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Memo to Commissioner Roy Romanow: A mind is like a parachute, it works best when it's open
By Walter Robinson
Buried amongst recent G8 coverage in most newspapers were a few articles about Roy Romanow's recent speeches and responses to studies gauging the Canadian appetite for health care reform.
Although we cling to the faint hope that Mr. Romanow's report this fall will address the unsustainable pay-as-you-go funding structure of health care, recommend modernization of the Canada Health Act, come to grips with demographic realities and facilitate an expansion of high-tech medicine that will raise Canada from it's current third-world ranking in this area, we should nonetheless prepare ourselves for a letdown.
Romanow's comments, especially those in which he rules out 'radical' changes to medicare are very disappointing. And in the interests of an informed debate some of his other assertions need to be brought into question. In a speech to the Canadian Nurses Association (CNA) on June 25th, Romanow is quoted as saying medicare was "the right road to take" 40 years ago and that "any objective evaluation" shows that it is a cost-efficient way to deliver health.
Question: If our single-payer system is so great, why hasn't any other industrialized nation outlawed private insurance for medically necessary procedures? Why hasn't any other industrialized nation ruled out co-payment options? And why hasn't any other Western country many of which are going through health system restructuring as well sought to emulate the 'cherished' Canada Health Act?
During his remarks before the CNA, Mr. Romanow also stated, "medicare is quintessentially Canadian because it embodies both social justice and fiscal prudence. Some Canadians do not share these values. But the vast majority of Canadians have told me loudly: As we remodel the medicare house we must maintain these values as its strong foundation."
Question: Invoking these 'values' is pretty much mom and apple pie kind of stuff. Does Mr. Romanow believe that our national identity should be a function of the fact that studies show health outcomes for heart disease patients and cancer patients are better in the United States than in Canada across all income groupings?
With respect to options for greater private delivery and financing of health care Mr. Romanow challenges advocates to come forward to show that it saves money, improves timely access, quality and is accountable. Specifically, he said, "if anyone does have that evidence, now is the time to bring it forward. Because, to date, it has be notable by its absence."
Question: Has Mr. Romanow looked at how medical savings accounts (MSAs) work in Singapore? How private finance initiatives and internal market reforms have saved the National Health Service in the United Kingdom? What about Stockholm's experiments in the heart of socialist Sweden with private hospital management, home care, ambulance services and laboratory and diagnostic service provision? Has he truly studied co-payment regimes in France, Germany, Ireland, and Norway? Or how does he explain South Africa's government encouraging its citizens to purchase private insurance?
It seems that Mr. Romanow is selectively considering the evidence, both domestic and international, in what is increasingly becoming a foregone conclusion of the limited vision and direction his November report will offer.
Mr. Romanow, these questions must be answered. Your mind and your inquiry should emulate a parachute, both of which work best when they are open. If you're not prepared to objectively look at the questions posed above, then please return our 15 million dollars. We may need it to purchase better health care abroad as Canada's health care system will no doubt continue to deteriorate.
Walter Robinson is the Federal Director of the Canadian Taxpayers Federation.
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