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Seeing health care clearly

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I had cataract surgery last year -- a terrifying prospect for a visual person. I love art and ocean views, and I was nervous about anyone working on my eyes. I delayed surgery a couple of times but finally committed. As it turned out, my surgery went fine. In fact, I loved that I could see colours vividly again. Our health system made that happen. And the care I received was expert and efficient.

Most Canadians report similarly positive encounters with the health-care system. A total of 71 per cent of Canadians responding to a survey in 2012 rated their family's care over the previous five years as either good or very good. But when the survey asked the same people to rate the state of the health-care system in general, only 55.5 per cent said it was either good or very good.

Those numbers don't line up: If the majority of Canadians are having good personal experiences with the health system, why are most people also saying the system works poorly?

It seems there is a disconnect between Canadians' personal views and their idea of how well the health system works for society at large. Canadians tout the public-health-care model as a big part of our national identity, say their experiences are mostly positive, but then worry the system is failing.

What we read in the newspapers probably has a lot to do with this. Two recent analyses of media coverage over several years, one by the Canadian Foundation for Healthcare Improvement (CFHI) and the other by researchers Stuart Soroka and Antonia Maioni at McGill University and Pierre Martin at the University of Montreal, found that when specific health issues, such as wait times and doctor shortages, received heightened attention in print and on the airwaves, Canadians rated the issues as more important. When the coverage of subjects was more negative in a given year, respondents graded those areas of the system more negatively.

Policy experts often describe health care as a problem with incompatible solutions. We try to deliver care quickly, cheaply to everyone, everywhere and at the highest quality possible. As we assess each of these measures and make constant adjustments to the policy balance, new difficulties arise.

What we don't always take time to note is that by and large, Canada's health-care system is a success.

The costs of the Canadian system are about the same as other countries with a similar GDP -- and much less than the cost in the U.S. ($4,602 versus $8,745 per capita). Life expectancy in Canada is also similar to other major European countries (and much higher than that of Americans -- 81.5 years versus 78.7). The big picture numbers tell a success story.

But there's more to a quality interaction with the health system than just statistics, there's also the human touch. My own recent surgery illustrates another winning aspect of the system that is best illustrated through the experiences of two other patients in the surgery wing that day.

The hospital told me in advance that all patients needed someone scheduled to pick them up after surgery. My husband agreed to pick me up, and on the day of my surgery, I sat in a waiting room with several other patients as nurses doled out pre-surgery eye drops.

The woman next to me did not speak English and there was an obvious problem: It seemed no one had been scheduled to pick her up after surgery. They found someone who could communicate with her in her language in a limited way, and explained they could not operate without someone to help her home. After about 45 minutes, the hospital staff located a family friend and in to surgery she went.

Another man that day received special care. After the surgery staff discovered he had planned to walk back to his assisted-living facility alone. The nurses told the man they couldn't let him walk home, and suggested he take a taxi instead. But he couldn't afford a taxi. Don't worry, they said, we can arrange for a taxi to take you back and you won't have to pay.

It's critical the quality of medical care in Canada is top notch, but it's equally important that care be delivered in ways that are sensitive to individual, family and cultural needs -- delivered with a human touch. I was impressed the nurses were taking particular care to make sure the system worked for everyone.

I'm thankful to our health system for seeing clearly now. I hope as we move forward on the perpetual path to reform health care in this country -- shortening wait times, improving access, enhancing quality -- that we keep in mind it's pretty good to begin with.


Noralou Roos is a professor in the department of Community Health Sciences, faculty of medicine, University of Manitoba, and the director and co-founder of

Republished from the Winnipeg Free Press print edition August 25, 2014 A9

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