As former Saskatchewan premier Romanow heads out across the land to fix our health care system, he should look at the big picture. As head of the new national commission, he needs to investigate the root causes of poor health as well as rejuvenate our current system.
Romanow can start by learning from the United States. If money alone is the solution to health care, the U.S. should have the heathiest people in the world. One-half of the world’s health care dollars are spent on just 4 per cent of the world’s population in the U.S. But Americans aren’t getting what they pay for.
American doctor Stephen Bezruchka rates his country’s health on what he calls the “health olympics”. By that, the professor at the University of Washington means life expectancy and infant mortality. “When I began medical school in 1970 we stood at 15th in the health olympics, … Twenty years later, we were about 20th, and in recent years we have plunged further,” says Bezruchka.
Bezruchka blames his country’s poor showing in the health olympics on the concentration wealth in the hands of a few. He has a simple way of determining wealth disparity. Compare what a CEO makes relative to an entry-level worker in the same company. In the United States, CE0s make about 500 times more than a worker starting at the bottom. In Japan the gap between rich and poor is not as great: CEOs make 20 times more. In the U.S. the life expectancy about 76 years and in Japan it’s 80.
Dr. Bezruchka’s simple method seems to work in Canada. Here, CEOs make about 35 times workers in entry level positions. Our life expectancy is 79 years, somewhere between the U.S. and Japan. Poverty shows up in infant mortality as well. Japan has the lowest infant deaths at 4.0 per 1,000 births, followed by Canada at 5.5 and the U.S. at 6.3
But there is more to good health than wealth. Romanow should also consider the shift in causes of disease. It used to be that infectious agents were the main cause of deaths . Infectious diseases — scarlet fever, measles, diphtheria and small pox– used to kill millions of people. These diseases have faded from memory to the point where some parents have the mistaken notion that their children don’t have to be immunized at all.
Now, chronic diseases such as cancer and heart disease are more prevalent. Chronic diseases in the industrial nations, and increasingly in the majority nations, are becoming more prevalent than infectious diseases. Chronic diseases include cancer and heart disease caused by exposure to hazardous environments and toxic chemicals.
These chronic diseases sometimes take years to kill, but their victims are just as dead as those who die from infections. The Ontario Medical Association predicts that deteriorating air quality in Ontario will cause an increase in premature deaths from the current 1,200 per day to 2,500 in just twenty years.
In the southern Chilean town of Punta Arenas, citizens were warned to stay indoors between 11 am and 3 pm due to an expanding hole in the ozone layer. The breakdown of the ozone layer is caused by tonnes of chemicals released in the past. The sun’s rays, unfiltered by the ozone layer, are responsible for increased skin cancer and eye damage.
And where infectious diseases are still a big problem, pharmaceutical companies are not interested in a solution. The world’s poor don’t have enough money to be of any interest to pharmaceutical companies. So, the poor are getting tuberculosis at an alarming rate. 200 million people now living will die from TB — more than died from the disease in the entire nineteenth century.
If anyone still wonders what governments can do better than corporations, here’s an easy one: governments can provide medical treatment to the poor where it’s not profitable for corporations to do so. And if that doesn’t seem important now, it will. Just wait until the antibiotic resistant diseases that are incubating in the poor spread to the general population.
Romanow has an easy job in one respect — just tell the feds restore funding to what it once was. Convincing governments and their corporate masters to reduce poverty and clean up the environment will take a little more time.