A Solution to Canadas Health Care Crisis The idea for this article has been with me for a number

of years, a little over twenty years to be exact. About twenty-three years ago blood tests indicated that I had cholesterol in the danger zone. My doctor told me to reduce my cholesterol by dieting and we would reassess in several months. Typical for me, I began to research diet and nutrition and putting my newfound knowledge into action. I also began to walk to work and often home from work. My cholesterol dropped, my weight dropped and my visits to the doctor were mostly happy affairs. Since then I have played with my diet over the years and I have maintained an interest in health. Now in my sixties I am listening to or reading about very disturbing statistics about my childrens generation and equally disturbing and unrealistic comments about the state of our health care system. This can be seen most clearly in the depths of current difficult economic times. Our federal and provincial governments are trying to cut costs to limit the impact of global and national economic problems. I believe, however, that they, like many governments, are busy looking in places that will yield very little in the way of savings instead of where major savings can be made with very little spending. For reasons of ideology, expediency or simply a lack of vision, they are recreating the past which got us into this muddle in the first place. An example of this kind of thinking can be seen in the report on health care policy released by the Fraser Institute shortly before the recent federal election. According to this report we should be afraid; very afraid!! In April 2011, as one of their Studies in Health Care Policy, The Fraser Institute released a report entitled: Canada's Medicare Bubble: Is Government Health Spending Sustainable without User-based Funding? As its title suggests, the authors argue that if we keep funding the Health Care system in the same way that we are doing today, the system is unsustainable. And, that is why we should be afraid. I didnt check their numbers, but I am guessing that they are pretty accurate. And their numbers lead them to their conclusions, which they summarize as follows: Transfers encourage the provinces to avoid making necessary reforms. Paying more is not a solution: taxes cannot rise indefinitely to chase expenditures. High and rising taxes discourage economic growth and reduce

the long-term potential revenue base for governments. Getting less is not a solution: provincial governments have used the blunt policy approach of rationing to constrain public expenditures without allowing private funding to fill the insurance gaps. This has reduced the availability of necessary medical goods and services. We conclude that Canadas health system produces rates of growth in health spending that are not sustainable solely through redistributive public financing. Supplementary user-based, private financing would off-load public cost pressures, encourage economic efficiency, and offer a sustainable source of additional resources. Now, I agree that the situation looks pretty grim. However, before we throw in the towel, we really should look at some of their assumptions, which match some of the assumptions of both government and the general public, and their jargon that is not much different from how many people talk and think about health care. In particular, throughout the report they refer to health spending. Nowhere in the report do they define health spending. In fact, they use health spending as a surrogate for spending on the health care system. Seemingly a small point, it bears examination not only because it is misleading, but also because it covers up the fact that nowhere in the report do they talk about health outcomes. Frankly, I am surprised that an organization which in most situations fixates on reducing costs, seems more concerned about how we are going to pay for the rising costs of health care services and products. Rather, they seem more concerned about how the products and services are going to be paid for. It will become clearer why this is so when we examine some of their recommendations. When reviewing discussions about health care I like to recall ads for Topol, known as the smokers toothpaste! In the early 1980s when my family would watch TV, we often saw commercials for Topol. We would laugh as the character in the commercial would take a white handkerchief and blow a puff of cigarette smoke into a hanky and then show us the yellow stain that it caused. If this is what one puff does, just imagine what a whole pack will do to your teeth. Obviously, to counteract the staining effect of smoking, there is only one solution: Topol to whiten your teeth. We laughed because there was clearly a much more elegant solution, dont smoke. The Fraser Institute among others would have us believe that there is only one solution to the health care funding situation: institute Topol user fees as a different way to fund the bloat. The Fraser Institute does not want to talk about the health of the population because there is a lot less money to be made by drug companies, factory food processors and insurance companies in a healthy

society. Their report is a form of Topol, social policy cleanser that costs everyone more, without dealing with the real issue, the state of every Canadians health. Well, not quite everyone: one of their recommendations is to speed up access to new drugs. Nor is the fact that we have access to more pharmaceuticals than at any other time in history and the general health of the population is declining. When talking about this one almost feels like Bugs Bunny, Duh, let me see Doc, you are giving all these people drugs to cure them and they are not getting curedso you want to give them more drugs? Maybe the drugs are part of the problem? After all, the reason why we have a health care system in the first place is to provide assistance when someone from what is supposed to be our otherwise healthy society gets ill, is injured or is faced with a situation where his or her health is at stake. Health Canadas mission and vision is relatively clear on the matter:
Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. Health Canada is committed to improving the lives of all of Canada 's people and to making this country's population among the healthiest in the world as measured by longevity, lifestyle and effective use of the public health care system. (http://www.hc-sc.gc.ca/ahc-asc/activit/about-apropos/index-eng.php#what)

And the Canada Health Act reaffirms this with its statement:
3. It is hereby declared that the primary objective of Canadian health care policy is to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.
1984, c. 6, s. 3. (http://laws-lois.justice.gc.ca/eng/acts/C-6/page-2.html#h-3)

While Health Canada may be committed to improving the lives of all Canadas people, the department has not been able to translate this commitment into action. And, while the Canada Health Act says that the aim of Canadian health care policy is to protect and promote the physical and mental well being of Canadians, those responsible for delivering this objective have obviously failed as well. If this were not the case, the number of cases of chronic disease would be dropping as opposed to rising on an absolute and a percentage basis.

So, it is hard to understand how the social policy cleanser of user-based funding1 will make this any better in the face of rising numbers of: diabetics in all age ranges, people with Alzheimers in an ever greater age range, heart disease and cancer. These are, for the most part, chronic lifestyle and environmental diseases. I was further surprised that the authors did not talk about the cost to the economy of lost productivity due to these diseases. There is data from 1998 that estimated the cost at that time to be $93 billion for the combined cost of health care spending of $34 billion and $59 billion of lost productivity to the economy. As the saying goes, people, this is not rocket science. In 2002, the Director of the Disease Intervention Division, Centre for Chronic Disease Prevention and Control, Health Canada presented a paper titled: Building the Case for the Prevention of Chronic Disease. The presentation to the Manitoba Alliance for the Prevention of Chronic Disease reviewed costs (see above) as well as causes. The evidence is clear. We need and integrated approach that will deal with lifestyle diseases. This approach requires an improvement in the diet and lifestyle of almost all Canadians. Availability of nutritious food at price for those in the lowest economic brackets is a necessity. Clearly what has to be done, and this is the role of the government and Health Canada, is to take an aggressive position on what will create health. Prevention in the face of rising rates of diabetes is actually not that difficult. The same is true of heart disease and many forms of cancer. We know how to prevent it and even more. We know how to reverse diabetes in as little as 30 days. Much of this relates to diet and exercise. Much of what passes for food in the SAD (Standard American Diet) is created to be addictive. The use of these substances attack our body while at the same time encouraging us to eat more of it. Our government has a role in letting the population know what is bad for them. Since tax harmonization has taken place, the federal government has appropriated the decsion making regarding taxation of what we consume. This means that the federal government bears responsibility for the strange tax practices as they affect foods that we eat. For example, if you buy a doughnut, you pay tax on that doughnut. But if you buy six doughnuts, you

dont pay tax on those six doughnuts. We are in the rather perverse situation of having the Canadian Revenue Agency creating nutrition policy. To further demonstrate how perverse it is to have the tax department determining nutrition policy, one only needs to read the following which comes from the tax guidelines on basic groceries:
(a) Identification as a dietary supplement or supplement. Although not determinative in itself, such an identification may be an indication that the product is consumed for the purpose of enhancing or improving a persons state of health and not as a food, beverage or ingredient.

So my partner and I try to eat healthy foods. One of the foods that we eat is rice protein of a very high quality. Of course, since we eat food with the aim of enhancing and maintaining our health, I might need to worry that the tax department will decide to tax specifically what we eat. I buy six packs of this nutritional food substance and pay HST. If I bought six doughnuts and ruined my health, I would not have to pay tax and I would probably have to access the health care system more often. The federal government has the tools to improve the health of Canadians, and reduce the cost of health care. For starters, they could create a junk food tax. That tax would apply no matter what quantities were bought. So, if a soft drink would normally cost a dollar, the tax would be a dollar; if a doughnut cost a dollar, tax would be a dollar and likewise for any items from fast food restaurants. We know that sugars and some fats are not healthy; tax them at 100 per cent. Many of the cereals that are sold for children have their first ingredient as sugar; tax them at one hundred per cent. Begin the process of disallowing fast food companies advertising toys to entice children to their stores. Enourage Health Canada to develop nutritional guidelines based on whole unprocessed or relatively unprocessed foods and use these guidelines as the basis for taxation. Use the tax system to encourage healthy and nutritional eating. Get Health Canada to develop measurable health outcomes for the population and start measuring whether people are healthy. Encourage schools to develop a walking program of twenty minutes twice a day. At least this would be a beginning and would focus the health care debate where it should be focused on health

The American satirist H.L. Mencken said that: No one in this world, so far as I know and I have searched the record for years, and employed agents to help me has ever lost money by underestimating the intelligence of the great masses of the plain people. My sincere hope in writing this is that at least the great masses of Canadian people can prove him wrong.

The Circle of Chronic Sickness 1. Poor Diet from processed and fast foods including but not limited to sugar, all processed drinks, all white flour products; Lack of exercise; High stress; Poor environment Lack of sleep; Possible high tobacco and or alcohol use.

4. Profit for food processors; profit for pharmaceutical companies; profit for diet companies; profit for insurance companies; profit for advertisers; losses for lost time at work; loss of quality of life; destruction of health care system.

2. Obesity, Diabetes, Heart Disease, Cancer, Depression, and lesser illnesses such as indigestion, sinusitis, food allergies and more.

3. Doctors, operations, insulin use, drugs, hospitalizations, more drugs, more doctors, looping and looping.

In the Circle of Chronic Sickness, Governments, Disease Associations, and the Medical Community enable both the destruction of health of the population and by extension the destruction of the health care system. Notice box 4. There is a general rule: follow the money. Notice how there are a large number of profit makers in the Circle of Chronic Sickness. They have a vested interest in keeping you alive - not well just alive.