AIMS releases alternative report on the future of health care in Canada

[HALIFAX] —  AIMS today released its newest study “Definitely Not the Romanow Report: Achieving Equity, Sustainability, Accountability and Consumer Empowerment in Canadian Health Care”. The report draws the research in AIMS’ Health Policy Background Papers together into a comprehensive proposal for fundamental reform of the Canadian health care system in order to address the number one challenge facing Medicare – sustainability.

“Medicare is not sustainable on its present course”, says AIMS President and Definitely not the Romanow Report co-author, Brian Lee Crowley. “A modest slowdown in the rate of spending increases has been bought chiefly through reductions in services, closure of facilities, fewer health professionals, dissatisfaction among those who remain, increased waiting times and forgoing innovative, but expensive, new technologies. The World Health Organization now ranks Canada’s health care system 30th in the world, measured on criteria like “bang for the buck” for health care spending, disease prevention and how fairly the poor, minorities and other special populations are treated. This suggests that, contrary to Mr. Romanow’s views, the chief problem with medicare is not lack of money, but a failure to get real value from the massive spending we are already making on health care. Yet Mr. Romanow has already rejected the only credible strategies for getting that value for money.”

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’ Definitely not the Romanow Report 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.

According to the research for this Report, and the experience in countries with similar social and political traditions to Canada, the sort of reforms recommended have enjoyed considerable success in moving various national health services in the direction of greater value for money, cost-containment and guaranteed access to health care for vulnerable populations. Canada has little reason to fear real reform, and much to gain from embracing it.

What they’re saying about Definitely not the Romanow Report:

Swedish health care reformer Johan Hjertqvist:

The AIMS Definitely Not the Romanow Report contributes to this exchange of ideas and knowledge [about health care reform] in a way that merits applause and congratulations. Focussed, sharp and constructive, it cuts through the arguments and illusions of a conservative establishment that advocates minimal change. Change is badly needed and change there will be. The question, as this report so eloquently makes clear, is: Do the politicians want to be influential in reshaping the country’s health care system or are they going to leave its future in the hands of others? It is up to them to decide. The best way to lose credibility is to neglect the system’s genuine problems and to deny the need for reform.

Hon. Don Mazankowski, former Chairman, Alberta Premier’s Advisory Council on Health:

This report provides a refreshing insight into new approaches and alternatives that should be considered and evaluated by all policy makers and stakeholders. As a country whose health care system is ranked 30th by the World Health Organization, it is realistic to suggest that improvements are required. It is also reasonable to assume that mere tinkering will not improve it sufficiently to meet Canadians’ expectations. This report provides timely and thoughtful input into the process of reform and advances new solutions to the problems that affect our present system. It constitutes an important contribution to the national debate.

Canadian M. David Low, Rockwell Distinguished Chair and Director of the Center for Society and Population Health at the University of Texas:

I applaud your thoughtful approach to these important issues. Thank you for the opportunity of reading this excellent work. I think it is important to do as you have done and talk about alternatives such as more taxes and/or cutting services. It is also important to give the readers a clear sense of the opportunity costs incurred while paying for most of health care from tax revenue. There are important calls on the public purse, such as subsidized child care, early childhood development programs, better elementary and post-secondary education, economic development programs, job-retraining etc. that together have an even greater impact on the health of Canadians than doctors and hospitals. Do we shelve these in favour of Romanow’s idea of putting the entire budget surplus into health care? I shouldn’t think so.


For further information, contact:
Brian Lee Crowley, President, AIMS, 902-499-1998
Brian Ferguson, 519-824-4120
David Zitner, 902-494-3802
Brett Skinner, 519-978-9936