Increasing self-care options will help our struggling healthcare system

Canadians have always liked to think we have one of the best healthcare systems in the world.?The ravages of COVID have changed all that. Hospitals are overwhelmed, family doctors are in short supply and healthcare workers of every description are burning out, creating a very real crisis in access to care. Now a new report shows we’re also well behind other leading industrial countries because Canada lacks a national self-care strategy that would empower people in ways that could make us all healthier and allow billions of dollars a year to be redirected to solving the crisis in access to care.?

The World Health Organization defines self-care as the ability of people to promote their own health, prevent disease, maintain health and cope with illness and disability with or without the support of a health worker. It involves making healthy lifestyle choices, self-monitoring and self-testing, managing your own treatment of minor ailments such as coughs and colds, preventing chronic illness or managing it, and using prescription and non-prescription medicines responsibly.

The Global Self-Care Readiness Index report, which for the first time includes Canada, assesses such things as public willingness to embrace self-care, health policies and initiatives that enable self-care, and how self-care products are regulated. It found that, of the 20 countries assessed so far, Canada is in the top three when it comes to support and adoption of self-care among healthcare providers, patients, consumers, and policymakers. This confirms a 2015 survey that found more than three-quarters of Canadians would rather treat their minor ailments themselves than see a doctor and a 2020 survey that reported almost total agreement that we need more tools to care for ourselves.

Where Canada starts to fall down the international rankings is when the report assesses consumer and patient empowerment to make their own health decisions and the extent to which policymakers take concrete action to maximize the value of self-care.?

Canada is slightly below average on empowerment, mainly because patients can’t access or manage their health records. While Canadians demonstrate levels of health literacy comparable to leading countries, we lack an active strategy to build those levels in the future.

We’re also slightly below average when it comes to self-care health policy, with the report noting that Canada disincentivizes self-care by providing tax-free status for prescription drugs and allowing them to be claimed under a federal tax credit but not giving the same tax treatment to self-care products.

Our real undoing comes, however, when the report looks at the regulations and processes governing the?creation of new self-care options for Canadians and their families. Here, we are well below the average score and far behind countries such as the USA, Australia, Britain, Germany, Singapore and Mexico.

Of the 10 countries assessed this year, Canada was in the bottom three on the availability of self-care products through a variety of channels, including in-store and online. We’re also in the bottom three on reclassifying prescription drugs to over-the-counter medicines, with approvals in Canada taking an average of more than two years. That’s four to 10 times as long as in Britain and more than twice as long as in the USA, Australia or Germany.?

Other countries have recognized that increasing the capacity of individuals to manage their health and giving them the information and tools they need to do that is critical to the long-term sustainability of any healthcare system. Canada must do the same.

A recent study by the Conference Board of Canada showed we could save $500 million in drug costs and $250 million in fewer doctor visits every year by switching just three categories of products (heartburn remedies, erectile dysfunction drugs, oral contraceptives) from prescription to non-prescription classification. Another study suggests that, if more people with mild to moderate cold symptoms practised self-care instead of visiting a doctor, half a million Canadians could gain access to a family doctor.?

Fortunately, Canadians are ready and willing to practise self-care, but we need more support and action from government. The federal government should start by embracing a national Self-Care Strategy that will help Canadians take better care of themselves and ensure they can access a broader range of self-care products and services when needed. That includes expediting the development of Health Canada’s Self-Care Framework to improve the regulation of self-care products and consumers’ access to them, and giving Health Canada-approved self-care products the same tax status as prescription drugs.

We all have a role to play in living healthier lives and ensuring our healthcare system remains sustainable for those who need it. Governments should be helping us do this, not standing in the way.