The Health Care Supermarket

(source: kickstarter.com)

For a school assignment, I watched Peter Nicks's documentary The Waiting Room.  The film takes a look inside the life of Highland Hospital in Oakland, California.  Here, I will share my thoughts on the film and provide a comparison of the Canadian and American health care systems.

The Film
The Waiting Room effectively portrays the life of an urban hospital in the United States.  For the majority of the film, the only sounds we hear are background noises such as beeping monitors, random murmurs, and ringing phones.  The director avoids manipulating the audience by only using music during the opening title sequence, transition sequences, and the ending.

Most importantly, the director lets the subjects tell the stories, and they are compelling ones.  We see a man talking about an old gunshot wound while pointing to his chest, a carpenter talking about his fear of losing his job to a leg injury, and a father expressing concern about his daughter’s strep throat.  All of these subjects are shown in a natural setting, not a staged set, and it makes for effective storytelling. 

One of the most unforgettable moments occurs late in the film, as we see doctors and paramedics trying to revive a 15-year-old gunshot victim.  The absence of music makes it such a chilling scene, and then we watch the haunting shot of his covered body being wheeled into a morgue.

By keeping interviews to a minimum, the director gives us a view of the hospital that is largely uncompromised.  We mostly see doctors talking to patients, patients expressing discomfort or concern while sitting in the waiting room, and receptionists telling patients what they need to know.  When interviews are done, they are effectively presented as voiceovers while the scenes unfold.

As a documentary about the life of a hospital, The Waiting Room succeeds.  However, it lacks a clear, concise message.  There are references to medical insurance, but there are simply not enough scenes about that topic to create a message that is truly sustaining.  Some quick edits could have presented this message effectively, as I noticed that most of the scenes were rather drawn-out. At the same time, the director lets the audience draw their own conclusions, which makes up for the lack of message the film may have.

Health Care: Canada vs. the United States

 Heath insurance is a great concern for some of the subjects in the film.  A 20-something man, for example, is unable to get his testicular tumour surgically removed due to a lack of coverage.

The United States does in fact offer government-run health insurance, but only for a select number of people.  One program, Medicare, is only offered to American citizens age 65 and over and for people under 65 with certain disabilities, according to the United States Department of Health & Human Services.   Another, Medicaid, is offered to only low-income citizens.

Many Americans instead get private health insurance through their employer or somewhere else.  They have to pay premiums in exchange for the insurance.  According to the 2007 Kaiser/HRET Employer Health Benefits Survey, American workers paid an annual average of $3,281 to cover the cost of a family health insurance plan.  On average, workers in the United States paid 16 per cent of overall premiums for single coverage and 28 per cent for family coverage.

American workers have been facing rising premiums at the expense of their paychecks.  The 2007 survey revealed that 21 per cent of employers expected to raise workers’ premiums within the next year. 

Canadians, on the other hand, do not have to pay premiums for most of the health care they receive.   Each of the ten provinces and three territories offer their own public health insurance systems to cover medical costs incurred at private hospitals and doctor’s visits, according to Health Canada.  

Health Canada states that these provincial health care systems are part of a joint federal-provincial health care co-operative unofficially known as ‘Medicare’.  The federal government’s role is to set and maintain standards for each of the provincial health care systems.  Provinces must meet these standards to qualify for federal transfer payments specifically for health care.  This funding mechanism is called the Canada Health Act. 

According to the Canada Health Act, a province/territory must meet five criteria to receive federal health care payments: public administration, comprehensiveness, universality, portability, and accessibility. A provincial health insurance system must cover every insured person who lives in that province.  The Canada Health Act also restricts user fees (premiums for public health insurance) and additional billing.

Recently, health care in the United States has undergone some major reform.  In 2010, the United States Congress passed the Patient Protection and Affordable Care Act.  President Barack Obama later signed the bill into law.  One of the key components of the Patient Protection and Affordable Care Act is the Pre-Existing Condition Insurance Plan. According to the United States Department of Health & Human Services, the Pre-Existing Condition Insurance Plan gives health care coverage to uninsured citizens with pre-existing conditions.  It is offered in states that do not have a state-run program.  The Patient Protection and Affordable Care Act also offers assistance to adults in their twenties who are struggling financially like the young man with the tumour.  People under the age of 26 are now allowed to stay on a family health insurance plan as per the requirements of the Act.