50 Years of Medicare Conference: Romanow says medicare needs federal vision to avoid disparity

Urges frank discussion with Ottawa

By Betty Ann Adam

Saskatoon StarPhoenix 

June 16, 2012

The unifying force medicare has played in Canada is being eroded by Ottawa's decision to make health care transfer payments to the provinces without overall national goals attached, former premier Roy Romanow says.

"The federal government is out of the picture and this opens the door to huge disparities. I don't think that's the way you build a modern day health care plan and for sure it's not a way to build a more unified, progressive and strong Canada," Romanow said after speaking to a public policy conference at the University of Saskatchewan on the future of medicare.

Canada needs a national vision for health care to prevent provinces with greater wealth benefiting from enhanced care while poorer provinces receive less, Romanow said.

"This not only makes a disparate national program, but it raises the prospect of a disunifying dimension to Canadian unity, which is always a very important aspect of Canada's life," he said.

A country as spread out and diverse as Canada won't have identical care everywhere, but it should have programs to ensure "roughly similar principles and quality of outcomes as a right of citizenship," he said.

"I would like to see our premiers generally, take the position of standing up to (Prime Minister Stephen) Harper and saying, 'Look, we want a federal-provincial conference. We want to talk about these costs-driver factors. We want to see what the new programs are, which can ease the cost and improve our health care, and we want a public debate about it.' "

With the federal government "unwilling to take a role for itself " in shaping medicare, premiers are left "scurrying to innovate," Romanow said.

"You have 10 premiers, 10 different economies, local circumstances, varying ideologies, how are you going to bring this all together - since the flood of technology and drugs keep coming on stream - in a cohesive, coherent fashion?"

Medicare began 50 years ago with the federal government transferring 50 per cent of health budgets to provinces with conditions that they all agree to similar objectives as to what that funding will achieve.

"Medicare is so central to our national narrative that how we reform it will determine the future nature of our country," Romanow said.

Ottawa's decision represents "a very serious loss of direction," by the federal government, Romanow said.

The federal government's plan to link health transfers to the GDP places too much weight on the production of goods and services, while ignoring other indicators of quality of life, he said.

The GDP does nothing to measure things like whether the quality of education meets current requirements, whether the environment matters or whether people are so busy they can't spend time with their families, he said.

"The preoccupation with the GDP, which has become the all-encompassing surrogate for everything with respect to well-being, is wrong," he said.

The conference was organized by the Canadian Centre for Policy Alternatives, the college of medicine, the department of community health and epidemiology, the Saskatchewan Health Coalition and the Saskatchewan Union of Nurses.