Thinking upstream — new institute invites us to think differently about health and politics

Dr. Ryan Meili has received considerable attention for his short 2012 book A Healthy Society: How a Focus on Health can Revive Canadian Democracy. Little did we know that the book would become a manifesto for a new institute dedicated to change how we think about politics.

The central theme of the book is based around a parable. In it a bystander leaps into a river when he or she sees a young child struggling in the current. After bringing the child safely to the shore, another child appears in the river. The bystander leaps in again to repeat the rescue. And then another child, and another. As a crowd develops to witness this spectacle, a wise person suggests that maybe they should look upstream to see who is chucking children into the river.

The parable is of course about our health system. Increasingly we are struggling to meet demand that results from changes in our society, including the widening gap between rich and poor. But are we really addressing the root causes of that spike in demand?

In his book Meili suggests that poverty alone is costing Canadians $7.6 billion in health care costs, $13 billion in lost income taxes and more than $35 billion in decreased productivity.

Not surprisingly the Saskatoon doctor’s new organization is called Upstream: Institute for a Healthy Society. While Meili has twice been the runner-up in contests for the leadership of the Saskatchewan NDP, he says the new institute is intended to be non-partisan. Rather than promoting a single party, he says it is intended to change the political landscape.

One of the first projects of the institute is to look at how the poverty in the life of a single person winds up costing all of us more.

In his book Meili argues that we need to reframe how we measure social success. While the traditional measure of success has been economic growth, it is not without significant flaws, including lacking any perspective on how the economy distributes those gains.

It’s how we deal with growth that matters. In his book he compares it to the growth of a child: “No one would be satisfied to see a child simply getting bigger without showing some evidence of development; why would we be happy with an economy that grows without being certain that what its growing into is positive?”

While the economy is a determinant of wealth, it should not be the goal itself but a tool towards reaching a goal of a healthier society.

Meili does acknowledge Roy Romanow’s efforts to establish a Canadian Index of Well-Being as a means of looking at the broader environment, although it has struggled to catch on with the media and with decision-makers since being unveiled in 2011.

The doctor says that while income redistribution has become a dirty word, he says we need to rethink our approach. That includes taxes.
While over taxation could impede economic development, the doctor says it has been taken to “ridiculous extremes” that disrupt public services and in the end cost us all more money.

“What we need is the intelligent embracing of complexity rather than blind adherence to ideology and the approaches of organizations like the Canadian Taxpayers Foundation, who act as though (as Prime Minister Harper famously said in 2009) all taxes are bad taxes and all collective investment is a bad deal.”

He says taxes, when properly used, result in a great bargain on things we really need. That average family earning $80,000 per year has a net benefit from their taxes of half that amount.

Meili’s new institute is inviting interested Canadians to sign up at

On the site you’ll see an animation of the central parable behind the organization’s name and purpose as well as a form to sign up for alerts from Upstream.

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