An Unpopular Opinion; Perhaps Universal Health Insurance Shouldn't be Universal for All

Agatha Farmer

We are starting to see clear dividing lines between certain sects of the North American population. Before I start this blog I will be upfront and honest when I say that I would prefer universal healthcare in conjunction with the availability of private clinics in this current overburdened system of ours. (No I'm not a conservative I'm dead in the centre middle of this ridiculous taking sides political circus) But that stance doesn't really mean anything because what I would really prefer is an entire overhaul and new approach to health care and life. I'd also like to make this clear, regardless if you wear a mask or not, those with genetic predispositions, the elderly, children, mothers at risk, should all have access to universal healthcare. I realize I generalized this but that's because recently the National Post published an article questioning whether those who choose not to wear a mask should receive Covid-19 free medical assistance or should "pay the price" for their advocacy.

I will also be honest when I say that's a fair game statement; but if we are going to hold people accountable for their healthcare then it will have to encompass more than just the virus. I'm all for a major change in the way we manage health care in this country and how the inefficiency of this system has hospitals backed into a corner. Hospitals that were already running at full capacity prior to Covid. Have a conversation with Brampton's mayor Patrick Brown and he will inform you of the chronic underfunding of a major city centre health hub. This was an issue prior to the virus, imagine now. What our governments of the past and present have been doing is clearly not working. Someone on Twitter today said that if Covid had the lethality of MERS given how fast spreading it is "civilization would collapse." So yes, let's overhaul the health care system to be future pandemic ready. But if that system includes having to wear a mask for public health safety and if not forgo Covid-19 care, then that same system should also have a major focus on actual public health. Public health doesn't include alcohol and cigarettes, those are not public health essential items. Huston we have a problem when health officials are terrified to close liquor stores because hospitals and doctors would be overwhelmed by the sick and in withdrawal addicts plus Covid patients. Newsflash! Public health and governments have been failing for decades, this is already a sick society. How sick? 67% of Canadians are overweight. Obesity is usually accompanied by chronic secondary conditions. In a July 2019 report public health Ontario had themselves acknowledged that "the data reported highlight the considerable burden of disease that could be reduced if more people in Ontario did not smoke, limited their alcohol consumption, were physically active and ate healthier."

This was not the first report of such kind and had any significant public health measures to save humanity like those for Covid been deployed since that report? Nope. The same report goes on to say that in 2015, chronic diseases caused about three-quarters of deaths in Ontario. Cancers, cardiovascular diseases, chronic lower respiratory diseases and diabetes were the most common causes of chronic disease deaths in Ontario and were responsible for 63.7 percent of deaths in 2015. There were more than half a million new cases of these four diseases in 2015. Their estimated annual direct healthcare costs are $10.5 billion (2010 estimate in 2018 dollars). In 2015, of the four leading causes of chronic disease deaths in Ontario:

Cancers caused the most deaths; 28,195 people died of cancer.

Cardiovascular diseases accounted for the highest number of new cases of chronic disease. They were also responsible for the largest number of hospitalizations in 2016.

There were 60,530 people newly diagnosed with chronic obstructive pulmonary disease, which is a major chronic lower respiratory disease, and tobacco smoking is its leading cause.

About 1.3 million people were living with diabetes, making it the second most prevalent chronic disease, after cardiovascular diseases. Diabetes also increases the risk of dying from cardiovascular and other diseases.

People in Ontario with the lowest socioeconomic status had disproportionately high rates of hospitalization in 2016 and deaths in 2015 due to a chronic disease.

Let's unpack that:

1.3 million people in Ontario have diabetes and that was in 2015!

Cardiovascular diseases have the highest number of hospitalizations and chronic lower respiratory diseases were the most common causes for death - how many of those are in ICU's right now fighting Covid?

That last part regarding socioeconomics - that needs to be addressed, acknowledged by corporate and governments alike and changed immediately and simultaneously with the changes to the health care system or NOTHING will change and the human race will never thrive.

Looking at all these factual Ontario stats and putting aside the issues of civil liberties perhaps those who choose not to wear a mask might not be entitled to universal Covid-19 healthcare but clearly neither do those who have and continue to cost the system billions of dollars decade after decade without any accountability for their own actions. Organ donor recipients are already held to this status of self responsibility. Under Ontario legislation, the Trillium Gift of Life Network is responsible for fairly rationing scarce organs from dead donors based on need. The agency does not generally allow people with livers damaged by alcohol to receive transplants unless they have been dry for at least six months. Interestingly the criterion does not apply to liver transplants from living donors, but it probably should.

A few years ago surgeons in Melbourne, Australia, were refusing to provide heart and lung surgeries to smokers, even those who needed the operations to stay alive. “Why should taxpayers pay for it?” said one surgeon quoted in media reports at the time. “It is consuming resources for someone who is contributing to their own demise.”

Though some were outraged by this stance — the Australian Medical Association called it “unconscionable” to ration services based on personal habits — many doctors agreed with it. They saw nothing wrong with patients paying for the consequences of their actions.

So therefore if you're contributing to your own demise by not regularly exercising, not eating healthy, abusing alcohol (yes wine and beer count), or smoking a pack a day it would make sense that perhaps your universal health care should be limited. That said none of the above unhealthy habits can be eliminated until our entire way of life changes including brining people out of poverty so that they are able to make healthy choices. And to that end there should be an implementation of the long overdue but much discussed tax on unhealthy foods and encourage people to choose healthier options which lead to improved health. A fat tax would also encourage producers to supply food lower in fat and sugar. Fast food outlets would have an incentive to provide a wider range of meals. Or even this wild idea about allowing people zoning and variance to grow large permaculre gardens with greenhouses or even indoor farming so that we can truly transition to a community based agri system - which is the healthiest system for humans, other species and the planet.

Yes our system needs to change, not just one but many of our systems, two can play the game of what should be covered under universal care, but the point is that it all needs to change. That should be the ultimate goal of any Re-Set. Re-Set the economics of life and the health care system will follow. Parents shouldn't have to choose between a job and sending a sick child to school as has been the "norm." The "norm" of our society needs Re-Set.

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