Three years ago I set out to answer what I thought was a simple question: how much do I cost the health care system? I sent a Freedom of Information request to Health PEI, the public service body that manages the health system in Prince Edward Island, and what ensued was an almost-three-year back and forth – detailed in part here – between Health PEI, the Information and Privacy Commissioner and me that, as time wore on, achieved a level of absurdity that surprised me given the simple question I was asking.
My most recent communication from the Information and Privacy Commissioner on the adjuication of my appeal of Health PEI’s decision not to release cost information to me was a letter I received on January 16, 2014 informing me that the expected decision date on my case was being pushed forward to September 19, 2014 (from the originally-extended-to February 13, 2014).
When I received an unexpected communication from Health PEI’s Privacy and Information Access Coordinator telling me that they had reconsidered and asking me to confirm my email address. A few minutes later I received an Excel file with the details of almost every medical procedure I had from 1996 (when their data starts) to June 2011, along with the name of the doctor, the location of the procedure and how much was paid to the doctor. It’s almost every medical procedure because, as Health PEI had informed me earlier, if “the service was provided by a non fee-for-service physician or was provided through a hospital (e.g. emergency department or day surgery) there are no individual payments.”
There are 58 procedures in total, ranging from “ALLERGIC RHINITIS” to “X-RAY ABNORMAL,” performed by 22 individual doctors. In total $1901.88 was paid out to doctors. While the amounts paid to physicians don’t reflect the total cost of my health care, it’s useful information nonetheless. Here, for example, are 10 items related to a the diagnosis and eventual removal of my gallbladder – an epic journey I related here – in the winter and spring of 2003:
|CHAMPION PAULINE||OFFICE||January 8, 2003||ABDOMINAL PAIN, COLIC||22.94|
|CHAMPION PAULINE||OFFICE||February 19, 2003||ABDOMINAL PAIN, COLIC||22.94|
|CAMPBELL CLARENCE M||QEH||February 25, 2003||X-RAY ABNORMAL||38.60|
|FLEMING BARRY D A||OFFICE||February 28, 2003||ABDOMINAL PAIN, COLIC||63.15|
|GILLIS LISA A||OFFICE||March 17, 2003||CHOLELITHIASIS||22.94|
|FLEMING BARRY D A||OFFICE||March 24, 2003||ABDOMINAL PAIN, COLIC||22.61|
|FLEMING BARRY D A||QEH||April 8, 2003||CHOLELITHIASIS NOS||432.55|
|KENNEDY RALPH DOUGLAS||QEH||April 8, 2003||CHOLELITHIASIS NOS||108.14|
|FARMER STEPHEN R||QEH||April 8, 2003||OTH SPEC PROB INFLUENC HEALTH||145.50|
|FLEMING BARRY D A||QEH||April 8, 2003||DAY SURGERY — HOSPITAL PAYMENT||NIL|
The total paid to the six physicians for my gallbladder issue was $879.37, and that table is a good blow-by-blow of how it was diagnosed: two visits to Dr. Champion, my family doctor at the time, a referral for an X-ray at the Queen Elizabeth Hospital followed by an office visit with Dr. Fleming, the surgeon who would eventually remove my gallbladder and then the operation itself on April 8, 2003 (“Cholelithiasis” is “the presence of gallstones”).
There are a host of other costs involved with taking out my gallbladder – nurses, machinery, heat, light, etc. It would be interesting to know what slice of the QEH budget my gallbladder removal was responsible for, but that figure seems impossible to determine, so the $879.37 will have to stand in.
Using pivot tables in OpenOffice allows me to do all sorts of analysis on my medical history: which doctors have I seen the most, what medical complaints do I seek assistance with the most, how often do I see a doctor. It’s an insight into my health care that I really value.
It really is absurd that it took almost 3 years to provide me with this information; indeed, perhaps my next request should be an accounting of the time and cost for Health PEI and the Information and Privacy Commissioner to take so long to say no before they said yes.
I’m a big believer in public health care; I consider it one of the distinguishing benefits of being Canadian. But I don’t think that not having to pay out of pocket for our health care necessarily means we all shouldn’t know how much our health care is costing the health system, if only because understanding more about the nitty-gritty costs of health care makes us more responsibile citizens when it comes to electing our politicians to make large-scale decisions about health spending.
If you would like to request the same breakdown for your health care, fill out a Request to Access Information application form (you can see how I filled mine out here) and send it to:
Privacy and Information Access Co-ordinator
P.O. Box 2000, 16 Garfield Street
Charlottetown PE C1A 7N8
Tel: (902) 368-4942
I presume that if you asked what I asked for you should receive your information quickly and without having to wait 3 years.
you are making a very important point Peter. It is important that each of us knows what we cost. For this is not free. We don’t pay directly but we do cost. I think a great first step is to have annual health cost report for each person and family. If they have the billing then they have the costs — like our credit cards.
With a sense of the costs we can then think of the alternatives
Now I want to do the same thing for me in Germany.
1. April 8, 2003. I remember it well — my birthday
2. Didn’t know OpenOffice featured pivot tables — why I’d been sticking with Excel
3. Worthy project, well done!