What factors drive health care spending decisions? Hint: It's not all about dollars and cents.
Have you ever considered the cost of Canada's universal health care system that lets us visit a doctor, have diagnostic tests and receive some treatments, free of charge?
Between 2017 and 2018, Health Canada will contribute more than $37 billion to provinces and territories for health care costs. Alberta Health will spend a total of $21 billion on its residents in 2017. These large sums of money are still not enough to cover all the needs of every citizen.
Dev Menon, a professor in the School of Public Health, has spent nearly 30 years of his career in health technology assessment (HTA) advising governments on how best to invest its limited resources to see the greatest return of health benefits for Canadians.
Menon explained the three key factors that go into his spending recommendations.
1. Evidence
Often patients hear about a treatment they believe could be a cure all and are disappointed when their doctor tells them it's not covered by our health-care system.
"An investment decision requires that a drug, device or technology is proven to be effective and safe under all circumstances, before being offered to patients" explained Menon. "Evidence that something works is much more than the promise it might work."
2. Resources
"Even with all the money in the world, we could still not buy a cure for everything," explained Menon. "So with limited resources and endless needs, we have to accept there will be trade-offs."
According to Menon, when the government decides to invest in a certain technology, it will trigger a corresponding decision to not invest in another.
3. Values
Decisions made about health care spending are not just a matter of dollars and cents. "We must balance budgets with society's preferences," said Menon.
"No one wants a child to suffer, and we want our elderly to be well cared for," explained Menon. "Our social values are important when making decisions that affect quality of life and health care costs."
Menon heads the Health Technology and Policy Unit (HTPU) supporting the Government of Alberta in making health technology decisions. He also leads Promoting Rare-Disease Innovations through Sustainable Mechanisms (PRISM), consulting citizens to understand society's values and preferences for investing in for rare diseases.
Menon was recently awarded the Dr. Jill M. Sanders Award of Excellence from the Canadian Agency for Drugs and Technologies in Health (CADTH) for his many contributions to establishing the field of HTA in Canada.