New York City – Until recently I wondered if there’s anything my native Toronto has over this city, with its robust cultural life, stunning architecture, all-night bars and superior transit system. But then I injured my foot.

Aside from the fact that T.O. has better (that is, more even) sidewalks, all the nightlife in the world cannot compete with public health care.

Fortunately, I have travel insurance, for which I’m eligible as long as I have OHIP. So recently, when an awkward step on the rugged terrain of East Broadway caused pain to shoot through my foot, I thought it was time I used that insurance. Now I had to deal with one of the unfortunate realities of living my New Yorker fantasy. 

While purchasing this insurance provided peace of mind, I had a lot of anxiety about actually using it. Had I read my plan carefully enough? Was there a loophole I hadn’t seen? 

I spent a day with an ice pack on my foot, googling different kinds of injuries and trying to decide if it was worth a bit of a gamble.

If I went to the hospital they’d take X-rays. How much do they cost if insurance doesn’t cover them? Maybe I should hobble my way back on a bus to Toronto? I got myself so worked up, I took a Trillium Plan-covered (Ontario government drug plan) pill to fall asleep. 

I suddenly realized this was the kind of thinking that accompanies every medical problem for an insured American who isn’t rich – except most don’t have the option of boarding a Greyhound for care in Canada. I wonder if treatment for anxiety over whether your insurance company will screw you is covered by HMOs. 

I had stomach surgery at Toronto Western Hospital a few years ago, but I didn’t appreciate at the time what a blessing it was to not have a for-profit company determining if I really needed it. Oh wait, it wasn’t a blessing. It was a right.

But indignation wasn’t going to ease my foot pain, so the next morning I called my insurance company and was assured that it would pay to have my foot checked out. I asked, “Are you sure?” a couple of times. 

I went to Governeur Hospital on Manhattan’s Lower East Side, one of the few “city hospitals” in New York, which means it’s the closest thing to public health care in this country. These hospitals focus on those poor enough for Medicaid.

I brought a copy of The New Yorker, anticipating a long day of waiting. I felt a little foolish reading it when the only publications in the waiting room were Chinese newspapers and the tabloidesque New York Post. “Where does he think he is, a private hospital?” I imagined the other patients thinking. I wanted to regale them with stories of Canadian ER rooms where Maclean’s and Toronto Sun readers sit side by side in agonizing pain.

While filling out the podiatry clinic’s new patient form, I didn’t note my American citizenship – I have both. I didn’t want to complicate matters, and part of me must have hoped that once they saw I was Canadian, they would say, “Oh, don’t worry we’re not going to subject you to our bizarre custom of for-profit medicine. Right this way, sir.” Then I’d be whisked away to a building with the comparative sanitary glimmer of Toronto Western Hospital.

While receiving my X-rays, I started thinking about free-market medicine and how absurd it was to act as though the typical citizen could make an informed “free” choice about consuming this or that treatment. Was I going to say to the X-ray technician, “I think I’ll take two instead of three X-rays. Yes, don’t bother X-raying the bottom of my foot, I’m not interested. Now, what can you show me in a navy blue lead vest?” 

Several hours later, the doctor informed me my foot looked fine and I should ice it. I told my roommate what the doctor had said, and she replied with surprise, “You went to see a doctor? You really are Canadian.”

Jacob Scheier is the author of the Governor General’s Award-winning More To Keep Us Warm.

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