Don’t talk to me about queue jumping.
It took more energy than it should have to dial my partner’s number on an afternoon last April. When he answered, I skipped past a standard greeting to loudly proclaim through raspy tears, “I… betrayed… Tommy Douglas!”
He was, understandably, confused. And I was, notably, upset. It was also apparent from the bubble and squeak percussion of my breathing that in the throes of pneumonia. A week and half prior to this call, I had undergone a surgery related to one of my autoimmune illnesses. If we’re just meeting for the first time reader, my name is Ro, and I am chronically ill. I was intubated for the surgery which led to me developing pneumonia. My partner had to travel for work right when the lung infection hit its literal fever pitch and I was stuck at home, immunocompromised, very sick, and unsure of what to do next.
I went online to see if there were any government insured online doctor services. If you live in Ontario and have ever googled such a thing prior to last month, you know the answer is no. There was, however, a service I could pay for. I laid in bed and thought about it for several hours. On the one hand, I had no vehicle, was recovering from surgery, was immunocompromised and had pneumonia. On the other hand, I was a lifelong defender of public health care and paying for health care services went against everything I stood for.
Somewhere around hour three, I broke down and paid to see a doctor on the internet. I got a prescription faxed to my pharmacy and it was over. I managed to receive care without putting myself at additional risk of harm. But I still felt sick about betraying my ideals. Hence the phone call and the tears about me and old Tommy D rolling in his grave.
Speaking of graves, I thought that I would take this secret to mine because it was sooooooo shameful to betray the principles of better medicare for all. Then this weekend happened.
This weekend, I was reviewing a document written by a health care advocate who was sounding off about this for-profit online service and how they allow people to “jump the queue.” I wrote a very thoughtful response. I explained that her choice to frame the arrival of an online for-profit service as “queue jumping” was very problematic. In a moment of vulnerability, I admitted that I had used a for-profit online doctor when I was immunocompromised, immobilized, and very overwhelmed by pneumonia. I explained that people in the disability community had been asking for telemedicine for years and been told that it simply wasn’t possible. When COVID-19 hit, it turned out lo and behold that we did have the technology after all. But disability rights have never been a priority. To that point, I explained that I was hearing from people on disabled twitter that jurisdictions where COVID-19 cases were dropping were apparently already removing their government-insured telemedicine services. I suggested, instead, that she consider advocating for the maintenance of a safe, secure, and accessible public telemedicine program across the country. I argued that this was important given that 44% of adults in Canada live with at least one of the ten most common chronic conditions. She asked where I got that statistic.
And that’s what drove it home for me. Health care advocates so often don’t know anything about health care users, particularly the disabled and chronically ill ones. The 44% stat is quite literally entry level. It is the “so you’ve started to think about the prevalence of chronic conditions” conversation starter that you can whip out at a cocktail party. Everyone who knows anything about chronic conditions knows it. And if health care advocates can’t be bothered to learn about the people who need the most consistent access to health care services, what do they think they are doing?
Which brings me back to the whole issue of “queue jumping.” What a profound strawman of an argument. And I say this as someone who has worked in health care advocacy. I have ghost written speeches and editorials and blogs. I know these talking points inside and out. And yes, I believe in a fully functioning, properly funded health care system. And no, I do not believe that a parallel public-private system is the solution. But I am also not interested in dying for a principle. And suggesting that I walk into a walk-in clinic when my immune system is offline is very much suggesting that I throw caution to the wind for a principle. To what end?
I do not write this as a defence of for-profit online health care. Far from it. I write this because as a chronically ill Canadian, my health care system failed me. When I was sick, I could not access care. A doctor on the internet offered to treat me for a fee and that was the only safe course of action available to me. I am privileged enough to have a credit card that allowed me to take this route. Many disabled and chronically ill people live in poverty and therefore their experience starts and ends with being unable to access care. To turn this horrendous experience into some misdirected argument about queue jumping obscures the reality that this is about denied access for disabled and chronically ill Canadians for whom there is all too often no guaranteed safe way to receive medical treatment.
We face enough hurdles within the medical community. We shouldn’t have to face them from health care advocates, too.
