It’s time we considered prevention strategies when trying to improve our health system
When a former boss of mine was asked to speak about how to fix the health care system, he’d sometimes start with a quip about which challenge he’d rather tackle: improving our health care system or negotiating Middle East peace. I don’t mean to make light of either issue—they both deserve our attention. His point being that both issues are incredibly complex. Where the heck do you start?
Lord knows, people have tried. No other sector has been put under the microscope more often than Canada’s health care system or components of it. A quick online search yielded 23 provincial, territorial and/or federal reports on health care published in the last 25 years. And I may have missed a few. If you go back further in time, you’ll find even more.
From my perspective (and previous professional life) in health care, the entire health care sector is driven by an ethos of innovation and continuous quality improvement in search of better outcomes for patients. But quality and innovation cost money and, with an aging population, the costs keep going up.
What strikes me, though, when I read these reports is how little attention is paid to prevention even though the benefits of a healthy lifestyle—one that includes regular physical activity and a nutritious diet—are well researched and documented. We know that being physically active helps prevent heart disease, stroke, diabetes and premature death, as well as certain cancers, including breast and colon cancer. It also helps us alleviate stress, improve our mental health and cognitive function, in addition to a long list of other positive health benefits. Similarly, eating whole (versus processed) foods, minimizing saturated fats and sugar, being mindful of the quantity of food we consume and moderating our alcohol intake all serve to give us the nutrients and energy we need to maintain our good health.
Yet, according to ParticipACTION, 22 million Canadian adults just aren’t active enough. In a 2018 submission to the federal government, the organization estimated the health care costs associated with physical inactivity are a staggering $6.8B a year. Even a 10 per cent bump in physical activity among Canadian adults would reduce the incidence of chronic illness, they say, as well as the associated health care costs by $2.6B over the next 25 years. Furthermore, the change would inject $7.5B into Canada’s economy by 2040. Between the health care savings and the economic boost, that’s a lot of money—money that could be reinvested in our health care system if we could somehow get our hands on it.
So how do we get people up and moving more to improve their health and help fund improvements to our health care system? ParticipACTION does a great job of educating people about the dangers of inactivity and raising awareness about the benefits of moving more. But we need to think more broadly about ways to ease demand on our overburdened system. We need to incent people to step up and do their part in preventing the enormous burden of chronic illness on our system, and on individual Canadians.
Here are some suggestions:
Provide an annual tax credit or some other kind of financial incentive (i.e., make gym memberships tax deductible) to get more people aged 55 years+ moving more to maintain and/or improve their health.
Offer free or discounted fitness classes (as they do in Massachusetts) for those 65 years+ to improve their cardiovascular capacity, strength, mobility, flexibility and balance so they can remain physically active, socially engaged and independent for as long as possible.
Add personal trainers with the required qualifications to Family Health (care) Teams so doctors can prescribe exercise and nutrition coaching for patients at risk of developing chronic diseases.
Add warning labels to alcoholic beverages about the health risks associated with consumption just like we did to cigarettes in 2001.
Prescribe exercise to individuals both pre-surgery to improve their ability to tolerate the procedure (where appropriate) and post-surgery to further enhance and possibly speed their recovery.
While I’m not naïve enough to think that getting more people to exercise and eat better is the answer to all of the challenges facing our health care system, I do know that these preventive measures would be cheaper and easier to implement reasonably quickly compared to other changes that will be needed to address long line-ups in Emerg and waitlists for long-term care. But, they just might help ease the current and anticipated future burden on the health system while adding years to people’s lives—good quality years at that!
If you have other ideas about how to ease the burden on our health care system. I’d love to hear them. Send them along to info.spryfandn@gmail.com.