Think about It: Another country, not my own

Published 1:30 am Wednesday, October 1, 2025

By Bertha D. Cooper

I began writing this column while visiting the country to our north and sitting bedside in the outpatient chemotherapy unit.

One of the pluses of our move to Sequim was it was just a trip across the water that brought us close to family — stepdaughter, husband, grandson and granddaughter living on Vancouver Island. Since then, we lost husband and dad Paul; stepdaughter has a different husband; and grandson and granddaughter have grown into adults.

The convenience has taken on greater importance since my stepdaughter, a beloved friend of over 50 years, was recently diagnosed with pancreatic cancer. I was eager to visit her recently, my first visit since her diagnosis.

I am deliberately not using their names to protect their privacy, and it is not important to the column.

Most readers will understand the urgent need to be with someone you love who has a serious illness and to feel her warmth, sense her feelings, know the status firsthand, and simply be there to spread enough love to suffocate the cancer.

She and I were making an event of the visit. We stayed in town at a very nice hotel near the water, ate great dinners, window shopped, and talked about all things important.

I accompanied my stepdaughter to her chemotherapy treatment. Besides wanting to be her support person and advocate, I wanted to observe the system of so-called socialized medicine.

My background as having administrative responsibilities for the cancer care program at Olympic Medical Center as it evolved into a service line gave me inside knowledge of the requirements of a chemo program.

Some of you will remember that OMC had a radiation oncology center for years before developing cancer care as a program. One of my roles when I took the job of OMC’s assistant administrator of Planning and Development was to oversee the development of community comprehensive cancer care services on the Peninsula.

Anyone who has experienced a cancer care treatment program is familiar with the components of the program — a team consisting of a medical oncologist, radiation oncologist, skilled oncology nurses, social workers, nutritionist, pharmacy consultant and other supports that mesh into a service that offers patient-centered care individualized according to a patient’s need.

To supplement our program with service we could not provide, OMC contracted with Seattle Cancer Care Alliance. The medical center’s program in Canada was no different in providing a team of patient-centered professionals. My stepdaughter received supportive phone contacts. I watched her reach out to pharmacy about a medication. Every call resulted in information and support.

I learned she was well supported which, of course, was very reassuring. She was also a cooperative patient who knew when to listen and when to ask questions, so she fully understood her plan of care.

I left feeling no question that her care and treatment were in the hands of caring professionals

But there was a difference.

At no time at the beginning or during the encounter was a fee or charge ever mentioned, or fee-related paperwork required. That is generally the case in America as well once the initial payment method is established.

However, in Canadian health care, the payment method is established once a resident is deemed eligible for the Canadian health care system, not at each encounter with a new provider or with a new diagnosis.

There are controls in place such as more specialized equipment or therapies that may require prior approval, but otherwise, care is delivered when and as needed.

I am certain, too, that referrals to specialized provider services such as oncologists and psychiatrists require sufficient documentation to justify the referral. So, there are some controls, but they are more related to care needs than care payment.

I gather there may be waiting periods for specialist services. My stepdaughter waited three weeks for her first appointment with an oncologist. She thought it would be longer. I wonder if they prioritized her referral due to the nature and stage of the cancer.

It is not that we do not have waiting lists in this country, because we do. Much depends on where we live and the specialty we require.

I know of no reason to believe Canadian medical care and access is any more or less quality than a like-sized university town in the USA. But my professional experience is limited, even though some was in oncology and services typically provided around those needed by the cancer patient.

I believe many readers have personal experience, theirs or someone close to them, that results in becoming very experienced in oncology services. It is not unusual to begin to have a “family feeling” around the many services that are often provided.

Cancer has been around long enough that oncology care has evolved into comprehensive interdisciplinary services that benefit patients throughout the disease and treatment process, including hospice services for cancers for which there was or is no cure.

Generally, and gratefully, cancer care nearly always starts with hope for remission and eventual cure for many good reasons.

Very smart people have taken on the cause of eradicating cancer — no easy feat since there are so many varieties.

Then there is the person with cancer and all her supporters who take on the prayers and wish to rid the body of cancer and regain health.

And we know too that our bodies have a certain power to fight things harmful to us.

Not to forget the power of prayer, meditation and other actions that focus our attention enough to support our own healing.

People diagnosed with cancer and their loved ones nearly always start there and hold on dearly to the belief that the disease can be stopped. That is where I live nowadays.