Reb Arie's Midrash

July 14th, 2009 | Tikkun Daily

Third in a series

Medicating in Montreal

Some commentators in Canada feel that the health care debate in the USA should open up a debate also in Canada.

I can’t imagine why. We’ve been debating it by complaining long and loud since 1995, when the Liberal government of Jean Chretien decided it was a Conservative government and began to destroy health care in the name of deficit fighting.

Canada abandoned Keynes and endorsed Hayek overnight.

It is a fortunate person who has a private physician today. For my first four years in Montreal I mostly used clinics, now ubiquitous in most Canadian cities, where one can wait two hours to see a physician.

My last three years in Montreal I was fortunate to find Mark, who has become a friend as well as my doctor, but now I’ve lived in Ottawa more than two years and don’t have a GP here.

I medicate for ADD. The difficulty in getting diagnosed properly in Montreal led to a nervous breakdown in 2001 and a trip back home to Vancouver, where Gabor Mate diagnosed me.He prescribed Dexedrine, which is counter-intuitive for a recovering drug addict.

It worked.

Not perfectly, not by a long shot, but I stuck it out for about three years. Gabor was in Vancouver and I was in Montreal and he absolutely (and correctly) prohibited a long-distance relationship with respect to medicating me.

The only physician I could consult regularly was a psychiatrist at a neighbourhood hospital. She insisted (incorrectly) that my mental health was fine as she wrote my prescriptions.

I finally found Mark at Congregation Dorshei Emet in Montreal.

LET ME MAKE THIS VERY CLEAR: NOTHING I SAY ABOUT MEDICATION APPLIES TO YOU IN ANY WAY. CONSULT YOUR PHYSICIAN OR TRUSTED MEDICAL ADVISOR.

Mark took me off the Dexedrine, which had serious side effects including chronic insomnia, and finally we settled on Concerta after exploring various other types of Ritalin.

Concerta was the breakthrough drug for me, though it caused me tremendous feelings of anxiety as it began to wear off. I began to take pure, sugarless cocoa powder for the caffeine since I don’t drink coffee. This worked.

But when I went back to Vancouver to attend to my father in his last months I couldn’t get Concerta. I have a regular GP there, and he adamantly refused to prescribe Concerta because it’s indicated for children, not adults.

How could I argue? He was right. And the last thing I was going to do was shop for a physician until I found one to prescribe Concerta. That’s what drug addicts do and I’m a recovering drug addict.

So, no Concerta. I tried again when I moved to Ottawa and did get it prescribed here — but I couldn’t fill the prescription! It would cost me $300 a month. Ontario’s pharmacare would not pay for adults.

I began to use more and more with the cocoa. Tasty with sweetener, useful, I kept my focus and accomplished a lot — and I gained 25 pounds.

I also developed an intolerance for dairy products, which is what I usually mixed the cocoa powder with.

It was a consultation with Mark that brought me to Montreal last week. I’m finally taking Straterra — but first I’m taking samples to see how they work. So far, so good.

Mark wanted blood tests, which my Ontario medicare will now pay for in Quebec, so I went to the local hospital and saw a line up that would have kept me there at least 90 minutes — you need to take a numbet to get a number.

Did I mention I have ADD? Standing around and waiting for 90 minutes is impossible.

I’m back in Ottawa and I’ll do the blod tests here. At least I’ll try. It will be an interesting test of the new meds to see when I can accomplish this goal.

The state of Canada’s health system in the 21st century is not ideal. And it is not what I grew up with. The health system I knew until 15 years ago allowed me to

• select my own GP
• paid for my basic medical needs
• paid private testing laboratories for blood tests and X-rays

Canada needs a new health care system. The United States needs a new health care system.

My prophetic voice calls for a combined health care plan funded jointly by the United States and Canada. This would create a single market of 350 million people. Canada’s single payer system worked well when it was financed properly.

Imagine the efficiencies available to a system funded in trillions of dollars rather than billions. NorAmed (North American Medical Plan) could eventually extend itself to all the Americas.

Imagine two continents linked by trade and social services both.

In Breshit – Genesis 11 we are told of the Migdal Bavel (Tower of Babel), the builders of which claimed Ve’na’aseh-lanu shem pen-nafutz ahl pnay kahl ha-aretz — which I translate as “…that we make a place widespread world-wide”…

The basis of this well-known story has one language spoken by everyone and a commons, which appears to be the Tower. One can make the case that a single language is “spoken” on the Internet that makes Tkkun Daily possible.

What is this “language”? Commerce, or perhaps Linux, or maybe TCP/IP? Maybe it was the free exchange of ideas, what we now call “open-source”? Count the Ws in the phrase “widespread world-wide”. WWW…

Whatever is meant by “language”, the story clearly teaches one thing: humanity was united in a single purpose that became corrupted as the Tower was built.

One purpose melds into another, just as an article on health care becomes a Bible lesson on an ancient Internet!

But that is the way of things. A foolish consistency, Emerson has it, is the hobgoblin of little minds. If a lesson on one matter can be taught by referring to a second, this is the way it ought to be. But note:

Emerson says foolish consistency.

It is foolish to maintain a system that no longer works. It is foolish not to entertain outlandish and visionary ideas. It is foolish not to contemplate a single, open-cource market place for health care in North America: NorAmed