We need our leaders to display the type of courage Tommy Douglas had.

by Gary Machan, Policy and Stakeholder Relations Team

While attending a national conference commemorating the 50th anniversary of medicare a few years ago, I had the good fortune to have dinner with an elderly couple who were but a handful of doctors that broke rank from their peers to support Tommy Douglas’s vision for public health care in Canada. When asked why they did it, their immediate response was: “It was the right thing to do.” Little did I know what they had to endure in the way of backlash from their peers. Enmity, I might add, that regrettably persists today.

I share this story because I firmly believe that unless those tasked with transforming Ontario’s health system, and in particular Premier Kathleen Wynne and Minister of Health and Long-Term Care Eric Hoskins exhibit the same vision and courage, it is highly unlikely that medicare will survive. The bottom line is that simply building more hospitals and hiring more doctors is not the answer. At best, it will buy us a few more years.

Why? Because it does nothing to deal with the systemic issues such as poverty and social isolation, which are the issues that a lot of high cost users contend with every day. Imagine you are faced with an overflowing bathtub. There are two courses of action: First, you could turn down the water flow, i.e. health promotion. Or you could try and grasp for more buckets, i.e. treatment. To date, the Ministry’s approach has been heavily weighted towards the latter, despite the fact that not only it is less effective, it is far more expensive.

Consider the case of North Simcoe Health Link. What made this research so potent is the extent to which it demonstrates not just the extreme poverty, hunger and social isolation amongst the people it serves, but also how even modest investments to address the social determinants of health yielded significant impacts, i.e. 30.8 per cent reduction in ER visits, 45.1 per cent reduction in patient care, and 37.5 per cent reduction in hospital costs. That’s not to mention the vastly improved quality of life for the Health Link’s patients.

But despite the success of this innovative Health Link, which if properly scaled up and replicated could net cost savings of hundreds of millions of dollars, there is nothing in the latest Patients First legislation that offers a definition of health, which is a red flag for the future. Neither does the health care reform legislation contain any object that would provide the LHINs with a mandate to support health promotion work, which they desperately need to do if they are to be successful in the ways AOHC and OPHA are advocating.

All of which brings me back to that “vision thing”: the need for a mindset that extends beyond hospitals and doctors, and courage to introduce legislation that supports primary health care providers to address the systemic issues through health promotion. Will Eric Hoskins rise to the occasion and do the right thing, like his brave predecessors did when they built medicare? The answer to this question may decide the fate of universal health care in Ontario, if not the country.