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Can we afford medicare? Romanow to find out
CMAJ 2001;164(11):1609 [PDF]

Roy Romanow promises that his new commission on health care will examine all the options — including privatization — in its search for a sustainable system.

Sustainability is the buzzword surrounding the $15-million Commission on the Future of Health Care in Canada, which is to report in 18 months. A previous national review, the National Forum on Health launched by the prime minister in 1994, made 2 major recommendations — for national home care and pharmacare programs. Neither was implemented because the forum "didn't come up with how we can afford this system," said Health Minister Allan Rock. This time, however, Rock expects his 1-man commission will come up with ideas for a "sustainable, affordable system."

Rock says the proliferation of new technology, treatments and ways of providing service, when coupled with patients' "increasing expectations," means that the country has to rethink its priorities. However, that "doesn't mean we will depart from our principles. The genius of the [5] principles [in the Canada Health Act] is that they can adapt to the changing circumstances of time."

The provinces and territories all reaffirmed their commitment to those principles — universality, accessibility, comprehensiveness, portability between provinces and public administration — when they signed a health accord with Ottawa last September.

Romanow, the former premier of Saskatchewan, acknowledges that consensus may not be possible. "It may well be that I'm just going to have to call it as I see it, with some tough decisions and some tough fallout on either side."

His commission will spend the next 9 months gathering facts, and will then issue an interim report. It will spend the final 9 months talking with Canadians, governments, health professionals and others about the system's sustainability, accessibility and effectiveness. The final report is due in November 2002.

Romanow, who resigned from the Saskatchewan legislature in February, faces a tough haul in Quebec, where Premier Bernard Landry has already questioned his ability to remain objective. "I'm hopeful we can get their cooperation," says Romanow. "In any case, nothing is stopping us from meeting with Quebecers." — Barbara Sibbald, CMAJ



Copyright 2001 Canadian Medical Association or its licensors