Sugar tax a step in right direction
This is the second of a four-part series looking into health policy under the Progressive Labour Party
Although the need for acute care will always be with us, reforms must take place and are taking place. The question facing Bermuda is simply this: do we want to lag behind the rest of the world in an area so critical and whose paths are so well trodden while we fight to regain leadership in the world of international finance?
The best way to fight the epidemic of cancer, obesity, diabetes, heart disease and Alzheimer’s is through prevention. There are powerful institutions and people who have built their careers in the system as it is. But no one can refute the long-term advantages of prevention. And while there will not be any quick turnaround results, it will certainly bear fruit in the long run.
A prevention model, focused on forestalling the development of disease before symptoms or life-threatening events occur, is the best way of confronting issues of health. The recent spat concerning health charges between the former attorney-general and Lahey clinic highlighted the extent to which Bermuda is lagging behind in the movement towards a healthier community. Lahey had focused attention on the installation of the latest technological advances to provide a good livelihood for their consultants, while the former attorney-general focused on what was “too much” for a trained consultant to earn.
The parties involved, being leaders in the community, had failed to point the community in the direction of preventive care.
The sugar tax is a small step, but a step in the right direction. If the focus had been on the health of Bermudians, there might have been an appreciation that we have come to rely on ever newer and more advanced technology. Moreover, our reliance on such newer, more advanced technology has perpetuated an expensive system in which costly new technology is widely adopted in the absence of lifestyles that would have prevented the occurrence of the diseases that we are now trying to diagnose and treat.
This realisation of the need for prevention is where the country could have really saved money. A national health policy should target several environmental and social areas.
First: the environment must be of a high quality, whether public, school, home or workplace. Our isolation in the North Atlantic gives us a head start in the quality of our air, land and water, but this should not be taken for granted. Far too few epidemiological studies have been done on some of our most pressing health issues.
We should not assume that because a person has a roof over their head that they have been provided with housing. Housing should be affordable, accessible and safe from mould and other toxins, hazards and pollutants. We cannot tolerate the views of one magistrate, who thought that a tenant should live in a house rather than break their contract, even though the house had mould, since everyone knew that Bermuda houses were always damp and mouldy.
Second: many clinical services can be provided by community organisations. Immunisations, cancer screenings, cardiovascular exercise and 12-step programmes for alcohol and drug abusers may be readily implemented, and would be far less costly if there was preventable treatment available.
We must maintain and enhance our clinical and community preventive services. Clinical preventive services can be supported and reinforced by community-based prevention, policies and programmes. Community programmes can also play a role in promoting the use of clinical preventive services and assisting patients in overcoming barriers to preventive services — for example, transportation, childcare and patient-navigation issues.
Third: empowerment is an elusive concept. It is hard to define but obvious when it is seen. It is transmitted more emotionally than cognitively. But somehow we must empower our community, starting with schoolchildren. Because health is so personal, each person must make their own decisions in a wise manner. This means that they must be sufficiently responsible to make wise decisions once given the tools and information to make healthy decisions. Their options, however, must be within their grasp.
Fourth: there are various groups within the Bermuda population. It is necessary to be aware of these differences and the susceptibilities in the questions of health so that disparities can be avoided. Some of the disparities may be genetic, while others may be a result of history or social policies, but no group should be left behind.
This is precisely the promise that God made to the nation of Israel in the 28th chapter of Deuteronomy on the condition that they lived right.
• Arthur Hodgson is a former Cabinet minister, Rhodes scholar and graduate of Oxford University in England, where he studied philosophy, politics and economics
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