Calgary Sun
Published: Sunday, February 10, 2002

Romanow's chatter holds little promise

This week, Roy Romanow released his interim report looking at the future of health care. Bottom line: there were not great surprises in what he wrote.

Rather, people should look to what he said for clues to where he will ultimately end up when he finishes his work this fall.

While Romanow rightly admonishes all who are raised the invective rhetoric in this debate, he engages in a bit of it himself in his report.

"First and foremost, I am convinced that the Medicare house needs remodeling not demolishing," the report intones.

As Howie Meeker would say, stop it right there. No one is talking about demolishing our system. Fixing, fundamentally restructuring and improving yes, but demolishing? As we say on the basketball court, quit the trash talk and just bring your game.

"There are many approaches to the delivery of health care across Canada - approaches like telehealth, regionalization, integrated community programs, public-private partnerships, population health approaches and a myriad of initiatives," the report states.

Yes some - not all - but some of these have been beneficial. But these are all supply-side, bureaucratically driven. We need to equally focus on the demand side and fundamental funding reform like co-payment or generational financing options where it is appropriate.

"It is unlikely that in the end, Canada will be able to simply import solutions from abroad," the report states.

Ahem, excuse me, why not? Other countries have adopted some of our medical practices holus bolus. Why not the inverse for medical savings account options in primary care, or sickness funds in union environments or Swedish hospital management?

On the positive side, it is clear that Mr. Romanow has echoed statements and findings the CTF made public six months ago.

But the real question becomes has Mr. Romanow already made up his mind. Consider this exchange between Peter Van Dusen (PVD) and Roy Romanow (RR) on CPAC last week.

PVD: "Do you believe that that's where most of the ability for reform lies on the efficiency side? I mean which one of these options -- and I know you said earlier you haven't picked one -- but I get the sense in talking to you if you had to pick one that system is fixable from within and doesn't need to be put out to tender necessarily."

RR: "No, to be frank with you what I have a hunch about right now is that it's probably a combination of more money which I think is inevitable given the costs of technology which is coming ... to a flood of new change which is going to hit us, plus reorganization."

Yikes, more money and efficiencies through reorganization. That's all we've been doing since the Medical Care Act since 1966. The Canada Health Act must be modernized.

We must implement generational pre-funding (like we do in public and private pensions) to ensure long-term sustainability. We cannot be afraid to try and adopt best practices in the delivery and financing and patient accountability dimensions from other countries

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