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| Apr. 18, 2003. 01:00 AM |
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It's time to see medicare not simply as a provider of health, but as a generator of wealth for Canada HENRY FRIESEN We've just come through a very significant time in our country. The Romanow and Kirby reports, as well as numerous provincial studies, have identified the health-care issues and proposed some ideas. One of the themes that came through very clearly in the Romanow report on health care was the whole notion of stewardship. When most people think about stewardship I believe they see it in terms of preserving and protecting what has been given to them. That's true and that's important. And I think the recent accords on health have gone a long way to honouring that part of the equation. But I'd like to suggest that there is another aspect to stewardship and that's the responsibility to take what we have been given and not simply preserve it, but pass on even more to those who follow. In business terms, we must grow the asset. I believe the only way we're going to grow the asset is to see the health sector in a whole new way — not simply as a provider of health for Canadians, but as a generator of wealth for Canada. We spend almost 10 per cent of our GDP on health — services, equipment and devices. Much of that we buy from others. In fact, this is one of the few sectors where Canada actually runs a trade deficit, some $8 billion a year. Over the next five years, this will result in 80,000 jobs in foreign countries, jobs that could — should — go to Canadians. If we could mine the potential that exists in the health sector, we could build an industrial enterprise larger than the auto sector. Think of what that could mean in terms of jobs and growth here in Canada. Think of what that could mean in terms of winning new markets abroad. So what would it take to unlock the potential of this sector? First, there has to be a better alignment between our economic and social agendas. But what does that mean? It means understanding that the key to sustainability — to ensuring that our health system will be there for you, your children and grandchildren — is not in more and more money from Ottawa or the provinces. Right now, our health ministries have one focus: reducing costs. That's understandable, but it's shortsighted. It's shortsighted because it sees health as something that gets consumed, but doesn't produce anything in return. "Give us more money and we'll give you better health." Not a single health ministry in this county has an economic development branch. They don't see the economic potential of the sector, only its costs, only what goes out, not what could come in. What would happen if we saw health as we do other areas of our economy and put innovation at its heart? Innovation is about continuous improvement; making the good better, and the better superior. After investing more than $1 trillion in health care since medicare was established, how many Canadian health-care products or services are selling globally for more than $100 million a year? I can tell you — almost none. The one breakthrough product introduced in 1930 came from the Hospital for Sick Children — pablum, the precooked cereal for babies. Perhaps pablum has typified our approach to health innovation: Soft, bland, mushy and distant. But what if things turned around? What if we said, let's set clear goals for ourselves? Let's aim to be the world leaders in the field of medical devices, or genomics, or proteomics. Let's establish expertise that no only benefits Canadians, but which can be exported around the world. The last two health accords provided $1 billion for health information systems. With the expertise Canada has in telecommunications, why not become the world's leader in health information systems? This will be an enormous global market in the years ahead, why not capture it for Canada? Or look at infrastructure. About half a billion dollars has been allocated for infrastructure in the coming years. Somebody's going to design it, build it, market it. Why not us? Let me share a story with you. A few years ago, a Winnipeg architectural firm, Smith Carter, designed the National Microbiology Laboratory, a state of the art high containment facility currently being used to study SARS. It took the knowledge gained on that project and sold its expertise around the globe, becoming the leading designer of such facilities worldwide. The Winning project cost $130 million. But the contracts from around the globe for construction of similar high containment facilities have now yielded more than $1 billion. That's what I call leverage. That's my idea of stewardship. Just think of the possibilities. Multiplied across the health sector and across the country, we could set in train a virtuous circle of innovation that benefits Canadians and Canadian health; these innovations leading to new opportunities around the world, attracting new investment and talent to Canada which in turn generates still more innovation — and so on. Can we all do this? Can we transform the culture and unlock the potential? Can we break out of old patterns of thought about what a health system is supposed to do, is supposed to be? Of course we can. As Margaret Mead said, "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has." Tonight, amidst this group of thoughtful people, I hope I have planted a seed and raised the possibilities of what true stewardship of our health system can be. This is an excerpt of a speech Dr. Friesen delivered at the Public Policy Forum's Testimonial Awards in Toronto, where he was one of the honourees. |
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