DOCSLIB.ORG

Romanow Final Report.Pdf

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Romanow Final Report.Pdf BUILDING onVALUES THE FUTURE OF HEALTH CARE IN CANADA ROY J. ROMANOW, Q.C. COMMISSIONER Final Report NOVEMBER 2002 BUILDING onVALUES THE FUTURE OF HEALTH CARE IN CANADA National Library of Canada cataloguing in publication data Commission on the Future of Health Care in Canada Building on Values: The Future of Health Care in Canada – Final Report Commissioner: Roy J. Romanow. Issued also in French under title: Guidé par nos valeurs : l’avenir des soins de santé au Canada Includes bibliographical references. Issued also in print format. ISBN 0-662-33043-9 Cat. No. CP32-85/2002E-IN 1. Medical care – Canada. 2. Public health – Canada. 3. Medical policy – Canada. 4. Health services administration – Canada. II. Romanow, Roy J. II. Title. RA412.5C2S52 2002 362.1'0971 C2002-980275-X November 2002 TO HER EXCELLENCY THE GOVERNOR IN COUNCIL By Order in Council P.C. 2001-569, I was requested to inquire into and undertake dialogue with Canadians on the future of Canada’s public health care system, and to recommend policies and measures respectful of the jurisdictions and powers in Canada required to ensure over the long term the sustainability of a universally accessible, publicly funded health system, that offers quality services to Canadians and strikes an appropriate balance between investments in prevention and health maintenance and those directed to care and treatment. I am pleased to report that my Commission’s multi-faceted consultations with Canadians demonstrated their commitment to the original ideals of medicare as well as their willingness to change basic practices and approaches in order to make the system as a whole more sustainable for the 21st century. I have relied upon their experience and wisdom as well as the best research and evidence available in coming to my conclusions and recommendations. I have been honoured to have the responsibility of working to fulfill this mandate and I am pleased to submit for your consideration the Final Report of the Commission on the Future of Health Care in Canada. Respectfully submitted, Roy J. Romanow, Q.C. Commissioner iii CONTENTS MANDATE . xi A MESSAGE TO CANADIANS . xv EXECUTIVE SUMMARY . xxiii 1SUSTAINING MEDICARE . 1 What is Sustainability? . 1 Health and Health Care Services . 2 Health Care and the Canadian Constitution . 3 Medicare and Beyond . 4 Private For-Profit Service Delivery: The Debate . 6 Needs and Outcomes . 9 Performance of the Canadian System . 9 Responsiveness to Specific Illnesses . 14 Disparities within Canada . 16 Anticipating an Aging Population . 20 Resources in the System: The Case of Funding . 23 Canada’s Reliance on Taxes . 24 Use of Private Insurance and Out-of-pocket Payments . 24 The Balance between Public and Private Funding of Health Care . 26 Alternative Funding Sources . 28 Sustaining Canada’s Health Care System – Looking Ahead . 43 2HEALTH CARE,CITIZENSHIP, AND FEDERALISM . 45 Directions for Change . 45 The Case for Change . 45 Establishing a Canadian Health Covenant . 48 A Commitment to Canadians . 48 Achieving the Vision: National Leadership in Health . 52 v A New Approach to National Leadership . 52 Role of the Health Council of Canada . 54 Health Council Operation and Structure . 57 Modernizing and Updating The Canada Health Act . 59 The Principles of a Modernized Canada Health Act . 60 Expanding Medicare Coverage: Short Term and Long Term . 63 Clarifying Coverage under the Canada Health Act . 64 Providing Stable and Predictable Federal Funding . 65 Introducing a New Canada Health Transfer . 65 Short-Term Funding Issues . 71 What Does This Mean for Canadians? . 72 3INFORMATION,EVIDENCE AND IDEAS . 75 Directions for Change . 75 The Case for Change . 75 Building Canada’s Health Information Technology Infrastructure . 76 Introducing Personal Electronic Health Records . 77 A Leadership Role for Canada Health Infoway . 79 Empowering Canadians and Protecting Their Privacy . 80 Expanding Health Literacy . 81 Streamlining and Improving Health Technology Assessment in Canada . 83 The Growing Importance of Health Technology Assessment . 83 Expanding Health Technology Assessment in Canada . 85 Building Canada’s Health Research Knowledge Base . 86 Taking the Next Steps to Expand Our Knowledge Base . 87 Forging Better Linkages . 89 What Does This Mean for Canadians? . 89 4INVESTING IN HEALTH CARE PROVIDERS . 91 Directions for Change . 91 The Case for Change . 91 The Current Situation for Canada’s Health Workforce . 92 The Nursing Situation . 94 Access to Doctors . 96 Paying for Nurses and Doctors . 101 International Mobility of Health Care Providers . 102 Allied Health Care Providers and Managers . 103 A National Effort Is Needed . 104 Immediate Investments in People and Change . 105 Addressing Gaps in Supply and Distribution . 106 vi Changing Roles and Responsibilities . 106 Planning for Change Over the Longer Term . 108 Improve Information about Canada’s Health Workforce . 108 Review and Renew Education and Training Programs for Health Care Providers . 109 Develop a Comprehensive Plan for the Future of Canada’s Health Workforce . ..
Load more

Recommended publications
  • LORIMER - CAT - F18.Pdf
    CoNTENTS NEW TITLES NEW chILDREN & TEEN TITLES Public Betrayal, Justice Denied ..........................................3 50 Things to see With a Telescope .................................14 Oil and World Politics ........................................................4 My River .........................................................................16 The Big Stall ......................................................................5 Worthy of Love ..............................................................17 Poor No More ...................................................................6 Righting Canada’s Wrongs: Africville............................... 18 Mining Country .................................................................7 Empty Net ..................................................................... 20 Oil’s Deep State (new edition) ...........................................8 Called Up .......................................................................21 Beyond Shelters ................................................................9 Tough Call .....................................................................22 The Age of Increasing Inequality (previously announced) 10 Breaking Through ..........................................................23 Getting to Zero (previously announced) ..........................11 Push Back ......................................................................24 The Creative City of Saint John 1867-1967 ......................12 Cold Grab ......................................................................25
    [Show full text]
  • Smashing Pumpkins Gish Mp3, Flac, Wma
    Smashing Pumpkins Gish mp3, flac, wma DOWNLOAD LINKS (Clickable) Genre: Rock Album: Gish Country: Mexico Released: 2011 Style: Alternative Rock MP3 version RAR size: 1418 mb FLAC version RAR size: 1777 mb WMA version RAR size: 1689 mb Rating: 4.9 Votes: 399 Other Formats: ASF TTA AAC MP4 AU AC3 RA Tracklist 1 I Am One 4:07 2 Siva 4:20 3 Rhinoceros 6:30 4 Bury Me 4:46 5 Crush 3:34 6 Suffer 5:08 7 Snail 5:09 8 Tristessa 3:32 9 Window Paine 5:49 10 Daydream 3:08 Credits Bass – D'arcy Co-producer [Reissue] – Dennis Wolfe Design [Reissue], Layout [Reissue] – Noel Waggener Drums – Jimmy Chamberlin Guitar – James Iha Guitar, Photography By [Postcard Photos ©] – Billy Corgan Management [Legal Saviour] – Jill Berliner Mastered By – Evren Goknar* Photography By [Cover Photos] – Robert Knapp Photography By [Inner Photos Courtesy Of] – Billy Corgan, Jimmy Chamberlin, Robert Knapp Producer [Original Album] – Billy Corgan, Butch Vig Producer [Reissue] – Billy Corgan, David K. Tedds, Kerry Brown, Michael Murphy Remastered By – Bob Ludwig Vocals – Billy Corgan Written-By – Billy Corgan Barcode and Other Identifiers Barcode: 5 099967 928828 Other versions Title Category Artist Label Category Country Year (Format) Smashing Gish (CD, Caroline CAROL 1705-2 CAROL 1705-2 US 1991 Pumpkins* Album) Records Gish (LP, Hut HUTLPX 2, 7243 Smashing HUTLPX 2, 7243 Album, RE, Recordings, UK 1994 8 39663 1 8 Pumpkins* 8 39663 1 8 RM) Virgin Caroline Gish (LP, CARLP 16, 211 Smashing Records, CARLP 16, 211 Album, RP, Europe Unknown 651 Pumpkins* Caroline 651 whi) Records
    [Show full text]
  • Parkland Institute: a Look Back at 20 Years
    Parkland Institute: A Look Back at 20 Years Parkland Institute was founded in 1996. During its 20 years The political strategy worked; the PCs were re-elected based of existence, the institute has established itself as one of on a political narrative that argued Alberta’s problems the most cited and influential think tanks in Alberta and lay not in the problems of a boom-bust economy but in Canada. At the same time, Parkland has remained true to government waste and inefficiency. The government its mandate of bringing together the academic and wider subsequently adopted a policy agenda straight out of communities in pursuit of public policy research for the the neoliberal playbook. In one of its first actions, the common good. What explains Parkland’s success? How has government sold off Alberta’s lucrative retail liquor a small institute been able to play such an important role operations. in shaping policy debates? To answer this question requires The privatization of the Alberta Liquor Control Board going back to the institute’s roots. (ALCB) set in motion the process of Parkland’s creation. Viewed as the opportunity to examine on an empirical level Setting the Context the consequences of the sell-off, four academics — Gordon Parkland’s founding in 1996 occurred against a backdrop Laxer and Trevor Harrison (Department of Sociology, of enormous political, economic, and cultural changes University of Alberta) and Duncan Green and Dean Neu sweeping across Alberta, Canada, and the world. The (Faculty of Management, University of Calgary) — looked collapse of the post-war Keynesian consensus in the at the consequences of ALCB privatization.
    [Show full text]
  • CURRICULUM VITAE Melville L. Mcmillan Professor Emeritus
    1 CURRICULUM VITAE Melville L. McMillan Professor Emeritus, Department of Economics University of Alberta June 2020 ADDRESS AND PHONE Office Department of Economics Home 7626 - 119 Street Tory Building Edmonton, Alberta University of Alberta Canada T6G 1W3 Edmonton, Alberta Canada T6G 2H4 Phone (780) 492-7629 Home (780) 434-5771 e-mail [email protected] BIODATA Date of Birth August 7, 1943 Place of Birth Edmonton, Alberta Citizenship Canadian Marital Status Married, two children ACADEMIC TRAINING Degrees and Distinctions BA: (Economics), 1964, University of Alberta, Edmonton, (First Class Standing) MSc: (Agricultural Economics), 1967, University of Alberta, Edmonton MSc Thesis: "Alberta's Pasture Resources and Estimated Potential Beef Production from Improvement of Privately Owned Land" PhD: (Economics), 1973, Cornell University, Ithaca, New York Dissertation: "Jurisdictions, Grants, and Public Good Supply in a Fiscal Federalism" Areas of Concentration Public Sector Economics: notably the Demand for and Provision of Public Goods and Services, Subnational Government, Intergovernmental Fiscal Relations (Fiscal Federalism), Taxation Resource and Environmental Economics Urban and Regional Economics Languages. English. Some reading ability in French. 2 EMPLOYMENT EXPERIENCE Academic Part-time Lecturer, Department of Economics, University of Alberta, Edmonton, Alberta, September 1966 to May 1969 Research Assistant, Human Resources Research Council, Edmonton, Alberta, May to August 1969 Graduate Teaching Assistant, Cornell University,
    [Show full text]
  • Alberta Disadvantage: Gender, Taxation, and Income Inequality
    The Alberta Disadvantage: Gender, Taxation, and Income Inequality The Alberta Disadvantage: Gender, Taxation, and Income Inequality Kathleen A. Lahey This report was published by the Parkland Institute March 2015 © All rights reserved. Acknowledgments iii About the Author iii About the Parkland Institute iv Executive Summary 1 1. Alberta’s Gender Equality Commitments 3 A. Institutional Mechanisms 5 B. Gender Mainstreaming and Gender-based Policy Analysis 6 C. Sex-disaggregated Data and Contextualized Gender Analysis 7 2. The Economic Status of Women in Alberta 8 A. Women’s Employment and Incomes, 1976-2011 9 B. Barriers to Economic Equality: Unpaid, Part-time, and Precarious Work 14 C. Gender, Children, and Employment Status 19 Contents D. Warning Signs and Critical Needs 20 3. Tax Policy, Income Inequality, and Gender 22 A. ‘Tax Cuts for Growth’ vs. ‘Taxing for Equality’ 23 B. Federal-Provincial Tax Cuts and Increasing Income Inequalities 27 C. Revenue Effects of Alberta’s ‘Tax Advantage’ Regime 31 D. Inequality and the Distribution of Alberta’s Detaxation Benefits 32 4. Gender Impact of Alberta’s ‘Tax Advantage’ Regime 35 A. Distribution of Detaxation Benefits by Gender 36 B. Loss of Fiscal Gender Progressivity in Alberta 38 5. Personal Income Tax Alternatives 41 A. Provincial/Territorial PIT Rates: National Context 42 B. Addition of Higher Graduated PIT Rates in Alberta 44 C. Addition of New Lower PIT Rates in Alberta 47 D. Gender Impact of PIT Alternatives 53 E. Low-income Tax Options and Gender 54 All Parkland Institute reports are available 6. Corporate Income Tax Alternatives 63 free of charge at parklandinstitute.ca.
    [Show full text]
  • Orange Chinook: Politics in the New Alberta
    University of Calgary PRISM: University of Calgary's Digital Repository University of Calgary Press University of Calgary Press Open Access Books 2019-01 Orange Chinook: Politics in the New Alberta University of Calgary Press Bratt, D., Brownsey, K., Sutherland, R., & Taras, D. (2019). Orange Chinook: Politics in the New Alberta. Calgary, AB: University of Calgary Press. http://hdl.handle.net/1880/109864 book https://creativecommons.org/licenses/by-nc-nd/4.0 Attribution Non-Commercial No Derivatives 4.0 International Downloaded from PRISM: https://prism.ucalgary.ca ORANGE CHINOOK: Politics in the New Alberta Edited by Duane Bratt, Keith Brownsey, Richard Sutherland, and David Taras ISBN 978-1-77385-026-9 THIS BOOK IS AN OPEN ACCESS E-BOOK. It is an electronic version of a book that can be purchased in physical form through any bookseller or on-line retailer, or from our distributors. Please support this open access publication by requesting that your university purchase a print copy of this book, or by purchasing a copy yourself. If you have any questions, please contact us at [email protected] Cover Art: The artwork on the cover of this book is not open access and falls under traditional copyright provisions; it cannot be reproduced in any way without written permission of the artists and their agents. The cover can be displayed as a complete cover image for the purposes of publicizing this work, but the artwork cannot be extracted from the context of the cover of this specific work without breaching the artist’s copyright. COPYRIGHT NOTICE: This open-access work is published under a Creative Commons licence.
    [Show full text]
  • “When I Listen to Gish,” Billy Corgan Says Today
    “When I listen to Gish,” Billy Corgan says today, “what I hear is a beautiful naïveté.” They say you never forget the first time, and even twenty years later, the 1991 debut album by Smashing Pumpkins –– guitarist and vocalist Corgan, drummer Jimmy Chamberlin, bassist D’arcy Wretzky and guitarist James Iha –– remains the unforgettable start of a musical conversation that continues to resonate with millions of fans all around the world. In retrospect, Gish can clearly be heard as a groundbreaking album in the history of what would soon become more much widely known as alternative rock. Gish was, after all, the promising debut of a band that would help alternative rock quickly become part of a new, grungier mainstream. But back in the beginning, Gish was simply the memorable opening salvo by a band from Chicago that really didn’t fit in anywhere in the rock world –– that is, until bands like Smashing Pumpkins helped change the rock world once and for all. To hear Corgan tell it now, Smashing Pumpkins came by their beautiful naïveté naturally. “We’d had very little exposure to the national stage,” he explains. “There’s no way that if we had been exposed to all of what was going on in New York and L.A. earlier, we would have made Gish. This is one of those weird albums that sounds like it came from some guy who crawls up out of the basement holding a record in his hands proudly –– a little like the first time we heard Dinosaur Jr. You think, ‘who the hell is this? And where did that come from?’ ” According to Corgan, the album originally came from Smashing Pumpkins’ early vow of poverty.
    [Show full text]
  • Powers of Horror; an Essay on Abjection
    POWERS OF HORROR An Essay on Abjection EUROPEAN PERSPECTIVES: A Series of the Columbia University Press POWERS OF HORROR An Essay on Abjection JULIA KRISTEVA Translated by LEON S. ROUDIEZ COLUMBIA UNIVERSITY PRESS New York 1982 Library of Congress Cataloging in Publication Data Kristeva, Julia, 1941- Powers of horror. (European perspectives) Translation of: Pouvoirs de l'horreur. 1. Celine, Louis-Ferdinand, 1894-1961 — Criticism and interpretation. 2. Horror in literature. 3. Abjection in literature. I. Title. II. Series. PQ2607.E834Z73413 843'.912 82-4481 ISBN 0-231-05346-0 AACR2 Columbia University Press New York Guildford, Surrey Copyright © 1982 Columbia University Press Pouvoirs de l'horreur © 1980 Editions du Seuil AD rights reserved Printed in the United States of America Clothbound editions of Columbia University Press books are Smyth- sewn and printed on permanent and durable acid-free paper. Contents Translator's Note vii I. Approaching Abjection i 2. Something To Be Scared Of 32 3- From Filth to Defilement 56 4- Semiotics of Biblical Abomination 90 5- . Qui Tollis Peccata Mundi 113 6. Celine: Neither Actor nor Martyr • 133 7- Suffering and Horror 140 8. Those Females Who Can Wreck the Infinite 157 9- "Ours To Jew or Die" 174 12 In the Beginning and Without End . 188 11 Powers of Horror 207 Notes 211 Translator's Note When the original version of this book was published in France in 1980, critics sensed that it marked a turning point in Julia Kristeva's writing. Her concerns seemed less arcane, her presentation more appealingly worked out; as Guy Scarpetta put it in he Nouvel Observateur (May 19, 1980), she now intro- duced into "theoretical rigor an effective measure of seduction." Actually, no sudden change has taken place: the features that are noticeable in Powers of Horror were already in evidence in several earlier essays, some of which have been translated in Desire in Language (Columbia University Press, 1980).
    [Show full text]
  • Provincial Legislatures
    PROVINCIAL LEGISLATURES ◆ PROVINCIAL & TERRITORIAL LEGISLATORS ◆ PROVINCIAL & TERRITORIAL MINISTRIES ◆ COMPLETE CONTACT NUMBERS & ADDRESSES Completely updated with latest cabinet changes! 86 / PROVINCIAL RIDINGS PROVINCIAL RIDINGS British Columbia Surrey-Green Timbers ............................Sue Hammell ......................................96 Surrey-Newton........................................Harry Bains.........................................94 Total number of seats ................79 Surrey-Panorama Ridge..........................Jagrup Brar..........................................95 Liberal..........................................46 Surrey-Tynehead.....................................Dave S. Hayer.....................................96 New Democratic Party ...............33 Surrey-Whalley.......................................Bruce Ralston......................................98 Abbotsford-Clayburn..............................John van Dongen ................................99 Surrey-White Rock .................................Gordon Hogg ......................................96 Abbotsford-Mount Lehman....................Michael de Jong..................................96 Vancouver-Burrard.................................Lorne Mayencourt ..............................98 Alberni-Qualicum...................................Scott Fraser .........................................96 Vancouver-Fairview ...............................Gregor Robertson................................98 Bulkley Valley-Stikine ...........................Dennis
    [Show full text]
  • The 2011 Provincial Election in Prince Edward Island
    Canadian Political Science Review, Vol. 7, No. 1, 2013, 65-71 65 The 2011 Provincial Election in Prince Edward Island Peter McKenna and Don Desserud Department of Political Science, University of Prince Edward Island. E-mail address: [email protected] ; [email protected] Introduction to his seat, but this time did so with a margin of victory of just eight votes over Compton. The largest margin of victory was in Evangeline-Miscouche (District 24) in which Liberal Prince Edward Island’s 64th General Election was held 3 incumbent Sunny Gallant defeated PC candidate Edgar October 2011, at which time Premier Robert Ghiz's Liberal Arsenault by 1,304 votes.7 Overall, incumbents ran in 25 of Party (Liberals) defeated Olive Crane’s Progressive Con- the 27 electoral districts. Two incumbents were defeated, servative Party (PCs). The Liberals won 22 seats; the PCs and both were Liberal cabinet ministers: Allan Campbell lost won 5. No other party won a seat.1 by 30 votes to Colin LaVie in the Souris-Elmira riding (Dis- Five parties (and one Independent) contested the elec- trict 1), while Neil LeClair lost by 33 votes to PC Hal Perry in tion, the most in Island history and one more than had con- Tignish-Palmer Road (District 27).8 tested the election in 2007.2 The three other parties running candidates in 2011 were the New Democratic Party of PEI (NDP),3 the Green Party of PEI (Greens) and the Island Party. With five parties fielding candidates, the total number Table 1: Party standings and election results: 2000 to 2011 of names on the ballots also increased: 103 candidates ran in th 2000 at 2003 at 2007 at 2011 the 64 General Election, 14 more than the number running diss.
    [Show full text]
  • X a Place in the Country
    X A Place in the Country 1843-1844 (LETTERS 446 TO 517) BRYANT's JUBILANT ANNOUNCEMENT to his brother John in February 1843 that he had bought land and planned to build a house on the Long Island shore reflected an overmastering urge to find a permanent home, for, during their eighteen years in New York City, he and Frances had lived at almost an equal number of addresses-not to speak of all the hotels and lodgings they had passed through on their travels. In their impatience to get settled at Hempstead Harbor, renamed Roslyn in 1844, they were occupying before the summer was over an old Quaker farmhouse on the property, and in September Sarah Bryant visited them for several weeks during her first trip to the East since her removal to Illinois in 1835. Having at last acquired their place in the country, Cullen and Frances traveled southward early in 1843, visiting William Gilmore Simms at his plantation, "Woodlands," in the interior of South Carolina, and becoming acquainted with the literary society of Charleston and Savannah, as well as the Spanish-Minorcan culture of St. Augustine, Florida. In July Cullen took his mother to visit his Aunt Charity Bryant at Weybridge, Vermont, and in October escorted her as far as Buffalo on her return to Illinois. For two weeks at the end of November he took a trip to Washington, the purpose of which, though unspecified in his correspondence, was apparently to arrange more effective coverage for his newspaper at the capital. After nearly six years during which such little time as he could spare from the Evening Post's affairs went to writing verse, Bryant had begun to take a renewed interest in community activities.
    [Show full text]
  • Dante Alighieri's Divine Comedy – Inferno
    DIVINE COMEDY -INFERNO DANTE ALIGHIERI HENRY WADSWORTH LONGFELLOW ENGLISH TRANSLATION AND NOTES PAUL GUSTAVE DORE´ ILLUSTRATIONS JOSEF NYGRIN PDF PREPARATION AND TYPESETTING ENGLISH TRANSLATION AND NOTES Henry Wadsworth Longfellow ILLUSTRATIONS Paul Gustave Dor´e Released under Creative Commons Attribution-Noncommercial Licence. http://creativecommons.org/licenses/by-nc/3.0/us/ You are free: to share – to copy, distribute, display, and perform the work; to remix – to make derivative works. Under the following conditions: attribution – you must attribute the work in the manner specified by the author or licensor (but not in any way that suggests that they endorse you or your use of the work); noncommercial – you may not use this work for commercial purposes. Any of the above conditions can be waived if you get permission from the copyright holder. English translation and notes by H. W. Longfellow obtained from http://dante.ilt.columbia.edu/new/comedy/. Scans of illustrations by P. G. Dor´e obtained from http://www.danshort.com/dc/, scanned by Dan Short, used with permission. MIKTEXLATEX typesetting by Josef Nygrin, in Jan & Feb 2008. http://www.paskvil.com/ Some rights reserved c 2008 Josef Nygrin Contents Canto 1 1 Canto 2 9 Canto 3 16 Canto 4 23 Canto 5 30 Canto 6 38 Canto 7 44 Canto 8 51 Canto 9 58 Canto 10 65 Canto 11 71 Canto 12 77 Canto 13 85 Canto 14 93 Canto 15 99 Canto 16 104 Canto 17 110 Canto 18 116 Canto 19 124 Canto 20 131 Canto 21 136 Canto 22 143 Canto 23 150 Canto 24 158 Canto 25 164 Canto 26 171 Canto 27 177 Canto 28 183 Canto 29 192 Canto 30 200 Canto 31 207 Canto 32 215 Canto 33 222 Canto 34 231 Dante Alighieri 239 Henry Wadsworth Longfellow 245 Paul Gustave Dor´e 251 Some rights reserved c 2008 Josef Nygrin http://www.paskvil.com/ Inferno Figure 1: Midway upon the journey of our life I found myself within a forest dark..
    [Show full text]