GARY | There's a small green card that Tamara Maciel says works like "magic."
When she is sick, she goes to the doctor, flashes the card, receives care and goes home -- without pulling a wallet from her purse to pay.
That card is how she and her fellow Canadians get access to health care in their country. Maciel doesn't think she has ever seen a medical bill.
She and a handful of international students who attended the human cadaver prosection program this summer at Indiana University Northwest in Gary agreed to sit down with The Times to discuss their experiences with health care in their home countries.
The discussion took place a month after the U.S. Supreme Court ruled the Affordable Care Act is constitutional.
During the conversation among the international students, attention turned toward Maciel and fellow Canadian Fraser Kegel, who said they are fortunate to have the publicly financed system in Canada.
“We're pretty lucky,” Kegel said.
On the downside, there can be long waits for care. A patient who needs an MRI scan might have to wait several months, he said.
Some Canadians cross the border to the United States for quicker care, even if it is more expensive, Maciel said.
As in the United States, a trip to an emergency room in Canada could lead to a long wait. Serious cases are handled immediately, Maciel said.
Even routine visits can take a while.
“There are long waits, because people go whenever they feel a little sick,” Fraser said.
He said it can be difficult to get into a new doctor's practice in Canada because of the heavy patient loads.
The waits are long at Spanish hospitals, too, student Roberto Sanchez Sanz said.
Aside from the hospitals, there are small offices where doctors handle basic illnesses, such as cold and flu.
The country sees health care as a right.
Even without a card, everyone in Spain -- whether they live there or are just visiting -- can get free care, Sanchez Sanz said.
He said it was “kind of stupid” to set up the system that way, because people from neighboring countries travel to Spain to take advantage of its free health care.
Overall, he is pleased with the country's program.
“I think our system is pretty good,” he said. “If you're completely penniless, you will get care.”
Medical insurance is not offered in Haiti, said C. Isabelle Verret, and health care options are limited.
“But they accept everyone who comes in,” she said.
Health care availability has worsened since the 2010 earthquake, she said.
Jose Mas, a veterinarian originally from Argentina, said health care in his home country is provided through a mix of private and public entities.
Many countries view medicine as an obligation of the state, Mas said.
Among to the international students, what stood out most is the high cost of health care in the United States.
“I don't know any other country where health care is so expensive,” Mas said.
A cut on his finger once yielded a $1,500 bill, he said.
Noting the plethora of advertising, Fraser said Canada does not have many ads promoting doctors and hospitals. It is seen as a service.
“Here, it's more like a business,” Fraser said.
“I don't remember seeing ads (for doctors and hospitals) in Argentina,” he said.
And the settings are different.
Some American hospitals smell more floral than sterile, the students noted. And many feature private rooms with flat screen televisions and Wifi for Internet access.
“Here, I see the hospitals like hotels,” Sanchez Sanz said.
In his home country of Spain, hospital patients share a room with at least one person. Sometimes four patients are squeezed into one room, depending on the size, he said.
Haiti's Verret shadowed a family practitioner in Florida and was amazed to see patients in the United States go through triage, in which patient conditions are assessed and prioritized.
In Haiti, there is no triage. The doctors do all of the assessments without help from medical assistants.