Romanow takes health care’s pulse

Roy Romanow must sometimes wonder why he ever agreed to this job. As point man on the Royal Commission on the Future of Health Care in Canada, he’s charged with the overwhelming task of diagnosing all that’s wrong with our health care system and coming up with a cure.

Finding solutions to the complex problems plaguing health care delivery in this country-primarily how we’re going to pay for it-is a frightening assignment. But the former Saskatchewan premier is undaunted. He relishes the chance to once again serve his country.

Renew, revitalize system
“It’s the perfect opportunity to help renew and revitalize one of Canadian society’s greatest achievements,” Romanow told CARP representatives at a meeting late last November at CARP’s Toronto offices.

Over the remainder of this year, Romanow will travel across the country, listening to what provincial and territorial leaders, health policy experts, caregivers and, most importantly, concerned Canadians have to say on this contentious issue.

Their informati will form the basis of his final report (to be released in January 2003). Romanow hopes the recommendations contained in his report will “give seniors-and Canadians of all ages-some comfort that there will be a stable, modern, publicly funded health care system around into the year 2020 and beyond.”

“No” to privatization
The “publicly funded” part of this statement may allay fears expressed by older Canadians-especially those living on low or fixed incomes-who worry that privatization will be the inevitable outcome of any discussion on health care.

By the same token, it will disappoint those who were expecting sweeping change.

“I’m not here to build up a competitive, alternative or for-profit system,” Romanow said, removing any speculation otherwise.

“Canadians have a very strong attachment to the ideals of a publicly funded health care system. The system needs to be reformed, not demolished.”

Next page: Status quo will go

Status quo will go
He did, however, attach a caveat: “For this to be a credible study, it’s going to have to look at all the issues, some palatable, some unpalatable. The only thing not on the table is the status quo.”

That leaves ample room for speculation on just what part of the status quo will go.

CARP has submitted a brief to the commission outlining the health needs of the 50-plus population. The Association also hosted a round-table discussion on health care, drawing on the wisdom and expertise of organizations, stakeholders and ordinary Canadians from this age group.

Romanow attended the round-table of national seniors’ organizations, held in February at CARP’s Toronto headquarters.

He says the voice of older Canadians needs to be heard: “There’s so much that they can to contribute to the debate,” he said.

“The aging of Canadian society and its associated costs to health care must be addressed but not from the perspective that it’s some catastrophic event,” he said, assuring CARP that 50-plus health concerns were a priority for the Commission.

Home care, drug priorities
High on CARP’s wish list is a recommendation to secure stable funding for home care and drug programs, two major 50-plus health services not covered by the current Canadian Health Act (CHA).

This is the 1984 legislation which governs health care delivery in Canada. Romanow told CARP these issues could be the next logical areas for expansion.

“I’ve been a strong supporter of the CHA in the past but it’s reached almost chronic status … and may be deficient.”

User fees contentious
Another hot-button issue for CARP is user fees, which the Association feels would punish older Canadians living on low or fixed incomes.

Romanow acknowledged that his commission will seriously examine user fees and cited his own negative experience with this issue.

According to Romanow, a user-fee program (an out-of-pocket charge every time a patient visits a doctor or stays in hospital) was used to cut down on the perceived overuse of medical services in Saskatchewan between 1967 and 1971.

Next page: Studies revealed two things

Studies on the effectiveness of that program revealed two things:

  • Doctor and hospital use weren’t substantially altered
  • Those who were deterred by user fees were those on the low end of the income scale.

CARP further points to other studies of user-fee ineffectiveness but because the health system is desperate for revenue, CARP analysts will be disappointed but not surprised if the final recommendations includes support for user fees.

Commission’s limited scope
However, critics say that if user fees are the most radical change being discussed, the commission will ultimately be a failure. Neil Seeman, a spokesman for the National Citizens’ Coalition, feels the commission’s scope is limited.

“It’s unfortunate that Romanow wasn’t given a larger mandate,” Seeman said.

“So many people these days, whatever their political stripe, are finding themselves increasingly disappointed and constrained by the limits of the publicly funded health care system.”

Long-term solutions
He says that health care in Canada needs more than just tinkering-long-term solutions must come from outside the publicly funded system. 

“We’ve hit the wall financially on health care,” Seeman said. “Increasing specialization, expensive technology and an aging population make it inevitable that we’re going to have to discuss options other than those being talked about by Romanow.”

Despite the critics, Romanow is adamant the system does not need a complete overhaul.

“People who say health care is in a crisis do so to promote an agenda-thus the calls for private health care,” he said.

Though Romanow is obviously aware his report won’t cure everything, he’s convinced it will end the finger pointing and start the process of meaningful change.

And, in the end, the Canadian public will be the judge.

“If the recommendations resonate with them, politicians will take action.”