Part One: More background papers to the “Definitely NOT the Romanow Report”

Improving Canadian Health Care: Better Ways to Finance Medicare

This paper takes a serious look at the alternative mechanisms available to introduce new money into the health care system in Canada. By combining a flat deductible and an MSA (medical savings account) targeted at low income individuals for example you can cut medicare costs, improve accountability, build in market incentives for service improvements and give people more power in the health care system. As with all other forms of insurance, a health care deductible would set the maximum amount that individuals would pay towards their own care. A MSA is a tool that allows people to build, tax free (like an RRSP), a pool of money for future health care needs. Better Ways to Finance Medicare looks at the health care usage of Nova Scotians over the last ten years and determines that combining a flat deductible of $325 and a government-financed MSA targeted at individuals who make less than $32,000 would save medicare $88.3 million in Nova Scotia alone and reduce overall demands on the system by about 5 percent, while ensuring the people on low-incomes faced no financial obstacles to obtaining needed medical care.

Medicare and User Fees: Unsafe at any Price?

This paper seeks to provide a second opinion about the practicality and implications of introducing some form of cost sharing to the Canadian health care system. Numerous studies, including one of the largest social science experiments in history, suggest that user fees do change patient behaviour. These studies also suggest that, if properly employed, user fees have no impact on health outcomes. User fees, thus, are safe and effective.

The authors of Unsafe at any Price do not suggest that user fees are a panacea for Canadian health care. Instead they point out that the problems facing medicare are numerous and complex but, with that being said, governments have been increasingly willing to experiment with new initiatives over the past decade and the time has come for a serious look at user fees.


Part Two: AIMS Events: Here’s what you missed!

Borderlines Conference: Atlantic Canada and the US-Canada Border of the Future

Canada’s place in North America, and particularly the next steps in the evolution of our relationship with the United States, is perhaps the most pressing public policy issue facing Canada today. Similarly, the burgeoning relationship between Atlantic Canada and the US is going to be a key part of any strategy to help this region escape its traditional underdevelopment.

On November 22, 2002 AIMS was the Atlantic Canadian organizer of a national consultation on these issues. This project, called “Borderlines” is national, non-partisan, and put together by organizations and individuals across the country who share the belief that this issue may be the most important of our time. We, as Canadians, need an opportunity to educate ourselves about what is already happening, what options we may have and then help foster a debate in the country about what we want in our evolving relationship with the US.

Jack Granatstein: Will Canada Ever Grow Up on Defence?

Canada’s defence policy is the subject of increasingly intense scrutiny in a world in which security and military concerns are looming ever-larger. Few regions of the country will be as affected as Atlantic Canada by the outcome of this renewed interest in defence. On November 18, 2002, Jack Granatstein, noted author of the recently published Canada’s Army: Waging War and Keeping the Peace, historian, former Director and CEO of the Canadian War Museum in Ottawa and a regular commentator on the state of the Canadian military, delivered the latest in New Perspectives (a partnership between the Atlantic Institute for Market Studies, Corporate Research Associates, Deloitte & Touche and the Greater Halifax Partnership). As the latest in a distinguished group of guest speakers brought in as part of this speakers series, Granatstein provided a stimulating perspective on what needs to be done to sustain the military’s ability to meet domestic and international responsibilities and what meeting those demands will mean for Atlantic Canada and the country as a whole.


Part Three: Swedish lessons: Pricing their services makes hospitals healthy

One of AIMS most popular commentary series returns as Johan Hjertqvist, internationally known health care reformer, discusses the positive effects of the reintroduction of prices for health care procedures.

According to Hjertqvist, among the important reforms to the medicare model in Stockholm, no single step has been of greater importance than the restoration of prices for health care procedures in hospitals. The acronym for the price tag per treatment is known as “Diagnostic Related Group”. The DRG price mechanism, introduced in 1990, underpins the remarkable increases in productivity and efficiency in the delivery of publicly funded Swedish health care. By attaching an official price tag to every hospital treatment, government budget makers enabled providers both to improve their performance and to shift the system’s focus to the needs of health-care consumers.


Part Four: AIMS in Maine on Canadian health care

The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t

Interest in the Canadian health care system remains high in the United States. Given the prominence AIMS has achieved in the health care file in this country, Institute President Brian Lee Crowley was recently invited to a major Maine Public Policy Institute health care conference in Portland, Maine, to talk about the relevance of the Canadian model to the US.

“Canadian health care not cure-all”: AIMS in the Bangor Daily News

As Canadians struggle with how to repair our increasingly overwhelmed health care system, some of our neighbours to the south are considering copying our system. They need to be careful not to repeat our mistakes.

AIMS President, Brian Lee Crowley, was recently invited by the Maine Public Policy Institute to Portland, Maine to compare the US and Canadian health care systems and to offer advice on how the Americans might improve upon our experience as they look to move to a public, single payer system along Canadian lines. As the Bangor Daily News reports, Crowley says that, “(b)oth Canada and the United States are only middling programs, we both have much to learn from other places.” Crowley said France, which has both public and private systems providing health care, offers some lessons for those looking to reform. The WHO rates France as having the best health care system in the world.


Part Five: Columnist Charles Moore says AIMS’ report better than Romanow’s

In this piece from the Daily News, commentator Charles Moore explains why he thinks the recent AIMS study “Definitely NOT the Romanow Report” is a much more compelling and informative look at health reform than the recently released royal commission. As Moore points out, almost a year ago he was able to accurately predict the content and direction of the Romanow study: a recommendation for the continuation of a public, single-tiered, no user fee system with higher funding. According to Moore, these obvious and predictable conclusions “merely rehash(es) the prejudices and preconceptions that brought Canadian health care to its current difficulties.” This is why he is encouraging everyone to” download a copy of “Definitely NOT The Romanow Report” and check (it) out for yourself at


Part Six: National Post Editorial echoes AIMS’ concerns on EI

In this editorial from the 12 December 2002 edition of the National Post the writer echoes AIMS’ oft repeated concerns about the negative economic effects of the over $180 billion in federal transfers into Atlantic Canada since the 1950’s. Targeting the recently released report about the Fishermens’ Employment Insurance program the writer highlights the disincentives to finding long-term employment created by a program where, in some cases, you can “qualify(ing) for [FEI] benefits with as little as a day’s fishing effort, and collecting benefits for the rest of the season.”


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