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A PRESCRIPTION FOR HEALTH CARE Introduction On November 28, 2002, Roy Romanow tioned whether it would be able to find Focus presented his long-awaited report on the all the new funding Romanow had This News in Re- state of Canada’s health-care system recommended. Finance Minister John view story focuses on the Romanow and a list of 47 major recommendations Manley wondered if the anticipated Report on the state designed to reform it. Eighteen months federal budget surpluses over the next and future of before, Prime Minister Jean Chrétien few years would be large enough to Canada’s health- had named the former Saskatchewan cover the great increase in funding. care system. It premier to head a royal commission to Advocacy groups that had mounted a includes the re- investigate the problems confronting strong campaign in favour of preserving port’s major recom- mendations and the country’s health-care system, and to and strengthening the country’s medi- the political re- recommend improvements to it. care system were delighted with sponse to it, as well Romanow’s report, entitled “Building Romanow’s endorsement of it as one of as its implications on Values: The Future of Health Care in the core values of Canadian society. for the country’s Canada,” was unequivocal in its de- One spokesperson for Canadian Friends medicare system and Canadians’ fence of the country’s free, universal of Medicare, Shirley Douglas, the access to it in system of medical care. It rejected any daughter of T.C. “Tommy” Douglas, future years. suggestions that there should be a the Saskatchewan NDP premier whose greater role for a competing private, government had pioneered public health for-profit sector. Instead, Romanow care in the early 1960s, claimed that her called on the federal government to father would have been proud of invest $15-billion in new money into Romanow and his report. On the other Canada’s cash-starved health-care hand, the opposition Canadian Alliance system over the next three years. condemned the Romanow Report as Romanow recommended that over half being the wrong way to tackle the of that amount be spent within two problems of the country’s health-care years, targeting what he claimed were system, namely by “throwing more five priority areas for increased health- taxpayers’ money” at it. Instead, it care funding. Among these were $1.5- called for a greater role for the private billion to purchase more MRI (magnetic sector in the delivery of health-care Further Research resonance imaging) devices and CT services, and the right of Canadians to If you think that the current debate (computed tomography) scanners, $1- choose between the publicly funded and about health care is billion for increased drug plan cover- private, for-profit systems. heated, then age, $2-billion for home care, $2.5- A number of provincial premiers, consider visiting billion for early treatment primary care especially Alberta’s Ralph Klein, the new CBC programs to ease the burden on hospi- British Columbia’s Gordon Campbell, audiovisual archives for a portrait of the tals, and $1.5-billion to improve deliv- and Ontario’s Ernie Eves, were also original stormy ery of health-care services in rural and skeptical about Romanow’s recommen- birth of medicare in remote areas of the country. dations. All of them led right-wing Canada. Visit http:// The response to Romanow’s report governments committed to tax cuts and archives.cbc.ca and ran the gamut from sweeping endorse- more privatization of health care. At the search under ments to pointed criticisms. For its part, same time, they welcomed the call for Politics and Economy. the federal government accepted the increased federal financial support to major thrust of the report, but ques- the provinces to restore levels of health- CBC News in Review • December 2002 • Page 6 care funding that had been slashed in effectively. According to Romanow, the Did you know . recent years. For the recommendations vast majority of Canadians had made it Romanow held 21 days of public of the Romanow Report to be imple- clear, in public meetings and through hearings in 18 mented, a very high level of federal- opinion polls, that they valued the Canadian cities, provincial co-operation would be country’s free, universal medicare received 240 formal required. Whether this would material- system as one of Canada’s treasures. submissions, heard ize in the final months of the Chrétien While they recognized that the system 591 presentations, administration in Ottawa remained an was in need of serious reform, most and received 7000 letters and notes open question. were highly reluctant to support from Canadians as During the months he spent research- changes that would reduce its accessi- part of his research ing and writing his report, Romanow bility to any citizen. Romanow’s report, for his report? criss-crossed the country. He listened to which underlined this viewpoint and a large number of Canadians who were eloquently championed a greater role anxious to present their views about the for government in providing and fund- state of the health-care system and their ing basic “social goods” like health care suggestions to make it function more was indeed a historic document. To Consider 1. What is the Romanow Report? Who is Roy Romanow? 2. What were the main recommendations of the Romanow Report? 3. What was the federal government’s reaction to the Romanow Report? 4. What groups supported the recommendations of the report? Why? 5. What groups opposed the recommendations of the report? Why? 6. What is the position of most Canadians on their country’s health- care system? 7. What is your opinion of our health-care system? 8. What challenges does the Romanow Report face regarding the possibility of the federal and provincial governments implement- ing its major recommendations? CBC News in Review • December 2002 • Page 7 A PRESCRIPTION FOR HEALTH CARE Video Review 1. What are the five basic principles of the Canada Health Act? Carefully view this video story and i) ___________________________________________________________ then respond to the questions on ii) __________________________________________________________ this and the next page. Because this iii) __________________________________________________________ is a complex, but important story, it iv) __________________________________________________________ might be necessary to take up the v) ___________________________________________________________ questions after 2. What sixth principle did Romanow propose? viewing or even to review the video a second time. 3. Romanow asked for (circle one) $10-billion $15-billion $115-billion in additional funding over three years. 4. Does Romanow support or reject more private health care? 5. How does Romanow propose to deal with the following problems? • Home care • High cost of drugs • Shortage of nurses and doctors • Primary health care 6. What percentage of Canada’s GDP (gross domestic product) is dedicated to health-care spending? ___________% 7. Note one argument for and one against private health care. For: Against: CBC News in Review • December 2002 • Page 8 A PRESCRIPTION FOR HEALTH CARE Text Analysis: Excerpts from the Romanow Report As part of his Royal Commission realistic nor desirable. Medicare Medicare report, “Building on Values: The Future must be constantly renewed and Milestones of Health Care in Canada,” Roy continually refined, if it is to remain 1962 Saskatchewan Romanow included this “message to relevant and viable. A new common adopts first medical approach is needed to encourage, insurance plan. Canadians.” In it, he stated that access to free, universal, high-quality medical not constrain, innovation. If we 1968 Ottawa allow medicare to become static, it passes Medical Care care was a “right of citizenship,” one to will become brittle and eventually Act that shares which all Canadians were entitled, break . costs for medicare regardless of their income or status in with provinces. society. Here are some excerpts from 1984 The Canada The reality is that Canadians em- Health Act enforces the Romanow Report, in which he brace medicare as a public good, a basic principles of states his core beliefs about the role of national symbol, and a defining health care on public health care in Canada, and why it aspect of their citizenship. I am provinces and is such an important and valuable therefore recommending a series of territories. institution: measures to modernize the legisla- tive and institutional foundations of Canadians’ attachment to medicare medicare that will better equip is based on their understanding of it governments to move forward as a right of citizenship. They con- together to provide Canadians with nect with the values that define the health-care system they want. medicare, not the particular features of the system in place in their prov- Early in my mandate, I challenged ince or territory. those advocating radical solutions for reforming health care—user Canadians expect the system to fees, medical savings accounts, de- guarantee them relatively similar listing services, greater privatization, access to a common basket of medi- a parallel private system—to come care services of equal quality, re- forward with evidence that these gardless of where they live. They approaches would improve and expect governments, providers, and strengthen our health-care system. caregivers to work collaboratively to The evidence has not been forth- maintain a system with these quali- coming. ties. I have also carefully explored the The fact that Canadians perceive experiences of other jurisdictions health care as a national endeavour with co-payment models and with should not be interpreted as an private-public partnerships, and invitation for federal intrusion into have found these lacking. an area of primary provincial juris- diction. Nor should it be interpreted There is no evidence these solutions to mean a “one-size-fits-all” ap- will deliver better or cheaper care, proach to health-care delivery.

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