When I was on book tour in the Spring of 2005, and I spent some time in Seattle and Vancouver, I got to meet and talk with Canadian mothers, and Canadian mothers who were living in the United States. The later would often be in a state of shell-shock. Used to Canada's health system, they were horrified at how difficult and expensive it is to access good health care in the United States.
I would nod. I know how hard it is: to find good doctors, to make sure your health plan covers them, to get different doctors and specialists and hospitals talking with each other when there's a problem. And I'm middle class and my husband has a decent health plan from a major health insurance company. I know that because we pay very large sums from his paycheck to have this policy (and yes, that large sum is in addition to his employer's "benefit") I can walk in almost anywhere, pay a reasonable co-pay, and see a doctor. Our family's concerns are usually with making sure we see the best physicians and specialists. We are very aware of our privilege here, very sensitive to the issue of what-the-hell-do-you-do in this nation if you don't have the cultural privilege and networks and connections to know who the good doctors are and where they practice.
That's why our experience with the city's Early Evaluation team, here, called Childlink, has been so mindboggling. Here's what it looks, and feels, like.
- Mother makes telephone call to city agency, Childlink. No one answers, she leaves a voicemail. One hour later, the receptionist calls back. Issues twenty-minute over-the-phone questionnaire. Says that a Service Coordinator will call within two weeks.
- Four days later, Service Coordinator, a Nigerian immigrant nicknamed Ola, calls. He asks more questions, and sets a date to come visit.
- Ola shows up on said day. Asks more questions, fills out lots of paperwork. Hands some off to me, and keeps the rest. Sets a date to return with an Occupational therapist and a Physical therapist to do a full evaluation of the baby's development. In the comfort of our home, so the baby would feel comfortable.
- Ola, the OT, and the PT show up at said time. They spend two hours at our home playing with the baby, watching her eat, and asking us questions. They listen as her older sister shows them some things, like that the baby can walk if you hold her hands and arms. They fill out lots of paperwork, and decide that the baby needs two hours a week of therapy. Hands are shaken, smiles exchanged, they leave. I fill out more paperwork, because the state and federal governments cover the costs of early intervention, and that coverage is need-based, the need being the child's health need, and not the parents' financial needs.
In short, all this has happened, and no copays were handed out. No one spent hours on the phone waiting for a health insurance representative to answer the phone, and then wrangling with that person to expand the usualy paltry coverage for physical therapy. There was no anxiety about how to pay for the services, no calculus about how to budget when the insurance runs out. Front and center was a child who needs health care services, and everyone involved was focused on how to make that happen. And the best thing: this would have been the case whether we were poor, or middle class, or very affluent.
I've never before experienced a health system that worked this way. Never experienced that kind of shared, social safety net, and a net that operates at a high standard.
A shame that this isn't the ordinary, but only kicks in under extraordinary circumstances, I thought, after everyone left. The baby was napping, and I made myself a sandwich, and well, just savored the feeling of actually being taken care of by health care professionals. Without any fuss or worry.
I can only imagine, friends, that this is what national health care would look and feel like.