Let’s do something different today and talk about healthcare and money. As a Canadian, I’m used to thinking that healthcare is this public, free, wonderful thing. It isn’t public; the bulk of it is private. Everything except hospitals is private (The difference between us and say, America, is that we have public insurance, not public health care. Both places are just as expensive. We just pay it in the form of taxes.) Half of this province’s budget is health care. So understandably, the government is always talking about developing “Sustainable Healthcare”.

The problem with that is the system is designed to be expensive. Let me illustrate through example.

Let’s say we have a patient who is a 40 year old male, and is very good about getting his annual checkups. Part of that panel is a cholesterol level, and let’s say his results over the years follow the graph below. Doctors don’t actually see results when they fall within the reference range, ie, “normal” (that’s too many lab results for him to look at; our one lab alone touches 2 million people a year, a routine checkup being about 15 tests). Of course, our patient will have never gotten his results either, and he’ll think his diet of fine wine and pizza is perfectly healthy.

But everyone of you can see the trend in his results. 

Come the 10th year, his cholesterol is officially high enough to call him in. Being a reactive health care system, the doctor thinks, well, let’s do an ECG, and start you on an anti-cholesterol medication just in case, sit down and have long lectures about lifestyle changes, etc. That’s assuming he hasn’t already had a heart attack or something. Altogether, we can eyeball about 800 dollars on that one visit. This is a patient who spent 10 years eating pizza and pasta in front of a bigscreen. He’s not going to go vegan for his health so easily! 

Look at diabetes. A person with diabetes sees a doctor maybe twice a year. Why? We have given patients the tools to understand the numbers we generate in the lab or on their point of care devices they have at home. We give them the tools to know how to manage their disease, but we don’t abandon them to their own devices. We are here if they need it.

If we give the man with the cholesterol the same tools, he could have seen by year 3, “Oh, wait, something is not right with my lifestyle choices. Maybe I should consult about this.”

He can keep monitoring his cholesterol to see how he’s doing with the help of his physician. Let’s look at the cost difference. 

One cholesterol level costs us $1.15. Over ten years, that’s less than 12 dollars.

10 years on our system? ~800 dollars for that visit and the associated tests. Cardiovascular disease? 30% of hospital costs in the province. An average night in a hospital once he finally ends up in there? Costs 3000 dollars. For ONE night. It’s far from a nice hotel visit. The service admittedly sucks because a whole bunch of other people there are there because of the same failure of the healthcare system and no one has time or space to handle that workload.

How many of you actually have a copy of your health records and lab results at home? Not many. We have more information on how to run our DVD players than we do on our own health.

So I guess my food for thought is: How come a 12 year old girl can walk into a dollar store and buy a pregnancy test for $1.50 (I’ve seen them!), but a man in his forties is not given the liberty to see his own cholesterol results and be accountable for his own health? It is not the healthcare provider’s job to watch each and every single one of us for signs that we will get sick. The amount of processing power you would need is exorbitant. “Oh patients’ imaginations will get out of control at these numbers” is a poor excuse for keeping them so ill informed on their own bodies in my opinion.