Roy Romanow, head of the Royal Commission on the future of health care, has made it clear that he will recommend not only retaining, but even expanding the centrally planned, government monopoly model of health care in Canada. He will also recommend major new infusions on tax dollars, without making a convincing case that lack of money is the true culprit behind medicare’s woes, as opposed to poor incentives, lack of competition and choice, and inadequate accountability within the system. Virtually every other major inquiry into health care, including Kirby and Mazankowski, identified sustainability of the health care system as the challenge we face. Mr. Romanow’s own former Minister of Finance in Saskatchewan, underlined this when she appeared to testify before his commission. Mr. Romanow’s only real response to these challenges is to throw more money at them.
In place of Mr. Romanow’s complacent defence of the status quo, AIMS’ newest paper: Definitely Not the Romanow Report: Achieving Equity, Sustainability, Accountability and Consumer Empowerment in Canadian Health Care proposes a system that concentrates scarce public health care dollars where they’ll do the most good, and gives users of the system incentives to be prudent about how they spend them. The authors make a detailed case as to where and how to introduce competition between public and private health care providers. They also recommend focusing on health outcomes for Canadians (rather than what we spend on health). Finally, they suggest that strengthened accountability for consumers, providers and governments can have real and immediate benefits for everyone, while maintaining the integrity of the goals of medicare and a central role for government.