There's been a great deal of press concerning the death of Natasha Richardson and the fact that there was no air ambulance available to transport her to Montreal. The discussion has been ignited by the embarrassing sniping by American news media at our medical system.
The simple truth is that an air ambulance wouldn't have made a whit of difference and anyone who can do sums should know that.
If Quebec had a helicopter service, the closest available would likely be in Montreal. The air ambulance would have had to fly 100 kilometers to the Ste Agathe hospital and then make the return trip to Montreal. Typically, it takes about 10 to 15 minutes from the time of the call to get airborne and with an average cruising speed of 150 miles per hour, the complete trip would have taken about an hour and a half.
An ambulance, dispatched immediately, with siren and red lights ablaze, would make the trip in about the same time, probably faster.
The real question that should be asked, is why couldn't the St. Agathe hospital treat her?
The head injury suffered by Ms Richardson needed to be treated immediately and any delay, including an hour and a half helicopter trip was clearly too long.
The Centre Hospitaler Laurentien in Ste-Agathe des Monts is not big, but it is well equipped.
It serves a large area, centered about a hundred kilometers north of Montreal, smack dab in the middle of the picturesque Laurentian mountains, an area that serves as a year-round playground for skiers, boaters, hikers, cyclers, cottagers and tourists, as well as the massive Mont Tremblant resort.
The small local population it serves is boosted on weekends, summer vacation and holidays, with tourists, cottagers and day trippers from Montreal. Because of the influx, the hospital, aside from treating the local community, sees a lot of recreation type injuries.
I've been to the emergency room only once, a couple of years ago, when my mother had a bad reaction to multiple bee stings, while berry picking. She was treated within minutes by a competent doctor who quickly prescribed some helpful antihistamines. The service was first class and professional.
It would seem to me that upgrading the hospital, to include a first class ER, trauma and orthopaedic unit should be a priority. It makes more sense than sending for a helicopter ambulance from Montreal. The area has been a growing and the expansion of the Mont Tremblant resort requires a re-evaluation of the hospital's facilities.
Canada has a rationed health care system with finite resources. When money is spent, bean counters always looks to maximize return. They analyze how to best to spend the available money in order to insure that the public gets the most bang for the buck.
If more lives can be saved by spending dollars on better emergency care, than by, say an emergency air ambulance service, then that's what the money is spent on. It's sounds cruel but it works on a large scale.
We have no apologies to make to those Americans, who tell us that their system is better because there is more first class and exotic treatments available. It is only available to those who can afford to pay.
The forty million Americans with no health insurance would dream of living the Canadian health care experience. Even people with health insurance are limited and denied life-saving treatment deemed too expensive by insurers looking to deny responsibility in pursuit of profit.
A trauma patient delivered to a hospital by an American air ambulance is still up 'up the river' if he has no money to pay.
Detractors of Medicare point to incidents like the death of Natasha Richardson as proof that our system is not as good as the US system. The real truth, is that our 'socialized' system keeps Canadians living longer and infinitely more healthy than America's private system and at sixty percent of the cost. It is designed to deliver the most service, to the most people. While it is true that exotic and expensive treatments are less available, on balance is it's a worthwhile trade off that statistics back up.
Before establishing an air ambulance, it would make a lot more sense to judge whether the money can be better spent else where.
But perhaps it's a question of controlling the cost. With a creative solution, it seems to me, that there is a way to establish an air ambulance service that makes financial sense and one that can be justified. Let me offer my humble proposition.
Just two teams, one based in Quebec city and the other Montreal would serve three-quarters of the Quebec population (within 30 minutes).
It would make sense that these helicopters be operated by the Quebec and Montreal municipal police departments, which would be subsidised by the Quebec government. To limit costs and increase efficiency they could also be be used in other emergency and security operations. The police departments are well-positioned to integrate and operate these units, which should be staffed by competent advanced-care paramedics who could do more than just scoop up critically injured patients.
It would be a wonderful Canadian solution.