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One fix for our ailing health-care system

Roslyn Kunin: The fiscal conservative case for more preventative care and better lifestyle choices.
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This used to be normal.

Canada’s medical system is one of the defining benefits of living in this country, but we have learned from the pandemic that our medicare is nowhere near as strong and resilient as we might wish.

Waiting lists have long been an indicator that the capacity of our clinics and hospitals was insufficient to meet our needs. Then the tidal wave of COVID-19 threatened the ongoing functionality of all our health services.

The need to protect our hospitals from overload, rather than the need to protect Canadians from illness, was used to justify lockdowns and other limitations that we’ve endured for almost two years.

We need a healthier health-care system but paying much more money into the existing structures isn’t an option. Health care is very expensive. Governments are already deeply in debt. Canadians take pride in not paying out of pocket for health care but are unwilling to hand over significantly more taxes for the service.

There is an alternative: Instead of providing and paying for ever more health care – which is really sickness care – why not try to prevent disease?

The pandemic has taught us that relatively few of those who are healthy to begin with are likely to be seriously affected by COVID. However, those with pre-existing conditions are fair game for the virus, and they become major consumers of medical resources.

Obesity increases the likelihood of not only COVID but also diabetes, heart attacks and other diseases. It’s endemic. Almost half the population of the United States is obese. In Canada, it’s closer to a quarter of the adult population.

We know what to do to prevent or reduce obesity. And prevention would significantly improve health in Canada and reduce the need for doctors and hospitals. We need to devote resources to encourage people to make the changes they would benefit from.

You might think we can’t get people to change their behaviour even when their health is at stake. But society has encouraged and established such behavioural changes in the past.

Watch the TV program Mad Men, set in the 1960s, or just about any movie set in the ’60s or earlier. The characters usually had a cigarette in their hand. Young and not-so-young people smoked to be glamourous and cool.

Smoking tobacco has gone from being a social status symbol to an indication the smoker is jeopardizing their health and is probably addicted. Smoking is banned in most public places and children warn their parents of its risks.

Using seatbelts in cars is automatic and taken for granted. Thousands have avoided hospitalization and even death by wearing a seatbelt.

But some readers will recall when cars didn’t have seatbelts and how their use was resisted when first required. Drivers took seatbelt laws as an insult to their driving ability and an infringement on their freedom. No one was planning an accident. Why do we need seatbelts?

We now know the answer to that question.

A third societal behavioural change that has dramatically improved our health and safety is no longer accepting drunk driving. This wasn’t always the case. How else would you get home from a party if you didn’t drive? And was it really a party if you didn’t drink?

Now we consume less alcohol (another positive change for health), designated drivers and other alternatives are the norm, and we do things like take car keys from those who are too impaired to recognize what’s not socially acceptable.

More seatbelt use, less tobacco use and clamping down on impaired driving are positive societal changes that have improved our lives and eased the pressure on our medical resources. The public efforts that led to these changes can be copied to make the kind of changes needed to prevent other diseases and accidents.

With strong societal support, people who have learned to wear seatbelts, stop smoking, and not drink or drive drunk can be encouraged to eat a few more vegetables and be a bit more active.

The overall health of Canadians will improve, and we won’t have to worry so much about overwhelming our health-care system.

Troy Media columnist Roslyn Kunin is a consulting economist and speaker.

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