Money won’t fix our health care
The Hon. Dr. Jane Philpott is a former federal minister of health and minister of Indigenous services. She is dean of the Faculty of Health Sciences, Queen’s University.
My predominant emotion when the federal election wrapped up was sadness. I don’t think anyone was elated with the results. In terms of seat count, the election took us back to where we were. It’s as if we made a collective decision that this is the best we can do for now. Yet I fear that we have a few more years of limited and incremental change ahead. I hope I’m wrong. From the perspective of health policy, I would like to be more optimistic that we will see significant action on drug policy, reforms in the governance of public health and substantive implementation of Indigenous rights to promote well-being.
If I’m honest with myself, a bit of my sadness was a recurrence of the grief I felt when my political career ended abruptly because I stood firm on a matter of principle. I didn’t go into politics because I needed a good job; I chose politics because I knew it could be a powerful tool to improve people’s lives. I loved being able to introduce or change laws and regulations that would promote better health. When I left politics, I feared that I would never be able to have the same depth of impact.
I’m recovering from my reawakened grief by the same remedy that healed me in 2019. I’m reminding myself that politicians are not the only ones who can cause significant health reforms and social change.
After all, some of my frustration inside politics was because things didn’t move quickly enough on important files; they were too difficult politically, and that was because there was an insufficient outcry for change. An obvious illustration of this might be climate change; it has taken decades to build the public support and political will to acknowledge the cost of polluting our environment.
Another example is the issue of the decriminalization of drug possession. Most politicians don’t have the courage to enact evidence-based changes in law if they fear that they will be punished for it at the polls. There is a big role for those of us outside of the corridors of power to see those changes through. After an election that disappointed almost everyone, we need to look to other institutions in Canada to push for meaningful action.
For instance, we can look to the expertise and creativity of universities. I’m now working in this sector, and it’s ideally positioned to accelerate social change. Solving big problems is literally on our to-do list. We have hundreds of researchers who spend their days trying to answer the world’s most pressing questions. We propose solutions, test them, then go back to the drawing board to get an even better answer. We create the space for many perspectives to be heard.
Our academic work also results in tangible new community services ready to scale. Health Hub is a rehabilitation program launched by Queen’s Health Sciences during the pandemic to serve people with chronic musculoskeletal disorders such as arthritis. Offered free of charge to those who otherwise could not access care, the program not only fills a health care gap but provides students with clinical placements. The students work alongside faculty members to provide care, while demonstrating how physiotherapists are an essential part of health systems.
It’s no surprise that people at a university are trying to solve some of the same problems as people at Parliament Hill, including racism in health care, affordability of health systems, or the public health emergency of the opioid crisis. Where academics identify the most effective approaches in theory, we often need political leaders to implement those solutions. For instance, there is now an acknowledgment that the federal government has a role and responsibility in improving health systems. The COVID pandemic highlighted the need for revised federal laws and policies on public health; we saw this reflected in party platforms during the campaign. Provinces are asking for cash infusions to cover the rising cost of health care delivery. While perhaps necessary, a cash infusion is insufficient and simplistic. Fixing our fragmented and inefficient health systems will take more than money.
One of the best places to find answers is the frontlines of care, where health professionals know how to get better value for money. In the academic health sciences sector, I see enormous potential to demonstrate how health systems can be better through research and policy analysis. We have computer scientists and biomedical experts who work with oncologists and surgeons to develop predictive models for cancer risk and maximize the effectiveness of cancer surgery. When translated to practice, this can dramatically alter the way that care is delivered, and the inherent efficiency in health systems.
Thankfully, we don’t need to wait on governments to see a transformation in health care. We have tools to build a more diverse health workforce and the courage to denounce policies that get in the way of better health. It turns out that academic health sciences could be the real winners in a pandemic election intended to identify leaders who will get some hard work done.