Dr. Noralou Roos: Why those in Poverty have the Poorest Health and Highest health care needs.

This podcast was recorded on the ancestral lands on Treaty One territory, the traditional territory of the Anishnawbe, Cree, Oji Cree, Dakota, and the Dene peoples, and on the homeland of the Métis nation.

This is Humans, On Rights. A podcast advocating for the education of human rights.

Here's your host Stuart Murray.

Dr. Noralou Roos is a professor Emerita in community health sciences at the Radio Faculty of Health Sciences at the University of Manitoba, Founding director of the Manitoba Centre for Health Policy.

She received funding for the Canada Foundation for Innovation to create Canada's first data laboratory containing population-based data on health, education and social services, and held a Tier one Canada research chair.

Citations to Dr Roos' work place her among the top 100 Canadian scientists, according to the Institute for Scientific Information, she was a member of Prime Minister's National Forum on Health in the Interim Governing Council.

She has received the Order of Canada.

She has projected with the media to ensure evidence on high profile health policy issues is accurately communicated, and she currently is co-director of the Winnipeg Foundation, supported Get Your benefits project to work with health care providers and community groups to ensure poverty is diagnosed and treated by helping people access the benefits from which they are eligible.

And I'm going to just close before we get into a conversation with my guest today.

Dr. Noralou Roos, You have a PhD from the Massachusetts Institute of Technology, commonly known as MIT.

Very, very impressive, Dr Noralou Roos.

Welcome to Humans On Rights.

Thank you very much, Stuart.

And let me start by saying that I do acknowledge that I live and work on Treaty one land, and I respect that.

This is an important time to understand and discuss the harms and mistakes of the past.

And we have to figure out how to move forward in the spirit of reconciliation and collaboration.

So Noralou.

I mean, you know, when you talk to somebody and they say they received a PhD at M I t.

That's some pretty heavy stuff.

But you've got a path that took you there.

I'd love to explore the path of how did you become interested in medical research?

Did you go to school here in Manitoba?

Tell me a bit about how you eventually became an M I t grad.

My whole well, not my whole life.

My early life until I came to Manitoba, was a very back and forth interesting process.

I was actually born in California.

I went to high school in a small town in Oregon.

My father at that point worked in a sawmill and supported me by borrowing money to go to Stanford on a scholarship.

And that's where I met my husband, who came from a very different background in San Francisco.

He was already at M.

I T and encouraged me to apply.

There.

I did was accepted, and we were in political science at MIT, which is sort of a crazy area, particularly at MIT, and in fact, seeing how Mitt pushed their undergraduates.

I always swore I would never allow a child of mine to go to MIT.

However, it's been a great credential, and we were offered Well, my husband was offered a job when we graduated from finished our degrees to go to Northwestern University, and at that point in time, in political science, nobody wanted to hire me.

They couldn't possibly have to married people in the same department, so I had applied to various other places around Northwestern without much success.

And finally, my advisor, who was fabulous at MIT, phoned his friend at Northwestern, who was in the business school, and said, You know, I've got somebody who's you should really hire And they were expanding into policy analysis in the business school.

So they offered me a part time job and I started, and actually it turned out to be very interesting.

But my husband decided at that point that being in a business school made more sense than being in political science.

And when John Monday, who was in the dean of the business school at University of Manitoba, sent a letter which was posted on the board saying, We're looking for faculty to join the business school less over my name sent a letter to University of Manitoba and said, Both of us would be interested in potentially coming.

And we were brought up for an interview and basically offered the job two jobs, and I was initially I have to admit a Paul.

This was back in 1972 and my father had grown up in Minnesota and I heard these tales of walking to school in the snow, and I just somehow couldn't believe that anybody could actually do this.

So we came to Manitoba.

It was obviously the best decision, both career wise, personalised we've ever made.

We love it here.

My kids, my daughter came back to Manitoba is here now with three grandchildren, and I couldn't have had a better life.

I must have there.

So as I said, it was complex.

But what a wonderful way to start.

And it's fascinating, though.

Nora Lou, when you talk about sort of the California, the West Coast American, the Oregon Peace and hearing about the University of Manitoba in Winnipeg, Manitoba, it's always interesting to get, you know, people's first reactions and years is probably not unlike a lot of others.

And I think your story is again not unlike a lot of others who come with some trepidation.

Not sure, but then, you know, try to get people to leave Winnipeg after they've been here for a short period of time, and it's almost impossible.

It's just an interesting sort of part of who we are and why I think we as Winnipeg's and Manitoba's.

We we don't really care when people talk, you know, talk about Manitoba in Winnipeg in a bad way because we know better.

I mean, we live here, it doesn't bother us.

And once people experience it than, like you and your husband, this is permanent home.

Absolutely.

It's a very interesting place from that perspective.

I just think that it's always fascinating, and I love sort of the way that you talked about your kind of academic journey.

It seemed to me that there was a bit of a political science interest early on in your career.

I don't read that in some of the things that you have done since you've been in Manitoba.

But did you, at some point, have an interest in sort of the policy around politics?

That's a very interesting question.

At one point, I was sure I was going to be the first US female president.

Okay, I was.

I was president of my small class in Oregon and had quite enjoyed that aspect of it.

What Mitt taught me, which is in retrospect, very interesting and hugely useful was how to use computers.

They were just starting sort of a computer revolution, and for our research, we had access to a higher level of computer stuff than probably anywhere else.

So that's really what I learned at MIT.

I taught there for six months, and I taught American politics, and I was always teaching something which I really didn't know anything about.

I felt it was weird, but when we came here, interestingly, I was in the business school for where my appointment was, but I had gotten involved with health issues.

I had a scholarship to go to Washington, D.

C.

For a period, and I met somebody from BC who was head of health policy stuff in British Columbia.

When I came to Manitoba, he introduced me to people in the medical faculty here, and they were just setting up at the medical faculty.

I don't have an MD, and the fellow who was setting up that department asked me to join him.

So I had a halftime appointment there, which is where I've stayed for my entire career, and it was a great opportunity, and I, at one point when I was about to retire, took Arnold Naimark, who was Dean.

When I came to the faculty, I took him out to lunch because He was one of the key people in my career and I wanted to say thank you And I said, You know, why in the world did you set up this department in the medical faculty of all of us, non physicians?

And he looked at me and he said, Nora Lou, you do realise that in 1970 Universal health care was introduced in Manitoba.

That's when they started funding hospitals.

I decided it would be useful in the medical faculty if we had somebody there who knew something about some of these policy issues.

And that's why he had started this group.

And I thought that was it was very interesting, and that is how I got involved.

And nor do I.

I look at sort of this transition as I listen to you.

You talked about your time at M I t.

Learning about the computer, how it worked sort of some of those elements of it.

And it's interesting that that is something that has made you create Canada's first data laboratory.

You know, as I mentioned at the beginning that getting data on health, education and social services, and I suspect that that was an opportunity for you to use some of that M I t knowledge and bring it and transfer it here to the University of Manitoba.

Absolutely.

That was an incredibly great opportunity.

When I first arrived, the fellow who was head of the department introduced me to several people, including Paul Hendry, left, who was then a physician at Manitoba Health, then called Mhsc Manitoba Health Services Commission.

And as I was talking to him, I realised that every time somebody goes to Physicians office, every time somebody is discharged from hospital, a record is created, which identifies what the diagnosis is, what's going on and that if one started putting these together, you could really understand in a very different way what the possibilities are for understanding effectiveness of treatments, etcetera.

I basically told Paul, I said, Is there anything that you would like to have researched?

Answer.

Because you've got some data which nobody else in the world, frankly, is using right now.

And so somebody had died after having their tonsils removed, and he said he would really like to know what the problem was.

How frequently are people following appropriate procedures when they do this and etcetera And so we started out doing research on Con Select Amis, and, uh, we went from there.

One of the challenges.

When you start a patient comes in and provides information, so that data exists.

Does it make sense for that data to follow a patient through a process?

Or does it make sense for that data to stay with a doctor or medical person who then has the ability to transfer it when required?

That's not an area that I've thought a lot about.

I think it is important, for I find now when you go into a positions office, it drives me a little crazy When the physician doesn't look at you, they spend all their time typing the information into the computer.

But it is very helpful when they know when you come back.

Two years later, what has happened then?

That really was what you were talking about.

It was on sort of the tonsillectomy, and that whole issue was more of the research around.

Why did that happen?

Capturing that data so that the next time something was, you know, another patient came in that had similar issues around tonsillitis or a tonsillectomy.

There was data that you could then use to sort of engage or learn from that.

Yes.

For sure.

Yeah.

Okay, so, doctor nor Lou Ruse, You know, one of the things that we chatted about and I thank you so much for coming on this podcast was the fact that December the 12th is universal health coverage day and and so, you know, we're really sort of focused on local issues as opposed to universal issues.

But I wondered if you could make a comment in, just generally to get into this conversation about quote unquote universal health coverage.

One of the challenges, it seems to me is, you know, I mean, I know it's an economic equation, but it's all around the issue of supply and demand, and it just seems to me that, you know, when universal Medicare came into Canada and I think it was 1969 that you're basically saying that there is you're offering, you know, unlimited demand on something that has an actual limit of supply.

Do you have a sense in some of your research about how some of those challenges might be met understanding that health care services I have a federal overview, but the delivery of that is really a provincial mandate.

When you suggested we might talk about universal health coverage, my initial thought was, Now what does he really interested in?

So, of course, I googled universal health coverage, and the universal health coverage means that all people have access to the health services they need when and where they need them without financial health.

That, I think, is a very important issue because and this is comes out of a lot of the research which I've done.

There's a very strong relationship between poverty and help.

Those who can least afford to pay for their services are the people who have the poorest health and the highest health care needs.

One of the examples that we use from research that we did was that life expectancy at one point in the Winnipeg North end was 16 years shorter than in the high income areas of Winnipeg.

And this was just to me an enormous the impressive number.

I'm just gonna interrupted one second doctor nor Larus because that is an unbelievable statistic that you just came out, and I you know, part of it might be to say while this research goes back to the early 19 hundreds, the 19 twenties just put a timeframe on that because that's staggering.

I'm not sure that it's much different now than then.

Well, but to me, also the interesting thing, as people tend to say, Oh, well, was probably drug overdose or it was self inflicted.

If you look at why people die who live in the poorest areas of Winnipeg, they're basically from the same diseases.

The people who live in the highest income areas.

Cancer and heart disease.

Circulatory disorders are the two most frequent causes of death in both areas.

So that also is, I think, really important to appreciate.

And I just put it in context.

Nor Luke.

You know, the notion that universal Medicaid or Medicare came into Canada and the idea of being is that, you know, everybody has access to health care that it is.

I mean, I always went through this notion of this conversation when people said, Well, you know, in Canada, health care is free, you know, that's a bit of a misnomer, for sure.

I mean, taxes pay for health care, but in terms of your ability to go into a hospital or to a walk in clinic.

Yes, you don't walk out with a bill, but tell me a little bit about what you discovered in your research that would show that if health care or access to health care is quote unquote free, why are those numbers so staggering in the north part of Winnipeg?

That is a very important point.

We find that because although we tend to think that it's access to healthcare, which drives how healthy somebody is that wait Times, et cetera.

The Canadian Medical Association created a summary a few years ago of what drives health, and what they concluded was your life, which includes income, early childhood development, disability, social exclusion, colonialism, aboriginal status, safe and nutritious food, housing and homelessness.

Etcetera contributes 50% to how healthy you are.

What makes Canadians sick?

Healthcare access wait times.

Quality of the system contributes 25%.

Biology contributes 15% the environment another 10%.

So while access to healthcare is incredibly important because these people are really sick, that's not the only thing that drives what makes us healthy.

What makes us not so Would you say that some of those numbers could be through whether it's through policy or through some mechanism.

Could some of those numbers be changed in terms of the percentage of those numbers that would allow for, you know, less people dying for the issues you just mentioned in the North End?

Absolutely there was.

This was some time ago I read a paper which was looking at they were planning on spending $350 million putting $300 million into the hospital system in Ontario.

And so one of their economist did an analysis and said, You know, if what you really want to do is to improve the health of those who are in Ontario, you should consider alternative expenditures for that 350 million, for example.

With that money, you could fund 70,000 rent geared to income housing units, 450,000 subsidised daycare spaces, 12,000 transitional shelter beds, and that it's likely that these investments would have a much bigger impact on improving health than putting 350 million into the hospital system.

So I think that's one of the reasons we've got involved in this.

Get your benefits project is trying to make health providers understand that diagnosing and treating poverty is an incredibly important part of making people healthy.

So let's just reference that one more time because I mentioned that in your into your intro nor Lou that your co director of the Winnipeg foundations supported Get your benefits and I'm going to say Get your benefits again because that's I believe the name of the project.

Tell us a bit about what that is doing specifically and what you're working on right now.

Well, one of the things.

And again I get involved in all these projects without knowing much about them.

And this one.

Hey, you were going to be the first female president.

United States.

Come on, Let's just put this in perspective.

I was working with people across the country trying to help them get evidence into the media, and one of these people was a physician in Ontario who runs an inner city health clinic.

And he had an opinion editorial op ed in the Globe and mail, which said, this time of year I prescribed filing taxes to my patients and went on to explain why he does this in terms of money withheld from their paycheck.

If they're working at Starbucks or somewhere for minimum wage, and they end up earning less than 40,000 during the year, which is often true, all the money that's withheld, they get back.

It also makes them eligible for benefits, etcetera.

So I contacted our local paediatrics association and doctors Manitoba and said, You know, why don't you do something like this in Manitoba?

And we started talking about opportunities for for working on this, And that's really how I got involved in this And the idea again, Nor Lou, is that you want to work with health care providers, community groups to ensure, as you say, that poverty is diagnosed and treated by helping people to get benefits, which they are eligible.

In other words, there's a lot of people out there that when you have these conversations, are there in the community, and these conversations take place that they may look at you and said, I wasn't aware that that was something that was available to me.

Absolutely.

One of my favourite examples was I was a big sister to a young man who had a fellowship his last year in high school to help him prepare for university.

And so he as part of this fellowship, he was working two nights a week and a couple of months during the summer at Y W c A.

And when I saw the data on this tax file, I said to him, Did you file your taxes this year?

And he looked at me like I was out of my mind.

He said, Nor Luke, I can barely afford an extra cup of coffee.

I don't want to give the government more money.

And I said, No, no, no, you don't understand.

He filed taxes.

He got back something like $800 and this was huge.

And when you look at, there are free tax filing clinics in Manitoba.

In Winnipeg, they're called C V I.

C v I v i.

T.

P yes, one of the Northway building.

They bring back literally millions of dollars to low income Manitoba ins by helping them file their taxes.

So that is one thing which we've been very much pushing and how how are you finding the ability to when you say we're pushing it?

How are you pushing it out nor Lou, because I think always and I want to ask you that question that I want to kind of set it up for the next one because you wrote a policy or you were part of a policy paper that talked about needing more Canadian health policy in the media.

But I want to ask that question second, But first of all, how are you pushing out to people?

This information that there's a service that will actually follow your taxes for you?

How's the project doing that?

Well, when we were working with the Winnipeg Foundation and trying to describe what we actually do that we had, our grant was renewed for another two years.

So what we really do is we make contacts and we work with the group Community Financial Counselling Services, which runs the Northwest Clinic and which does all this fabulous work they were interested in.

Trying to demonstrate for their purpose is how much they actually do and how what's going on in Manitoba.

Well, I have had conversations with the Canada Revenue Agency's, and they're interested in providing data if you specifically ask them and tell them what you want.

So just last week.

We put them in touch with the people in Winnipeg who are doing this and said, You know, ask your questions and they will help you.

We do the same thing with There's a Canada learning bond, which makes with kids who are turning 18 in January.

If their parents have been contributing or have filed for this Canada learning bond, they're eligible for up to $2000 from the federal government.

And there are thousands of people in Manitoba who are eligible for this but who have never filed.

And so we have been trying to.

I was contacting people in superintendents of schools, the University of Manitoba, Red River, various people trying to put them in touch with the federal people who can give them.

They will send a letter to every eligible child saying You can claim $2000 basically are up to $2000 and we sort of put everybody in touch to try and make sure that they ask the questions.

They're aware of this programme because a lot of them aren't even aware of the programme and that they get the material which they need and can distribute to their students and say, You know, if you get this letter, it's real.

It's not.

People get so much scam stuff now that you have to figure out some way.

How do you know when something is real and you can work with it?

So that's that's a big part of what we do, you know, and and it's like really, really important and very impressive initiatives to take on.

One of the challenges so often is there are these amazing programmes that ones that you just described if people were made aware of it, it's that issue of how do we communicate to people who number one?

You know, frankly, if somebody stops, somebody almost quote unquote on the street and indicated to them that, you know, look, are you aware of this project?

And if you are, if you're not, here's how it works and you can actually access $2000 if you proceed and do the following.

I think they look at you like you're crazy, you know?

I mean, part of it is just trying to make sure that people understand.

As you said, there's not a scam, there's nobody asking it and and part of it is.

I want to just see if I can explore a little bit with you because I was fascinated with something that I believe you were part of.

Nor Lou, please correct me if I'm wrong on that.

But, uh, some of the research I did show that you talked about an article or wrote an article about why we need more Canadian health policy in media, you know, So there's two elements that I want to talk about.

Their one of them is maybe to talk a little bit about where we are with covid and understanding the vaccinations, et cetera.

The vaccinations, I should say.

But coming back more to what you're talking about with your get your benefits project, which is local something while it's a federal programme.

But it's a local thing funded by the Winnipeg Foundation, you know you're going to, as you say to the university, to Red River to various places to school divisions to try to make sure that that information is is given to those that need it.

And can I just ask, are you in a position now nor allude to say that you're starting to see some uptake that you're starting to see.

It may be slow, but the point is, is that you're seeing some progress, and some progress means that there will be more progress down the road.

But are you?

Are you seeing some uptake on the project to date?

Yes, I think we are.

We have a it's called Get Your Benefits booklet.

It's a fact.

Better income can lead to better health, and we've distributed over 100,000 copies of this booklet.

It's available online through Manitoba Health and through the Ministry of Education.

Or we take it out to community agencies, etcetera that want to have a copy to distribute.

And it started slow but has every year many more copies are requested.

Another project which we've done is there's a first book, Canada Project, which, if you're serving low income people and apply for this, you can access up to 3000 and three books, and we started working with people several years ago telling again, just telling people to apply etcetera.

They've increased every year.

Last year, when they were here, they asked us if we would take all of the extra books that they ended up having because they go from province to province.

And rather than taking them on to Saskatchewan, they were happy to leave them with us if we could find a place for them.

My assistant, Eileen and I are car was completely packed and they were marvellous books.

And we took them to health clinics to various things people were very interested in because if you have free books, you can give them to people who otherwise don't have access to them.

And just to be clear on this on this project, nor Lou, these books would be more like novels, if you will.

I mean, could be they could be mystery books.

That could be This is not something.

So these were for kids, Okay?

They were from grade 1 to 12.

Basic?

Yeah, And people could say, you know, what age group were they looking for?

And I could see the title.

So it wasn't People were concerned.

Are you pushing a certain type of thing?

We had a list of the titles and people said, no, that's not an issue, right?

Okay.

And normally what I'm gonna do is I'll circle back with you just to get some of these websites that we talked about here so I can put them into the episode notes that if anybody is listening, people can go to the episode notes and they can go online and sort of find which which websites to go to.

So I'll make sure that I'll get that from you once were completed here.

So, Nora, you let me go back to what I started out kind of talking about the notion of more Canadian health policy in the media.

I'd love your thoughts on, and it's been a difficult global conversation we've been trying to have around this covid 19 and the various kinds of vaccines that are available.

The NRA.

They're all of these issues.

Pfizer, Moderna.

So lots and lots of information out there.

How would you sort of feel?

Or how do you feel about how the media has been handling some of the health policy issues?

And I'm not asking you specifically to comment on any of the vaccines, but just in a general way, with the role of the media to sort of provide information around health policy as it pertains to, say, Covid, that's a That's an interesting question I think locally I've appreciated the what the Winnipeg Free Press does, where you can track the new number of new cases every day and their graphs and all I think communicates to me very well, sort of what's going on and whether I need to start worrying.

And they also have been tracking where these this is our and reasonably well, who's dying, who's being admitted.

And there was an article the other day trying to think who it was, but who was said, You know, the numbers that people are reporting need to be more clearly stated, and he stated it very clearly that the people who are dying are the unvaccinated or vaccinated.

They're largely kids who were not eligible for vaccination, et cetera, so that, I think, has been reasonably well reported.

I worry about how can people not be vaccinated and where does that come from?

And I'm continually told that comes from the media.

But we don't see that very clearly.

If we're reading regular media like, I can't fathom how people cannot be getting vaccinated Well, it's a fascination, and this is, you know, kind of just one of the things that I get involved in these conversations because it fascinates me, nor Lou.

And when you know my podcast is called humans on rights and so you know people have rights and that is very clear and I support that.

But it's interesting when somebody uses that argument to say, Well, it's my right not to get vaccinated And I look at them and I say I can't argue that But I do think that in a global conversation this isn't about me and you.

This is a global conversation that is talking about the health of a community, the health of a nation, the health of the world that is tracking on the basis that the vaccine is something or a vaccination is something that is.

People getting vaccinated, I should say, is clearly having impacts.

And it's global.

So that notion, it's a difficult conversation.

But, you know, I I do think that the notion of of the global good, the better good of the global community is where we need to focus our conversation versus one person's ability to stand up and say, Well, it's my my right not to get vaccinated.

I don't disagree that it's you're right But the notion that you know you're not going to be able to go into a restaurant or go into an aeroplane or to travel or to be in public places, they might resist that.

But I think that's just they're missing the bigger scale and the bigger importance of what this is all about.

I thought there was an incredibly interesting piece again, then the free press last week by somebody in Brandon Devran Ross, I think, was his name.

Who said It's time for the unvaccinated by choice to bear the cost.

And he noted that if you smoke your life, insurance costs more.

If you drive dangerously, you pay higher licence being car insurance says now there are basically few costs to an individual for refusing to get vaccinated.

But if he catches covid, the health system encouraged big costs.

This should change, and he notes that in Singapore, the unvaccinated by choice are now responsible for the payment of their medical costs, which is huge, apparently, and I don't know where you got these figures.

That said the average cost for someone testing positive for covid was about $25,000 per patient and if I see you as necessary.

It's about $55,000 per patient.

And when we hear about the backups that are happening in the system now, who's responsible for this?

The unvaccinated are responsible.

Yeah, no, nor Lewites, obviously.

And now we're going to find out as they start talking about, you know, kids 12 and up or six, you know, six and up.

I should say, What does that look like?

You know who's going to get that vaccine who isn't.

It's a very, very challenging conversation and one that I think is going to be with us for a while.

But I don't want to kind of end our conversation there because, you know, frankly, I it's just something that I find, you know, incomprehensible.

So I want to kind of pivot back to you the great work that you're doing.

I mean, you know, after I read this this bio, which I could only read a portion of it because you have done incredible work, you have received incredible accommodation for the work that you've done.

And you know, of course, when I said What's your offline?

Before we started, I said no.

Nor Lou, What can I say is your that your current position is and you kind of look kind of through the zoom camera said.

Well, I'm retired, hardly.

You know, you're you're obviously have way too much energy.

You have way too much intelligent knowledge background.

And so when you get involved in projects like to get your benefits project, as is happening here, supported by the Winnipeg Foundation in Winnipeg, those are the kinds of things nor Lou that I think make us a stronger community and why I'm so delighted to have your time and your voice and your thoughts on this podcast.

And I just want to close simply by asking you the question.

And it's It's a big question.

The World Health Organisation has kind of made noises or promises or commitments or conversations, whatever you want to call it, to say that we should have a goal to have universal health coverage globally by 2030.

Is that possible?

I don't I don't have a clue, and I'm not even quite sure what that would mean, You know, in Manitoba, for example, we don't have dental care is not covered, and that's a big problem, particularly for poor kids who have a lot of teeth extracted because they get cavities.

There's no universal pharmacare.

That's sort of an issue.

What I also worry about is, although there is a very good effort that's now going on when we focus on universal coverage, we always think we have to put more money into the health care system to enable this.

But what we also have to do is figure out what are the effective treatments and what are the effective parts that were funding and what isn't.

And there's a group that's called choosing wisely Canada.

And there's a choosing wisely group in Manitoba, which is supported by the College of Physicians, surgeons, et cetera.

And what they're really trying to figure out and promote to physicians is, Is this test necessary?

When is an MRI necessary?

And they've come up with something like 30% of medical tests.

Treatments and procedures are potentially unnecessary well, so I would be very reluctant to push for a huge expansion of coverage everywhere, without very clearly focusing on Is this a youthful expenditure of resources?

Because all these other things finding housing for the homeless, finding better nutrition, basic income They're all sorts of investments which need to be made, which will make people healthier.

And it's not necessarily more health care.

Yeah, and I think that's such an important statement to make, because I think, you know, there's a bit of a myth there, and I think we get caught up in the notion that when there's a challenge around health care, you know, the first pivot is more money, but we have to get more money.

You know, we have to build more hospitals, we have to do more of this and you come back to some of the statistics that you had said earlier on.

And I think that that you know, you we get on this treadmill of just sort of trying to going faster and faster.

At some point, you say Stop.

Let's just do an analysis because it might validate that we're doing is right.

But on the other hand, if we're open, it might validate that we're actually not getting the kind of results that we need to get.

Absolutely.

So I'm I'm gonna thank you for our conversation, Dr Nora Larus, Uh, there's so much more we can talk about and we will at some point I know, but on this topic of universal health coverage and what I loved about, and the purpose of this podcast is really to talk about local people who are advocating or educating around human rights.

And you brought this back to the north end of Winnipeg with something that is kind of depressing.

Frankly, I mean, it's a fact, but it's depressing when you look at the numbers that are what's happening in the north end of Winnipeg.

That's local, and your comments about how we can look at doing things better are very much appreciated.

And I would just have to say on a personal note As my neighbour, it's always great to see you at walking.

And I would just tell you that your your time, your energy today and your commitment to this community is greatly appreciated.

And I thank you very much for that.

Thank you.

Been very interesting to think about these issues with Okay, take care and we'll talk to you soon.

Bye.

Humans On Rights is recorded and hosted by Stuart Murray, Social Media Marketing by the Creative Team at Full current and Winnipeg thanks also to trick seem a bit you in Music by Doug Edmund For more go to human rights hub dot c A produced and distributed by the Sound Off media company.

Hey, podcast listener, this is Andrea.

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