Romanow’s report: What’s in it

If you favour a health-care system that’s publicly funded and available to everyone regardless of ability to pay, then you’ll like Roy Romanow’s report on health care in Canada.

But if you favour public-private partnerships, for-profit medical clinics, user fees for patients, or the creation of a parallel private system for those who can afford it, then you’ll find the Romanow report a big disappointment.

The head of the Commission on the Future of Health Care in Canada states emphatically in his report, released Nov. 28, that health services provided by private businesses are better or more efficient than services funded by taxpayers.

Here are the highlights:

• Federal, provincial and territorial governments should create a “Canadian Health Covenant” pledging their commitment to a universally accessible, publicly funded health-care system.

• Ottawa should spend $1.5 billion to improve access to health care in remote and rural areas of Canada — this could include money for capital purchases, telehealth projects, new programs, and more money to pay nurses and doctors in remote regions.

• Ottawa should spend $1.5 billion to reduce waiting times for diagnostic services such as MRI scans. This would include money to buy more MRI and other scanning devices for use in publicly funded hospitals and clinics — so that affluent people will be less likely to buy their way into better health care by paying cash to for-profit diagnostic clinics.

• Ottawa should spend $2.5 billion a year to shore up primary care delivery. “Primary care” is the jargon word used to describe the “first-contact” care that people get from doctors or nurse practitioners.

• Ottawa should spend $2 billion over two years to create a national home-care program — Romanow also says home care should be listed as an insured service and people who quit work to look after sick family members should get EI and other benefits.

• Ottawa should spend $1 billion to help people pay for highly expensive prescription drugs that force them to make a choice between life-saving prescriptions and things like food or rent — this should benefit lower-income non-Inuit in Nunavut who aren’t covered by employee drug plans.

• Scattered pots of funding for aboriginal health care within territories and provinces should be gathered together into consolidated pools — but Romanow doesn’t directly address Inuit complaints about high costs in the Arctic, especially the cost of medical travel.

• Ottawa must pay at least 25 per cent of territorial and provincial health insurance costs — at least $6.5 billion a year more by 2005-06. Romanow says the money should be paid out to the provinces and territories through a new program called the “Canada Health Transfer” — that means it would be earmarked for health only.

• Federal, provincial and territorial governments should create a body called the “Canadian Health Council” to act as a watchdog over the performance of the health system, and to resolve disputes.