Rather than reiterate what you will read elsewhere, I would like to touch on other initiatives which the CSA has recently undertaken.

In November 2001, under the presidency of Bob Jackson, the CSA was invited to appear before the Standing Senate Committee on Social Affairs, Science and Technology ­ otherwise known as the Kirby Commission. This was an opportunity for the CSA to present our opinion of the Canada Health Act before the committee members, and to underline the fact that Canadian provinces are not in compliance with Section 11(1)(b)(ii) ­ the Portability Principle.

An interim report by this committee had already been released, and we were pleased to note that a number of points raised echoed what we have been saying for years. "There are many critical trade-offs that must be made between the population health and the financing roles... Thus, experts argue that it might be possible to achieve a better return on the health-care dollar by promoting healthier lifestyles for Canadians than by spending the same amount of money on the treatment of illness.¹

The 'ounce of prevention' argument was one that we had been making for a number of years, and we were gratified to note that it was being taken seriously by those who were helping to advise and shape Canada's Medicare system. One comment in particular appeared in the interim report and followed us through to our appearance before the Commission on the Future of Health Care in Canada. "The Committee proposes that the following objectives should apply to the federal government's population health role...With respect to health protection: to strengthen our national capacity to identify and reduce risk factors which can cause injury, illness and disease, and to reduce the economic burden of disease in Canada."²

The CSA is adamant in its belief that wintering away from cold and ice leads to greater outdoor activity and prolonged good health. As a direct result, we are less of a strain on our health-care system in Canada. As well, the major financial cost of medical emergencies, while we are travelling, are taken care of by supplemental medical insurance.

In April 2002, the CSA was invited to appear before the Commission on the Future of Health Care in Canada ­ otherwise known as the Romanow Commission. Again, we discussed why we believe that the provinces should comply with the Canada Health Act ­ most provinces are completely out of line.

Following President Ellen White's presentation, Commissioner Romanow asked for a follow-up report as further substantiation of our submission. This required extensive research but, by May, we had produced a comprehensive report for him, which we believe delivered the facts he requested.

One specific point which Commissioner Romanow raised was that those who didn't travel likely kept active through winter sports ­ were they not as healthy as those who travelled south? We took his question to the public by posting it on our Web site (www.snowbirds.org) which is accessed by Canadians in all walks of life. We asked, specifically, in which warm-weather/cold-weather activities do you participate?

The following illustrates our results:³

The Johns Hopkins Medical Letter quotes research in the British Medical Journal, stating, "deep vein thrombosis (or DVT) are more likely in winter months...Researchers in France studied 65,081 hospital admissions for DVT during a four-year period. The number of admissions in the winter was 18 per cent above average and 18 per cent below average in the summer, possibly because people are less active in winter."⁴

For many who do winter away from Canada's harshest climate, supplemental travel medical insurance is relatively expensive. For some, this is the costliest purchase of the year, depending on the individual's medical history. Travelling without this insurance, however, is risking bankruptcy should an illness or injury occur outside of Canada. In the event of hospitalization, the resulting bill is paid by a private insurance company, at the expense of the traveller. Remaining at home could result in injuries and ailments leading to hospitalization and/or other treatments, with the province incurring this cost.

Commissioner Romanow alluded to the stereotype that retirees living south are in a better financial position than most, and can afford the cost of supplemental health insurance. Both Ellen White and Heather Nicolson-Morrison quickly refuted this line of questioning and, with our follow-up submission, we were able to dispel this myth.

The average Canadian senior, while having a greater discretionary income than that of some younger Canadians, is by no means wealthy by today's standards. The purchase of supplemental medical insurance for many is an exercise in precise budgeting. Statistics Canada has recorded the 1997 median total income of seniors, 65 years of age and older, at $16,000. The median income for husband-wife families increased to $35,600 in 1997.⁵

Wintering in a warmer climate promotes outdoor activity and social interaction. In addition to the obvious immediate health benefits, the National Institute on Aging reports, "Regular exercise can improve some diseases and disabilities in older people who already have them. It can improve mood and relieve depression, too...Staying physically active on a regular, permanent basis can help prevent or delay certain diseases (like some types of cancer, heart disease, or diabetes) and disabilities as people grow older."⁶ Physical activity is prevention. Those who are able to winter in a warmer climate are better able to take advantage of the activities offered to them, and thereby take a proactive approach to their health by staying active.

We will continue to keep a watchful eye on problems related to the health and well-being of our members, both while they are in Canada and while they are away in warmer climates. We are closely monitoring the provinces and the federal government with the hopes that, with close critique, continuing dialogue and ongoing advocacy, we can provide the confidence for long-term travel for those Canadians who wish to pursue this lifestyle.

Within a few months, we will be presenting an evaluation of the role the provinces and Canada play in this field. We are looking forward to sharing it with you.