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Democracy best Rx for healthcare

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Only in Canada, this never-ending high-caffeine serial on who’s to blame for the erosion of medicare? Pity us.It’s not like this in England, the country that inspired Canada’s universal, government-funded health care.

Prominent English journalist Will Hutton has just released New Life For Health, a blueprint for wholesale renewal of the health service there, commissioned by the community health councils, watchdogs of community and patient interests.

Hutton, one of England’s most respected political and economic analysts, believes that the most important health-care deficit that needs topping up is the “accountability deficit.”

“A health-care gap has opened up between government and citizen that urgently needs to be closed,” says Hutton, writing in the country of mad cow disease and genetic engineering.

Citizens want to take charge of their own health because they have little trust in elected officials, he says. He’s backed by the Council of Europe, which has called citizen participation “fundamental” to democratic society and “indispensable” to health reforms designed to prevent diseases through lifestyle changes.

Hutton’s remedy? He wants to see a Swedish-style system where medical care is financed centrally, organized by a public agency that’s at arm’s length from the central government, and directed by citizen boards elected in each municipality.

This argument for people’s control could shake up our own mouldy health-care debate — but it’s interesting that even an energetic mind like Hutton’s doesn’t venture into the policy implications of what we now know about food and health. This is where the next round of health-care reforms are to be found.

Current nutritional research confirms that healthy diets can prevent diabetes, heart disease and several cancers as well as many of the flus and infections that lead to overcrowded emergency wards. Yet, curiously, food access still remains one of the few sectors of the public economy to be regulated strictly by consumers’ ability to pay.

Access to schooling, housing, roads, transit and cultural and economic development are all supported by governments, but access to food remains untouched by a century-long march toward the “welfare state.”

Interestingly, a few weeks after the release of Hutton’s report, senior doctors Andrew Neil of Oxford and Neil Poulter of London’s Imperial College urged that expensive cholesterol-lowering foods be made available free.

They argue that since government subsidizes the tobacco, sugar and dairy industries, which all contribute to heart disease, it makes sense to channel funds to help people buy food that supports heart health.

This particular call wasn’t anticipated by Hutton’s report, but it ought to be part and parcel of the new debate on the fundamentals of universal health care.

Wayne Roberts is co-author of Real Food For A Change.

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