If you haven't read Jules Fauteux's "In Defense of the NS Healthcare System", I encourage you to do so.
There are those of us (like John Ross, referenced in Jules Fauteux's blog) who advocate regularly for more evidence-based prevention, health promotion, and population health work (including work on the determinants of health). I know that all may sound like a bunch of gibberish to those not in this field, because health, like every other sector, has its own internal jargon. Although there are important differences between all these terms, simply put it all refers to using specific methods that are known to keep individuals and populations healthy. When we do advocate for more of this kind of work, we are not suggesting that the current health care system is a failure (which, according to Jules, Dr. Zitner was more than implying), but rather that it could be assisted. The key point is that we need to take the good health care (treatment of illness) that is provided, and supplement it with a strategic focus on the prevention and health promotion end of the continuum. That focus, based on the evidence, will take several forms, but will be built on a foundation of public policy that actually causes and sustains "health", and prevents "illness" (I know these seem the same but sometimes the required methods are different).
The Government of Nova Scotia, under every political party over the last 15+ years, has continued to use legislation, regulations, and taxes to protect our children from the harmful influence of the tobacco industry (recently by banning flavoured tobacco designed to attract kids). As a result, we have over 100,000 fewer smokers in the Province. That is 100,000 fewer children who will eventually need the "illness care" services in our system, because of less COPD, heart disease, and cancer. That is evidence-based health promotion. That is collective public leadership at its absolute best.
There are more examples. When jurisdictions implement the same evidence-based approach to alcohol, using public policy to protect their children from the harmful influence of the alcohol industry, they can achieve reductions in underage drinking, and in children eventually suffering from the diseases alcohol causes or contributes to (heart disease, breast cancer, at least 4 other kinds of cancer, etc.). Again, this creates reduced demand on the health care system to treat illness. The number of areas in which this approach can improve health and prevent illness is long, but includes regulating foods high in salt, sugar, and fat, ensuring adequate housing, and providing effective education particularly in relation to literacy.
So thanks Jules for putting this post out there, as it highlights the need for us to be taking an evidence-based approach and equally as important to be visionary and optimistic. There is no value in simply criticizing and tearing apart what is, if we are not willing or able to imagine, articulate, and contribute passionately to what can be. The latter is the essence of leadership.
