If Canada’s health-care system is out of shape, where better to look for inspiration than the fitness club business?
There are some lessons applicable to the health-care debate we can glean by studying the fitness clubs.
In fact, Roy Romanow’s recent report on health care states that fitness and recreation organizations fit under the rubric of “primary health care.” Fitness clubs are in the health-care business, in its broadest sense.
Last week, I plowed through the Royal Commission on Health Care report, reading 103 pages and scanning another 90 or so pages of less interest. It was gripping reading.
One of the most startling elements is a paragraph that almost nullifies the reason for conducting the study in the first place: “Health care is what the economists call a superior good in that, as individuals we tend to spend progressively more on health care than on other goods and services as our incomes go up. Based on a series of international studies . . . higher income is the single most important factor determining higher levels of health spending in all countries. Indeed, the more economically developed the country, the more pronounced the effect. According to Reinhardt et al (2002), per capita GDP is without doubt ‘the most powerful explanatory variable for international differences in health spending.’ ”
If this is true, and Romanow certainly gives it credence, why worry about escalating costs at all? Cost-wise, it might not even matter what system any country uses: the biggest factor in having an expensive health-care system may be having a healthy economy.
All the debate may be a waste. As Canada gets poorer, spending will decrease; as we get richer, spending will increase. No matter what. Surely, that implies that the rise of for-profit health clubs in recent decades probably has a lot to do with our increasing wealth as a society.
But it also implies that the surest way to kill health care in Canada would be to kill our economy. Romanow should have simply given a lesson in good government.
Of course, I’m exaggerating. Romanow was analysing much more than costs. But it is hard to question the assertion that the rapidly rising costs of health care were the primary impetus behind Romanow’s study.
Probably one of the most-quoted passages in the report reads: “More funding must not go simply to shore up the status quo – it must buy change.” Later, the commission follows up with a more specific threat: “If the status quo continues, the result will be the eventual unravelling of Canada’s health-care system into a disparate set of systems with differing services, differing benefits and differing ways of paying for health care across the country.”
So, if we’re going to change, we may as well apply real-life lessons from a related business: fitness clubs. The fitness business is likely more related to traditional health care than you would think.
Fitness is a business where the government (mostly municipally) holds the dominant position. It’s similar to the way health is controlled by provincial governments. Apart from the public fitness clubs, non-profit clubs (such as the YMCA and YWCA) have found a role; even for-profit fitness clubs have been providing services that government can’t or won’t provide.
To wit, there are privately owned fitness clubs that serve alcohol; some have TVs in workout areas. I can’t imagine a publicly owned or publicly supported (private, non-profit) club being allowed to provide such “non-health” services, but there is obviously a market. And there is an argument to be made that providing the alcohol and TV could be encouraging people to work out who might not otherwise.
Additionally, some companies such as Spa Lady forbid men, a potentially illegal proposition in a publicly administered facility.
For-profit clubs provide a much wider array of services (lounges, boxing, computer golf, etc.) than do the public ones, or even the non-profit fitness clubs.
If Canada’s health-care system is out of shape, where better to look for inspiration than the fitness club business?
There are some lessons applicable to the health-care debate we can glean by studying the fitness clubs. In fact, Roy Romanow’s recent report on health care states that fitness and recreation organizations fit under the rubric of “primary health care.” Fitness clubs are in the health-care business, in its broadest sense.
Last week, I plowed through the Royal Commission on Health Care report, reading 103 pages and scanning another 90 or so pages of less interest. It was gripping reading.
One of the most startling elements is a paragraph that almost nullifies the reason for conducting the study in the first place: “Health care is what the economists call a superior good in that, as individuals we tend to spend progressively more on health care than on other goods and services as our incomes go up. Based on a series of international studies . . . higher income is the single most important factor determining higher levels of health spending in all countries. Indeed, the more economically developed the country, the more pronounced the effect. According to Reinhardt et al (2002), per capita GDP is without doubt ‘the most powerful explanatory variable for international differences in health spending.’ ”
If this is true, and Romanow certainly gives it credence, why worry about escalating costs at all? Cost-wise, it might not even matter what system any country uses: the biggest factor in having an expensive health-care system may be having a healthy economy.
All the debate may be a waste. As Canada gets poorer, spending will decrease; as we get richer, spending will increase. No matter what. Surely, that implies that the rise of for-profit health clubs in recent decades probably has a lot to do with our increasing wealth as a society.
But it also implies that the surest way to kill health care in Canada would be to kill our economy. Romanow should have simply given a lesson in good government.
Of course, I’m exaggerating. Romanow was analysing much more than costs. But it is hard to question the assertion that the rapidly rising costs of health care were the primary impetus behind Romanow’s study.
Probably one of the most-quoted passages in the report reads: “More funding must not go simply to shore up the status quo – it must buy change.” Later, the commission follows up with a more specific threat: “If the status quo continues, the result will be the eventual unravelling of Canada’s health-care system into a disparate set of systems with differing services, differing benefits and differing ways of paying for health care across the country.”
So, if we’re going to change, we may as well apply real-life lessons from a related business: fitness clubs. The fitness business is likely more related to traditional health care than you would think.
Fitness is a business where the government (mostly municipally) holds the dominant position. It’s similar to the way health is controlled by provincial governments. Apart from the public fitness clubs, non-profit clubs (such as the YMCA and YWCA) have found a role; even for-profit fitness clubs have been providing services that government can’t or won’t provide.
To wit, there are privately owned fitness clubs that serve alcohol; some have TVs in workout areas. I can’t imagine a publicly owned or publicly supported (private, non-profit) club being allowed to provide such “non-health” services, but there is obviously a market.
And there is an argument to be made that providing the alcohol and TV could be encouraging people to work out who might not otherwise.
Additionally, some companies such as Spa Lady forbid men, a potentially illegal proposition in a publicly administered facility.
For-profit clubs provide a much wider array of services (lounges, boxing, computer golf, etc.) than do the public ones, or even the non-profit fitness clubs.
