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Now, Medical Waiting Lists Include Health Care Reform: Proposed Changes Collecting Dust; Ottawa, Provinces Blamed For Delay

Editor's Note: Editor's Note: This article is reprinted from the Toronto Star, September 20, 2003, courtesy of Torstar Syndication Services.

Ten months after his much-anticipated royal commission recommended crucial changes to Canada's health care system, a frustrated Roy Romanow says Ottawa and the provinces are just spinning their wheels.

Ticking off his key recommendations one by one, Romanow says all have been stalled by either federal inaction or provincial obstinacy.

It's not just his report that has been dead-ended, he says in a telephone interview from Regina, but the entire Medicare reform file.

"It's like a patient on the waiting list," the former NDP Saskatchewan premier says.

"What progress has there been on aboriginal health? Rural and remote health? ... What is the position of the federal government on health and globalization (protecting Medicare from international trade agreements)?"

But his barely concealed anger was directed at governments' failure to move in three key areas.

He criticized Ottawa for not giving the provinces enough money to bring federal Medicare contributions to their historic levels.

Ottawa's latest $27 billion, five-year transfer, announced in February, still falls well short of Romanow's recommendation that the federal government pay 25 percent of the Medicare bill.

And, in his own polite way, he blasted the provinces for reneging on their promise, also made last February, to set up a national health council that would report to the public on how Medicare is doing.

"It's amazing to me that four months after this thing was supposed to be set up, it's still a work in progress," he says.

The health council, which should be the least controversial of Romanow's recommendations, was sandbagged this summer by Alberta Premier Ralph Klein and Ontario Premier Ernie Eves.

Klein said the proposed council would allow Ottawa to muscle into Alberta's jurisdiction over health; Eves threatened not to sign on unless he got more money from Ottawa.

All parties insist some aspects of the national health council are still going ahead. But there is still no agreement over what it will do or to whom it will report.

Indications are it will be far more ineffective than even the modest body Romanow proposed.

Far more telling, though, is the failure of the country's governments to expand Medicare coverage beyond just physicians and hospitals. This was probably the central element of last November's royal commission report.

Romanow recommended broadening Medicare to include a limited amount of home care services and, eventually, some drug treatments. He also called for an amendment to the Canada Health Act, the law defining Medicare, to specifically include advanced diagnostic services such as MRIs.

His argument, backed up by research from around the world, was that a so-called single-payer public health insurance monopoly like Canadian Medicare is the most efficient way to deliver health care.

But so far, nothing has been done in Ottawa to bring any new services under the ambit of Medicare. Romanow says that's frustrating.

"If the single-payer system is the most efficient, as every study shows it is, then surely we should be adding to the core basket of Medicare services," he says.

Ontario already has some home care services that the government partly covers, as well as a drug plan for those overwhelmed by catastrophic illnesses such as AIDS. However, in the area of advanced diagnostic services, it has been going in the opposite direction.

In a move denounced by the two main opposition parties, Ontario's current Conservative government is allowing private firms to set up clinics that will offer computed tomographic (CT) and magnetic resonance imaging (MRI) scans to those willing to pay out of pocket.

Theoretically, Ontarians will be able to get these out-of-pocket scans only if they claim they don't need them. That's to get around the Canada Health Act, which says all medically necessary services must be covered by Medicare. By law, only medically unnecessary services can be offered to those willing to pay cash in order to get faster treatment.

Romanow says he does not want to comment on the health platforms of the three main parties in the current Ontario election campaign.

"This is something for the people of Ontario and the politicians of Ontario to work out," he says. Both the Liberal and NDP health platforms refer glowingly to Romanow's report. The Conservative platform ignores it.

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