Far from Free: The Canadian Medical System

By | May 15, 2019

There is a notion of “free health care” in Canada. That is far from the reality for many, our system remains well beyond the reach of various demographics, particularly those living below the poverty line and the working poor. We do, indeed, have a more open and accessible health care system and there is much to be said about our system but all too often the costs of health are overlooked with the idealized notion that everything is free.

It is extremely frustrating for people with chronic health conditions to see medical professionals who suggest products and services without thought to cost. Much of what is suggested is unaffordable except to a select few. Some patients would rather not even hear about the options that could improve their quality of life than know they exist but that you cannot access them.

There are so many costs associated with our medical system it can quite overwhelming. Even before you get into a hospital, you have to pay for parking, and that alone is a deterrent to getting the help you need. Then when you see a doctor, they make suggestions without the knowledge of what it costs. Often, when one tries to talk to a medical professional about the barrier of affordability, they get responses of judgement and being told that they just aren’t prioritizing their health or don’t want to get better, neither the truth. The problem with “prioritizing your health” when you live in poverty is that there is no savings, whatever you use for medical issues is taken from other necessities like house, food, or medications; this leaves you stressed, with poor nutrition, and/or inadequate housing, all of which worsen chronic health conditions.

This disconnect between the reality of the financial abilities of patients and what doctors and specialist suggest needs to be improved. Poor health is not fixed by will alone, there needs to be services and products but there also needs to be affordability. For those who are working poor, the stress is increased because getting the proper medical care can actually cost them money; they have to take time off work to make appointments, losing money to see medical professionals who then expect them to pay for therapies and supports. Some don’t seek out the medical care they need because they know they can’t afford it.

One of the key tenets of accessibility is options. We need to have a medical system with options. Currently there is some government funding, but doctors have to fill out forms, which costs money, so we once again get stuck in a cycle of not having money to pay for what is needed. Doctors should be aware of the costs of what they are suggesting and know cheaper options.

Our health care has a lot of issues to address and affordability is one of the important topics, but it is very rarely discussed. Money is an uncomfortable topic; people don’t want to talk about living in poverty in case it affects the care they receive. Experiencing poverty bias is real and frustrating and keeps some from trusting or turning to medical professionals when in need of help.

Medical students should be taught that there are many intersecting identities that they will encounter: sexuality, gender, religion, income level, race, disability, etc. They should be given lessons and basic information about the various demographics of their patients and learn how to interact with those patients. Health care does not start and stop at the body, brain, and senses, we need to consider the entire person, their environment, and their financial limits.

It is estimated that one in 5 Canadian have precarious jobs. Not only does this affect one’s finances, it affects their health, their stress levels, their mental health. Being given medical solutions or suggestions that further stigmatize and stress people in poverty, or working poor, is not the answer. Being more mindful and respectful about finances and how that affects a person’s ability to access health care is one step we can take towards a future where patients aren’t offered hope only to have it snatched away when they see the price tag. Medical professionals becoming aware of the costs of therapies, medications, support, etc. is another step that is vital to bridging this gap. Doctors should ask patients whether their medical decisions will be reliant on what they can afford, and if that is the case, it should be marked in their chart.

There are ways we can work to support both patients and medical professionals in being more aware of the costs of our medical system and how that affects those in need. Poverty, unfortunately, is shamed, and many are not comfortable talking about it, but dialogue is vital. Thank you for reading this. Please continue this conversation where you can.