False, straight-line projections about future growth in health care spending are distracting Canadians from the real challenges facing our health care system. That’s the warning that Will Falk from the Mowat Centre for Policy Innovation delivered in a compelling op-ed piece in the Toronto Star. Overall, his message is that the critical debate on health care in Canada is in danger of being overwhelmed by exaggerated fears about looming health care bills. Canada urgently needs a national dialogue on how we spend our health care dollars. The Wellesley Institute is developing a health equity roadmap (download a flip sheet from our home page) to help inform Canadians, and health care policy-makers, about ways to ensure that health care spending, and good health, are enjoyed equally by all Canadians.
Simply taking federal and provincial health care spending over the past decade, and projecting it forward, ignores the historical record, argues Falk. For instance, in the previous decade, health care spending rose by just a fraction of the amount during the most recent decade. He cautions that right-wing think tanks are using “Malthusian projections” – predictions of a future that will never happen – to create a “game of self-fulfilling prophecy” and to drive the debate towards ideological solutions – like increased privatization of our health care system. After bursting the bubble of false expectations, Falk calls for a focus on 21st century issues and solutions, such as looking for ways to “harvest productivity gains from new technologies and virtualization of care.”
There is a large and growing body of evidence that links growing social and economic inequality with poor health and health disparities, including the Wellesley Institute’s 2008 study Poverty is Making Us Sick, and the City of Toronto’s 2008 report Unequal City. Canada urgently needs to use federal-provincial initiatives to tackle the underlying foundations of pervasive health disparities and to identify the necessary policy changes that can build towards greater health equity. In 2009, the Wellesley Institute’s Bob Gardner presented a 12-point action plan to a Senate of Canada subcommittee. Most of the action will be at the local level through multi-sectoral community-based coalitions, but senior levels of government have the social and economic policy levers to address systemic inequality, and can play a critical role in supporting local initiatives.