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Dodging the health insurance minefield

By David South

Today’s Seniors (Canada), 1992

Don’t leave home without it. No, not American Express Travellers cheques but health insurance. With changes to OHIP coverage for out-of-country hospital visits and rising U.S. health care costs, any snowbird who pays a visit to an American hospital will face hefty bills. To make things even more complicated, the recent growth in competing travel health insurance schemes in Canada has created a minefield of policies that must be entered with caution.

Luckily for snowbirds, the newly formed Canadian Snowbird Association is trying to make these changes a little easier to cope with. Formed in March, the Association boasts 8,500 members and is looking for more. They hope to advocate for the rights of snowbirds and collect information on private insurance plans to help seniors make the right decisions.

Communications co-ordinator Don Slinger says he will have a list of appropriate private health insurance policies ready by the end of August. The Association has been meeting with private insurance companies to find out the best plans.

“Snowbirds shouldn’t be in a hurry to get insurance,” says Slinger. “Many insurance companies are using the situation to exploit panic-stricken seniors.”

Slinger warns snowbirds never to go down to the U.S. without extra insurance on top of OHIP. “OHIP is just a drop in the bucket of the cost of a stay in an American hospital. Unfortunately, a lot of people still take the chance.

“I had been going south for 12 years without a problem until a ruptured appendix. It ended up costing me $12,000 for an eight-day hospital stay.

“When we met with the government they weren’t sympathetic. They said snowbirds are a wealthy group and can afford the payments. However, a lot of people are on fixed incomes and won’t be able to afford to go south with these higher costs.”

Slinger advises against buying coverage after arriving in the U.S. The Snowbirds Association emphasizes that it believes in medicare and will fight hard to ensure it provides full coverage for seniors.

Gerry Byrne, a vice-president at non-profit insurers Blue Cross warns against buying U.S. insurance because companies require a medical exam and skim off the healthiest people for full coverage. But Blue Cross itself will introduce rates based on age and medical conditions in September.

American health insurance plans have long been criticized for hurting older seniors and those with ongoing medical conditions. In these schemes, the healthiest seniors pay low premiums while seniors with chronic conditions are saddled with higher rates or, worse still, refused coverage. Unlike medicare – which covers everybody regardless of their health – private insurers are tempted to reduce their costs by covering only the lowest risk group – favouring the young and healthy.

Unfortunately, a quick survey of travel health insurance plans shows this trend to be in full bloom in Canada. Credit card companies, which have recently begun to offer travel health insurance, are revising their conditions. The Royal Bank’s Visa Gold card will drop coverage for seniors over 65 starting Nov. 1. The Canadian Imperial Bank of Commerce and Scotia Bank Visa cards still offer coverage to seniors – but both are revising this. American Express’s annual plan has no age limit, while its per trip plan has a higher rate for seniors between 60 and 74 and doesn’t cover anybody 75 and over.

Suzanne Deul, who helps market the Toronto Dominion Bank Visa card, blames the insurance companies for changes. “Because of high costs, the pressure is on to change policies. We are trying to be more equitable but the insurers want age restrictions. In some ways it could be justified to charge more for people who attract higher costs.”

With so many health insurance companies losing money covering seniors, the challenge for private insurers is to make covering seniors profitable without excluding people. To this end, Robin Ingle, president of John Ingle Travel Insurance, has instituted changes to increase the money available for more expensive hospital stays.

“About one-third of our policy holders are over 65, and we have a lot of snowbirds. This group is only getting bigger, so instead of raising rates and placing restrictions, we increased the number of policy holders to include a broad range of people young and old.”

Ingle blames rising U.S. health care costs for making it unprofitable to provide health insurance to seniors. His company has set up an office in Florida to prevent hospitals overcharging Canadians and has negotiated deals with some hospitals for lower rates. John Ingle Travel Insurance offers special rates for seniors’ groups and gives a 10 per cent discount to members of the Canadian Association of Retired Persons.

Three years ago there were 10 companies in Canada offering travel insurance; now there are over 50.

According to Ingle, many of the neophyte companies are losing money. “I predict the whole industry will shrink because they have had high losses and can’t take care of their clients. I would advise seniors to watch out for companies that might not be around a year from now.”

Ingle says seniors should also beware of glitzy marketing and flashy pamphlets and read the fine print to make sure the policy covers their age and medical condition.

Irene Klatt of the Canadian Life and Health Insurance Association, which represents all private for-profit insurers, advises seniors to look for insurance plans that have toll-free numbers that can be called 24 hours a day in an emergency. This will cut down on hassles with American hospitals which will not admit patients without insurance. The Association also has its own toll-free advice line staffed by seniors from the insurance industry. Klatt warns that her association represents all for-profit insurers and can’t favor one scheme over another but does have a pamphlet that offers advice on choosing insurance.

Insurance, of course, isn’t enough to ensure a healthy stay. Irene Turple of the Canadian Association on Gerontology has some helpful health tips: “Discuss your trip with the family doctor. Make a list of all your medications; and remember – the names of the drugs can be different in the States. If you have an echocardiogram handy, bring it along. Make a health diary listing your medical history. Remember that physicians aren’t all-knowing and if you can provide as much medical information as possible it can make a difference.”

Turple also stresses getting immunized for the flu before going to the States and remembering to cover up from the sun.

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ORCID iD: https://orcid.org/0000-0001-5311-1052.

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Time Machines

By David South 

Flare Magazine (Toronto, Canada) 1992

Time Machines

While many designers are telling us to don platform shoes and love beads, the man behind London-based Hi-Tek watches is looking even further back in time – drawing his inspiration from classic visions of the future. 

Hi-Tek’s stainless steel timepieces bring to mind early futuristic films such as Lang’s Metropolis and Chaplin’s Modern Times with their grotesque exaggerations of modern machinery. That era’s confusion, fear, or simple wonderment at new technology influenced everything from toasters to steam trains. 

For the equally economically and technologically turbulent ‘90s, Hi-Tek designer Alexander has captured this sense of techno-wonder with watches, sunglasses, and other hip accessories. One watch looks as if a Cuisinart hit it, leaving gears strewn across the face. Another has a retractable lid like an astronomer’s observatory. Yet another tells time with the blinker of a radar screen. Despite their made-exclusively-for-James-Bond appearance, all cost less than $190. Available at Possessions in Montreal, Body Body in Toronto, and D and R in Vancouver.

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Health Care In Danger

Worrying breakdown in Ontario reforms

By David South

This Magazine (Canada), October-November, 1992

The Senior Citizens’ Consumer Alliance for Long-Term Care’s report on the Ontario New Democratic government’s health care reforms, released in July, documents what many people suspected: the much-needed reforms are mismanaged and dangerously close to chaos.

The report compares the present crisis to the failed attempt in the seventies to move psychiatric care out of institutions and into communities by closing 1,000 beds. Patients were left with inadequate community services, resulting in many homeless and jailed former patients. The alliance fears seniors – the biggest users of health services – could fall victim to reforms in the same way.

According to many health care reformers, Bob Rae’s government seems to have lost control of the issue, resulting in massive job losses and a worrying breakdown in services.

The NDP’s health care document “Goals and Strategic Priorities” reads like a wish list for progressive health care reformers, ranging from disease prevention programmes to improved access to health care for minorities, natives and women. To many, the debate isn’t over these goals but how they are achieved and what the government’s true motives are. Under pressure from big business and its lobby groups, the NDP is desperate to save money where it can, and as Ontario Health Minister Francis Lankin says, “not disrupt or destroy business confidence.”

Emily Phillips, president of the Registered Nurses’ Association of Ontario, is blunt: “The NDP’s plans sound good on paper, but they can’t give a budget or direct plan on how they hope to carry out reforms. They are going about things backward. They cut hospital beds and lay off staff without having community health care services ready.”

The national trend in health care is to deinstitutionalize and bring services to homes and communities. It is hoped that emphasizing prevention and healthy living will significantly reduce the need for hospitals, expensive drugs, surgery and high-tech equipment. The NDP has pledged to spend $647 million to reform long-term care services by 1997 – creating services that will allow seniors to stay in their own homes.

Problem is, the NDP has embarked on radical down-sizing of hospitals – closing beds and laying off thousands of health care workers – right now. Lankin claims that in the worst-case scenario, layoffs this year wouldn’t exceed 2,000, but the Ontario Hospital Association claims 14,000 jobs are in jeopardy. Phillips believes it will be hard to estimate job loss: “It is hard to even record the number of nursing jobs lost, because for every full-time job cut many part-time and relief positions go with it.”

Chaos will result when people who depend on hospitals have nowhere to turn but the inadequate community health care services, which are uneven and narrowly focussed. To make things worse, the same funding restrictions placed on hospitals have also hit the services that are supposed to save the day.

“I haven’t heard of any change in the quality of care. It is just too early,” says Phillips about the effect of layoffs on hospitals. “Right now the nurses are picking up the slack, but soon they will burn out. I don’t feel confident this government has the management skills to do this. I’d like to see a plan in place before moving people into the community.”

Training for laid-off hospital workers will have to come from the $160-million allocated for retraining workers laid off by cities, universities and school boards – all of whom are coping with record-low budget increases.

In February, Lankin appealed to hospitals to do everything in their power to make layoffs painless and to trim doctors and administrators first. But the NDP has yet to pass legislation that would bind hospital boards to make the right cuts. The boards operate at arm’s length from government and continue to make unnecessary decisions, ignoring the NDP’s moral pleas.

Rosanna Pellizzari, a member of the Medical Reform Group and chair of the Ontario Association of Health Centres, wants better community accountability for hospitals before they lay off staff and cut services: “Sometimes it makes sense to bring people to hospitals. Planning must be at the community level and open and democratic. Health care workers, who are mostly women, should not be scapegoated for financial problems. Doctors and management should go first. Physicians experience very little unemployment.”

Carol Kushner, co-author of the book Second Opinion, which evaluates the country’s medical system, sees chaos resulting from the conflicting agendas of governments and health care reformers: “Will the tremendous contradictions of institutions be transferred to the community? The federal government is rapidly draining money from medicare while provincial governments are having a hard time. This hasn’t produced extra funds for re-allocating services to the community – which was recommended by reformers. You have to ask: who is going to fall through the cracks?”

Find in a library:

Worldcat.org: Health care in danger: worrying breakdown in Ontario reforms, This Magazine, 26, Oct-Nov 1992, 6

ISSN: 1491-2678

OCLC Number / Unique Identifier: 8250614985

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

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Pavlov’s Army | This Magazine August 1992

By David South

In August 1992 I wrote a feature for Canada’s This Magazine. The country was in the depths of a severe recession and an austerity crisis but this also came with two emergencies requiring the Canadian Armed Forces: the first Gulf War from 1990 to 1991, and at home, the 1990 Oka Crisis. A few years prior (1988) changes were made to the War Measures Act (Canada invoked the War Measures Act in 1970 during the October FLQ Crisis, bringing troops to Canadian streets and mass arrests), replacing it with something called the Emergency Measures Act (EMA) (now Emergencies Act), which was given Royal Assent in 1988. I interviewed various legal experts on this new legislation and its implications and applications in future civil emergencies.

“The EMA WILL be used to suppress civil liberties in various parts of the country,” says Rosenthal. “A thing to keep in mind is that although the War Measures Act was passed during the First World War, it wasn’t used in a terrible way until 1970. The emergencies legislation is on the books. The Public Order Emergency could be used to suppress any kind of legitimate dissent.”

Many critics fear there is potential for manipulation of the EMA in the heat of the moment in the hands of an unscrupulous government.

“Words are very malleable,” says Rosenthal. “It was absurd for Trudeau to claim that there was an apprehended insurrection in Quebec in 1970. As he said the words he knew it was a lie.”

Find in a library:

Worldcat.org:

Pavlov’s army, This Magazine, 26, August 1992, 37

ISSN: 1491-2678

OCLC Number / Unique Identifier: 8248796243

Taking measure of the Emergency Act, This Magazine, 26, August 1992, 38

ISSN: 1491-2678

OCLC Number / Unique Identifier: 8248423587

Further reading: 

Canada evolves from peacekeeper to war-fighter by A. Walter Dorn, The Toronto Star, Dec. 21, 2013

IS CANADA A NATION OF WARRIORS OR PEACEKEEPERS? HOW TO REFOCUS ON UNITED NATIONS PEACE OPERATIONS by Maj M.C.C. Lafortune, Canadian Forces College, 2016-2017

Law in Times of Crisis: Emergency Powers in Theory and Practice by Oren Gross and Fionnuala Ní Aoláin  (2006)

Manitoba Law Journal: The New Emergencies Act: Four Times the War Measures Act, 1991 CanLIIDocs 129

Doug Ford declared a state of emergency. Should Justin Trudeau do the same? 

October 1970 by Louis Hamelin (Publisher: House of Anansi, 2013). “October 1970 is a thrilling fictional account of the events that shaped one of the most volatile moments in recent history.”

Trudeau’s Darkest Hour: War Measures in Time of Peace, October 1970 Editors: Guy Bouthillier, Édouard Cloutier (2010)

Warrior Nation: Rebranding Canada in an Age of Anxiety by Ian McKayJamie Swift (2012)

Warriors Or Peacekeepers? Building Military Cultural Competence, Editors: Kjetil EnstadPaula Holmes-Eber (2020)

Canadian Peacekeeping Is Under the Gun by Craig Turner, Los Angeles Times, Aug. 1, 1996

My journalism:

1992

Top Reporters Offer Military Media Handling Tips

1993

Continental Drift And Military Complexities

Somali Killings Reveal Ugly Side Of Elite Regiment

Does the UN know what it’s doing?

Peaceniks Questioning Air-Raid Strategy In Bosnia

1996

State Of Decay: Haiti Turns To Free-Market Economics And The UN To Save Itself

U.S. Elections Update: Clinton is using Canada to keep control of Haiti

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021