Promotion + Prevention

Promotion and prevention may not be the only ways to save Canada’s health care system, but the ideas are gaining considerable buzz as the federal parties gear up in anticipation of an election in 2008.

“Promotion is the whole healthy-choice part, and prevention is those specific things that you can do to prevent, say, osteoporosis,” said former federal NDP health critic Penny Priddy in a phone interview from the House of Commons. She added, “If every girl who is five now started to exercise and build bone density, we wouldn’t have people breaking their hips when they were 70, and then dying of pneumonia in hospital.”

The MP for Surrey North admitted that the NDP has no written position on alternative and complementary health care, basic factors in the promotion-and-prevention equation.
It is only the Conservative and Green parties that referred to alternative and complementary health methods in their 2006 election platforms. The Conservatives’ platform included one line, promising to “improve access to natural and complementary health products and supplements.”

The Greens went a bit further, promising to “include coverage for effective health care treatments such as chiropractic, acupuncture, or herbal medicines,” among other things.
But representatives from the Liberal, Conservative, NDP, and Green parties say they believe strongly in any measures that will ease the burden on the health care system and reduce wait times, especially by keeping Canadians healthy and ensuring that they have a variety of treatment options if they do get sick. (The Bloc Quebecois did not respond to alive’s request for an interview.)

Bonnie Brown, Liberal health critic at the time of writing, pointed to her party’s accomplishments. “When we were the government, we actually established a whole bureaucracy to review the safety of alternative medicines, which was a huge step forward for that whole industry,” the MP for Oakville (Ontario) said in a phone interview from Ottawa. “Now people can go and buy things and know they’ve been tested, and there have been clinical trials and they’re safe. So certainly that was a huge recognition of the role of preventive things and alternative medicine.”

Health Minister Tony Clement also believes regulation of alternative and complementary health methods is important. “Where Health Canada can be effective is to make sure that what is available as a health product is safe and effective, it meets the terms that are touted by those various products, and to make sure that there’s a balance between any benefits to any risks that are posed by these products,” the MP for Parry Sound-Muskoka (Ontario) told alive via phone.

Clement said “a Health Canada survey commissioned a couple of years ago indicates that 71 percent of Canadians regularly take vitamins and minerals, or herbal products, or homeopathic medicines.” He noted, however, that in many cases it’s an individual decision and that the government’s role is limited to providing information and ensuring that products and methods are safe.

The Conservatives’ promise to improve access to natural and complementary health products and treatments, along with its anti-tobacco and physical activity promotion strategies, he said, are all part of the government’s commitment to reduce the burden on the health care system.

Policy from Personal Experience

Priddy’s attitude toward alternative and complementary health care methods comes more from personal experience than party policy. “I’m a breast cancer survivor,” Priddy said. “I used complementary medicine throughout my breast cancer. I used therapeutic touch. I used acupuncture. So I absolutely see a role for complementary medicine. My only codicil is that people do their research…and make sure they’re not doing something that’s either going to endanger them or is going to be countereffective to something that they’re already doing or taking.” Priddy, who had to undergo radiation and chemotherapy for her cancer, also noted that, as BC’s health minister under Glen Clark’s NDP government in 1996, she established the College of Traditional Chinese Medicine Practitioners and Acupuncturists of BC, which licenses and regulates practitioners.

Priddy also stressed the importance of thinking of more than just wait times for surgical procedures. “I don’t want us to have a hospital system, which is really all people are focused on right now,” she said. “We wouldn’t even have a discussion around private health care if there weren’t surgical wait times…But I don’t want us to have a better surgical system with just as many patients…that’s not a success. That’s just a success in innovation of how you do your work. The real success is doing fewer surgeries, and if people make good health care choices and parents model and help make good health care choices with their children, then in 10 years’ time, in 20 years’ time, in 30 years’ time, we’re going to see fewer women requiring hip replacements, fewer women with osteoporosis, and fewer men withheart attacks.”

Shifting Emphasis

Brown agreed that a shift in emphasis is important. “Right now, in my view, the system is far too tilted toward the medical model,” she said. “In other words, wait ’til something goes wrong, identify it, and treat it, usually with strong measures, and we would be much better served if we were absolutely sure everybody had access to clean water, good sewage treatment, all the public health measures, clean restaurants, safe food?

The Green Party, which has the most comprehensive platform when it comes to promotion, prevention, and alternative health care, agrees that the focus must go beyond treatment of disease, and indeed, beyond health in isolation. Green Party leader Elizabeth May told alive that her party’s “holistic vision” is what sets it apart from other parties. “We want to shift the discussion to the kind of World Health Organization definition of health, which is health as a complete state of mental, physical, emotional, and spiritual health,” May said. “The Green Party is very strong on the links between our deteriorating environment and our health,” she said. “If we’re going to have a war against cancer, for instance, perhaps we should engage the enemy, and the enemy is carcinogens.” May argued that health care can’t be looked at in isolation, because everything, from the environment to agricultural practices to working conditions, affects the healthof Canadians.

“When we talk about health, we mean health,” she said, adding that a government with a holistic outlook could create what in economic terms are called “virtuous circles, where, for instance, a policy that wants to get more cars off the road also happens to involve more children walking to their schools in neighbourhoods that are safe. By the time you do that virtuous circle you’ve taken in climate change policy, obesity policy, reducing crime rates, creating secure neighbourhoods, and it just keeps circling around, reinforcing each element.”

May also said that the party believes in looking at all methods of keeping people healthy. She said the Green Party recognizes the wide range of health care providers, and the party wants to make them more accessible to Canadians.

Medicare Works

The approaches and priorities of the political parties vary. Although all profess a commitment to maintaining Canada’s universal health care system, the Conservative and Liberal party members pointed out that the health care system already includes private sector activities, such as lab services, and that as long as those are provided within the parameters of the Canada Health Act, that’s not a problem. However, Brown did say that she is “opposed to any increase in the activity of the private sector.” On the other hand, May believes that the “crisis” in health care is, to some extent, manufactured as a way to increase the role of the private sector.

“The enormous risk here, and it is enormous, is that under the national treatment provisions of NAFTA [North], if Canada moves toward two-tier health care, the for-profit industry in the United States will move in and challenge us under NAFTA and we won’t have a leg to stand on, and we’ll lose universal health care. We can’t run that risk,” she said.

Priddy pointed to the NDP’s role in creating Canada’s Medicare system and said it is one of the party’s highest priorities. “I think that the most important thing that faces Canada is an ability to understand that, indeed, Medicare was working, can work, and with innovation, we do not need to look to the private system for health care.”

Regardless of what one believes about the state of Canada’s health care system, there’s no doubt that innovation is needed to keep it healthy.