This week, the federal government put nearly $200 billion on offer for medical care over the next decade. Premiers claimed it was insufficient.

A new alliance of research and community leaders argues that we can’t achieve our health transformation and innovation goals so long as Premiers focus primarily on more money for medical care.

Together with Think Upstream, the Canadian Centre for Policy Alternatives, the National Collaborating Centre for Determinants of Health, and leading health researchers from the University of Calgary and Dalhousie University, Generation Squeeze is launching Get Well Canada, an alliance to invest where health begins. 

Get Well Canada is about fulfilling the promise of Canada’s commitment to health care. For decades, governments have bought into a myth that medical care is what most makes us healthy, ignoring science showing that social supports contribute more to our wellbeing. Get Well Canada calls on governments across Canada to put this evidence at the forefront when designing health policies.   


Flowing billions more into a health system that is on fire can never be enough on its own to extinguish the flames. Medical care wasn’t designed to create health, it was designed to treat people once they’re already sick. That’s why the medical care we receive accounts for only one quarter of our health. Canadians will ‘Get Well’ when we invest in safe and affordable homes, living wages, quality child care and schools, and a healthy environment—even more urgently than we invest in medical care
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“We need to rebalance our investments in wellbeing by growing spending more urgently on social supports than on medical care,” argues Dr. Paul Kershaw, policy professor in UBC’s School of Population Health and Founder of Generation Squeeze. “In the 1970s, provincial governments consistently spent more on social services and education than they did on medical care. Now, the opposite is true.” (See table below)

Across the board, provinces have retreated from investing in social supports. Growing medical care budgets have crowded out other spending, especially for younger people. The federal government has helped pick up the slack, and now spends more than many provinces on social supports and education. By resisting provincial calls for even more medical spending, the Government of Canada has left fiscal room to continue to grow social investments.

These changing investment patterns confirm that provinces aren’t following the evidence on how to create health. Science shows that the best long-term solution is to do all we can to help prevent people from becoming ill in the first place. Many doctors wish they could prescribe poverty reduction, child care or housing, but can’t.

It’s time to grow spending on social supports more urgently than medical spending to reduce pressure on our health system and tackle our affordability crisis. This is the best strategy to make Canadians happier, healthier, wealthier and more resilient for generations to come.

To rebalance spending on health, Get Well Canada is calling for:

  • Better tracking and reporting: The Prime Minister observed in his speech this week – What Gets Measured Gets Done. A key data point for genuine health innovation is monitoring of the ratio of social spending relative to medical spending. So we ask Ottawa to task the Canadian Institute for Health Information to feature this ratio as part of its annual reporting.   

  • Better balance in government budgets: Governments can use their annual budgets to grow social investments more urgently than spending on medical care. Science shows that’s the winning strategy to improve life expectancy, reduce avoidable sickness, and address the current cost of living crisis.

  • Culture change: Canadians must broaden our understanding of health, so that we never again witness a First Ministers meeting where so many leaders overlook that health begins where we are born, grow, live, work and age. Health does not start with medical care.


Alliance Member Quotes

“Federal medical spending may be appealing to provinces experiencing a crisis, but to the average Canadian the health care system seems to be perpetually in crisis. More of the same will not work forever, and part of rethinking how we spend on medical care involves thinking about what we are buying: health outcomes. There are other ways to improve those, cheaper, than additional medical spending.”

—Dr. Daniel Dutton, Dalhousie University, Department of Community Health and Epidemiology

“We’ve forgotten that medical care and social investments are not an either/or proposition. They are two sides of the same coin. We’ve neglected the social side of the equation for far too long, leaving our health system unfinished and out of balance, and now we’re paying the price.”

—Trish Hennessy, Think Upstream, Canadian Centre for Policy Alternatives

“We want people to recognize that clinics and hospitals are the last stops for health, not the first. The first stops are in our ecosystems, neighbourhoods, jobs, child care centres, schools, and so on – recent events, including the COVID pandemic, have made these interconnections painfully clear.” 

—Dr. Lindsay MacLaren, University of Calgary, Department of Community Health Sciences

Get Well Canada wants to change the way Canadians and their governments think about health. So long as Canadians can’t access safe homes, good incomes, quality child care, and a healthy environment, our medical care system will never be enough to prevent people from dying early.”

—Dr. Claire Betker, Scientific Director, National Collaborating Centre for Determinants of Health

 

Provincial social & education spending relative to medical spending

 

around 1976
2019
AB

+ 36%

- 26%

BC

+ 22%

- 28%

ON

+ 16%

- 5%

QC

+ 53%

- 22%

SK

+ 30%

- 24%

MB

- 3%

- 25%

NS

+ 3%

- 49%

NB

+ 58%

- 2%

PEI

- 27%

NFLD

+ 55%

- 48%

Source: Calculations by Dr. Kershaw based on sources from the Canadian Institute for Health Information, Statistics Canada and data collected by Dr. Kneebone at the University of Calgary