CKNW Editorial
for April 5, 2001

There are few people in public life for whom I have more respect than former Saskatchewan premier Roy Romanow. I first got to know Roy back in 1976 when the Western premiers appoinbted me to chair an interprovincial task force to look into federal intrusions into matters of provincial jurisdiction. Roy, then Saskatchewan attorney-general represented his province on this committee. Then we saw a great deal of each other during the Trudeau exercise to patriate the constitution. I came away with a great admiration for Mr Romanow and his people skills especially. Having said that, he is the wrong man to head up a federal inquiry into Canada's health system.

The investigation must have, as its starting point, that there is no
starting point. In other words, to make any sense the investigation should be the equivalent of zero based budgeting. It must inquire, from a philosophical point of view, as if there were no Canada Health Act in place.

Now, in saying that, I concede that there are realities and that at the end of the day the realities of how we deliver health care now must be considered. But if we are to truly understand what is not only required for today but for the future, we must start from scratch. Let me dwell on this point a moment. I fully expect that any report will conclude that much of what is done now will remain. But we'll never know what should be unless we assume, for the sake of argument, that all aspects of publicly financed health care are open to discussion.

There are, of course, a great many things that are not now covered by medicare. Drugs outside hospital, much long term care, dental care, much plastic surgery and so on are outside the scope of medicare. There are also some extremely expensive healthcare tools now being used that weren't contemplated at the time medicare came in. Worse, from an expense point of view, more is to come.

Consider ... at the time of the Canada Health Act there were no scanners, Cat or MRIs, no organ transplants and precious little by way of Kidney dialysis ... indeed, 25 years ago we hadn't really proceeded very far since the wonder drugs of World War II. Since then we have had a revolution in health care. Costs have escalated accordingly - when I was health minister in 1980 the budget was about a billion - it's now six times that.

What we have never done - and a commission must surely do that for the first time - is define just what is the medical care we will publicly fund. Will we simply fund the basics ... will our goal be to provide a decent level of mordidity and mortality ... or will we pay for every procedure that might reasonably cure or enhance health? If it's somewhere in between, where?
This leads, of course, to the question of a two tiered system. Do we have some increased private care in the system, bearing in mind that we have a sizable amount now? Despite what trendy left economists tell us, there are lineups for what is serious surgery and it’s not only causing patients a great deal of grief, people are dying for want of timely action. That, surely, is unacceptable.

Jeffrey Simpson, in his column in the Globe & Mail sets it right - we must look past medicare.

Why then not have Roy Romanow, with all his experience? It's his experience that's against him. And the optics.

He will appear – and appearances are everything – to represent the position that medicare is indeed a holy institution, brought to Canada by Tommy Douglas as Premier of Saskatchewan (it was actually his successor, Premier Lloyd but that's a quibble) and that it can only be changed by adding to it. Prime Minister, in commenting on Mr Romanow’s support of the five principles of medicare both in literal but especially in symbolic terms places Mr Romanow not in the position of an impartial arbiter but a loyal descendent of the present system. Inherent in this appearance is that any involvement of the private sector leads us inexorably into the hands of multi national American based companies.
Mr Romanow, by being who he is, raises expectations that he could never live down. He will be seen by the left as the protector not examiner of medicare.

If, at any time in the recent past, Mr Romanow had made some revolutionary thoughts about how we deliver health care in this country perhaps he might have shucked off his image as the direct descendant of Tommy Douglas and bound, therefore to sustain whatever views the left have of that legacy.

The notion of a full inquiry into health care is long overdue ... it's just that my friend and former colleague, Roy Romanow is not the man to head it.