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Measuring success in the federal budget

A wellbeing budget goes beyond debt and GDP
An image of Canada's parliament building.

Alex Paterson

Everyone in this country probably knows what the latest federal budget is predicted to do to the public debt and deficit. You’ve heard about it, ad nauseam, for the last week from the punditry.

The conversation we have about the budget has been the same for decades. No matter which partisan stripe is running the government, the conversation is stuck in the same cycle.

Debt. Deficit. Taxes. Rebates.

Can you tell me what this budget will do for Canadians’ average life expectancy or our sense of mental wellbeing? Can you tell me how many years of life expectancy the people in Pangnirtung or Attawapiskat will gain from the commitments in this budget?

Few people have an immediate answer or a government-produced table they can pull from the budget to answer the question of whether this budget makes Canadians physically and mentally healthier—and, if so, how many years does it add to our expected life span, to the quality of our life, or how many fewer suicides we predict will happen because of key investments.

For too long, the conversation around government budgets has been too narrow and detached from the lives of the average Canadian.

There is a shred of hope though.

That comes by way of Gender-Based Analysis Plus (GBA+). This is how the federal government now measures the effects of policy and budget items on different groups (all governments should do this). GBA+ could be used more rigorously and be oriented towards measuring universal indicators for how healthy the population should be. We haven’t set goals for how healthy we want society to be, we just measure the deficit between groups.

All we know about the universal goals of government budgets is that we should, according to the pundits, eliminate the deficit and pay down our debt or maintain a certain debt-to-GDP ratio.

But we really should be asking: to what end?

I want to break down the federal budget exercise in a different way. GDP, debt, deficit, unemployment, inflation, purchasing power, and job creation can all be considered crude ways of measuring a community’s health. When we talk about those economic measures we are talking about creating a HEALTHY economy.

We want a healthy economy because we assume that means healthy people. Having a good job means you have access to a good income and can keep your family healthy by having a safe home and nutritious food.

We value health. Our underlying belief is that healthy people are more likely to be enjoying their lives.

But here’s the thing, when we don’t look at the bigger health picture and, instead, penny pinch, we end up doing our own health and the health of our communities a disservice.

Pharmacare is the perfect example. Investing in a single $10.7 billion commitment to a universal pharmacare program would literally save lives, but there is political hesitation to raise the revenue needed to fund such a program.

Everyone paying for medication would end up paying less in the long term, yet politicians fear backlash. There’s a disconnect.

Yes, some people who aren’t on prescription drugs would have a moderate tax increase — but, in exchange, someone in our family or someone in our best friend’s family would be able to get the medication they need to stay healthy, without charge. That would save our health care system money over the long term and it’s just common sense public policy.

Let me diagnose the problem for you: because we don’t compare the predicted health results of a proposed public program to the economic and social cost of inaction, we’re overlooking some very important cost benefits. Like increased life expectancy or more years before losing physical or cognitive ability.

We also fail to connect the policy dots. For instance, the only policy we see that lowers poverty over the next 20 years is a poverty reduction plan when, in reality, every policy that government makes in any department has trickle-down effects on poverty and health—for better or for worse. The same goes for greenhouse gas emissions— the budget should account for those, too.

We are only focusing on a part of the story. This is why GBA+, the sustainable development goals, and even the human development index offer us such rich potential to look at budgets and legislation in a different way. For our budget process to be truly effective, we need GBA+ initiatives to tangibly model and quantify the health outcomes of particular policies in the future and put them side by side with the economic models. If we can do it for debt and GDP, we can also do it for life expectancy and other key health indicators. That would be a game-changer.


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