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Kim Voynar

By Kim Voynar

Health Before Wealth

I wrote in yesterday’s column about my recent trials and travails with medical issues, but one thing I didn’t really cover in that piece was my experience with the Canadian health care system, which I find particularly relevant in light of current debates here over universal health care. Throughout the many debates by pundits and politicians on the health care issue, I’ve heard brought up again and again from the right that many Canadians, and Canadians who work within that system, don’t like it. And I’m sure that it’s true that there are, in fact, average Canadian citizens who have complaints about Canada’s health care, and health care workers with issues as well, but I’d like to relate the experience of this American chick who ended up inadvertently thrust into it on a business trip, and give you my perspective.

During my week-long stay at Toronto Western Hospital, I was continually impressed by both the care I received there and by the competence and attitudes of every person I encountered, from the staff who came in to clean the rooms, to the nurses and aides who cared for me daily, to the outstanding medical team responsible for my diagnosis and treatment. Many of them asked me about health care in the States, and there were frequent expressions of shock and disbelief when I explained how our medical insurance works, and how you cannot just go to a doctor, or take your sick child to a doctor, if you don’t have insurance and you don’t have the cash to shell out over $100 for a doctor office visit. I talked to several doctors and nurses who had worked in hospitals in the US, who had migrated to Canada specifically because they were unhappy in the United States health care system.
There were several striking differences I noticed between the care I had in Toronto versus my experiences in more than one hospital in the United States. First and foremost, in Toronto the attitude of everyone on the staff, from the docs to the patient accounts/business office was “Health Before Wealth.” I heard this said over and over again, and although I do have (for the moment at least) excellent medical insurance, the doctors, the nurses, and even the business office folks all reassured me that A) it didn’t matter to them in the least that I was not a Canadian citizen, their only concern was finding out what was wrong and getting me well and B) should my insurance end up not paying for my stay for any reason, not to worry about it, that it would ultimately just be written off and I would not be pursued to pay it myself.
Another difference that struck me was the aggressiveness with which the Canadian doctors pursued testing and diagnosis. Because their hands are not tied by, and they are not beholden to, bean counters at insurance companies, medical decisions are made by the doctors based on what they feel is in the patient’s best interest, period.
While I usually don’t name names without consent on my blog, in this case I feel it’s merited because I want credit given where it’s due. The medical team doctor placed in charge of my care was a young woman named Dr. Showler. She was a resident (I assumed a third year) and she had excellent, gentle bedside manner. She took her time in talking to me in assessing my entire history, both the immediate history and that of the past year or so. She listened attentively to everything, and never once made me feel she was rushed or impatient. Her physical exam was extraordinarily thorough, and she caught on the first exam that my spleen was quite enlarged. This would prove to be crucial after I was admitted.
The next day Dr. Showler came in with one of the two attending physicians who supervise Team 2 Medical. She had told him about the spleen. He very briefly examined me himself and declared emphatically that he did not feel any enlargement. Dr. Showler, I assume, either fought on my behalf behind the scenes or persuaded him that an ultrasound should be done anyhow, and so it was. Not only did that ultrasound catch that she was right and he was not — the spleen was indeed enlarged, as was the liver — but that ultrasound (thanks also to an excellent tech and radiologist) caught that there appeared to be a small lesion on my pancreas. The CT scan ordered as a follow-up confirmed that, and also found that I had two blood clots in my lungs that needed treating.
Bottom line: this fiery, determined first year resident was responsible for both the blood clots being caught and treated in time, but also for the mass on the pancreas being caught early enough that, I hope, the prognosis for the now-diagnosed pancreatic tumor will be hopeful rather than terminal. I owe her, and the aggressive care of that hospital, my thanks and perhaps my very life.
Now a brief word about medical insurance here. Right now, I am fortunate enough to have excellent coverage. The medication I have to inject into my stomach daily to prevent further coagulation of my blood that could kill me with another blood clot costs me a $25 co-pay right now. Without that insurance, it would cost me over $3000 a month — more than half my monthly income, including child support — to buy that medication. Without my insurance, I would just have to forego that life-saving medication and pray that a blood clot didn’t kill me. These are the choices that millions of Americans have to make. This is the kind of choice that I, once our divorce is filed and finalized, may be faced with. That, my friends, is reality.
Now that I’ve blathered about medical crap once again (but hopefully at least not bored you to tears), I’m off to a screening of Law Abiding Citizen. I have a very sore ass from today’s Fun with Bone Marrow Biopsies, but I also have some very helpful Dilaudid that will, I hope enable me to sit there for 90 minutes to watch the film, and I will aim to get a review up of that for you by tomorrow. Until then, please consider the state of health care here, and consider calling your senators and congressmen and telling them that every American citizen deserves what our neighbors to the north have: access to quality health care when they need it, period. Health before Wealth, for everyone.
I, and the millions of other uninsured (or potentially uninsured) American citizens facing serious medical issues thank you. And some day, if you find yourself in that position, you may thank yourself as well for demanding that our representatives take action on this crucial issue.

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It shows how out of it I was in trying to be in it, acknowledging that I was out of it to myself, and then thinking, “Okay, how do I stop being out of it? Well, I get some legitimate illogical narrative ideas” — some novel, you know?

So I decided on three writers that I might be able to option their material and get some producer, or myself as producer, and then get some writer to do a screenplay on it, and maybe make a movie.

And so the three projects were “Do Androids Dream of Electric Sheep,” “Naked Lunch” and a collection of Bukowski. Which, in 1975, forget it — I mean, that was nuts. Hollywood would not touch any of that, but I was looking for something commercial, and I thought that all of these things were coming.

There would be no Blade Runner if there was no Ray Bradbury. I couldn’t find Philip K. Dick. His agent didn’t even know where he was. And so I gave up.

I was walking down the street and I ran into Bradbury — he directed a play that I was going to do as an actor, so we know each other, but he yelled “hi” — and I’d forgot who he was.

So at my girlfriend Barbara Hershey’s urging — I was with her at that moment — she said, “Talk to him! That guy really wants to talk to you,” and I said “No, fuck him,” and keep walking.

But then I did, and then I realized who it was, and I thought, “Wait, he’s in that realm, maybe he knows Philip K. Dick.” I said, “You know a guy named—” “Yeah, sure — you want his phone number?”

My friend paid my rent for a year while I wrote, because it turned out we couldn’t get a writer. My friends kept on me about, well, if you can’t get a writer, then you write.”
~ Hampton Fancher

“That was the most disappointing thing to me in how this thing was played. Is that I’m on the phone with you now, after all that’s been said, and the fundamental distinction between what James is dealing with in these other cases is not actually brought to the fore. The fundamental difference is that James Franco didn’t seek to use his position to have sex with anyone. There’s not a case of that. He wasn’t using his position or status to try to solicit a sexual favor from anyone. If he had — if that were what the accusation involved — the show would not have gone on. We would have folded up shop and we would have not completed the show. Because then it would have been the same as Harvey Weinstein, or Les Moonves, or any of these cases that are fundamental to this new paradigm. Did you not notice that? Why did you not notice that? Is that not something notable to say, journalistically? Because nobody could find the voice to say it. I’m not just being rhetorical. Why is it that you and the other critics, none of you could find the voice to say, “You know, it’s not this, it’s that”? Because — let me go on and speak further to this. If you go back to the L.A. Times piece, that’s what it lacked. That’s what they were not able to deliver. The one example in the five that involved an issue of a sexual act was between James and a woman he was dating, who he was not working with. There was no professional dynamic in any capacity.

~ David Simon