• Taxpayers thank committee for their fiscal prudence in conduct of review
  
• CTF applauds committee stance on "fiscal sustainability" but questions action plan
  
• CTF agrees public governance is needed, disagrees with more bureaucracy
  
• Changes to Canada Health Act still needed
  
• Flawed pyramid-scheme of health care funding left untouched, pre-funding ignored
  
• CTF disagrees with increases to GST and health-care premium approach

OTTAWA: The Canadian Taxpayers Federation (CTF) has reacted to the final report released by the Standing Senate Committee on Social Affairs, Science and Technology (aka: the Kirby committee) entitled Volume 6: Recommendations for Reform. The release of this report completes the Kirby committee's two-year review of health care.

Fiscal prudence
"Over the past two years the Kirby committee has exercised fiscal prudence in speaking with Canadians and gathering international evidence for its review of health care as opposed to Mr. Romanow's $15-million exercise," said CTF federal director Walter Robinson.

Fiscal sustainability
"The Kirby committee is bang-on and Mr. Romanow is dead wrong, our health care system as presently structured is not fiscally sustainable," added Robinson. "Sadly, many of the Kirby Committee proposals simply perpetuate the present system and to paraphrase the committee's words, will not buy change."

More bureaucracy not the answer
"Proposals for a National Health Care Commissioner and National Health Care Council while well-intentioned are misguided," stated Robinson. "The governance problem today in health care is multiple and competing oversight bodies with little real accountability to taxpayers. Yes we need our Auditors General - both provincial and federal - to annually report to taxpayers, but this can be done within existing, if not, streamlined governance structures."

Canada Health Act still needs to be changed
"Sadly, Mr. Kirby and his colleagues backed away from recommending needed changes to the Canada Health Act. We remain convinced that the public administration must give way to public governance, universality must be clarified and new principles of quality, choice, accountability and sustainability must be built into the act," said Robinson. "Yet the committee deserves credit for pointing out that public administration deals with funding only and not service delivery."
Internal markets

"Proposing that regional health authorities should be able to choose between providers - individual and institutional - in contracting for services based on price and quality is positive," stated Robinson. "This means that public, private and community-based providers must compete for funding. Putting public services to the competitive test is long-overdue."

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."

The Health Care Guarantee
"The proposal for maximum waiting times for certain procedures acknowledges the painful reality of waiting lists which our politicians have discounted for over a decade," stated Robinson. "However our fear is that the health care system will manage to the maximum times, in this sense we're caught in the classic price control dilemma where setting a price ceiling ensures that it becomes a price floor."

Mr. Robinson added that the constitutional question of the Canada Health Act violating the "security of person" provisions in the Charter of Rights and Freedoms remains unresolved.

Home care options
"The committee is to be commended for sub-dividing home care into its component parts. And we support the suggestion of extending EI benefits - or better yet some other assistance scheme - to family members caring for terminally ill individuals in their final weeks, but this cost must be borne through reallocation," stressed Robinson. "Tightening of EI eligibility, diversion of funds from failed retraining programs and higher premiums for repeat EI users should finance this program."

Infrastructure
"Senator Kirby and his colleagues deserve credit for identifying critical health care infrastructure shortages. However, these needs may be better met though public-private financing and other private finance initiatives," said Robinson.

Financing the changes
"We are vehemently opposed to hiking the GST or a national health care premium. Ottawa continues to blow $4 billion annually on failed corporate welfare and regional development schemes and doles out another $13 billion in discretionary grants and subsidies," concluded Robinson. "Present and future health care needs can and must be met through reallocation from existing budget envelopes and individual pre-funding. We don't need new taxation, we need new political will to make tough, but necessary changes. Canadians deserve no less."