I’m Finally Giving Up on America’s Broken Health-Care System—And I’m Moving to Canada

There’s an episode of Friends I keep thinking about: It’s the one where Joey’s health insurance lapses around the same time he develops a hernia. His storyline for the episode revolves around his search for an acting job so he will continue to qualify for his SAG-provided insurance (shoutout to unions!). His search is complicated by the extreme pain he’s in (again, hernia). Finally, he lands a role as a dying man. In the end, he gets his insurance back. The episode, in retrospect, is incredibly dark, but it’s not framed as such. Viewers aren’t meant to identify with Joey. He’s framed as the fool—his lack of insurance is due to his own carelessness, not a result of a cruel and senseless system. He ignored letters; he hung around in the coffee shop instead of looking for work. When he does look for work, he finds it almost immediately. There’s always work—and insurance—to be found, for those who want it, the episode suggests.

I wonder how Joey would fare in a pandemic, when the television and film production industry has ground to a halt and 18 million Americans are collecting unemployment. It’s possible he would spend an episode or two trying to convince the gang to pack up and move to Montreal (cue studio audience laughter as Joey tries to speak French).

I’m moving to Canada is a liberal cliché, and now that we’re staring down the barrel of another presidential election, it’s making the rounds again.

Or maybe I’m projecting. Because for the last six months, all I can think about is leaving the United States for somewhere—anywhere—with universal health care. My Google history is glutted with government websites from various countries. (Unfortunately “Are you interested in naturalizing a 34-year-old monolingual diabetic writer?” is almost never one of the immigration FAQs.) God help me, I even applied for a Canadian graduate program.

I’m moving to Canada is a liberal cliché, and now that we’re staring down the barrel of another presidential election, it’s making the rounds again. If he wins again, I’m definitely moving to Canada. Personally—though I certainly consider Joe Biden the lesser evil and fully intend to cast my vote for him in November—a Biden victory doesn’t make the prospect of remaining in the U.S. much less frightening to me, at least not when it comes to health care. In the middle of a pandemic that is nowhere near under control (it’s neither the beginning of the end nor the end of the beginning), Joe Biden still stands cravenly against Medicare for All.

Ady Barkan, the tireless progressive health-care activist who suffers from ALS, recently sat down with Biden and pressed him on whether he believes health care is a human right. Biden claims that it is, but says that “taking away the right to have a private plan if you want a private plan, I disagree with.” Because, you see, unfettered capitalism is a human right, too.

A Biden victory doesn’t make the prospect of remaining in the U.S. much less frightening to me.

Biden has stated that his plan to address the horrifying inequalities of the U.S. health-care system is to “protect and build on Obamacare,” while providing a “public option, like Medicare.” A public option may help ameliorate the enormous monthly premiums plans on the exchange charge (my husband pays $800 a month for a plan with no out-of-network coverage), but it does nothing to address the enormous power insurance companies wield when it comes to the people they cover. It’s no coincidence that on Super Tuesday, when Biden made major gains toward securing the Democratic nomination, health insurance companies gained $48 billion in market value.

If mass unemployment and a literal pandemic won’t convince the Democratic establishment to forsake their for-profit insurance overlords, will anything? Or is it time to admit that this country is only habitable for people with unlimited financial resources?

I’ve written here before about my personal stake in the issue of health care. I’m type 1 diabetic, which means I require insulin to live. Multiple injections a day, every day. Yes, even when I exercise. Yes, even if I go paleo. Yes, I’m sure chia seeds are fantastic, but they are not, unfortunately, a substitute for insulin.

Is it time to admit that this country is only habitable for people with unlimited financial resources?

At the moment, I have insurance through my employer. But if the past months have taught us anything, it’s that the condition of employment is more tenuous than we had previously imagined.

In the months before COVID-19 consumed the news cycle, stories about diabeticsdying from insulin rationing were a fixture in mainstream outlets. Democratic politicians decried the shameful state of affairs. Minnesota Gov. Tim Waltz signed the Alec Smith Insulin Affordability Act, which would provide a one-time, 30-day supply of insulin to eligible residents in “urgent need” for a $35 copay. (The bill was named for a 26-year-old in Minneapolis who died because he couldn’t afford the drug.)

Earlier this month, a pharmaceutical industry group sued the state over the program. There’s no compromise to be found between profit and patient care. As long as health insurance and pharmaceutical companies remain for-profit industries, the American health-care system will continue to fail Americans.

Moving to another country like Canada requires organization and luck and, yes, money. The fact that I’m able to consider it at all betrays my extreme privilege. But as someone whose constant need for health care is non-negotiable, it seems recklessly irresponsible not to at least consider it.

It’s a matter of life and death.