole out hefty tax dollars to cover their “free” health care plan. But I lived in Canada last year, and the total amount I paid the Ontario government in health care taxes comes out to around 25% of the total cost of that sinus surgery I had in the ’90s. True, if I’d had the surgery in Canada, I might have had to wait several months. But still.

Here’s another little story. As an infant, I was sickly and spent many of my first months at the Hospital for Sick Kids in Toronto, Ontario. My parents, then a young couple of modest means, paid not a cent out of pocket, thanks to Canada’s Socialist health care system. I shudder to think of the bills they’d have racked up, had they lived in the U.S.

One last story (this one’s short and bittersweet). In the U.S., I know a woman who’s been making diligent, monthly payments into her employee-based health insurance plan for years. She recently had an emergency operation and racked up $30,000 in charges; through her insurance plan, she “only” had to pay 1/3 of the balance, or $10,000. This is a familiar story; countless Americans are regularly hosed by health insurance companies. What gets me, though, is that this same friend is adamantly opposed to any talk of health care reform. Sigh.

Don’t get me wrong. I’m not saying Canada’s Socialist health care system is the pinnacle of success. This spring, I had to wait two months just to see an allergy specialist. There’s no question in my mind the Canadian system could use a good injection of American-style Capitalist hustle. Quite frankly, though, the American system could use a little more compassion.

And by the way, contrary to what even my most educated American friends seem to believe, Canada’s Socialist health care system does not render its medical services third-world rate. Our doctors are not schooled at butcher shops, nor are they forced to live in adobe huts due to their miserly salaries. Another aside: pharmaceuticals cost less in Canada, which is why thousands of Americans flock north to spend about $1 billion each year on prescription drugs.

OK. I’m finished my raspberry pop and I’m ready to turn off tonight’s episode of The Health Care Reform Terrors. As I absentmindedly chew my popsicle stick, I realize it’s a lot like the tongue depressors doctors use in hospitals. I wonder how much they’re charging for those, nowadays? And if the Democrats’ current health care reform bill isn’t passed, what will they cost down the line?