The Premier's Alberta Food for Health Awards is taking applications

This is a relatively new award created by the Alberta government to recognize excellent work around the creation of healthy Alberta foods. There are numerous categories for producers, as well as researchers. Last year, Owen Petersen of Edmonton's Prairie Mill bakery won one of the awards, which comes with a $10,000 prize. Go to the Alberta Food for Health Awards  website for more details on how to apply. February 1st is the deadline to be considered for the 2010/11 award.

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To manage health costs, invest in social well-being

Jim Stanford4 comments

Governments are still reeling from recession-induced deficits, but now their attention is turning to another fiscal elephant marching into the room: the coming renegotiation of federal-provincial transfer payments. The Canada Health Transfer (CHT) expires in 2014, and must be extended soon. Finance Minister Jim Flaherty plans to clamp down on transfers to reduce his own deficit. But that just passes the buck to the provinces, whose fiscal position is even worse.

As this debate heats up, there’s a new piece of knowledge that should be considered carefully as finance ministers arm-wrestle. Since the CHT was implemented in 2004, researchers around the world have established a whole new field of scientific knowledge regarding the social determinants of health.

There is now hard medical evidence that a person’s economic status and social participation directly affects their physical health. And that, in turn, affects the cost of health care. This is not vague, bleeding-heart sentimentalism; it is hard scientific proof.

For concrete physiological reasons, human health suffers when people are subjected to prolonged hardship, stress and disparity. The physiology of this connection involves many body systems, including the impact of stress and unhappiness on metabolism, hormone production, circulatory function and other systems.

This research is well-established in medical journals, was popularized by British epidemiologist Richard Wilkinson in his best-seller The Spirit Level, and was further affirmed by the World Health Organization in a recent expert commission.

What does all this mean for health-care finance? It means that addressing the underlying social problems that scientists now know cause so much ill health, can help to rein in health costs. Governments must therefore be holistic in their programming and budgeting, instead of obsessing on reducing one budget line without regard to how that may affect other expenses.

Diabetes, for example, is an illness with especially strong links to poverty and inequality. Incredibly, poverty is a greater risk factor in diabetes than diet or exercise. Canadians with annual incomes under $30,000 are at least twice as likely to contract diabetes as those with incomes over $80,000. Poverty thus drives up the overall incidence of diabetes – and public-health costs in the process.

Researchers estimate that one in 10 hospital admissions in Canada are due to diabetes and its complications; the Canadian Diabetes Association tallies total direct health costs at over $13-billion per year.

Ironically, however, while medicare shells out billions to treat diabetes, we penny-pinch when it comes to supporting poor people so they don’t get it in the first place. Ottawa denies employment insurance to most of Canada’s unemployed; meanwhile, the provinces underfund social assistance (even programs with direct health impacts, like Ontario’s special diet allowance).

Governments then bicker over who should shoulder the burden of health costs, much of which results from the poverty and ghettoization that their own policies caused. Worse yet, many patients are poor and can’t afford the substantial expenses associated with diabetes (including medication and supplies); this often lands them with expensive complications. Penny-pinching in one fiscal envelope thus contributes directly to ballooning costs in another.

If we reduced the incidence of diabetes among the poorest Canadians to the same average experienced in the population as a whole, we’d cut overall incidence by about 15 per cent. More ambitiously, countries with very low poverty rates (like Sweden and Norway) suffer less than half as much diabetes as Canada.

We could therefore cut diabetes costs in half (saving $7-billion per year in health costs) if we matched their social performance. Exactly the same math applies to many other socially determined diseases, such as hypertension, digestive maladies and mental health.

So a holistic strategy to improve the living conditions of Canadians would not just produce a stronger and more inclusive society. It would pay off in more manageable health-care costs. That would give finance ministers, as well as social planning officials, something to smile about.

Jim Stanford is an economist with the Canadian Auto Workers union.

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Canada's 2010 health spending predicted to inch up to $192-billion: report

Total health-care spending in Canada this year is predicted to reach almost $192-billion, up almost 5 per cent over 2009, says a report by the Canadian Institute for Health Information.

The 155-page report, released Thursday, says that figure translates into about $5,600 for each man, woman and child in the country.

“Over the last 10 years, we've seen the growth in health-care spending over and above population growth and inflation,” said Chris Kuchciak, manager of health expenditures for CIHI. “However, what's different this year is that the growth rate in 2009 and 2010 seems to be decelerating.”

Taking inflation and population growth into account, actual per-capita health-care spending is expected to rise by just 1.4 per cent this year, Mr. Kuchciak said from Ottawa.

“The growth rate of 1.4 per cent is actually the lowest growth rate in the last 13 years.”

Mr. Kuchciak said a number of factors are likely behind the shrinking growth rate in health spending, including belt-tightening by provinces in response to the 2009 recession.

A similar squeeze on spending occurred during the mid-1990s, a period of restraint when the growth in health spending was either flat or negative, he said, noting that the trend was reversed in the late ‘90s when governments made a concerted effort to boost allocations to health.

“So there were significant investments in health care. But now fiscal positions have changed and we see that growth rate decelerating.”

The report shows health-care spending is expected to account for 11.7 per cent of Canada's gross domestic product in 2010, down from 11.9 per cent in 2009, but above the 10.7 per cent share of the GDP in 2008.

Mr. Kuchciak said hospitals, prescription and over-the-counter drugs, and doctors' services remain the three biggest-ticket items.

Hospitals are still the largest at 29 per cent, he said. “That's actually declined over the years. Twenty-five, 30 years ago, hospitals accounted for over 40 per cent of health-care spending.”

“What we've seen over time is a growth in the share attributable to drug spending – that's been growing – but also in the last four years, physician spending has actually outpaced the growth of drugs and hospitals.”

This year, drug costs are expected to carve out 16 per cent of the health-care spending pie, while physician services are predicted to take up almost 14 per cent.

“Yes, physician spending has grown faster than the other two categories,” Mr. Kuchciak said. “We know there are more physicians today than there were years ago. There's more demand for the use of physician services as well as compensation.

“Those are factors that could play into that increase in spending.”

The report also says government spending on health care this year is expected to reach $135.1-billion, while private-sector spending – which includes both private insurance and out-of-pocket expenses – will reach an estimated $56.6-billion.

For more than a decade, public- and private-sector health spending in Canada has been growing at about the same rate, with the public sector accounting for about 70 per cent of the total health-care bill and the private sector for the rest.

While Canadians over the age of 65 account for less than 14 per cent of Canada's population, CIHI found they consume almost 44 per cent of all health-care dollars spent by provincial and territorial governments. In 2008, the latest year for which data is available, the provinces and territories spent an average of $10,742 per senior, compared with $2,097 on those aged one to 64 years old.

For Canadians age 80 and older, health spending averaged $18,160 per person, more than three times the roughly $5,800 spent per senior under the age of 70.

However, the report shows that the share spent on those 65-plus has not changed significantly over the past decade.

“While it is true that care is costlier for people who are 65 and older, we have not seen a rise in the proportion we spend on seniors,” said Jean-Marie Berthelot, CIHI vice-president of programs. “An aging population may have an impact on health-care spending, but so far the average expenditure on seniors has not risen faster than for younger Canadians.”

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Newfoundland Liberal apologizes for questioning Premier’s mental health

Published Thursday, Oct. 28, 2010 2:00PM EDTLast updated Thursday, Oct. 28, 2010 2:12PM EDT0 comments

The new spin doctor for the Liberal Opposition in Newfoundland and Labrador has apologized for an e-mail that raised the prospect that Premier Danny Williams is mentally ill or in the last stages of a venereal disease.

Craig Westcott said in a statement released Thursday that he's sorry for the “unacceptable” e-mail to the Premier's office — which was private correspondence — that asked if Mr. Williams is being treated for a mental condition or other illness.

The former journalist just signed on earlier this month as the Liberal Opposition communications director. He has criticized the Premier's policies in the past and has been labelled by the most ardent Williams supporters as a “Danny basher.”

“I want to strongly apologize to everyone who, rightfully, was offended by my reference to mental health issues in such a manner,” Mr. Westcott said in a five-paragraph apology sent to media.

“It wasn't my intention to disparage anyone suffering with a mental health issue, but I see now that that was the effect and I am sorry for having done so. I deeply regret that the contents of the email (have) added further stigma to an issue that needs more public support and understanding.”

Mr. Westcott was editor of The Business Post when he wrote to the Premier's communications director, Elizabeth Matthews, 20 months ago. Under the subject line “A delicate matter,” he asked if Mr. Williams was receiving any medical treatment.

“Please excuse the nature of this question,” Mr. Westcott wrote on Feb. 27, 2009.

“I regret to have to ask it, but it may be germane given the premier's behaviour. It has been suggested to me that Mr. Williams is bipolar. Another person suggested to me that he acts as if he is suffering in the later stages of syphilis.”

The Premier's office didn't respond to the e-mail at the time, but released it to media Wednesday after a cabinet minister raised it on a radio program.

Acting Liberal leader Kelvin Parsons said the overwhelmingly popular Mr. Williams released the private e-mail in an effort to bully and discredit Mr. Westcott.

Mr. Parsons initially tried to downplay the contentious e-mail as a joke, but Mr. Westcott was then accused by open-line radio callers of trivializing serious mental-health issues.

Mr. Westcott ran unsuccessfully for the federal Conservatives in 2008, when Mr. Williams made national headlines with his ABC – Anything But Conservative – campaign. The acerbic effort shut Prime Minister Stephen Harper's candidates out of all seven federal ridings in the province.

Mr. Williams accused Mr. Harper of breaking a 2006 promise to exclude non-renewable energy sources from the calculation of federal equalization payments. Relations between the two men have since improved.

Mr. Westcott wrote the 2009 e-mail to the premier's office a few weeks after Mr. Williams lambasted Ottawa for what he saw as punitive federal budget measures that he said would cost the province $1.5-billion over time.

Mr. Parsons has said Mr. Westcott was hired for his writing and communication skills, and that his job is safe despite the “distraction” of the e-mail controversy.

Mr. Westcott concluded his apology by saying he'll make no further comment on the matter.

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