The actress Natasha Richardson died after falling while skiing in Canada. It took eight hours to drive her to a hospital. If Canada had our healthcare she might be alive today. In the United States, we have medical evacuation helicopters that would have gotten her to the hospital in 30 minutes.We're fortunate to live in the United States where we're free to form and express opinions. Like whether the healthcare reform measures on the table are, indeed, the right way to go. I'm still working on an opinion, learning more about what's in the package and how it will effect dimensions of care that are important to me. Like, will the changes make healthcare safer? More effective? Timely? Efficient? Patient-centered? Equitable?
It's no secret that I've been dissatisfied, personally and professionally, with the bang we get for the buck under the highly fragmented and hard-to-access system we currently have.
And, no, I'm not going to Canada.
But I do know a thing or two about Canada, being married to an ex-pat Canadian for a quarter-century and all that comes with that.
Canada is relatively easy to find on comparative health outcome rosters (they're usually a goodly number of notches ahead of the U.S. in measures of population health like infant mortality rates and life expectancy). Oh, and Canadians do pretty well in dollars spent, too (in 2005, using 9.9% of their GDP on healthcare relative to the U.S.'s 15.3%).
All citizens in Canada recently got free online access to the Cochrane Library, where credible studies are synthesized and results shared (using both highly technical language that appeals to researchers and with words that make it easy for consumers to understand complex topics). So Canadians understand concepts like "due date" and "hospice care" which is why, perhaps, they spend less money fixing what ain't broke and trying to fix things that can't be fixed. Don't know for sure, just a guess.
Empowering citizens by ensuring they have access to high-end, evidence-based medical information is not particularly sexy or glamorous (especially when compared to the health education we enjoy in the U.S. where advertisements portray middle aged men who can't pee as the next generation of Outward Bound campers).
One pay-off is that with credible information, Canadians--and others who use facts to inform their decisions--increase their ability to make satisfying, even life-preserving, decisions. It's helpful to know, for example, that more than 10% of the U.S. air ambulance helicopter fleet crashed between 1995 and 2000. And that the safety of air evacs, to this day, is below--far, far below--what passengers on craft subject to FAA oversight enjoy.
Because it's big, fast, and glamorous doesn't make it necessary. And making it subject to regulatory oversight doesn't have to diminish its safety or effectiveness. Outcome data are helpful to know, should you have to weigh the risks and benefits of air transport--and other high tech gadgetry--to facilitate the care of someone in your family.Frankly, just knowing that Canadians have helicopters might be a step in the right direction.