By Terrance Hunsley
We could take a lesson from the health system.
Over the past four decades, the federal government, with provincial involvement, has invested in health research, health information systems, performance evaluation and innovation. Those investments are paying off in improved population health, improved health knowledge, services and products. We can sequence our DNA. We live full good quality lives with diseases that used to kill us. We replaced many surgeries with medicine. The system is improving and becoming more accountable. In the past fifteen years, according to the OECD, the annual growth rate in hospital beds shows a negative two percent! Despite our ageing population! The Canadian system costs about 60% of what Americans pay, provides universal coverage, and results in better population health results and self-rated health than in the US. And now we have the capacity to invest more in home care and perhaps, pharmacare.
But the contrast of federal investment between the health and the social sector is startling. On the health side we started with a Medical Research Council and then grew into the Canadian Institutes of Health Research, comprising:
the Institute for Aboriginal People’s Health,
the Institute of Aging,
the Institute of Cancer Research,
the Institute of Circulatory and Respiratory Health,
the Institute of Gender and Health,
the Institute of Genetics,
the Institute of Health Services and Policy Research,
the Institute of Human Development, Child and Youth Health,
the Institute of Infection and Immunity,
the Institute of Musculoskeletal health and Arthritis,
the Institute of Neurosciences, Mental Health and Addiction,
the Institute of Nutrition, Metabolism and Diabetes,
the Institute of Population and Public Health.
All told, the funding of these institutes runs about $1B per year.
Besides that, there is the Canadian Institute for Health Information (CIHI) funded at about $100 million per year. And in the health field, the private sector also makes substantial investments. The pharmaceutical sector invests heavily and the various health professions support substantial institutions which operate on the national level.
The social side – income security, human rights, immigration, heritage and culture, labour market programs, social services – is dealing with massive societal problems, and the research and development investment is minuscule. The Social Sciences and Humanities Research Council provides funds to students and university researchers in a wide array of academic areas, and the amounts which flow into social policy research are minute in comparison with funding in the health field.
At the national level when it comes to the social, economic and cultural health of the nation, there is a big empty hole. No solid institutions to support research into solutions to social problems; no systematic evaluation of service delivery systems; no national support for social prevention programs; no hub for innovation in services, building of resiliency, improving social relationships, reducing inequality. We spend about 13% of our GDP on income security, social services, labour market programs and education.
Yet Canada has made almost no progress over the past few decades in reducing poverty, and is witnessing increasing economic inequality.
We have not been able to reduce, let alone eliminate homelessness. We have food banks, and soup kitchens, and emergency shelters, from one end of the country to another. They form an industry with thousands of employees and supported by many more thousands of good-hearted people trying to help the victims. They are not solving the problems. The whole mess is a legacy of inattention.
We haven’t learned how to deal with suicides of children in native communities. Raising children with fetal alcohol syndrome. Child welfare systems that take children into the care of the state and are not able to give them a healthy upbringing. Delinquent youth and gang violence. Human trafficking. The issues that bridge social and health concerns like diabetes, obesity, mental health problems.
We have fragmented service systems that provide fragmented services. (Social services people call them “silo systems”). Ineffective employment insurance which leaves many of the unemployed trapped in social assistance, and considers it a success when someone who loses their job in a middle class occupation gets fitted into a low wage service job. We have a tidal population wave of people with disabilities that we don’t know how to deal with. Working people living in poverty. Indigenous communities living in third world conditions. And we are one of the richest countries in the world!
We have an income security system that spends $150 Billion every year but with absolutely no accountability for results. Canadian society has become better educated and our economy benefits greatly from our cultural diversity. But we have embedded racism, discrimination for any number of cultural or social reasons, and hate crime. We don’t know how to deal with it. Many Canadians look to our neighbour to the south and fear for our future.
We are already seeing substantial job destruction in the economy. We have good jobs being developed by the new economy. But more so, we have low level service sector jobs with little occupational mobility.
With the coming wave of job-replacing technology, and the still widening gap of economic inequality, it is essential that Canada find the best ways to ensure that all of our people find pathways to social integration and economic success, and not be left on the sidelines looking at a fast-moving train. Investment in R and D will pay off for the people and for the economy.
We should have a national council to support research and innovation in social, cultural and labour market concerns. It could be funded primarily by the federal government, but free to develop partnerships with provinces and the private sector. It could be governed by combined federal/provincial/first nation representatives, and by representatives of national social and cultural organizations, and major corporations and unions. It could fund research and innovation in Canada, gather and disseminate the most advanced knowledge from across the globe. There could be live-streamed national fora to bring forward research results, and support for a continuous cycle of innovation and improvement in social programs. The cost would be small. The gains for the country could be large.