By Kerry Gibson, Health Convenor
The Covid-19 Pandemic has shown us, once again, that crisis breeds innovation. The crisis is not only demonstrated by the virus, but in the systemic issues pre-existing in our health care infrastructure that were so greatly exposed under such stressors. However, the innovation that resulted may indeed be our pathway forward in building a more resilient system; innovation in thought, policy, process, and technology.
Dr. Ronald Wyatt, for instance, has been making headway highlighting the issue of and closing the gaps on institutional racism throughout the United States. His medical expertise, and that of his professional peers and researchers are bringing to the attention of the medical establishment the specific health needs and concerns of persons of colour, and the need to focus research spending in order to provide effective treatment. Also, his work has shown the impact racism plays on these demographics through discriminatory care. This type of work and research could be invaluable in a Canadian context whether borrowing the research for further development or expanding upon it particularly in the Indigenous context if the government is truly sincere about Truth and Reconciliation in more than virtue signaling but creating true change.
The United States has recently trended to the adoption of Food RX or Food as Medicine as a vital factor in preventative care propositions, financially supported by government, Medicare, and Medicaid initiatives. Canada has a vital agricultural industry, however food distribution is inequitable, resulting in remote communities unable to benefit from the same nutritional knowledge and access as urban centres. Therefore, greater investment in local and traditional food systems growth should be a key budget consideration for health care investment. This would also include a review of colonialist laws that prohibit Indigenous populations from benefitting from traditional fish and game harvests. The “catch a fish, eat a fish” legalities prohibit able harvesters from providing nutritional opportunities to the greater community through food banks, school and elders programs, and local hospitals that would benefit from a minimization of processed options. Regions such as Quebec have already made exceptions and are evaluating an evolution of legislation on hunting, processing, and distribution. The US SNAP program (food stamps) is even working with private partners such as InstaCart to not only enable persons with limited access to nutritious food the ability to pay through government credits or medical programs, and also these sites have registered nutritionists that create shopping lists for specific conditions where the patient can access the InstaCart app, click on either a “prescribed” shopping list from their physician or a list associated with their diagnosis (ie., Diabetes, heart disease, etc.) and the list will be auto-ordered, delivered quickly, and covered by the appropriate government program.
Although the Canadian Federal Government has pitched a CAD $46 Billion ten year health care investment proposal, the concern is distribution and allocation processes as well as the dire need to restructure Health Canada and other bureaucratic agencies that would allow more effective methods and means to be introduced from outside Canada or even private entities within Canada that would allow the alignment of Canada’s one-tier health care system with improved systems and tools that would ease the strain on traditional structures. For instance, the paramedicine program introduced on Vancouver Island in 2016 has shown great results with zero growth. With additional tools such as ZiphyKits and RPM technology and a province wide expansion, particularly given that paramedics across BC have been repositioning themselves for more lucrative opportunities, the government could re-engage that lost talent into full-time paramedicine, ease the burden on hospitals and clinics, reduce cost from readmission (or preventable admission), decrease overhead, increase cultural relevancy, and a multitude of other factors that would create a more equitable health care system at a reduced cost. Strategic investment would then allow time to build in other areas, such as medical student recruitment and retention, northern health care initiatives, and legislative advancements that would streamline relationships between private and public. Currently, most Made in BC tech firms are focussing their market growth in other geographies (Alberta, Ontario, US, Europe) as in BC there lacks a clear path and requires a significant investment to adoption of innovative technologies. Tech that has been adopted and implemented here in BC has been sourced from over-hyped sources with little due diligence (Babylon, whose Canadian rights were purchased by Telus Health, were not only pushed out of Alberta for lack of data compliancy and has appeared in many scathing articles in the UK regarding both the leaking of private medical records as well as the inaccuracy of its bots, but currently the majority of its executive and management staff have been jumping ship which shows considerable concerns that the public may not yet be aware of). With a non-biased approach, technology from all corners of the world could be tested, analyzed, and implemented without it being yet another BC Ferries government debacle. Then, a public procurement process could introduce these technologies to schools, institutions, hospitals, and any other agency that would benefit from the knowledge, experience, and implementation while remaining a one-tiered system. The current vetting process is an obscure one which is cumbersome for both government and innovator, which provides significant barriers to change and betterment.
