Prior to writing this column on health care I found myself in the emergency room on Christmas Eve being admitted for pneumonia. A bit of field research never hurts a columnist – well, maybe a little.
Fortunately, I haven’t spent much time in hospitals, excepting during the birth of my daughters. My eldest came via an emergency C-section followed by a three night stay. I was curious about the cost of that to our health care system. Since then, I’ve often said I’d be in favour of an invoice (with a zero balance) to inform us of the charges our encounter racked up. I’d like to believe this would take us a long way towards valuing what we receive, educating us on true costs of the services and encouraging us to use the system more conscientiously.
Wasteful scenarios do exist. A fellow manages to ignore his sore thumb until one Saturday night he decides he can’t take it anymore and hits the emergency room. This minor injury which could have been seen at the family doctor’s office for $40 winds up costing over $600 at the ER. Worse yet, when the fellow gets tired of waiting and walks out without being seen by a doctor, the charges for creating his chart remain.
There is another incredibly wasteful situation that Andre Picard of the Globe and Mail describes in an article: “Hallway medicine: Do we really need more hospital beds?”. He cites the overcrowding that jams patients into makeshift rooms and corridors. Picard proposes “we figure out if beds are being used appropriately and cost-effectively.” Well, about 10 percent of hospital beds are taken up by “alternate level of care” (ALC) patients. ALC describes folks who are not in need of the acute level services which hospitals are intended to provide. The problem is they have no place to go as they are often candidates for home-care or long-term-care. Such placements are a long time coming, and so people wait, sometimes for months, in the hospital. It is a complex issue, but my calculations put the cost of a long-term care bed, paid by the user, at $65 per night (nearly $24 000 annually) versus about $2000 per night ($730 000 annually) in a hospital, paid by the healthcare system. Seems to me it is worth investing the money to create more facilities.
Thrifty and innovative ways to deliver health care are being bandied about and one of my favourites is the patient centred approach. Electronic medical records improve health care. A physician associated with a group of caregivers ranging from nutritionists and counsellors to personal fitness coaches can head off some chronic disease in the early stages costing much less and resulting in a healthier population. In the meantime, we can take a page out of Ontario’s book. Their provincial government spends $55 a day for a person to remain in their home with care. This has proven to be a more efficient use of resources while reducing the congestion so common in our hospitals today. Some of the simplest, economical solutions are also the most successful.
Jill Cunningham grew up in St. Albert, has a Bachelor of Education from University of Alberta and is passionate about nature, the environment, and building community.
