Modest new thinking on health care

Posted on September 24, 2011 in Health Debates

Source: — Authors: – opinion/editorialopinion
Published On Thu Sep 22 2011.   By Carol Goar, Editorial Board

If health means shorter waits for surgery, more nursing homes, more MRI machines and more pharmaceuticals, the fact that all three provincial parties are pledging to increase medical spending should ease voters’ fears.

If health means having enough to eat, a decent place to live, safe drinking water, an income that allows wholesome choices, a non-toxic environment and the opportunity to be a productive member of society, medical spending is the wrong yardstick.

Ontario does a relatively good job of patching people up after they get sick. If does a relatively poor job of keeping people — especially disadvantaged people — out of hospitals and long-term care institutions.

It is no coincidence that the highest morbidity rates in the province are among the working poor, social assistance recipients, people with disabilities and mental disorders and members of First Nations. And it has long been clear that conventional medicine — delivered in doctors’ offices, hospitals and operating rooms — doesn’t have an answer to this problem.

All three political parties recognize that it is short-sighted to keep putting ever-larger larger amounts of public money into the health-care system to make incremental improvements in existing services, when most Ontarians want to stay healthy and age at home.

That is a welcome change. Political leaders used to demonstrate their devotion to public health care solely by the size of their dollar commitment.

What isn’t changing as much — although there are promising signs — is the way health dollars are spent.

What is barely changing at all is the reluctance of Ontario’s politicians to address the factors that condemn 412,000 children in this province — half of them in Toronto — to unhealthy choices, preventable diseases and foreshortened lives.

None of the parties is proposing to raise welfare rates ($592 per month for an individual, $1,014 per month for a single mother raising a child).

They’ve all said no to a nutrition supplement ($100 a month) proposed by public health officials, led by Dr. David McKeown, Toronto’s medical officer of health.

One party — the NDP — supports a provincial housing benefit ($100 a month for Ontarians who spend more than half of their income on rent). The Liberals are prepared to “consider” the idea, but they’ve been considering various housing proposals for the last eight years without acting.

Only the New Democrats would raise Ontario’s minimum wage (to $11 from $10.25).

On the positive side, all three parties have begun to shed their hospital-centric view of health-care.

The Conservatives are pledging to “increase investments in home care” (no dollar figure provided) and ensure that mental health doesn’t get lost in the system.

The Liberals are proposing to help seniors retrofit their homes with ramps, walk-in shower stalls and mechanical lifts (a $1,500 tax credit); revive doctors’ house calls; offer family caregivers up to eight weeks of paid leave (if they can get Ottawa to cover the cost) and set a goal of reducing childhood obesity by 20 per cent within five years.

The New Democrats are promising to invest 1 million hours in home care, open 50 new community health-care clinics, help seniors stay in their homes by hiring housekeepers to help them with laundry, meal preparation and cleaning; and make phys-ed mandatory in high school.

None of these proposals is bold. No party proposes a major reallocation of health-care funds. No leader is offering to tackle Ontario’s health inequities.

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