By Charles Moore
I’m constrained to pour some cold water on the irrational exuberance that greeted last week’s release of Roy Romanow’s Commission on the Future of Health Care in Canada report. The commission’s recommendations were preordained from the get-go, amounting to a waste of $15 million of taxpayers’ money, contributing nothing to address the structural problems besetting health-care delivery in Canada that couldn’t have been downloaded for free from the Web sites of sundry socialized medicine advocacy groups.
In a column last April, I predicted:
“It is increasingly evident that the recommendations from Roy Romanow’s roving commission on health-care reform will be for a continued public, single-tier model with no user fees and increased funding through higher taxes. That was virtually a given when Jean Chretien appointed a socialist to head the commission. In other words, what Romanow will prescribe is more of the same faulty policy that got us into this mess.”
Aside from the higher taxes bit, I nailed it. Romanow prescribes $15 billion in increased medicare funding over the next three years, but optimistically expects it to come from federal budget surpluses. His commission produced no new insights, and merely rehashes the prejudices and preconceptions that brought Canadian health care to its current difficulties.
The ideological baggage Romanow brought to the process is clear in his references to medicare as “a public good, a national symbol, a defining aspect” of our society a “moral enterprise” no less, that must be preserved regardless of outcomes analysis. He is a cheerleader for dog-in-the-manger socialism, nicely captured in Nova Scotia Federation of Labour president Rick Clarke’s surly comment that, “Just because someone can afford to jump the queue doesn’t mean they should be allowed to jump the queue.” What was it Winston Churchill said about the inherent virtue of socialism being “the even division of misery?”
An “alternate” health-care study that does merit consideration is Definitely NOT The Romanow Report, by Brian Lee Crowley, et al., of the Halifax-based Atlantic Institute for Market Studies, which, unlike Romanow’s stand pat and shovel money platitudes, attempts to analyse what’s wrong with medicare, and to prescribe solutions that could work.
“Medicare as we know it can be sustainable only if Canadians are willing to accept decreasing levels of service or increasing levels of taxation,” declares AIMS. “And medicare’s cost problems are only going to grow.”
The AIMS researchers charge that, “Mr. Romanow has rejected any analysis that might call into question the sustainability of medicare” instead “repeating the tired old mantra that Canada’s health-care system is superior to others at containing health-care costs,” something the authors say “is simply a myth,” noting that Canada’s health-care system is now ranked 30th in the world by the WHO.
They point out that during the 1970s and 1980s, we borrowed much of the money we spent on health care, consuming the services, but unwilling to pay the taxes to cover the costs. Consequently, we are now stuck with paying interest on money borrowed to pay for health care in the past, so while medicare spending has remained constant as a share of GDP, the tax burden needed to cover that spending has increased substantially while the quality of services has declined.
I was delighted that the AIMS folks also explicitly acknowledge that many people are consulting alternative medical practitioners, who are frequently outside the medicare system, as their primary caregivers, which skews the “constant expenditure” equation, and constitutes the quintessence of “two-tier” health care.
Speaking of which, AIMS points out that “If you are on workers’ compensation, are in the RCMP or the military, if your company has its own salaried physicians, if you use a private hospital … if you are a member of the medical professions or a medical administrator or know someone who is, if you are just articulate and determined, or if you have the taxi fare to Buffalo, Detroit or Seattle, or travel abroad to any one of a number of other places, you can get better, faster and more satisfactory care than someone who just lets the wheels of medicare grind on.”
Unlike the Romanow report’s “shell out more for the same old dog food” motif, the AIMS study proposes real-world reforms that actually address issues, present and future, that afflict health-care funding and delivery. I haven’t room here to summarize them, but I encourage you to download a copy of “Definitely NOT The Romanow Report” and check them out for yourself at www.aims.ca/Publications/Notromanow/notromanow.pdf.