Dr. John Haggie is a strong proponent of the adage “an ounce of prevention is worth a pound of cure.”
As a surgeon practising in Gander, Nfld., he has first-hand experience with serious medical conditions that could be prevented with early intervention.
Among his examples, Dr. Haggie points to a patient who is about to lose her leg due to complications of type 2 diabetes. “This outcome could have been avoided at any number of points,” he says. “Better childhood nutrition and fitness could have prevented the obesity that led to the development of this woman’s diabetes. Better drug coverage could have improved her blood glucose management. Even something as simple as having her feet checked by a nurse, which costs about $20, could have saved this woman’s leg and tens of thousands of dollars to the health care system.”
As president of the Canadian Medical Association, Dr. Haggie is promoting a transformation of the health care system that will focus on illness prevention and health promotion. “The current acute disease model of health care is 20 years out of date. Today, the biggest burden on the system comes from largely preventable chronic diseases and their complications,” he says, noting part of the challenge in promoting health is that many highly effective interventions are based in the community, not in hospital or doctors’ offices (for example, programs to encourage youth fitness and smoking cessation initiatives). As a result, they are not funded by medicare.
“We have to convince the government to invest in primary and secondary prevention initiatives. The evidence shows that an upfront investment more than pays for itself down the road,” says Michael Cloutier, president and chief executive officer of the Canadian Diabetes Association. He notes that just a two per cent reduction in diabetes prevalence rates would result in a nine per cent reduction in direct health care costs.
Unfortunately, the tools and medications that promote health are not accessible to all Canadians. Almost two-thirds of people with diabetes report that they cannot afford to comply with their prescribed therapy to effectively manage their disease. “A lot of people have to choose between paying for their rent or for their medications. Many more – especially those in remote and lower income communities – cannot afford healthy food. The result is more diabetes-related complications, poorer quality of life for these individuals and an increasing strain on our health care system,” says Mr. Cloutier. “We need to create a standard of care for chronic disease management across Canada.”
The Canadian Medical Association is advocating for co-ordinated investments in health promotion and disease prevention that will eliminate these gaps.
“Our goal is to ensure that by the end of the end of the next Health Care Accord, Canadians will have the best health in the world,”
says Dr. Haggie.
“There is no reason why we can’t do that. By emphasizing health promotion now, we will see results by 2020.”
RISK MANAGEMENT
Poll shows Canadians need to wake up to chronic disease truths
According to poll results reported in the 2011 Heart & Stroke Foundation Report on Canadians’ Health, nine out of 10 Canadians are jeopardizing the quality and length of their lives. The foundation found that many Canadians are in denial about their risk factors for heart disease such as being overweight and being physically inactive − risk factors they can manage and control.
While the poll results indicate 90% of Canadians rate themselves as healthy, the reality is:
9/10 Canadians have at least one risk factor for heart disease and stroke.
Approx. 50% of Canadians don’t meet the physical activity and healthy eating recommendations.
25% of Canadian adults are obese.
