Good health takes more than access to doctors and hospital beds it takes wealth too
TheStar.com – opinion/editorials
14 August 2012. Editorial
Will it be diabetes medication or dinner tonight? Will a prescription to combat high blood pressure get refilled this month, or is it time to pay the hydro bill? These are not choices that anyone should have to make, especially in an affluent country that takes pride in having universal health care and a decent social safety net.
But these are the ugly choices that too many of us face. More than 1 in 4 lower income Canadians have delayed or stopped buying prescription drugs and have skipped meals because they were short of money, a recent poll for the Canadian Medical Association found.
No wonder there is such a gap between rich and poor Canadians when it comes to health. More worrisome still, the poll found that the gap appears to be growing, with those who earn $30,000 or less reporting poorer health and more frequent use of medical services than those who earn $60,000 or more.
Commendably, Canada’s doctors have used their annual meeting in Yellowknife this week to forcefully draw attention to this troubling health gap. It’s good to see them taking this on at a time when our political leaders are focused on reducing budget deficits.
Even in times of austerity, Ottawa and the provincial governments are quick to reassure the public that health care spending will be protected. But health and health care are not one and the same thing. Just paying for doctors and hospitals does not necessarily lead to positive or equal health outcomes for everyone.
Getting exercise, eating well, properly managing chronic illnesses, butting out — all these practices contribute greatly to overall health. And they all have more to do with income, education and working and living conditions than sheer access to health care.
Yet, despite all the evidence about these “social determinants” of health, governments have failed to fund accordingly. At the federal level Health Minister Leona Aglukkag expects credit for continuing with annual 6 per cent increases in health transfers to the provinces until 2017. But at the same time her colleague Human Resources Minister Diane Finley has abdicated responsibility for affordable housing in this country, leaving many poor Canadians scrimping on medication, food, and other necessities that affect their health just to pay the rent.
Here in Ontario the last provincial budget nipped and tucked just about everything to try to keep health care funding stable, with predictable results. People living on social assistance had to make do with a minuscule 1 per cent increase. That’s far outstripped by the rising cost of food, housing and other necessities, leaving the poor and those on disability support even worse off than before. As Canada’s doctors know, that’s not conducive to good health.
It’s a false economy, too. The link between poverty and ill health is well established. By not addressing the root economic and social causes of ill health we’re just adding to health care bills down the line.
Canadians should be able to expect that all citizens have an equal shot at being healthy. Doctors are reminding us that they alone cannot make that happen. It’s time politicians stopped talking a big game on health care and started acting on what the evidence shows.