Medicare in distress and near 'tipping point,' Roy Romanow says

Mark Kennedy / Ottawa Citizen

Former Saskatchewan premier Roy Romanow, who led a federal inquiry into medicare more than a decade ago, says the public health care system is deteriorating and close to a “tipping point.”

In an interview with the Citizen, Romanow called on Prime Minister Stephen Harper’s government to adopt a more activist federal approach to health care, including working to create a national pharmacare scheme. Romanow also urged Harper’s government to start enforcing the rules of the Canada Health Act, which sets broad principles that are supposed to apply to provincial health systems.

Romanow, a New Democrat, will be in Ottawa later this week to participate in a conference organized by the Broadbent Institute, an organization that promotes “progressive,” or left-leaning, policies.

In the last eight to 10 years, he said, the public health care system has dropped from the limelight as a prime political issue.

As a result, he said, there is a “growing voice” from advocates of privatization for the “abandonment” of medicare – even though he believes Canadians still cherish it as a reflection of their basic “values.”

“Unless it can be dealt with by way of federal-provincial co-operation, I think we’re very close to a tipping point. I can’t put it into weeks or months but this is not something that we can sit and idle about for another year or two years.”

Romanow said that in addition to slashing health-care funding, Harper has adopted a hands-off approach to medicare on the mistaken basis that provinces have exclusive constitutional jurisdiction for health care.

The consequences are dire if that pattern continues, he said.

“This (medicare) plan will continue to dissipate in its effectiveness, its costs will increase and the voice for privatization, let alone the lawsuits for privatization, will only increase.”

Romanow said it’s crucial for federal and provincial governments to start working again to rescue medicare from the steady decline it now faces.

“There hasn’t been much debate about health care at all. We talk about other very important issues, but it’s about time we re-ignite this debate in a civilized and emotional way.

“This is going to take visionary leadership. Leadership with, to be blunt about it, guts.”

Romanow said that since he delivered his royal commission report in November 2002, necessary reforms such as pharmacare and homecare have gone nowhere.

Moreover, the federal Conservative government has slashed the growth rate of funds to provinces for health care and has abandoned any pretense of telling them how to spend the money for necessary reforms.

“We are in poorer condition as a nation for the delivery of health care than we were 13 years ago,” said Romanow. “Up until that time we had a history of federal-provincial co-operation on this very important file.”

“I think we are in a worse condition, in a more difficult condition. And Canadians ought to be concerned about that.”

Romanow said Harper’s governing Tories are offside with how most Canadians rank the importance of medicare.

“I still think it is at the heart of Canadians. We care for each other, regardless of our region, our background, our age.

“I believe the current government has a different interpretation of the values of Canadians.”

Romanow was appointed by then-prime minister Jean Chrétien in 2001 to study medicare. The next year, he delivered a report concluding the system was financially sustainable if the federal government gave billions more to the provinces for health care on the condition they implement reforms in areas such as home care, primary care and pharmacare.

In 2004, Paul Martin’s Liberal government struck a 10-year accord to give provinces billions in extra cash, but Romanow said it came without the necessary strings attached for reform of the system.

Since Harper came to power in 2006, the governing Conservatives have said they are committed to a “universal public health-care system and the Canada Health Act, and the right of provinces to deliver health care within their jurisdictions.”

But Romanow said that the Tories have “withdrawn” federal involvement in health care.

“Canada needs an active co-operative federalist mechanism in order to put this health care program back on its feet and leading the world as it once did.”