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70% for
Health Care is a Self-fulfilling Prophecy
Response to Ontario’s 2010 Budget
by Brice Balmer, ISARC Director [article
in ISARC e-newsletter, April 2010]
Announcing the cancellation of the Special Diet and its transfer to the Ministry of Health and Long Term Care has unsettled many people on social assistance.
How are they going to have the nutritious food they need to stay healthy? Analysts and advocates see another program going into this mega-ministry.
The provincial government is predicting 70% of the budget will be health care and is worried about the effect of the “baby boomers” aging. The government’s alarm is that the population is growing older and will need more health care.
But there are other reasons this mega-ministry has grown. Does the Special Diet belong in this ministry and is a medical model needed to determine who qualifies?
During the Harris years, mental health, addiction services, and homes for the aged were transferred to Health and Long Term Care, which also began to fund many support services for a variety of people with special needs. These were previously in the Ministry of Community and Social Services. But it was not only that these services were transferred, it was also that the medical model was increasingly used. A model with expensive and highly trained staff added to funding needs. Recent news confirmed high salaries in the medical community – many were deserved, but their annual increases were higher than many other professions.
Many homes for the aged were not pleased with the transfer to the new Ministry. There were more rules and regulations. If there was a problem, new rules and regulations were brought forward. In Ministry of Community and Social Services, there were other ways of negotiating changes where incidents had occurred. Where services could continued to improve without new systemic regulations.
Addiction services do not need medical oversight or medically trained staff. A doctor needs to be available and withdrawal management centres should be close to a hospital in case of an emergency, but social workers, counselors, and para-professionals are very capable of helping men and women recover and begin living sane and sober lives.
Individuals struggling with addiction need time to work through the abuse and shame that has caused the addiction. They need support groups and counselling. Many re-experience the pain of relationships in the past and learn to understand themselves and their addiction. This process leads to health but does not need to be a medical route.
Addiction is the issue with which I am familiar. Other issues can be solved with non-medical models. I have been excited with the creation of a Ministry of Health Promotion but have not seen the province spend significant dollars to prevent illness and disability. The emphasis has been on obesity, smoking, and drinking – all legitimate. But what about nutrition, exercise, safe housing, and good child care?
Even the province expounds on the long term benefit of a healthy beginning for children from conception through 6 years old. Good programs are being instituted for babies, preschoolers, and kindergarten students. There are many social determinants of health which need to be emphasized and could reduce the budget of the Ministry of Health and Long Term Care.
Special Diet is an example of a service going to this mega-ministry. The transfer is medicalizing essential funding for food. The medical officers of health across Ontario have found in their studies that it is no longer possible to pay for safe housing and nutritious food within the dollar limits of Minimum Wage, Ontario Works, or Ontario Disability Support Program. Special Diet is not a medical issue, but becomes one as people visit the doctor or go to the hospital more often.
Advocates, including ISARC, are promoting the Healthy Food Supplement of $100 a month. This would allow people to purchase the food that they cannot otherwise afford and would build up their nutritional assets so that they would not get sick and need to go to the doctor, urgent care clinic or emergency room of the hospital as often. I personally do not know the cost of a visit to the doctor, but I know that one trip to the hospital emergency room could pay for several months of Healthy Food Supplement for an adult. For further information, go to Do the Math or Put Food in the Budget.
Recently a person living on Ontario Disability Support Program (ODSP) talked to me because he was upset about losing the Special Diet Allowance, which he needed because of his diabetes and his mental health issues. I assured him that the allowance was not yet cancelled; that it was being transferred to Health and Long Term Care; that the Ministry of Community and Social Services was doing a Social Assistance Review, which may bring improved benefits and income; and, that many groups were advocating the Healthy Food Benefit. He receives $41 a month Special Diet plus his ODSP income, but he runs out of money on the 20th of the month. The food hamper program did not have enough vegetables, fruits and meat for his diet, a number of the foods in the hamper had high sugar, starch, and salt which had to be minimized in his diet. “What can I do?” His anxiety was increasing. He gives the foods he shouldn’t eat to his neighbours.
The Ministry of Health and Long Term Care budget does not need to be 70% of the provincial budget.
Ontarians and the Provincial Government can promote healthy living, but we need to emphasize the social determinants of health.
People on social assistance and working for minimum wage need more money per month to care for themselves and children. It is not medical acute care and the medical model that will increase our health. It is exercise, nutritious food, less stress, safety, affordable housing, income security, education, quality child care, and good relationships with other people.
Let’s increase Health Promotion! And let's see attention paid to the social determinants of health for everyone in the next provincial budget.
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