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January 28, 2002
Medical Officer of Health calls on Romanow to shift Medicare debate
Dr. Sheela Basrur, Toronto's Medical Officer of Health, today called on Roy
Romanow to use a "public health lens" to provide a new focus to the medicare

"We need to rebalance the system toward health promotion and protection," Dr.
Basrur said in her submission to the Romanow Commission on health care. "Fiscal
pressures are framed exclusively within the supply or treatment side of health
services when we all need to pay more attention to the demand side, where
prevention and early intervention strategies are critical."

Dr. Basrur cited examples of an "upstream" approach focusing on health
determinants, where preventive interventions achieve substantial savings. She
described a Toronto program where low birth weight rates in low income
neighborhoods were reduced by 30 per cent among highest risk women. Health care
is seven times more expensive for low birth weight infants.

"Public health strategies are an essential foundation to sustainable health
care," said Dr. Basrur. "People living in poverty have fewer choices and poorer
health status. Healthy populations need treatment less often and respond better
when treatment is required."

The submission calls for a review of the Canada Health Act from a public health
perspective and says the role of the federal government should be strengthened
in environmental protection, communicable disease control and nutrition

"It makes sense to target investments in the nation's public health
infrastructure," said Dr. Basrur. "Federal leadership and vision must move
beyond acute care and hospitals and toward the gains we can all make through
strategic and nationally co-ordinated public health initiatives."

Dr. Basrur presents her submission to the Romanow commission to the Board of
Health at 1 p.m. today in Committee Room 1, City Hall.

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