Its Selection Is Not A Choice

It happened in the late-‘oughts after decades of targeted barbs in the media about Canada’s healthcare system. In retrospect studies found this narrative of long “wait times”, medical “refugees” and substandard, even rationed care to be, simply, propaganda.

But just personally, it has been my lived experience in America as a survivor of several head and neck tumors, to be excluded from any employment not bundled with the benefit of large-group insurance, which accepts preexisting conditions. By necessity of my very existence, my lifelong work experience from the get-go has been limited to enormous institutions with premium insurance contracts, e.g., academia, government. The fiction of “choice” afforded by the free market has quite simply been a permanent, existential, cruel tease.

In my 40’s I developed neurological problems treated with ganglia blocks and then surgery. And subsequent to this I was diagnosed with a pain syndrome I concluded to be like “phantom limb” syndrome where perception is of a physical reality that does not exist:  and there is no way to “fix” what isn’t there. The very real, excruciating pain I experienced was an interpretation, not a reality.

The prognosis is poor and treatment is inexact. Physical therapy with expensive, never-ending copayments appropriated a significant fraction of each session to gathering metrics for the insurance company rather than therapy to address my pain. After one such session devoted entirely to untherapeutic measurements I dragged myself into a stairwell and just sobbed. I could not have explained my anguish to concerned passersby if I tried. I was out of options. And when the insurance company refused to pay for more treatment I agreed that assuming full responsibility for such tenuous care could well be pointless.

Then my husband accepted a sabbatical position in Canada. As a guest of the government his family was entitled to their national insurance coverage. I was inducted into the Canadian medical system following a serious bicycle accident. And when they undertook to treat me for my unrelated, preexisting condition, to my skepticism regarding appropriateness and ROI, they responded:  “it does not matter how or when you acquired this problem, the task is to address it.”