Friday, July 25, 2014

The Value of Unused Bandaids

There is a box of Band-Aids and Polysporin on the top of our pantry. We buy them at Costco – so there is quite a quantity and variety. There are Mickey Mouse Band-Aids, and blister Band-Aids, water proof ones, big ones and little ones. If a skinned knee happens, or a kitchen whoops involving the vegetable peeler, we’re covered.

However, we do what we can to avoid needing to use the Band Aids in the first place (I’m endlessly reminding the kids to look where they are going), and should we need them, we also use the Polysporin. Further, when we do find ourselves needing them, we take the opportunity to learn from the experience, hoping to avoid repeating past errors. As a result, we are far more likely to use the Band Aids on stuffies rather than on people. That is a good thing.

The alleviation of suffering once it has happened is meritorious – by all means, bad things do happen (even under the best circumstances), and when they do, it is important to do what is possible to mitigate the harm. This is what the vast majority of health spending is focussed on – mitigating the harm after it has happened.

However, by focussing on merely alleviating the harm after it has happened. By failing to learn from past errors. By failing to take a step back and recognize the tremendous opportunity to prevent harm in the first place (and doing the work that is needed to be done to avoid harm), the health system is limited to having just Band-Aid solutions at its disposal. It is limited to merely coping, and will be making endless trips to Costco to replenish the supply of Band-Aids to alleviate the suffering.

Unfortunately, I think there is an attitude problem when it comes to health care that stands in the way of moving past the Band Aids to a place where fewer Band Aids are needed in the first place. There is an attitude that access to health services should be limited to those who “need” them, where need is defined as already suffering harm. There is an attitude where the immediate needs are considered, but the long-run needs are ignored. There is an attitude that costs and impacts outside of the health system, simply do not count.

Perhaps it is because it is hard to imagine the value of things that do not happen. The value of avoiding birth trauma. The value of avoiding disability. The value of avoiding the harm in the first place. Perhaps because it is easier to cut a ribbon that celebrates the opening of a new acute care facility than to celebrate the much larger success of not having a need for a facility in the first place.

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