Two tier medicine yet again

I had to go to see my doctor today. As it turns out, I have recurring chicken pox, also known as ‘shingles’. There is not much she can do about it she said. (Are you beginning to see a pattern in my life?) I was walking around with it for a week, she thinks that it is now at its worst; spending money on an antiviral medication would be a waste. I’ll get better. I am little too young to get it but it’s not unheard of, besides, this is a mild case, it could be much worse. She also explained the details, that once I had it as a child, it will always linger around and it may come back at an older age. Can anything be done, I asked. Not now, she said, but once this goes away, maybe a year or two down the road you may get a new kind of vaccine designed specifically to prevent this old-age recurrence of the illness. Your immune system will get a boost from fighting this now so we should not hurry with the vaccine. It is quite expensive, and OHIP is not covering it, but who knows, maybe in a couple of years the government may decide to pay for it. What a surprise. Two tier medicine again. One kind of medicine for those who can afford it, another for those who cannot. Actually, if only, it was this simple….. If you are on welfare, the taxpayers will pay for it. If you are rich, it won’t matter that much to you. If you are in the middle, like me, you will itch. Don’t you wonder who makes these decisions and how? This isn’t exactly cosmetic surgery. It is a real bona fide medical problem. If I do not get the vaccination and it returns when I am 80, it may cost the system several times the cost of the vaccination today. I may end up with a chronic condition (postherpetic neuralgia). It does not make sense, except, if we see it as a gamble. The decision maker takes a calculated risk about the outcome for a large number of patients versus the likelihood of them developing the problem. If the cost of the vaccine for the number of patients who would opt for it is greater than cost of treating a subset of them who would develop the disease if they don’t get it, then it is a good bet not to pay for it for anybody. It is just not very caring. Or humane. Or universal. It is cold and calculating. It is, on the other hand, understandable. Since the decision has been taken away from you, SOMEBODY has to make it. Besides, you still have the choice. If you are a good comrade, you reach into your pocket and pay for it to save the system from some potential future expense. The system, the decision makers, cannot consider your interest; they have more important things on their minds. The system is like a living organism, it wants to survive. The decision makers want to keep their jobs, not for selfish reasons, of course, only so that they can keep doing noble deeds for the greater good – such as deciding what constitutes a medical condition. About that….  When I was running for office in a provincial election, a person, clearly in the phase of change, with the target being a ‘she’ asked me what I would do to ensure that sex-reassignment surgery (and the whole surrounding process) is covered by OHIP. I don’t think I won his vote by pointing out that as a libertarian, I would oppose OHIP altogether, but even if that was not the case, there is a far greater number of people with dental problems and I would probably consider their needs first. Here is the million dollar question: which one do you think will be covered first: Dental care (including bridges and implants) or sex change operations? Your homework is to think about it and tell me why. I said the system does not care about you and neither do the decision makers. Their primary concern is their own existence, not yours. Would private health care providers care about you? OF COURSE NOT! They also care about themselves first. The difference is that in their case, their survival depends on their ability to please you. If they don’t you can give your money to their competitors. All of this of course is not as serious or as simple as it sounds. The vaccine is not proven. There is no data going beyond four years. It is a vaccine with all the usual caveats of these weakened forms of the virus itself. In this case, I have the same choice I would have in a free system without any government involvement or interference. I can evaluate the cost and the risks against the potential benefits.  The only problem is that I already paid for it. I am paying into a system that promised to take care of my health in return but every second encounter I have with the system I find out that IT DOES NOT. The universality is a sham, the availability is a sham. The only thing this system does well is the sanctimonious, self-congratulatory posturing through which it presents itself to Canadians and to the rest of the world.