Canada vs. Switzerland: Musings on private health care

Disclaimer: this post is mainly about pregnancy, so if you have little interest in that, skip over it. Or about the politics of health care. Look at the cute baby and move on!

CanadaSwitzerland

The weather isn’t the only benefit of living in Switzerland

 

I have lived in Switzerland for nearly 10 months now. I have lived in our little house at the foot of the Saleve for a longer period of time than I lived in our renovated house in Calgary. The reality of this just blows my mind. And we’re getting comfortable here. Things I used to find intimidating are just a part of the daily routine for me. Of course that’s going to happen – it’s not really a surprise. But I’d say at this point we’re able to make some comparisons between our newly adopted country and the one we were raised in.

It’s not just the superficial stuff. Like, food is a little different in Switzerland. Well, yeah. And the weather is nicer (it really is – we just had the first snowfall here last week. Instead of something I dread, immediately calculating how bad the roads are going to be, how long the cold snap will last, what I’m going to do with the little one until it’s over, I can think “pretty” and yell for X to go get his boots on).

But there are some deep seated differences when it comes to how the countries are run. I think that if it were just Z and I here, without kids, I would still feel more like a visitor than anything, and wouldn’t pay as much attention to the system. But having a child means you necessarily have to get involved and engaged with the world around you. Getting pregnant and having a child here, well, that throws you overboard into the system. There’s no escaping it, you must learn how to swim.

The biggest difference that I’ve been dealing with has been the health care system, again obviously. It was something that gave us a pause before moving here – no universal health care. In Canada, health care is akin to godliness and privatization is an evil vile word uttered by only the most craven and hopelessly greedy. So we were wondering how it was going to be.

So, here’s the deal. We pay for our health care here. You have to pay for health care here, it is mandated, so everyone who lives here is covered. There are different levels of health care, from “basic” to “catered to by a personal helicopter and someone hired full time to wipe your ass.” (not really) (I don’t think) (not actually sure – there are some massively rich people in Switzerland – what else are you going to do with all that money?)

Anyway, having survived basic health care for most of our lives, we figured we could handle that here in Switzerland. Although I was warned by several moms about going basic. Having a baby here was horrible then – you would have to share a room with another mom after you give birth! I’m thinking: yes, and … but I guess if you’re not already used to that it might seem horrifying (?). Anyway, we’re roughing it, according to many ex-pats over here, but we’re tough Canadians so no big deal. Interestingly, every gyno and pediatrician I’ve spoken to says the best way to have a baby is with the basic system, because you give birth in the hospital. Higher levels of insurance mean that you go to a spa – like, they actually call it a spa. You get catered meals and spa services while there. However, if something goes wrong … they have to haul you over to the hospital, where your actual medical needs will be serviced. It might mean the baby goes without mom, or vice versa. After already going through a difficult delivery with a five-day stay in the NICU for X, I’d rather not chance it. I’ll same my mani-pedi for when I’m not pushing a human out of my vagina.

So we established we’re okay with the lowest level of health care here. And while we do have to pay for our health insurance, taxes here are a bit lower and it kind of all comes out in the wash for us. I looked into what was spent on health care in Canada and in Switzerland. The total health expenditure percentage of the GDP, whether that money is coming from tax dollars or your private pocket spent per country. In Canada, it’s 10.9 % of GDP (in 2012, based on the World Bank’s information). In Switzerland, it’s 11.3%. Pretty close, although I guess you can give that one to Canada. How else to quantify health? I looked into average life expectancy (at the World Health Organization, in 2012). Canada stands at 82 years (80 for men, 84 for women). In Switzerland, it’s 83 years (81 for men, 85 for women). I guess that’s where that .4% goes. But anyway, you can see that expenditure and health advantages end up being fairly similar in a general way.

The real difference comes into the type of care you receive. I can only give you my anecdotal evidence from being here and receiving care through my pregnancy, compared to what it was like in Canada. Keep in mind I am at the most basic level, the level which every Swiss resident MUST have, and you can go far, far higher in terms of quality of care. The experience has been like night and day different. For fear of exaggerating, I’m just going to tell you it’s basically paradise.

It took me approximately five minutes to find my obstetrician. It was a brand new clinic, I found out, opened the week after I made my appointment, so I was pretty much the first person to get naked on their gyno chair (it’s not a bed, it’s like a dentist chair with stirrups that reclines and is oddly much more comfortable.) The clinic is rarely full. As in, usually I am the only person in there at the time. I usually have X in tow with me. The nurses at the clinic will take him with them and he spends his time there watching cartoons while sitting in their laps. So pretty personalized help, I have to say. I have one obstetrician, who will see me until my 36th week, when I am handed off to the midwives who will be helping with the actual delivery. In Switzerland, if there are no health issues, a midwife will be the main go-to caregiver during delivery, although there are also obstetricians there to oversee should medical issues arise.

In Calgary, I went to a clinic that had four separate child-based practices going on – usually it was full to the brim with women about to burst and crying children. Sometimes I’d have to stand to wait, which was never that long, before I was given a card and told to go weigh myself and then find the empty room where one of 10 or so obstetricians would see me. I had never met my obstetrician who delivered X before that night, and I don’t remember her now. Not even her name. It was a fine system. Just now, I realize that the experience can be more pleasant.

Here’s a case in point – the gestational diabetes test. This is an unpleasant test that must be done, where you come in fasting (starving!) and give blood, before downing a glass of the most uniquely disgusting sugar water, kind of like Gatorade but worst. Then you wait, giving blood every hour for two hours. I had to do this twice in Calgary. I went to the clinic in the hospital across the street. It’s a big clinic, where people are getting tested for all kinds of things. It’s usually crowded, the kind of place where you take a number and sit on those uncomfortable hospital chairs. You’re surrounded by people with all sorts of unpleasant medical conditions, making you want to bury your face into your shirt when they start coughing. It’s fine – it’s what it is.

But then. I made an appointment here in Geneva to get my testing done, and was told the day I wanted to come in was full. That frightened me. They only actually see you for five minutes really – to give you your juice and take blood. Other than that, you’re just waiting around. How busy was this clinic going to be? I got an appointment for the next day instead.

I walked into a quiet calm office with no visible waiting area. I did pass a dark room where a woman was fast asleep, but I assumed she was having some kind of treatment. I was seen to by the one nurse, who was very nice and happy, practicing her English with me, who apologetically gave me my horrible juice and even let me have a sip of water to help get the taste out of my mouth. She then saw me to that dark room I had passed, the waiting room I realized. There were only two large leather chairs, which stretched fully out to beds. She tucked a fleece blanket around me and lowered the light over my chair down, leaving me for my hour. Soft music was piped in. I fell asleep. I was gently woken by the same nurse who apologetically told me I had to have my blood taken again. She did the procedure quick and just as quick got me back and tucked me in again. I slept for another hour. The other woman who had been going through the same treatment was gone by then, so it was just me in the waiting room. No wonder the clinic was full that one day – they only see like eight people a day! It was incredible. I left feeling rested and revitalized. It was like going to the spa, with a few not great tests that just had to be done for your health.

I realize that these differences are superficial. At the end of the day, I am healthy. I gave birth to a healthy baby in Canada (the complications that arose during delivery did not, I believe, have anything to do with the care I received there). I hope to give birth to a healthy baby in Switzerland, with minimal complications. This is the only end result I care about. But in the meantime, it’s really nice to be treated a little bit. When you’re pregnant, you’re tired and uncomfortable, and being hustled along like cattle doesn’t really help you feel any better. Being treated like you matter, like you’re cherished, even, means a lot to me. The difference is that in this private health care system, it’s a customer service based experience, so they do things in a way to make it an enjoyable experience. I know this is sacrilege to say as a Canadian, but maybe privatization isn’t such a bad way to go about things. We are certainly enjoying the benefits here. I’ll get back to you once I get through the main event, though. As I said, having a healthy child (and maintaining my own health) are the only real standards that matter to me.

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