Several weeks ago, I wrote about the importance of factual debates. This week let’s talk about transparency. It’s one of those words that gets thrown around in health discussions. Politicians promise it. Hospital administrators profess it. Insurance companies advertise it, but when ordinary people go looking for reliable information about their own health, we hit a wall, there’s silence, or confusion prevails.
Take something as basic and important as our own medical records. In Canada, we’ve been talking about universal digital access for years. Yet, in many provinces, it is still astonishingly hard to get a picture of your health history. In Ontario, there are perplexing tools, portals and disjointed systems, and even after years of public outrage, we still don’t have good access to our records. Most people still end up calling around, waiting for responses, or even paying fees to see their own information, and it’s not that sharing personal, or sensitive information isn’t possible. We can check our bank balance in an instant, but not the results of a blood test taken last week.
There are brighter spots. In British Columbia, the Health Gateway app lets residents pull up: lab results, imaging reports, immunizations, and medications going back decades. Updates appear within days. This is proof that transparency is possible when the will exists. It also highlights the inequity of a patchwork system where some Canadians enjoy open access to their records and others remain in the dark.
In the U.S., the issue shows up in different ways. In 2021, for example, a U.S. law came into effect requiring hospitals to post the prices of common procedures online so patients could shop around. It sounds like common sense, especially in a system where patients are paying costs out of pocket. Yet, when investigators first looked, they found most hospitals ignored the rule or buried the information in ways that were incomprehensible to patients. Some reports put compliance as low as 14 percent. Even today, after penalties were increased, many hospitals remain noncompliant. Progress is being made, but patients are still left asking, if restaurants can post menus online, why can’t hospitals share something as fundamental as their prices?
What unites these examples is that transparency is never just a technical problem. The systems exist. The technology exists. What’s missing is the decision to put users of healthcare ahead of providers. What is worse is deliberate obfuscation. A lack of openness doesn’t happen by accident. It reflects vested interests, whether: governments that want to downplay wait times, hospitals reluctant to expose their performance, or corporations that profit from complexity.
It doesn’t have to be this way. When patients have access to their records, they become partners in their care rather than passive recipients. When people can compare prices, or outcomes, they can hold institutions accountable. Transparency builds trust, reduces misinformation, and forces systems to improve. Opacity, on the contrary, breeds frustration, suspicion, and inequity.
I also want to be transparent with you. My father, Dr. W. Gifford-Jones, was a physician. I am not. I know some readers have assumed otherwise, and I don’t want there to be any confusion. What I can offer is continuity of his work, which was never about hype, or fads. For fifty years, his column translated medical research into plain language and encouraged readers to weigh evidence for themselves. That remains my goal; to report honestly, to point readers to credible sources, and to highlight where the system is letting people down.
It is time for health care in Canada, the United States, and everywhere else, to be a lot more transparent.
This column offers health and wellness, not medical advice.
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