Every health professional I know finds clinical work to be the most satisfying part of their day. Despite this, many patients do not feel as if they are the driving force behind the health care system. When they go to a doctor or the hospital, it often seems as though everyone else’s schedules are more important than theirs. It seems as though, as critical as their health care is, the cost of their health care is becoming too much of a burden on the public purse.

My experience is patients are as eager as their care providers to contribute to reducing waste, eliminating inefficiencies and containing the cost of healthcare. They have, after all, the largest stake in the system as they are dependent on it for their health.

Many doctors say that there is a great need for patients to understand the costs of the system so that they can participate in keeping costs down. Many doctors and patients suggest that patients and their families should see an “account” outlining the cost of their healthcare and treatments so that they can better understand costs. It does seem as though governments won’t consider this but, on the other hand, as much as I have heard a number of doctors say that this would be a good idea, I do not actually know of any who have done given their patients a summary of what their care cost. I would like to know what impact they feel this had, as unscientific as such an appraisal would be. One outcome that would not be good would be to make patients feel guilty for getting care that they need since the sooner one gets care, the better the outcome usually.

There is also the question of whether having patients pay for health care would improve sustainability and both some doctors and some patients believe that this is the answer. I have never believed that this is the answer. Most psychiatric patients could never afford this, nor could most children’s families. Also, if you look at those parts of health care for which some people have coverage but many do not, such as medications, vision care or physiotherapy, the costs of those have risen more in the same period than those which are completely covered.

What I want most is for patients to be brought into the discussion about healthcare sustainability so that everyone is working toward this goal. Surely that’s not too much to ask?

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