An American in Canada: a Winter's Tale

When people asked me why my family and I moved from the United States to Canada, my answer is typically succinct: “Trump.”  I’m able to convey a whole bevy of data to that person in a single monosyllabic word vomit.  The reaction is typically the same: a knowing nod, or a laugh, or some variation on “Wish I were coming with you.”  I live in enough of a liberal bubble that I’m not too worried about offending anyone, and if they are offended, I honestly don’t care any more.  I’m through worrying about hurting the feelings of right-wing crazies. And let me be clear: at this point in U.S. history, if you are a Trump supporter, you are either crazy, racist, or an ignoramus, and I’m done with trying to figure out which one you are.  I moved to an Arctic netherworld full of ketchup-flavoured potato chips and unnecessary extra letters in words in order to get away from you people, and I’m not going to apologize for it.  Except I probably will apologize for it at some point, because I’m Canadian now.

To be fair, Trump wasn’t the only reason we moved to Canada.  I’m closer to my adult-aged children, who both live in Ontario. Also, my wife wanted to live in a smaller town than the one we were living in in Ohio.  And the town we moved to, Windsor, is just across the river from Detroit, where I grew up, so it’s a homecoming of sorts for me. 

We’ve lived here a little less than two years now, and we have remarkably few regrets.  Though we’re closer to some family, we are now further from others, which is a bummer.  Being a smaller city, Windsor has far less culture and entertainment that Columbus Ohio, our last home.  And although I have repeatedly tried, I just can’t wrap my head (or my tastebuds) around poutine.  That’s about it.

The good news is that there aren’t all that many major cultural changes to get used to here.  Caanadian culture and Midwestern culture really aren’t all that different when observed from a distance.  But the bad news is that because of all the similarities, people assume the two cultures are identical, which means that no one really warns you when something will be different.

We learned this lesson quickly.  We found a very nice real estate agent in Windsor, who showed us around, and when we were ready, we made an offer on a house.  We had brought a few thousand dollars for earnest money, which is the typical U.S. process.  Turned out, in Canada we had to turn over at least 5% of the purchase price in order to seal the deal.  The “earnest money,” therefore, can run tens of thousands of dollars.  We didn’t have anything like that kind of money on hand, so we had to do a madcap scramble, which involved liquidating some assets and then sending huge sums of money via PayPal to a cross-border bank account.  Our realtor was deeply apologetic: it simply hadn’t occurred to her that the process was different in the States. 

As I reflect on my time here, I would say the biggest real cultural shift we had to adjust to was in the realm of health care.  The two systems work very differently, and adjusting to it was a shock to the system.  In the U.S., if I got the flu or something, I would make an appointment with my primary care doc.  They would see me, usually the same day.  Here, it doesn’t work that way.  If I get the flu, my primary care doctor has better things to do than deal with my germiness.  Instead, I’m supposed to go to an urgent care.  My primary care doctor is primarily there for physicals, and to coordinate with specialists. And those specialists, by the way, aren’t on call 24/7 the way they are in the States.  I called my cardiologist a few months after arriving here, because I was having heart palpitations.  The receptionist was very nice, but utterly baffled as to why I was calling.  They typically booked their appointments weeks out, and by then the palpitations would presumably be over.  Or, you know, I’d be dead.  It genuinely took several minutes before I understood her confusion: If I had an issue like  heart palpitations, I should get my butt to the emergency room, and they’ll handle it there.  So I went.

And I didn’t pay a penny. 

Yes, I pay for prescriptions, but after I see a doctor, I just walk out the door.  No credit card exchange.  No co-pay.  I’m done.  I have made multiple trips to the ER, and I never paid a cent.  And they don’t “release me from the hospital,” a process that can take hours in the States, either.  Once I’m awake after my procedure, the nurse tells me I’m free to go whenever I’m ready. 

I don’t want to paint the Canadian health system as a paradise.  It isn’t.  The reason I made over a half-dozen trips to the ER in my first year in Canada was that I needed a relatively simple procedure, called an ablation, to fix the atrial fibrillation that was causing my heart palpitations and irregular heartbeat. The wait to get the procedure done in Ontario was about 10 months.  I had the procedure once before, in Columbus (though it didn’t work properly, which is why I needed another one), and they had it scheduled about three weeks after the cardiologist determined I needed it.  Here, I spent months struggling with medications, and occasionally having to go to the ER to get my heart shocked back into behaving.  Here, I was on a first-name basis with the ER nurses, who would shake their heads in mock disgust when they saw me getting wheeled in again. 

And yet, after experiencing the two systems up close, I think I prefer how health care works in Canada. For one thing, the health care system here is more equitable.  It’s irrelevant what job you have: we all get seen by the same doctors and are given the same treatment.  The system is more fair, more available, and it sure is nice to not have a co-pay.

The U.S. has the fancier tools.  Because hospitals are competing for your dollars, each one is trying to outdo the others in having the coolest new equipment.  But Canada seems to have landed on a system that ultimately works better for the majority of its citizens.

Part of what makes this observation particularly interesting is that Ontario is in the midst of a health care crisis.  Doctors and nurses are leaving Ontario, because they are seduced by higher salaries and more flexible schedules they offer in the U.S.  Emergency room wait times are higher than they have ever been because of the shortage of medical personnel.  And yet I still like it better here. 

The next time the Republicans and Democrats start barking at each other about health care reform, just remember: somewhere North of you is a place where you don’t have to shell out a co-pay, your health insurance isn’t based on your job benefits, and any doctor will see you, regardless of whether they are in network. 

You just have to put up with ketchup-flavoured potato chips.