• Few "new" cures among shopping list of "old" prescriptions
• Further modernization of the Canada Health Act still needed
• Bureaucratic solutions trample on federal and provincial efforts now underway
• Relegation of private sector to "dishwashing and laundry" is intellectually dishonest
• Flawed pyramid-scheme of health care funding left untouched, pre-funding ignored
• CTF raises spectre of 1.5% hike in GST rate

OTTAWA: The Canadian Taxpayers Federation (CTF) has responded to the release of the report entitled Building on Values from the Commission on the Future of Health Care in Canada headed by former Saskatchewan Premier, the Hon. Roy Romanow.

The Big Picture: No new cures, many old prescriptions
"Over the past eighteen months Mr. Romanow traveled the country and the globe to deliver a report which - in many areas - falls far short of expectations," stated CTF federal director Walter Robinson. "At a time when our health care system desperately needs a crash cart of new ideas, sadly, the Romanow report mostly offers warmed up leftovers from the cafeteria of past health care reports."

"In fairness to Mr. Romanow, he has correctly identified the key themes of leadership, governance, responsiveness, accountability, transformative change and strategic investments as key elements integral to achieve meaningful health care reform," added Robinson. "However, his choice of policy vehicles - most of them requiring more central planning and an even larger health care bureaucracy - to meet the objectives inherent in these themes is suspect."

Robinson asked: "At $15 million, Canadian taxpayers effectively paid $27,332 for each day of the commission's work or $42,857 for each page of the commission's report. It is justifiable and wholly defensible to ask: Is this the best that we can do for the nation's most pressing policy issue "

Modernizing the Canada Health Act - A good start but -
"Suggestions to better clarify the meanings of portability and comprehensiveness are laudable. As is the call for a dedicated cash transfer for health care so Canadian taxpayers can better follow their money and see how it is spent," said Robinson. "But we remain convinced that public administration must give way to public governance, universality must be clarified and new principles of quality, choice, and sustainability must be built into the act."

Is more bureaucracy really necessary
"Recommendations for a Health Council or National Drug Agency are well-intentioned, but unnecessary," noted Robinson. "Such approaches merely duplicate existing provincial and federal coordinating efforts and will merely devote needed dollars to paper instead of patients. While health care is a national issue, needs vary widely in different regions and one size does not fit all."

Public vs. Private: Romanow's ideological intransigence
Mr. Romanow's introductory Message to Canadians states:

At a minimum, I believe governments must draw a clear line between direct health services (such as hospital and medical care) and ancillary ones (such as food preparation or maintenance services). The former should be delivered primarily through our public, not-for-profit system while the latter could be the domain of the private providers.

"This relegation of the private sector to dishwashing, laundry and food preparation is at once both ideologically intransigent and intellectually dishonest," stated Robinson. "Who does Mr. Romanow think will deliver the new technology, innovative pharmaceuticals, amongst a host of other changes that will occur over the next decade The private sector of course."

"Canadians are pre-occupied with universal access to timely and quality medical services, they really don't care who delivers them, as long as their health outcomes are improved," added Robinson. "It's time we also called double-digit union wage settlements in the health care sector for what they are - profit taking by organized labour at the expense of patients."

Primary health care reform
"In theory one-stop shopping for our primary care needs makes sense, but theory and practice are two different things," noted Robinson. "Nurse practitioners and other allied health professionals play an integral role in the delivery of primary care, however, insurance and liability issues still fall primarily on the family doctors. These risks will manifest themselves in higher insurance premiums and eventually higher physician compensation which could negate any savings gained from primary care reform."

Infrastructure
"Apart from diagnostic imaging technology and information technology infrastructure to buttress accountability efforts and electronic health records, the commission remains silent on pressing needs for new bricks and mortar health care infrastructure," observed Robinson. "These needs are best met though public-private partnerships and other private finance initiatives. On this point, Mr. Romanow expresses caution when courage and commitment are needed."

Financing the changes
"By 2005/2006, Mr. Romanow's suggestions will cost an extra $6.5 billion annually. While he doesn't mention where this money will come from, we can't help but observe that a hiking the GST from 7% to 8.5% would easily net this cash for Ottawa," concluded Robinson. "We do and will vehemently oppose this option if pondered. Present and future health care needs can and must be met through reallocation from existing budget envelopes, individual pre-funding and innovative private finance options for infrastructure. We continue to fund this afternoon's surgeries from this morning's tax collections - it is akin to a pyramid scheme and contrary to Mr. Romanow's assertion, this is categorically unsustainable. This isn't ideology, it is simple actuarial arithmetic; our health care future still doesn't add up."

"Canadians have reason to be disappointed. Of the commission's 47 recommendations, 20 are symbolic, 22 are bureaucratic, only 4 address legislative options and only 1 deals with finances. Our health care system remains on life support, it is truly regrettable," concluded Robinson.