Dealing with and Affording a Mental Illness Diagnosis

My son is twenty years old and suffers from depression. For the longest time he has been in a very dark place, not willing to accept that he could possibly be suffering from a mental illness. What are his options for treatment? Well for starters, he works in a local fast food chain, earning minimum wages, and doesn’t have health insurance coverage to be able to seek the services of a psychiatrist of his choosing. He doesn’t have a family doctor so he either has to go a hospital emergency room or visit the local walk-in clinic in order to get a referral slip to see a psychiatrist, which could take months due to the long wait lists. No matter what, it will be a long time before he sees a doctor and receives treatment.

Statistics Canada released a study in September, 2014 that revealed the following data with regard to young people with mental illnesses.

• Since 2002 there has been an increase of about 10% of Canadians aged 15 and older who are experiencing a mental health issue.
• The total number of 12 to 19 year olds in Canada who are at risk for developing depression is a staggering 3.2 million.

The study also revealed how inaccessible it is in Canada to get psychiatric and/or psychological treatment. Only 1 out of 5 children needing mental health services receives them. 

A diagnosis entails both psychiatric and psychological assessments. Psychiatric services are covered under the public health insurance program, but psychological services are not, unless the doctor works from a hospital. That is, services from a psychologist practicing in a private office, outside the hospital, are not covered by the public health insurance program; therefore, patients must pay out-of-pocket.  However; with a private health insurance plan, a patient can afford counselling sessions as well as any prescribed medications.

When I think of the troubling issues my son is facing, I also think about the many others who, like him, will not have easy access to treatment. While Canada’s health care system has many advantages, there are areas where it falls short, and too many young people pay the price. 

A good healthinsurance plan can go a long way in allowing you treatment options and helping with the costs of prescribed medications should you need them.

Is Insurance on your To-Do List?

Last night my son’s girlfriend, her friend and son were the victims of a house fire. They barely escaped with their lives, jumping out of a two storey window to safety. They were renting the premises and didn’t have home insurance for tenants. 

As a consequence, they have walked away from this experience with nothing but the clothes on their backs and the support of loved ones. It was fortunate that the girls only sustained a few minor injuries and the baby was unharmed. 

The Red Cross has helped them a great deal, and so have friends and family. There has also been an incredible outpouring of aid from city residents. Nevertheless, the incident has brought about the realization that having home insurance can make a big difference.

Acquiring insurance is too often put on the “to-do list” to be dealt with later on, be it  house insurance, health insurance, or life insurance. When all is going well in life, we tend to ignore the “what ifs”.  What if I suddenly get sick and cannot work? What if my house goes up in smoke? What if I have an accident and meet an untimely death? In such situations, many will worry about how to get back on their feet and about the support of their family. 

There’s no time better than the present to address the subject of insurance.

Filing a Health Insurance Claim

So you’ve decided on a health insurance plan that fits your needs, what now?

You will receive your ID card in the mail that has all of the information necessary that your health service provider will need to process your claim.

Individual claims must be submitted within 12 months of the service charge. Once the insurance company receives your claim it shouldn’t take more than 5 business days to process your claim and another 24hrs after processing to send out your re-imbursement. Make sure to include all necessary information including original receipts, for prompt processing and payment.

Many health care providers, hospitals, pharmacies dentists and optometrists most likely will bill your insurance provider right from the office, eliminating the process of having to fill out and send a claim form. If your health care provider does not bill your insurance provider directly, you are then required to pay the initial cost in full and then submit your claim yourself. You would then receive your re-imbursement by mail. You can use your receipts for tax purposes so make sure to retain the top portion of the cheque for verification.

What is Canada Doing to Address the Shortage of Family Doctors?

Are you as concerned as I am over the thought that there is a real shortage of family doctors in Canada? Did you know that a staggering 4.4 million people in Canada do not have a family doctor? 

According to the Canadian Institute for Health Information, more than 75,000 doctors were actively working in 2012, which was a 4% increase from the previous year, and $22 billion was paid out for their services, which was a 9% increase from the previous year. So let’s see, we have more doctors working, their pay cheques are rising, but yet, patients are having the hardest time finding a family doctor. Something doesn’t seem right! Geoff Ballinger, manager of health human resources at CIHI said “I don’t believe Canada has a problem with the number of physicians, I think we have a substantial problem with the types and, furthermore, the distribution of doctors.”

Why are medical students not choosing to practice family medicine when there is a dire need for this profession? And what is the government doing to entice future doctors to enter this category of medicine? 

According to Statistics Canada, family doctors work an average of 51 hours weekly. The fact is, in this day and age, many young doctors are not willing to work the long hours that are part of a traditional family practice, especially those with children. The emphasis today is on adopting a work-life balance.  

While family medicine saw a spike in the 1980’s, it hasn’t been a chosen profession for many graduate students since the 1990’s, one of the reasons being that it is viewed a lower paid and less prestigious position than a career in the field of specialized medicine. What has the government done to address the problem? Since 1998, when pay caps in Ontario were removed, family doctors’ salaries have generally seen a substantial increase. In 2004, a yearly salary for a family doctor was about $200,000 and that amount steadily rose to $300,000 by 2010. As a result, family medicine professionals in Ontario have more than doubled over the last 10 years. 

Cities like Cambridge, Ontario present a good example to other Canadian cities as they’ve begun to handle the problem by mounting physician recruitment campaigns to entice young doctors to open practices in their communities. The response has been a positive one. Part of their recruitment plan includes outlining the highlights of living and working in the city for doctors and their families.

What have doctors and clinics done to address the issues of heavy case loads? Doctors who are practicing family medicine are finding ways to ‘lighten the load’ by joining group practices. Clinics have begun to hire more registered nurses who can interpret diagnostic tests, prescribe medications, and perform specific procedures, which are usually performed by doctors. 

It’s a work in progress.  Hopefully, as the needs of both doctors and patients are addressed, and the shortage of family doctors becomes ever more apparent, a greater number of future doctors will choose family medicine as their specialty.

The Lack of Family Doctors in Canada: Millions are Going Without!

Are you one of the 4.6 million Canadians who don't currently have a family doctor? Well, the fact is this: 15 percent of Canadians are without family doctors, which causes overcrowded hospital emergency rooms, which translates into very long wait times, and results in much frustration and general dissatisfaction.  

If there is such a demand for family doctors, then why aren't more medical students motivated to practice family medicine?  The UBC Family Medicine Registry is eager to rectify the situation with a new program on the North Shore called Coastal Family Practice Residency. Its purpose is to hopefully entice students into family or general practice.

According to The Society of Rural Physicians of Canada, towns, with a population of under 10,000, account for about 22 percent of the nation's population but are served by approximately 10 percent of physicians. 

The College of  Family Physicians of Canada states, "More than 90 percent of Canadians indicate that a family physician is the first person they would turn to in order to address their medical problems" and, "on average one additional family physician per 10,000 people is associated with 5.3 percent reduction in mortality."

Demographics seem to factor into the decline of family physicians as a large number of health professionals will be retiring in the next 10 years.  The Canadian Medical Association reported in 2014 that out of the 38,000 physicians practicing family or general medicine, 41 percent are 55 years of age or older. Such statistics should appeal to the up and coming doctors, and make them keen to explore the incentives associated with the practice of Family Medicine.

Incentives: 

Let’s take Nova Scotia for example. This province offers the following incentives for practicing family medicine in the rural communities.  

• Relocation allowance of $5,000 to cover moving expenses such as airfare, car rental, accommodations and such.
• A bursary of $60,000 for establishing a practice in a rural Nova Scotia community.
• Eligibility to receive debt assistance between $20,000 and $40,000 for up to 3 years.

Medical students, who are uncertain as to which area of medicine to choose, would be wise to examine the particular needs of Canadians as well as the various incentives being offered by the provinces before making a decision.

Consider yourself a fortunate Canadian if you have a family doctor. And, should you find it necessary to seek medical care elsewhere, at some point in time, supplemental health insurance can be significantly valuable when health services are not so readily available.

According to Statistics Canada, in 2013 more than 15 per cent of Canadians or approximately 4.6 million people reported they did not have a regular medical doctor. - See more at: http://www.nsnews.com/news/family-first-1.1316489#sthash.z95U37CD.dpuf