In the playground

Not long after we arrived, we were at a nearby playground to burn off some collective energy. A couple of women with a kid arrived with the same idea.

We started chatting, the mother of the boy heard me say "eh" and they laughed at my Canadianisms.

The other woman, somewhat older, told a story about her son who, some years ago, caught Necrotizing fasciitis (the "flesh-eating baceria") at age 2. It was touch-and-go, and the hospital asked about her medical coverage; she had none, but she told the doctors to save her son. The medical system in Boston is known for being a good one, and the boy survived.

They were obviously not well off—much of Norton seems to be actually quite poor—so the mother learned to change his bandages and perform nursing duties so that she didn't have to hire a nurse. Nevertheless, by the time her son had recovered, she had spent $48,000 to save his life.

Last summer we had to decide whether we could afford to pay for surgery on our cat—surgery which would save his life but was something that financially we really couldn't afford. I left that playground with the sudden realization that what we went through with our cat, that woman went through with her child—something that I found nearly unimaginable under a public system.

---

Having said that, things may be changing in the U.S. I have heard several people (including the women at the playground) mention that Massachusetts is the first state to bring about universal health coverage—or, as it is consistently put, Massachusetts has made it illegal to not have health coverage. (The fact that people describe it as such strikes me as an interesting difference in perception from Canada).

I really don't have a clue about this (I haven't even seen Sicko), but this is what I've managed to come up with so far: the health care system now has a managed clearinghouse for all the various kinds of health plans available. If you do not have coverage, you will be fined. However, the deregulation of health plans means that more affordable options will be available to individuals and small companies. Hmmm.

I find it interesting to look at the differences in approaches between the States and Canada; the Massachusetts model has elements of universality (particularly the enforcement of medical insurance on everyone), but the solution is still essentially a market-based one: deregulation and an arms-length Government referral service.

I can't help but wonder – what if (effective) universal health coverage just can't fit into a for-profit market-driven framework? What if universal coverage just isn't profitable enough? Is the idea of "consumer choice" going to work in the context of making decisions—sometimes life-and-death and on the spur of the moment—about the survival of family members?

Public universal health coverage it ain't, but it seems to be the closest thing in the states—and it was a bipartisan effort. Then again, the Heritage Foundation thinks it's a good idea...