Community-based and Preventative Health Care Will Cut Health Care Costs
“There’s no money.”- I hear this over and over again. It is a common refrain when people hear new ideas that would make life better for New Brunswickers.
But I can’t understand why anyone would expect that spending money in the same way year after year is going to produce different results. On Tuesday, government brought down its budget, which is largely a repeat of last year’s.
We spend more than $9B each year to serve New Brunswickers and our communities. The biggest ticket item by far is health care at nearly $2.8 billion. You would think there would be a huge emphasis on prevention and health promotion in the budget to reduce the incidence of illness. There is not. This money is primarily going to treat people when the fall ill.
Liberals and Tories argue over whether or not to close hospitals, but closing hospitals doesn’t reduce the number of sick people. We have to look upstream to do that.
The conditions into which people are born, grow, live, work and age, largely determine whether someone falls ill or develops chronic diseases. Even the vast majority of cancers are caused by these conditions. A decent income, financial security, secure housing, sufficient and healthy food, a sense of belonging, mental wellness, an education, a healthy environment in the workplace and at home, and clean air and water are what keep us healthy, and therefore, avoid health care costs.
Let’s look at just one determinant of health – poverty. The budget fails to tackle poverty head on – it in fact, perpetuates it.
The level of income assistance is inadequate to meet even the most basic of needs. A single person receives $537 a month, which is not enough to pay for food, shelter and other necessities of life. Once on social assistance, single mothers are not allowed to keep their child support, the disabled cannot keep disability pensions, and indigenous people living off-reserve lose any meager income from their band.
If you are on income assistance and try to make you money go further by sharing accommodations, you are immediately cut-off and lose your health card so you can’t fill your prescriptions.
The failure to address the social determinants of health has driven up health costs, as has the way we deliver health care.
Our health system was designed to address acute health problems, but a huge portion of our health care dollars is spent on treating chronic conditions and minor ailments.
Greens believe we can improve access to health care, at a lower cost, by moving more health care into the community and incorporating a wider array of health professionals.
Pharmacists can treat many minor ailments and issue prescriptions, but unlike most other provinces, Medicare will not cover those costs. Instead of being treated by the local pharmacist for common infections, people are forced to use the expensive machinery of the emergency departments in our hospitals, waiting hours for a doctor to write a prescription, when this could have been done in the local pharmacy in a matter of minutes.
Nurse practitioners could become the primary care provider for many without family doctors, but this government will not permit them to establish private practices and be reimbursed by Medicare.
Midwives can provide pre- and post-natal care, and deliver babies at a lower cost than obstetricians, freeing up the specialists to concentrate on high risk pregnancies. Yet there are only three midwives funded to practice in the entire province – all in Fredericton.
We have to do better. Greens embrace community-based and preventative health care. This will mean better chronic and acute care for people in our communities, better employment opportunities for the trained medical professionals living here now, and savings that can be diverted to addressing other determinants of health, including poverty. We have what we need to change the face of health care, right here, right now. There is enough money. It’s a question of how we spend it.
David Coon is the Leader of the Green Party of New Brunswick and the MLA for Fredericton-South.
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