Dear Editor,
The minority-NDP government will table its next budget today.
The budget will likely under invest in programs that promote health and well-being, especially for younger residents, by over investing in health care, according to a new study published in the Canadian Journal of Public Health.
The scientific evidence is clear.
Health doesn’t start with health care.
It starts where we are born, grow, live, work and age.
These conditions are shaped by social policy investments, like childcare, parental leave, education, poverty reduction, housing, and climate change mitigation – among others.
It will always be important to have a strong medical care system. But this system primarily treats illness after people fall sick.
We need more focus on what makes people well, and prevents their becoming sick in the first place.
Canadian research shows that as social spending grows relative to medical spending, we are more likely to reduce avoidable deaths and increase life expectancy.
Generally, however, provincial and federal governments have done the opposite over the last several decades, which risks compromising life expectancy.
The B.C. government is no exception.
Medical care received the largest budget increase of all program spending last year – a billion dollars. So it did the year before, and the year before that.
By contrast, last year’s budget allocated $431 million to social services, which includes child care, poverty reduction, child welfare, community living, housing and other services – a paltry 44 per cent of the latest increase to medical care.
Failure to prioritize social policy investments is especially risky in B.C., where the conditions into which we are born, grow, live, work, and age are under severe pressure due to affordability issues.
Home prices have left behind young people’s earnings more in B.C. than in any other province.
It will be important for the B.C. government to build on its 30-point housing plan to search for additional ways to address the health, social and economic harm caused by the extreme housing affordability challenges in our province.
It will be equally important to reduce other rent-sized costs in people’s lives, like child care, which can cost parents thousands per month.
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Over the next few years, annual provincial investments in child care will need to increase by about $1 billion to build a system where high-quality spaces are available to all who want them at prices that don’t exceed $10 a day.
Fortunately, B.C. governments routinely find more than an extra billion to invest each year, with medical spending being the chief beneficiary.
The challenge now is for government to better allocate available tax dollars between medical care, child care, and other social policy in order to align with the evidence about what really makes people healthier.
I encourage B.C. ministers responsible for poverty reduction, child care, housing, education, and climate change to join forces around the cabinet table to advance a common message: “Health starts with the issues on which our social ministries work, not medical care. So our government needs to revisit the slice of the budget pie received by the Ministry of Health, especially when exploring new investments. An ounce of prevention is worth a pound of cure.”
I will attend the budget lock up in Victoria today (Tuesday, Feb. 18) to study the degree to which the 2020 BC budget reinforces risks to local life expectancy by over emphasizing medical care when allocating new investments.
Dr. Paul Kershaw
a Pitt Meadows policy professor at the UBC School of population & public health and founder of Generation Squeeze
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