An intimate look at health care

For the past two weeks I’ve been in Victoria. My parents live here and my Dad, who is 76 and otherwise in good health, was going in to the Royal Jubilee Hospital for heart bypass surgery. I’ve been here to help out around the house, with errands, and as a younger pair of ears as the doctors explained what was going to happen. It’s given me a very close up view of the advanced health services available here in BC.

Just what level of health care small communities like Nelson should have is not an easy question to answer.

Just what level of health care small communities like Nelson should have is not an easy question to answer.

For the past two weeks I’ve been in Victoria. My parents live here and my Dad, who is 76 and otherwise in good health, was going in to the Royal Jubilee Hospital for heart bypass surgery. I’ve been here to help out around the house, with errands, and as a younger pair of ears as the doctors explained what was going to happen. It’s given me a very close up view of the advanced health services available here in BC.

At the pre-op session the day before surgery, we met two other families who were also having bypass surgery the next day. One was from Princeton, the other was from Fruitvale.

The only two locations where open heart surgery is available currently are Vancouver and Victoria. They are building an open heart center in Kelowna, but it won’t be open for about another year. The Princeton folks were staying at Heart House run by the First Open Heart Society, and the Fruitvale couple were fortunate enough to have a son here they could stay with.

As Dad’s hospital stay progressed I witnessed the amazing care he received in the cardiovascular unit for the first 24 hours, and then the attentive care in the brand new, spacious patient care center for the next four days.

I was grateful for the high level of care that was available and began to ponder the conundrum we face regarding rising health care costs, the demands for better facilities in the rural areas, and our aging population.

I’m going to stick my neck out here and ask a couple of uncomfortable questions.

Lots of people move to Nelson (and other rural areas) for the lifestyle. We all know there’s a tradeoff when we do that. On the plus side there are fantastic outdoor recreation opportunities, a slower pace of life, and a safer community for our kids. On the down side there are lower wages, less opportunity for advancement, not as much variety in shopping and other services. Some view isolation as a plus, others as a minus.

In that context is it reasonable to demand that we have the same level of care in health services even though our population is a fraction of the larger centers? I’m not saying there isn’t room for improvement in how health services are delivered — it certainly seems that the health authority model is not working cost efficiently. And it is only fair that our area be able to deliver the same services that any other rural area our size is funded to deliver. However, around the council table we’ve also been dealing with the issue of delivering services to the public. We’ve come to recognize that even though there are a lot of great ideas for amenities out there that it would be wonderful to have, we are a small city with a small tax base and we can’t deliver everything.

Just because advanced techniques for delivering all kinds of health services exist, does it really make sense to have those services delivered everywhere?

The other question is the individual’s responsibility for their own health.

If person A chooses to smoke, drink to excess, doesn’t bother exercising and fills the shopping cart with pop, chips, ice cream and very few fruits and vegetables should they really have the same access to the same free health care as person B who chooses not to smoke, to exercise moderately and to make the effort to prepare healthy food? Should the likelihood of a procedure increasing the quality of a person’s life be considered? Should a person’s behaviour in contributing to their own health be considered? These are really tough questions, but I think we should start having conversations around them.

In the environment of a shrinking economy, rising costs and global shortages where and how we spend each tax dollar is important at all levels of government.

What do you think?

Nelson city councillor Kim Charlesworth shares this Wednesday space with her colleagues around the table