- Robert Roach, Director of Research, Canada West Foundation
As we stumble through this recession, there are two things Canadians and their governments should understand about health care.
First, no matter what we do to reform the system, short of reducing the amount or quality of care available, the cost will continue to rise. Health care will get more expensive and we will, one way or another, have to come up with the cash to pay for it.
Second, until we as individuals, and as a society through our governments, fully embrace prevention and wellness as the first principle of health care, our individual levels of health will be lower than they could be.
There are many reasons why health care costs have gone up in recent years. One often-overlooked element is the fact that we have developed better ways of healing people and keeping them alive. With luck, these advances will continue and diseases like diabetes will no longer take our loved ones from us and the survival rate after serious accidents will go up and up.
These new treatments cost money. We didn't get MRIs 30 years ago, and didn't have to pay for them, because magnetic resonance imaging didn't exist.
The last thing we should be contemplating is cuts that will undermine providing the best possible care we can. You only get one life, and if you have the ability to keep yourself healthy until a ripe old age, you should not shy away from the investments to make this possible for everyone.
What is all our prosperity for if not to achieve things like this? There is more to life than being healthy—far more—but being healthy sure helps!
And the debate is not about “public” versus “private,” or some mix of the two like we currently have. That is for a different day. Whatever funding method we use, the overall costs will go up as we continue to figure out better ways of treating our ailments. Personally, I am glad to pay more for computer assisted surgery if it means I get more than my throat looked at with a tongue depressor and a prescription for aspirin.
Canadians and their governments need to accept this basic truth: good health care with high tech gadgets, better drugs and thorough rehab services costs a lot of money in the same way that a faster car costs more than a jalopy. This means more taxes and/or more out-of-pocket costs. Get used to it and don't fall prey to the idea that we can have excellent health care at little cost.
This does not mean that throwing more and more money at the current system is the answer to our many health care system woes. It is naïve to think that reforms of any kind will magically make health care inexpensive. More importantly, we should not be too quick to cut, or using doublespeak, “delisting” things like chiropractic services, physiotherapy, drug coverage, psychological counseling, advanced diagnostic tests and other services in the name of saving money unless we are prepared to see overall health outcomes deteriorate. That's the choice we are facing and it should be crystal clear what we are deciding to do.
This is especially true for the most vulnerable members of our society who cannot just dip into their disposable income and cover the extra costs. Cutting coverage and ignoring things like eight-hour waits at walk-in clinics because of a lack of doctors makes people suffer—it is as simple as that.
What are some of the first things to get cut when governments look to trim the costs of public health care? Wellness and prevention programs. Should the goal be saving money or increasing the overall level of health? Study after study shows that if we significantly increase our efforts to promote wellness, we would be much healthier. This seems like a smart thing to do and, frankly, more important than cutting costs.
This, by the way, is not about Big Brother putting people in jail for eating Doritos. There is a lot we can do that does not force people against their will to be healthy.
It is less clear if greater attention to wellness will slay the health care expenditure dragon. On the one hand, every person who avoids a heart attack by improving their diet, getting more exercise and taking medication to control their blood pressure, is one less person who needs a series of costly treatments. On the other hand, wellness services are not free and, especially in the short-term, are likely to increase costs.
As governments look for ways to cut back in this recession, let's hope we have the collective foresight not to abandon the advances we have made in health care by cutting back on its availability to everyone regardless of their income. Similarly, let's hope that we don't cut wellness and prevention services in a kneejerk reaction to the slowdown, but keep our eyes on the prize of being the healthiest people in the world.
