The Other Side Of Health Costs

The Other Side Of Health Costs

The Other Side Of Health Costs

by Ray Deonandan

Jan. 1, 2002

This article originally appeared in Id Magazine in Guelph, Ontario, on Jan. 19, 1995. It is reproduced here with the author’s permission. Please note that many of the statistics cited herein are no longer accurate. As a result, the author no longer fully espouses many of the opinions stated.

Let us discuss the distribution of wealth, and the misguided perceptions that direct the disbursement of such wealth. In these times of necessary fiscal restraint, a staggering national debt and economic woes, it is prudent to remember that we of the industrialized world still control 80% of humanity’s wealth, though we comprise a mere 20% of its population.

These are figures bantered about idly at cocktail parties and high school geography classes, but often go undigested. When examined in terms of health care expenditures, however, the numbers take on an entirely new dimension. The world health budget is about 2 trillion dollars, of which 98% is contributed, managed and consumed by the industrialized countries, while the majority of disease and diseased people is to be found amongst the poor camped outside our doors.

Canada, as a leader in universal health care, is one of the world’s highest per capita spenders. And what is important to Canada’s health care system? The National Health Research and Development Programme (NHRDP), one of the two largest national medical funding bodies, gives clear preference to researchers investigating a “priority” of Canadian health. A “priority” is typically a big-ticket item that has appeared in newspaper headlines, like AIDS, Alzheimer’s Disease and various cancers.

But are such “priorities” justified? Malaria is without a doubt a larger health issue than AIDS, and one whose spread is far less human-mediated. And yet lobby groups advocating greater relative funding for what are essentially less eminent diseases are given louder voices because of the glamour and dramatic tragedy of their portrayal.

There will be no movie-of-the-week about the film star who died of malaria or intestinal worms. Indeed, the World Health Organization’s budget for all tropical diseases, of which malaria is a prime member, is a mere $35 million, less than a star baseball pitcher’s yearly salary. The numbers describing the prevalences of non-glamorous illnesses are staggering: there are 600 million new cases of tropical disease worldwide, while AIDS and other sexually-transmitted diseases (STD’s) account for only 250 million; there are 2 billion cases of Hepatitis B, of which 1.8 billion could have been prevented by vaccinations; and about 30 000 children die every day from simple causes like pneumonia and diarrhea.

One can almost hear the retorts of fiscal conservatives and Reform Party back-benchers: “why should we divert our funds to serve the rest of the world? It’s our money, it should be spent on our health!” It is true that the North may do as it chooses with its money. But that the world economy is becoming increasingly interdependent is also an undeniable truth. A disease like malaria cripples whole nations, halves their productivity and generates further burdens to global sources of relief.

Beyond that, of course, is the ethical issue. No one claims that, in this case, those that shout the loudest do so without reason; diseases like AIDS and Alzheimer’s are terrible scourges that need to be fought. But it is one thing to withhold our dollars from medical issues beyond our borders when we truly believe ourselves to be impoverished and unable to give. It is quite another to let the management of our purses be dictated by the political agendas of special interest illness groups.

Ray Deonandan is an epidemiologist and co-owner of The Podium. His personal website can be found at