` Columbia Journal- Romanow No-Go for Status Quo
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Romanow No-Go for Status Quo
by Marco Procaccini

"defining aspect of their citizenship,"

As expected, the report on health care by the Romanow commission has levelled a devastating indictment against government under-funding over the last 20 years and is calling for major reforms and increased public investment in the health care system.

The report, released on Thursday, cites years of tax-and-cut policies have left the system short changed. The federal government, and some provinces, have taken more and more tax revenues away from health care funding, and that is apparently at the core of Medicare's woes, creating a dangerous threat to access to health services by many Canadians.

The report calls for over $7 billion in increased public investment in health care services and expansion of Medicare coverage of prescription drugs, home support and other convalescence and palliative care. "Canadians consider Medicare the defining aspect of their citizenship," said Roy Romanow, the former NDP Premier of Saskatchewan, in his report. He emphasized that putting tax dollars back into the system and keeping it under public control is by far the best way to ensure it remains viable.

The commission spent ten months touring the country conducting interviews and investigations and soliciting input from individuals and organizations across the spectrum. Romanow outlined four general approaches to deal with the health care system: increased public investment, more dependence on user fees and self-pay measures, for-profit private sector options and overhaul of the service delivery system.

The contentious issue for private for-profit corporations taking over public health care was central during the commission's deliberations. On the pro side are right-wing think tanks and many politicians and major corporate lobbies, including private insurance and service companies looking for profitable investment opportunities.

Opposing this are a variety of public interest groups, labour and health care professional organizations, and patient and user groups who are concerned about the increased cost of private care, declining wages and working conditions of care givers and loss of public and community input into running the system. While Romanow stops short of calling for banning private for-profit health care, he does say it is not a viable option for the most part, citing increased costs to the system and inaccessibility to large sectors of the population.

Many groups, including several physicians' associations, welcomed the report.

"Sustainability is not only about finances; it is about political leadership and public confidence in our health care system," said Dr. Henry Haddad, president of the Canadian Medical Association. "Canadians today are worried that their health care system will not be there for them today or in the future." He adds that despite the good news in the report, implementing the changes will take time. "Physicians, nurses, pharmacists and other health care professionals recognize that the shortage of health care professionals is a key challenge in Canada," said Haddad. "The CMA calls upon all levels of government to urgently address this critical shortage and to take steps to ensure a sustainable health care workforce."

The College of Family Physicians of Canada estimates an additional 3,000 full-time doctors are needed to address the health care system's needs.

In BC, the report's release got a warm reception from worker reps at last week's BC Federation of Labour convention in Vancouver, as delegates from the Hospital Employees Union, Health Sciences Association and Nurses gave it thumbs-up.

"The report has been accused of taking us back to the 1960s," said Canadian Labour Congress President Ken Georgetti while addressing the convention. "I say, 'yes it does.' Then, we had a 50-50 funding deal between Ottawa and the provinces, and wait lists and staff shortages were unheard of."

But the report has left the BC Liberal government, which has recently imposed a taxpayer funded but privately operated hospital on the town of Abbotsford over that community's objections, un-swayed. "There's nothing really in the report that shows we should change out direction," said Premier Gordon Campbell in response to the report. While Campbell says he agrees with some of what Romanow calls for, he says increased funding for the system is the federal government's responsibility, since Ottawa has taken more money out of the system over the years than the provinces.

In addition, the powerful International Monetary Fund, which, along with the World Bank, regulates fiscal policies on a global scale, warned the federal government upon the release of the Romanow report to minimize any increase in public investment in health care, threatening a devaluation of the country's bond and credit rating if it goes ahead.

The Alberta government also says it is not on side with much of Romanow's report. That government is looking to the recommendations of the provincial health care report from former federal Tory cabinet minister Don Mazankowski, which calls for substantial user fees, de-listing of coverage for a variety of services and private for-profit involvement in service delivery.

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