Public smoking ban a simple way to save lives, MLAs say

VICTORIA - Pretty brave, those Liberal backbenchers on the health committee who took a stiff shot at their government's smoking policy.
It's been almost three years since the Liberals over-ruled the WCB and said people could go on smoking in bars and restaurants, despite the health risk
The result, based on the latest report from the legislature's health committee, has been more sickness, death and hundreds of millions in health costs.
The committee - 12 Liberal backbenchers and New Democrat Joy MacPhail - has just weighed in with its latest report, focusing on ways of preventing illness and injury.
And although the skittish Liberals stopped short of calling for smoking ban in bars, restaurants and other public places, they might as well have.
The committee said municipalities should ban smoking, since a provincial government ban might seem too intrusive to some people. (Never mind that other provinces seem to have found the will.)
"More communities should consider banning smoking in all public buildings, particularly in bars and restaurants," the committee recommended.
The most direct beneficiaries would be the people who work in those businesses.
"This move is most important to protect restaurant and bar workers, who must inhale secondhand smoke and risk harm by tobacco's hundreds of toxic elements," the committee warned.
Why do they have to risk harm from toxins? Because the Liberals gave in to a fierce lobby from the industry and - for the first time ever - over-ruled the Workers Compensation Board order that employees not have to work in smoke-filled rooms.
It's not just the employees who are at risk. The committee reports that legislation banning smoking may be the greatest help to smokers who have the most difficulty quitting. A public health study found that 36 per cent of ex-smokers cited legal bans as the prime motivation; smokers who tried to quit were three times more likely to succeed when a ban was in place.
It's not really a question of an individual's right to choose to risk illness. As the committee noted, the current policy puts the health of employees in bars and restaurants at risk.
And anything that encourages smoking, or makes it harder for people to quit, costs us all money. The committee report says that about 16 per cent of British Columbians now smoke; getting that down to 12 per cent would save $160 million a year in direct and indirect health costs, plus much more in lost productivity and social costs.
Sadly, the committee wimped out on advocating a province-wide ban. Instead individual communities should ban smoking, it suggested.
But they've had the chance to do that, and many of them haven't. (Sixteen municipalities across the province have ordered full or partial bans on smoking in enclosed public spaces.) Many of the holdouts complain that a municipal ban penalizes local businesses. If smokers can simply drive outside the city boundaries and smoke in a bar, then establishments in the city will be unfairly penalized.
The committee has delivered a useful report taking aim at our individual responsibility for our own health.
The public debate around health often centres on waiting lists and drug costs and what kind of care we can afford.
But it needs to shift to focus much more on obesity and exercise and healthy food choices, all things that can enhance our individual health and save the system a fortune. Even modest progress on preventing chronic diseases and avoidable injuries, increasing physical activity and reducing obesity and smoking could save close to $1 billion a year.
We spend almost $11 billion on health care in B.C., with more than 97 per cent of that going to treat people when they're already hurt or sick, often from preventable causes. "We have a sickness care system, not a health care system," the committee reported.
The committee wants spending on prevention doubled, to six per cent or $660 million a year.
The government should quickly promise to meet that goal.
Footnote: The committee found up to 40 per cent of chronic diseases could be prevented. Obesity is on track to replace tobacco as the number one preventable killer. More exercise and healthier food choices could do more for health that a dozen MRI machines.

Autism ruling sound; now the province should pay up

VICTORIA - OK, the province doesn't have to pay for treatment that could save autistic children from disastrous lives.
But it should.
The Supreme Court of Canada disappointed parents who hoped it would uphold B.C. court decisions requiring the provincial government to pay for intensive treatment for their autistic children.
The charter of rights and freedoms doesn't guarantee that Canadians will receive the health care they need, the court ruled, only that the provinces will provide core services - the things doctors do, and the care offered by hospitals. Other treatments are optional, and the province's right to say no will be increased if the treatment is new or controversial.
Painful for the families, who say that if their children had cancer they would get treatment without question.
But the ruling is realistic. Governments are elected to make decisions on how much money should be spent, and on what. The charter, and in this case the Canada Health Act, offer minimum guarantees and bar discrimination, but the politicians retain much of the power.
However their exercise of that power should reflect our will, and most British Columbians would support the parents' push for treatment on the grounds of both compassion and common sense.
The parents of four infants diagnosed with autism argued in this case that the government should pay for Lovaas therapy for autistic children, a program that requires intense one-on-one work and costs $45,000 to $60,000 a year. The government will now provide a maximum of $20,000 per year for treatment for children under six. Parents can either scrape up the rest of the money, or accept lesser care.
The therapy was controversial when the court case began under the NDP government, but B.C. courts found that in "some cases" it could produce "significant results."
For a parent, that's enough. Autism remains a baffling syndrome, one that too often locks its victims behind walls, unable to communicate with other people or form relationships, shunned because of odd behaviour. What we do know, the Supreme Court noted, is that 90 percent of untreated autistic children end up in group homes or other residential facilities.
That's not something you or I want for our children. And it is not something, that as a society, we wish upon other people's children.
It's also not something that makes any kind of business sense. The therapy costs about the same, per year, as residential care. A half-dozen years of treatment can head off decades of costly care. The right, and smart, thing to do is to help families help their children when it can make the most difference.
The Liberals used to think that too. About a year before the election Linda Reid - now the junior minister for early childhood development, then the children and families critic - said the province should be paying for the Lovaas therapy if families find it to be the most effective treatment.
"It doesn't work for every child," she said at an autism conference. "In the view of the opposition this has to be a choice for families.'' The NDP - which began the court fight against having to provide the care - was dithering while children and families suffered, Reid said.
None of this is simple. Governments have to choose among competing priorities all the time. Attorney General Geoff Plant says the therapy could cost $250 million a year, instead of the $30 million now spent on autism treatment for about 2,600 children. (Parents put the extra cost much lower, under $100 million.)
But if the treatment could save thousands of children from a difficult and costly life it seems a bargain - just as the Liberals used to argue.
The Supreme Court ruling does reinforce an important principle. We elect governments to make choices about what is important to us as a society, balancing our priorities and concerns.
That's their job, not the courts, and it's a reminder of why politics should matter to us all.
Footnote: The Supreme Court is still weighing an even more critical case about government's obligations. A Quebec man is challenging that province's failure to deliver basic medical care in a timely fashion. The ruling could tilt the health care debate in a whole new direction.

Offshore report weak, bad news for Liberal plans

VICTORIA - That was a disappointing report from the Priddle panel on offshore oil and gas development.
And it's going to pose a huge problem for the Liberals' hopes for offshore riches.
The federal panel was supposed to find out what British Columbians think about development off the B.C. coast, and come up with conclusions and recommendations.
The hearings went OK. But the panel members did a poor job of bringing their expertise to the task of analysing the information and coming up with useful recommendations.
Instead, the panel focused mainly on a count. How many presenters were for lifting the moratorium, and how many against.
Mostly people and organizations were against. Three out of four of the almost 4,000 people who presented to the panel opposed lifting the 30-year-old moratorium on offshore development.
But the panel didn't consider the size of the organizations being represented by presenters. Comments by one concerned person, perhaps with only a limited rationale, were given the same weight as major presentations by organizations like the Western Canada Wilderness Committee or the B.C. Chamber of Commerce.
The panel didn't attempt to analyze the issues, and decide which were critical. And it failed to come up with a clear recommendation on what should happen next. Instead, the panel outlined four options and threw the problem back to the governments.
The report is still useful. It notes, for example, just how deep the divisions are between people on the opposite sides of the issue and warns of the near impossibility of compromise right now. The panel also found that there hasn't been any sort of broad discussion of the issues involved, and said that needs to begin.
But the report is a lot less useful than it should have been. The panel had the expertise. Roland Priddle is a former National Energy Board chair; Diana Valiela practises environmental and natural resource law, and is expert in salmon management and habitat management; and Don Scott is a former Prince Rupert mayor, with a lot of experience in the economic issues of the north coast.
They didn't do enough.
Energy Minister Richard Neufeld reacted crabbily to the report, which poses a big threat to Liberal hopes to have offshore development by 2010.
The federal Liberals are already split on the issue, and in no hurry to lift the ban. They now have more reason to delay, able to point to the lack of support within B.C. for any change. (They'll will also be mindful of the potential lost votes in the Lower Mainland when Paul Martin's minority government once again faces the voters.)
The report makes it extremely unlikely that the moratorium will be lifted without a lot more time and work.
That's also the view of former Newfoundland premier Brian Peckford, who has been through the process of opening the offshore. Peckford, who lives on Vancouver Island now, says that without broader support governments won't be able to go ahead with offshore drilling. He proposes a two-year review, led by a three-person panel representing both governments and First Nations.
Their job would be to get more information out, encourage discussion, fill the scientific gaps and come up with a recommendation on next steps.
The provincial government wants to go quicker. It sees the potential of tapping offshore oil resources worth up to $110 billion - ten times the potential of the Hibernia field that brought a boom to Canada's East Coast. And it points to the energy industry's success in drilling safely on coastal waters around the world and generally positive scientific reviews on the risks in B.C.
But the moratorium is not going to be lifted anytime soon.
Even with its flaws, the panel's report showed that the B.C. government has to do a much more effective job of increasing public awareness of the issues, and building support, if it hopes to tap the wealth under the ocean floor.
Footnote: The panel came under heavy attack by environmental groups during the hearings, as they complained about Priddle's energy industry connections and Scott's past support for a review of the moratorium. The enviros ended up very happy with the final result.