Romanow says medicare 'moral enterprise, not business venture'
Roy Romanow has unveiled his landmark report on the future of health care in Canada: his prescription calls for a national drug strategy, home care, increased accountability and a multi-billion dollar injection of new funds. But most all, he says, Canada's health care system must always remain publicly funded.
Romanow has recommended that a floor be established for federal funding, eventually at $6.5 billion above current levels. And he wants better accountability. To achieve that he wants the Canada Health Act (CHA) updated.
The CHA now says the provinces and territories must uphold five standards:
Romanow wants to add accountability to that list forcing Ottawa and the provinces to explain to Canadians exactly where the money for health care is being spent and to eliminate any question that money intended for health care is being spent on other programs.
Ottawa now transfers almost $19 billion every year to the provinces under the Canada Health and Social Transfer (CHST), which includes both health and social programs. Romanow wants to simplify the way the money is paid by separating out the health-care funds. He is also recommending the creation of a new Health Council of Canada to keep an eye on both Ottawa and the provinces.
"Canadians are often left out in the cold, expected to blindly accept assertion as fact and told to simply trust governments and providers to do the job. They deserve access to the facts," Romanow said.
Canadian seniors lobbied for specific changes to the health-care system and Romanow has offered his support.
The report says Canadians should get a national drug strategy, but one with limits, and home care should be insured. Both, he says, are important new ways to improve health care.
"We insisted that until we get long-term home care and pharmacare included in medicare, that we will not have true medicare in Canada," Nelson Muise, the president of the Cape Breton Council of Seniors and Pensioners, told the Cape Breton Post last month.
Romanow has heard the complaint and has sided with those seniors who fear having their life savings wiped out if they have to pay the full cost of prescription drugs.
The report calls for improving prescription drug coverage. The recommendation falls short of the hoped-for national pharmacare program many seniors asked for, but the report says that establishing a national drug agency will "contain drug prices and provide comprehensive, objective and accurate information to health care providers and the public."
But Ottawa should bring in a program to cover so-called "catastrophic" drug costs, such as those faced by HIV/AIDS patients drug costs that can quickly wipe out a patient's life savings. The report also says those who want to be nursed at home should not to have to pay, calling for a national platform for home-care services.
It also supports an increase in the supply of advanced diagnostic services, such as MRIs. Romanow calls the current growth of private MRI clinics "troubling."
Defending public health care
But the Romanow report is, at heart, a strong and eloquent defence of Canada's publicly funded health care system. The former Saskatchewan premier says there is no place for a private system. Medicare, he says, is not only viewed as a right of citizenship, it defines Canadians and must remain public.
Romanow said "evidence has not been forthcoming" that greater privatization will improve the Canadian health care system. "I believe it is a far greater perversion of Canadian values to accept a system where money, rather than need, determines who gets access to care."
But there are questions about how much attention will be given to the $15-million report, compared with other legislative priorities facing the government.
The Romanow report's call for a revamped, re-energized and better funded health care system in Canada may be powerful reading, but it is unlikely to be a blueprint for rapid government action.
Besides health care, there are already urgent calls for extra funding for defence, education, research and development, housing and urban centres. And with the prime minister fighting off challenges to his leadership, there are fears the report may not get the kind of attention Chrtien promised when the royal commission was announced.
Analysts believe Romanow needs Chrtien to hold on to power long enough not only to get the report's recommendations accepted by both Ottawa and the provinces, but to see those recommendations put into action.