Awesome photo from Cute Overload, nothing to do with what I want to talk about today.

Despite the fact that Canada has "universal health care", not all our patients have access to this care. Women find themselves in a position of needing to choose between affording birth control and paying rent. I met one of these women who ended up pregnant, keeping the child and now has even more financial problems than if she had forgone her rent and bought birth control.

The Mirena IUD, one of the best options for women who are myopic in their health care choices, is the most expensive option at the initial outlay. It costs approximately $400. This is a one time cost and the Mirena lasts for 5 years. There is no need to remember to take pills daily or ensure his love is gloved to prevent a pregnancy. It's also a fabulous way to control heavy periods. The $400 is quite a bit for the woman who can't afford utilities.

Some docs are good enough to keep some of the samples given out by drug reps. This is disturbing on a whole different level. There is something to be said for beggars can't be choosers. If the birth control that may be the best choice for the patient (e.g. a mini pill, the nuva ring, mirena), is not available as a sample, then the patient gets the second (or third, or fourth) best option. Samples are given to the docs as good will from the drug reps to get their foot in the door, but also so that the docs can give them out to the patients who need them and see how they react and learn how the drug works.

New research out of Kingston shows that poverty plays a role in cancer prognosis. I assumed it would be because these folks are less likely to seek medical attention early, but one of the things they found was that patients presented at the same stage in their cancer. While it's true that we have universal health care in this country, we don't have universal access to healthy foods, education about our health and access to health promoting activities. The researchers are looking at "other factors such as tumour biology, presence of other illnesses, access to treatment, quality of care, or differences in nutrition, exercise and smoking may also play a role in survival".