For Your Information
The Romanow Report
The Commission on the Future of Health Care in Canada, led by former Saskatchewan Premier Roy Romanow, tabled its interim report in the House of Commons on February 6th. The 70-page Report summarizes the fact finding and research done by the Commission to date.
According to Romanow, the interim report is intended to serve as a framework for the Commission's public consultation process (public hearings will be held in Winnipeg on March 6th). While his final report will offer a series of recommendations for health care, the interim report confines itself to a series of observations, without drawing any conclusions.
The Commission's mandate is to advise the Government of Canada on how to "ensure the long-term sustainability of Medicare and to ensure it continues to deliver timely, affordable and quality health care services to all Canadians." The Commission's final report is due in November of this year.
According to Romanow, it is important to note that the health care system is not, in fact, in crisis. He provides some financial data to back this up. For every dollar spent on programs and services, provincial governments spend an average of 40 cents on health care - up from 35 cents five years ago. However, the report points out, health care expenditures as a share of provincial revenues account for the same proportion - 32.5 per cent - as they did five years ago. This is largely due to the fact that provincial governments have slashed spending on other social services. Furthermore, the reason the federal government established the Commission is because governments (provincial and federal) say they cannot meet rising health care costs.
The report does acknowledge that on average, provincial health care costs are rising by about seven per cent per year. This increase is almost entirely due to two factors: the soaring costs of prescription drugs and an increase in the number of people living in chronic care facilities.
In his report, Romanow points out that the 1984 Canada Health Act does not specifically deal with pharmacare, home-care, chronic care and a number of other fields which have become permanent features of the health care systems in every province. Romanow writes that the Commission is seeking "input and advice on whether and how to modernize the CHA."
The interim report, in establishing the framework for public consultations, posits that almost every proposal for reforming the health care system can be categorized into one of the following perspectives:
1. Medicare needs more money and this should come from public investment.
2. Medicare needs more money but any new investments should come from individual Canadians through co-payments or user fees.
3. Allowing more private sector participation (non-profit and for-profit) would increase consumer choice and relive pressure on the public system.
4. The system needs fundamental reforms to increase efficiency, not more money.
In a news conference following the release of the interim report, Romanow stressed repeatedly that he rejects the assertion the medicare is in crisis.
"I want to say at the outset that I am convinced that the Medicare house needs re-modeling, not demolishing," he said. "In the coming months, I want Canadians to tell us what they want and expect their health care system to provide, and what they believe they and their elected representatives must do to give expression to their objectives. I also want the expert policy and advocacy communities to come forward with options and solutions for strengthening our health care system."
Romanow also called on provinces to hold back on any wholesale changes to their health care systems until his final report is delivered in November. However, the governments of British Columbia, Alberta and Ontario have all said they will continue to move ahead with proposed changes.