Betsy is 27 years of age. She is bright, articulate and social. However, for some reason she developed an aversion to food. She lost 20 pounds over 2 months. She ate very little, if any food.  The family was concerned and called RCM Health for assistance.


Her condition of food aversion is complex so we immediately organised a team. The team included our nurse practitioner, a family systems therapist and coach and a psychotherapist for Betsy. She started her food journal. We had daily weigh-ins. Her labs were stable. We checked in on her daily. 


Betsy did not increase her intake so we reached out to the eating disorder clinic in her city. The hospital had information about the programme on the website. However, when we dug deeper, we learned that the wait list for an assessment was 185 persons long. The 3 staff doctors were reduced to 1. Their nurse practitioner had quit. And their beds were closed. No luck there. 


Then we reached out to a private mental health facility in her province. We organised her intake. Then we asked about the price for private eating disorder residential programming. We learned that the cost of a minimum 8 week stay is $79,800. The centre suggested up to 16 weeks of programming. I had trouble doing the math. 


Does this prove that 2 tier is here? It certainly is.


So what is one possible solution? First the problem must be recognized. Then we might try low cost health insurance provided by a not for profit health insurer. With the law of large numbers, the insurance would be affordable for most. And possibly supplemented by employers or unions. 


 Most of the premiums would go into funding private services not provided by the province. Like the eating disorder programme. We might call it Medibank. That is what Australia did about 30 years ago. Maybe we can catch up. It seems to work for Australia and other countries.