Fighting a serious illness brings powerful emotions 鈥� fear, anxiety, hope, despair. Perhaps for that reason, we tend to assess the treatment we receive in very personal terms.
Was the doctor considerate and helpful? Were the nurses kind and caring? Was the stay in hospital comfortable?
Go to an online 鈥渞ate my doctor鈥� site, and most of the comments focus on bedside manner 鈥� empathy, sense of humour, compassion.
Those are certainly essential qualities. But isn鈥檛 there a more immediate question? During a debate about profit margins, the head of an American health-insurance firm once asked his staff: 鈥淒id anyone here save anyone鈥檚 life today?鈥�
That seems like the critical question. When assessing our health-care system, we need to know how many patients it cures and sends home alive.
Last week, the 91原创 Institute for Health Information tried to answer that question. The institute published a report that compares patient care in each of the provinces with 33 of the world鈥檚 advanced economies. You can find the results at cihi.ca.
The good news is that with life-threatening ailments, B.C.鈥檚 health system does a first-rate job. Only the U.S. treats breast cancer more successfully, and then just by a fraction. The mortality figures in Denmark are twice the B.C. rate.
Only Iceland and Italy do a better job preventing cervical cancer (again, just marginally). Women in Ireland are three times more likely to die of the disease than women in our province.
Our heart-attack survival rates put much of Europe to shame. In Finland the death rate is 30 per cent higher, in Belgium 40 per cent, in Britain 45 per cent, in Germany 65 per cent. And the mortality rate in Japanese hospitals for heart-attack patients is more than double our rate.
Of course, numbers like those tell only part of the story. We鈥檒l fill out the rest in a moment.
But what the CIHI report shows is that B.C.鈥檚 health-care system ranks at or near the top in dealing with medical emergencies.
And we do it economically. Countrywide, Canada鈥檚 health spending is somewhat higher than the international average.
But among the provinces, B.C. is at or near the bottom in most spending categories. Our hospitals in particular are notably efficient. When it comes to cost-control, those on 91原创 Island lead the country.
Now the other side of the story. B.C. is not nearly as good at providing routine care.
Hospitals in our province do a poor job of delivering babies. Rates of damage to the birth canal caused by the attending physician are sky-high 鈥� twice the level in New Zealand, five times the level in Spain, 12 times the level in Italy.
Far too many surgery patients in B.C. leave hospital with a foreign body inside them 鈥� often a surgical tool or swab. Our rates are double those of Slovenia and Ireland, and four times those in Denmark.
More patients return to hospitals in B.C. with complications than do elsewhere in Canada. And community-based mental-health services are inadequate.
The bottom line seems to be that our health managers are topnotch at providing care in really serious situations, and they keep expenses down. With an aging population and cancer rates rising, those are absolute necessities.
But our hospitals mishandle too many patients, perhaps by hurrying them through too quickly. And some community-based services are being neglected in an unacceptable manner.
There is a message here for government. Economy has its virtues.
But B.C.鈥檚 health system has been pared to the point where only the essentials are done well. If next month鈥檚 provincial budget shows a surplus, it鈥檚 time to loosen the purse strings.
