Elderly man sitting in an armchair and watching tv at home

Live Healthy, Help Fight COVID

The other day I was talking with a senior citizen on the phone about COVID-19. He told me, “not a heck of a lot is new. They want us to stay home.”

By “they” of course he was referring to the government.

The senior went on to describe how he was living a relatively sedentary lifestyle that consisted of sitting in a chair, using his iPad and eating. I suggested going for walks outside but that advice fell on deaf ears.

The conversation struck me as a massive missed opportunity on the government’s part.

Since COVID-19 emerged, we’ve heard politicians repeatedly urge Canadians to “wash your hands,” “wear a mask” and “social distance.” We’ve also heard we’re supposed to “stay home.”

These directives have been part of an attempt to prevent the spread of COVID-19 and reduce stress on the health care system. We can debate how effective lockdown measures have been, but what can’t be debated is the fact that thousands of people are still contracting COVID-19 every day.

With that in mind, why are we seeing so little from governments when it comes to reducing the chances that someone will need hospitalization if they contract COVID?

The Alberta government’s COVID-19 data includes a striking statistic – 86 per cent of all patients who died from COVID had high blood pressure.

So why not tackle the causes of high blood pressure?

According to WebMD, smoking, too much salt and alcohol in your diet are contributing factors for high blood pressure. Have you heard governments urge the public to cut back on those substances to help fight COVID?

Being overweight and obesity are also listed as contributing factors for high blood pressure. Obviously, someone cannot get in shape over night, but let’s not forget: we’re nine months into the pandemic now.

Perhaps if “exercise and eat healthy” had have been stressed early on by governments, it might have incented some people to kick their exercise goals into high gear and cut back on junk food.

In fact, WorldObesity.org is concerned that COVID-19, and related government measures, could actually make obesity problems worse: “the current pandemic might contribute to an increase in obesity rates as weight loss programmes (which are often delivered in groups) and interventions such as surgery are being severely curtailed at present – and this is likely to go on for a long period of time.”

WebMD also notes that “a lack of physical activity” is a contributing factor for high blood pressure. The government’s “stay at home” messages, plus the decision to shut down some parks and playgrounds, hasn’t helped.

Finally, another contributing factor for high blood pressure is stress. Imagine if governments had have put forward more positive messages once in a while about beating COVID-19 through healthy living instead of driving hysteria through daily press conferences.

Picture a politician holding a press conference outside while putting on their runners and encouraging the public to go for a walk each day (while social distancing). Couldn’t have hurt.

Make no mistake, some factors for high blood pressure are beyond someone’s control – age and genetics being a couple examples. It’s also true that even otherwise healthy individuals have passed away due to COVID-19.

But it seems clear that encouraging Canadians to live healthier lives could have helped our health care system – even just a bit – in the short-term and the long-term.

Now if you’ll excuse me, I need to take my own advice and go for a run.

 

Colin Craig is the president of SecondStreet.org, a new Canadian think tank. He’s not a doctor, so please don’t interpret this column as official medical advice.

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.