Evidence Based Decision Making

Responsible government is tasked with making endless decisions on subjects that affect you, whether financially, socially or physically. It should not matter if the issue is large or small, the need to make these decisions based on all the best evidence available at the time is paramount. Being open to change and a difference of opinions is part of the process. Issues like the Olympics, CalgaryNext and the ever present fluoridation of drinking water, are only some of the examples.

CalgaryNext Arena

There is much interest in this issue. We certainly do not want to lose our NHL franchise to another city. At the same time, the city taking on a considerable financial risk to benefit a private organization owned by billionaires and employs millionaires does not seem to be a reasonable use of scarce civic financial resources. We all know the example of Edmonton and their recent new arena that had funding arrangements from both the City and the Province. It has been a hit – attracting many acts that are bypassing Calgary. The cities of Vancouver, Ottawa, Toronto or Montreal are not mentioned, though their existing teams built their own arenas on their own dime – all to great financial success. From a fiscal management point of view, the latter options are far more appealing. I am not interested in taking on business risk for the benefit of private enterprise. There is no place for socialism for the rich. If the business case is there, the team will build their own arena. The city may contribute excess land, but no monetary risk taking.

Olympic Bid

Similarly, the bid for a future Winter Olympics is a constant topic of discussion. Based on current information available, I would vote no. While the current report available to the public indicates it would be possible for Calgary to host the Olympics, it does not weigh the financial commitments required against the benefits of hosting the games. The latter can be many, as we experienced to the lead up, during and after the 1988 Olympics. But we also know the costs associated with the Olympics have ballooned and the sharing of the financial risks by the IOC has not been demonstrated. Nostalgia for ’88 and hatred of the IOC are terrible ways to make decisions. There is additional information being gathered to flesh out the full financial implications and long term benefits to Calgary. I remain open to Calgary hosting the Olympics if the additional information gathered makes a convincing case, but at this time, my vote would remain “No”.

Drinking Water Flouridation

This is the historical case in point of how many on council, including our current Ward 7 Councillor, have shirked their responsibility to base their decisions on the full evidence available to them. Here are only a few of the headlines we’ve seen since the decision to remove fluoride for our water in 2010:

Removing water fluoride spiked cavities in kids, dentists say – CBC 2013

Here’s how removing fluoride from Calgary’s water affected kids’ teeth – Global 2016

Why did Calgary cave to chemophobes over fluoridation? – Globe & Mail 2016

Lack of fluoride in Calgary drinking water leads to rise in kids’ tooth decay, study indicates – CBC 2016

Calgary Council, in a very pro forma manner, decided to discontinue fluoridation in February 2011. This despite not one of the aldermen (as they were called at the time) having raised the issue during the previous 2010 election. Furthermore, it was not even raised as an issue when the new 2010 council met for the first time to list its top 100 priorities for their new term. Lastly, fluoridation was originally passed by plebiscite in 1989.

I am no fan of governance by plebiscite, but I do believe that any representative government, whether local, provincial or federal, has the overarching responsibility to follow due process of informing themselves of all evidence to make a decision. If that decision is to over turn a public policy that was put in place by way of plebiscite, that process must be even more scrupulously followed.

Instead the 2010 Council, led by Druh Farrell, dispensed with almost all formality of addressing the evidence on both sides of the argument, relying instead on an internet published 18 page summary of anti-fluoridation commentary by a chemical engineer and professor emeritus from the University of Calgary. Not a medical professional, not a dental professional, not an expert in biology or public health. Not one of the Council members voting against continued fluoridation has professional expertise in any of these fields either. Most disappointing of all, the Council had the opportunity to refer the issue to an expert panel and/or to simply hear testimony from a panel of experts from the Medical Faculty of the University of Calgary who offered their services for free. Both options were rejected out of hand by the majority on Council. It is impossible to have confidence in a decision when council refused to be informed of counter arguments.

In making the decision based on little information and an utter attempt to vilify fluoridated water, this same majority on Council failed to note that Calgary has a naturally occurring level of fluoride in its water supply. Yet none of them asked to have a new, non-naturally fluoridated source of drinking water or an expensive fluoride filtration system installed to prevent this apparent “poison” from continuing to “harm” the citizen’s of Calgary. The logic is lacking, which leads one to suspect the decision ultimately had nothing to do with fluoride but rather the expense of optimally fluoridating the water to help prevent cavities in children – particularly the poor.

Yes, some of the savings from not fluoridating the water supply was set aside to offer direct assistance to poor families – though not one cent of it was spent in two years. This decision has been made with heartless disregard to the poor who are less likely to have dental care coverage and most benefit from water fluoridation. Simply put, there is no other effective means to address this public health issue outside of fluoridation of the public water supply based on all current public health information. Lastly, many of the points that the majority on council relied on to make their decision were simply false, as a follow up editorial in the Globe and Mail pointed out.

What to make of Council’s decision then? It was undertaken with almost no one taking their responsibilities seriously to fully inform themselves on all sides of the issue. Was the wrong decision taken? Based on the preponderance of information in the public domain, it is fairly easy to come to the conclusion that it was. But one will never know, at least not from the process undertaken by our City Council. Blood letting was once an almost universal cure to all that ailed us as late as the 19th century, but it lost its appeal as evidence mounted to the contrary. Are we at that tipping point on water fluoridation? It is hard to know when the process of discovery is largely ignored by many of our elected representatives. A responsible government must be fully informed when making decisions.