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To the Editor

The Romanow Report on the Future of Health Care is clear: Canadians want a publicly funded health system that is universally accessible and offers equal and timely service to all. The Report also documents that such a system, built on the successes of Medicare and augmenting its role in publicly provided health services, is possible with provincial and federal cooperation.

"Implementation of the Romanow Report is now the key issue", says Madeline Boscoe, Executive Director of the Canadian Women's Health Network (CWHN). "Romanow has provided a good first step for sustaining a publicly insured health care system that addresses the diverse health needs of Canadians -- now we need to see swift government action on the Romanow recommendations".

The CWHN applauds the Report's emphasis on access to health care for those living in rural and remote areas, on holistic approaches to aboriginal health, on the health needs of new Canadians and visible minorities, and an expanded national homecare program. "But women have been left out of the equation", Boscoe observes, noting that women represent the majority of paid health providers, and also provide the bulk of unpaid caregiving in communities and homes. As well, women are the most frequent users of health care services, yet women's specific health needs do not receive comprehensive assessment in the Romanow report. This failure to appropriately address gender differences in health care use and delivery means that many of the recommendations in the Report fail to protect and promote women's health, leaving women vulnerable and without the necessary support.

Abby Lippman, Professor of Epidemiology at McGill University and Co-Chair of the CWHN notes, for example, that the Report's recommendations on a national prescription drug program do not go far enough, addressing only acute health care requirements, "To meet the needs of most women more than 'catastrophic' situations must be covered in a comprehensive pharmacare program".

The CWHN also believes that the report fails to focus meaningfully on measures that address health promotion and disease prevention, highlighting only methods of treatment and intervention, which are often costly and inefficient. Lippman states that "while we welcome attention to the provision of primary care, this seems to assume preventive approaches based on changes by individuals rather than on structural changes that will promote the diverse health needs of all women in Canada". Lippman also notes that the report does not address the impact of economic and social disparities on individual health status, "Government programs and policies should require health impact assessments and programs that address structural inequities", Lippman concludes.

The CWHN believes that a renewed vision of healthcare must reflect and support the principles of equity and social justice for all Canadians, and strongly endorses the general recommendations of the Romanow Report. "A renewed commitment to access based on need and not on the ability to pay is an essential component of the Romanow Commission findings", Boscoe notes, "and it is one that is wholly supported by the Canadian Women's Health Network. The time for action is now".

Kathleen O'Grady, Director of Communications
Canadian Women's Health Network:a national, voluntary bilingual organization of individuals and groups concerned with women's health.

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