Undocumented, Not Undoctored

They swarm across the border like fecund rats off a sinking ship, streaming north into a foreign land to give birth in hospitals that are clean and safe. They pay nothing for the privilege of parturition in a country with a sophisticated medical establishment.

And they are sucking dollars away from the deserving.

Government and health officials are baffled about what to do. Why are these women being allowed to take advantage of a generous system paid for by the hard-earned tax dollars of the country’s citizens?

And what about the other interlopers, who show up in hospital emergency rooms with fractured arms and busted heads, bearing borrowed or counterfeit health insurance cards?

Who are these rip-off artists, anyhow?

Americans, actually.

And man, are Canadians ticked off.

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In December, the New York Times reported that Americans were “filching” free health care in Canada in increasing numbers. The Canadian system, which offers health insurance to all legal residents of the country, is quite easy to abuse.

Everyone gets a health card, and since the cards do not have photos (although there is talk of adding them), they are easily shared by people of the same sex and age. There is also, apparently, a thriving counterfeit industry. And doctors are quite uninterested, said the newspaper story, in becoming “secret informers.”

The story, based on a report delivered to Ontario’s health minister, said that about 600,000 improper claims were made in Ontario between August 1992 and February 1993; 60,000 of those were found to have been made by patients with U.S. driver’s licenses.

Ultimately, said the report, the illegal use of health cards is costing close to $700 million a year.

An obstetrician who practices in Windsor, across the border from Detroit, was quoted as saying: “It’s not an epidemic in any one person’s practice, but I would estimate that from 12 to 20 of my patients at any one time are ineligible Americans.”

My theory is that Canadian doctors, like Canadians in general, are simply too polite to turn anyone away.

Or they used to be at any rate, until their economy went over Niagara Falls in the same barrel ours did. According to the New York Times story, two Americans have been nabbed for health card fraud so far. They borrowed their Canadian friends’ cards after having accidents while visiting.

“Our intention is not to send thousands of Americans to jail,” a Canadian bureaucrat averred, “but to get them to pay their bills.”

A frightening image: Americans in splints, casts and stitches, languishing in Canadian prisons, taking tea at exactly 3 p.m. each day. I wonder . . . will they get jam with their crumpets?

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I won’t bore you with the numbers here, but it’s no secret that the Canadian health insurance system is superior to ours in many ways. My best friend lives in Toronto, and when I lived in Michigan, I used to spend quite a bit of time with her. We often found ourselves in the midst of competitive, sibling rivalry-like conversations comparing the American quality of life to the Canadian.

I was at a distinct disadvantage trying to explain why Detroit was superior to clean, safe yet stuffy old Toronto, but I think I made my points: homes were much less expensive, gassing the car cost half as much, and you could order a Scotch on the rocks and still have change from a five-dollar bill.

Once the discussion turned to health care, though, I didn’t stand a chance. She could simply wave her little Ontario Health Insurance Program card at me, and I would shut right up. Here I would be, shuffling paperwork, figuring out deductibles and writing checks for the 20% or so of my medical care not covered by my insurance. And she never even saw a bill! Under the single-payer system in Canada (the payer being the government), doctors simply bill the provinces. No pesky insurance companies second-guessing the docs, either.

However (a big, giant, whopping however) the system costs--how to put it technically?--up the wazoo. Taxes are high. No mortgage-interest deductions for the poor Canadian home owner.

Well, my taxes aren’t going down anytime soon. So it’s too bad the Clintons didn’t have the guts or the juice to put a single-payer system on the table. Instead, it looks like we are going to end up with a messy new hybrid of a system, if we get one at all.

In the meantime, I’ll be praying for the sake of my border-dwelling countrymen and women that we get health care reform soon.

It breaks my heart to think of them--driven by desperation into a foreign land, willing to risk time in those clean Canadian jails, for a taste of something they can’t get at home: a taste of, yes, freedom!

From medical bills, anyhow.