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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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Truckus Maximus: The Big Boys With The Big Toys Do Some Hardcore Pogo At Monster Truck Show

“I got laid off too many times. Now, I work harder for less money. But I get to do what I want to do. Not many people get that.”

By David South

Id Magazine (Canada), February 6 to 19, 1997

The little tiger-striped four-by-four is definitely going too fast. In an instant, the diminutive Suzuki stands balanced, its front wheels squashed at 90 degrees. A millisecond later, it’s on its back like a ladybug flipped over by the wind. The cacophony of the crowd reaches a crescendo. But the noise had been building; the Skydome crowd saw the writing on the wall for the little jeep. 

Frantic helpers pry open the door of the jeep, wrestling free the driver, Dwayne Robichaud. He emerges in an orange jump suit and prances around, looking vaguely like the Oklahoma bomber. The audience lets out an even louder cheer as he walks away, smug and happy. 

Half an hour earlier, two monster trucks, Young Gun and Samson, line up behind a pile of crushed cars, with a dirt ramp at each end. The methanol engines let out a roar like the mother of all hairdryers. The revving turns into a drag race. The pulsating white noise rattles the cavernous Dome. The effect on the audience is almost sexual: the stomach rattles, the heart skips a few beats. It is a short buzz, but it is good. And the noise? I begin to notice that everyone around me has ear plugs and I realize I’m going to regret this in 20 years. 

The exhaust fumes are starting to reach toxic levels 40 minutes into the rally. I shake my head and feel the motion a few seconds later. I’m getting a CO2 buzz, too. It’s the USA Motor Spectacular monster truck derby at Toronto’s Skydome. But monster trucks are just a small part of the show, there for the crowd to ogle while they get off on the noise. There is the amateur truck rally involving the tippy Suzuki and other monster-truck wannabees, and a ridiculous car-eating, fire-breathing robot called Robosaurus for the kids. The metal bashing of the demolition derby serves to satiate the audience’s thirst for damage – and is truly the highlight of the night. 

I can’t get out of my mind comparisons to spectacles in Roman times. Titans of spectacle, the Romans set the benchmark by which all other public entertainment must be judged. On the spectacular scale, Roman bloodsports involving gladiators, wild animals and the sacrificing of Christians definitely rate a 10 – anything else falls below. I figure monster trucks rate about 4. Watching pick-up trucks with over-sized $10,000 tractor tires crush cars can’t match the gore and death of ancient Rome but it will do for now. 

If monster trucks join professional wrestling and American Gladators as today’s answer to blood sports, why does this spectacle seem to lack that je ne sais quoi? Maybe it’s the sanitization of risk. The cabin of a monster truck coddles the driver. There are cushioned seats, a kidney brace, a five-point racing harness, neck braces, helmet restraints and a roll bar. Several drivers tell me that the job only looks dangerous. At half time, Young Gun’s Saskatoon-based driver, Kevin Weenks, tells me he doesn’t seek out danger. “I think some of those (amateur) guys are nuts and want to do the crowd a big favour [die]. You don’t want to run it hard. A win isn’t worth flipping over.” 

Derby destruction

Thirty demolition derby wrecks crawl into the centre of the Skydome. The flag is dropped and an orgy of car crushing begins. It goes on for half an hour. Now I’m not bored. Cars are still driving despite engine fires and rear-ends that stand at 45 degrees. It is down to two cars: one more or less intact, the other driving on its hubs, engine on fire, half its back a mangled piece of crumpled paper. The driver doesn’t give up. His engine stops, then starts again. This is repeated three times until, exhausted, he concedes defeat. 

After the derby it’s time for Robosaurus. The press release claims the hunk of grey metal stands five stories tall and costs $2.1 million. The driver flicks on the switch on a very expensive stereo system and Robosaurus starts to growl like Godzilla. Two guys with radio headsets help direct the beast onto the floor. It burps and farts for a while before picking up a pre-cut car. It crushes it, drops it to the floor and incinerates it with a flame thrower. The crowd roars.

It seems things haven’t changed with spectacles. The Romans drew on slaves, freed men, foreigners and the lower social orders to provide fodder for their spectacles. Monster trucks are driven by farmers hired for six months at a time. The amateur drivers are a hodgepodge of laid-off workers, farm labourers and guys who make a meagre living fixing four-by-fours. 

Wearing a waist-length monogrammed racing jacket is Don Frankish. The shy and patient Alberta grain farmer owns two of the four monster trucks in Canada. He has been racing for seven years and divides his year 50/50 between farming and tours on the monster truck circuit, which mostly takes him through the U.S. 

He is definitely attracted to the excitement of the stadium, but not necessarily a love of death-defying acts. “It’s the rush of the crowd as they get behind you, talking to the kids who look at you as a superhero,” he says. “I like the speed, the unpredictability. We know the risks. There is a danger to it. But the Monster Truck Racing Association makes sure we have a killer radio to shut off the engines if the truck is out of control. The worst I’ve ever seen is a truck going end over end three times – it just destroyed the truck.” I ask him about insurance and he laughs. “We can’t get insurance!”

Pit boys

Down in the pit, the air is thick with exhaust fumes. The pit boys are milling about, patting each other on the back. A sprinkling of pit girls hang around, with hairstyles straight out of Xena: Warrior Princess. The dress for today is black: black t-shirts and black jeans. Don McGuire, 32-year-old partner in the Three Stooges four-by-four shop in Brampton, sports a mischievous grin as he tells me with pride about his chosen vocation: mud bog racing. It’s the messier outdoor version of tonight’s amateur truck rally. McGuire has been a mud bog racer for 10 years and isn’t doing it for the money. “First prize is just $200 – I spring for more money than I would ever win,” he says. “We do this for the pure adrenaline. It’s just heart and soul. It takes bucks per cubic inch to win in this business,” he says resentfully, looking across the Skydome to where the monster trucks are parked. Big Foot’s sponsorship by Ford seems to be a sore point with racers who spend thousands of their own dollars to come here. 

McGuire gave up a $700 a week job to earn $300 a week and race. “I got laid off too many times. Now, I work harder for less money. But I get to do what I want to do. Not many people get that.”

“We do this for the pure adrenaline. It’s just heart and soul. It takes bucks per cubic inch to win in this business”

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UNDP Travelling Seminar: Environment and Development | Mongolia 1998

As head of communications for UNDP/UN Mongolia, I organised and led press tours across the country for international journalists in 1997 and 1998.

Library catalogue description: https://www.e-varamu.ee/item/NG6OSO3DWRMB4NGGULKHVE434XN4KJ4R

A book published by UNDP chronicled the press tour in 1998. (UNDP Division of Public Affairs)
The media tour of Mongolia included the following journalists: Kathleen Lally (The Baltimore Sun), Florence Compain (Le Figaro), Suvendrini Kakuchi (Inter Press Service), Charu Shahane (BBC World Service), Lim Yun-Suk (Agency France Presse), Leslie Chang (The Asian Wall Street Journal).
An Interoffice Memorandum from Djibril Diallo, Director, Division of Public Affairs, UNDP, to Mr. Nay Htun, Assistant Administrator and Director, Regional Bureau for Asia and the Pacific.
An interview with the BBC World Service while visiting gardens in the Gobi Desert, 1998. I led media tours of Mongolia while serving as the UN/UNDP Mongolia Communications Coordinator from 1997-1999.
The UNDP Mongolia Communications Office would reach out to journalists to help tell the story of Mongolia’s late 1990s transition to free markets and democracy.
UNDP Mongolia staff photo 1997. I served for two years as the UNDP Mongolia Head of Communications (1997-1999).

“Mongolia is not an easy country to live in and David [South] showed a keen ability to adapt in difficult circumstances. He was sensitive to the local habits and cultures and was highly respected by his Mongolian colleagues. … David’s journalism background served him well in his position as Director of the Communications Unit. … A major accomplishment … was the establishment of the UNDP web site. He had the artistic flare, solid writing talent and organizational skills that made this a success. … we greatly appreciated the talents and contributions of David South to the work of UNDP in Mongolia.” Douglas Gardner, UN Resident Coordinator and UNDP Resident Representative Mongolia

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

© David South Consulting 2022

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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

Available to subscribers to Gale In Context: College database.

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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 2023