Roy Romanow is a former NDP provincial premier who is heading up a commission
into the future of Canada's health are system.  This is from the Globe and Mail
newspaper in Toronto


 Expand public medicare system,
 Romanow says

 Canadian Press

 Wednesday, October 16 - Online Edition, Posted at 6:55 PM EST

 Ottawa - In a major speech foreshadowing findings of his report due next
 month, Roy Romanow has rejected greater private-sector involvement as a
 remedy for medicare.

 Publicly funded medicare is far more efficient than a U.S.-style free-market
 approach and indeed should be expanded into new areas, Mr. Romanow, who
 heads the royal commission on the future of health care, said Wednesday.

 A single-payer insurance system like medicare has lower administrative costs,
 he said in an address prepared for the Weatherhead Center for International
 Affairs at Harvard University.

 "Private insurance systems spend a lot of money on the extensive
 infrastructure required to deal with multiple insurance companies, assess risk,
 set premiums, design benefit packages, review claims and reimburse
 beneficiaries."

 In 1999, Canadian health spending on a per capita basis was much less than
 U.S. spending - $325 (U.S.) - compared with $1,150 paid by each
 American.

 In Canada, costs for services where the private sector is dominant have
 grown far faster than those covered by the single-payer publicly funded
 system.

 For example, per capita drug costs have doubled in the past 25 years while
 hospital and physician costs have remained stable, he said.

 "I think the universal, single-payer system should actually be expanded beyond
 the basket of services offered in hospitals or by doctors."

 He did not specify which areas should be included in an expanded system, but
 national pharmacare and home care programs are possible candidates.

 Mike McCarthy, an aide to Ontario Health Minister Tony Clement, said the
 Ontario government would welcome a national pharmacare program, if
 Ottawa provided funding.

 "Drugs are a runaway train with 15 to 16 per cent increased costs annually,
 which is not sustainable," Mr. McCarthy said. "If there was a
 recommendation for national pharmacare we'd embrace it."

 Mr. Romanow's speech said expanding medicare coverage would require
 additional public funding in the near term but ensure a more rational,
 cost-effective system in the long term.

 "If we don't lay the groundwork now, the private costs for these services will
 continue to grow with little restraint."

 In a direct challenge to policies in several provinces, he warned that medicare
 is threatened by private clinics that charge fees for MRI and other diagnostic
 services.

 MRI (magnetic resonance imaging) technology provides images of the internal
 organs, and is offered on a fee basis in several provinces.

 "This is a growing phenomenon and, in my view, potentially threatening," Mr.
 Romanow said.

 "Why? Because it is a serious violation of a core value shared by Canadians:
 The notion that people should have equal access to care."

 Patients who are tested sooner will also be seen sooner for surgery and
 follow-up care, violating the principle that medical need alone should
 determine who gets served first, he said.

 Mr. Romanow said everything must be done to reduce waiting lists and
 recommended a system in which patients would deal with teams of
 health-care providers available 24 hours a day.

 He did not specify how much money would be required or where it would
 come from. Ottawa has said it is prepared to discuss new investment in health
 with provinces.


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