The article by Steven Lewis1 proposes some interesting new roles for the federal government in the “bog and fog” of health care. However, these proposals leave me wondering what tinkering with a multilevel governance system would really accomplish in providing better health care to Canadians. I am not a health care economist or a politician, but I keep wondering why none of the multitudes of studies and reports on our medicare system, as if we had one system, did not hint at the possibility of a truly radical reform.
Why do we tolerate multiple levels of bureaucracy at all? If health care is truly a core value of Canadians, why not amend the Constitution to give the federal government complete authority to provide these services? This would eliminate 13 provincial and territorial departments of health, provincial health care associations and regulatory bodies, many federations that collectively represent these bodies at the federal level and the need for transfer payments for health care, among others.
Think about it: no more provincial medical associations or colleges of physicians and surgeons, colleges of nurses, physiotherapy and so forth. No more wrangling about inequalities in fees or regulations and no more disputes over transfer payments.
C.N. Ghent Liver Diseases and Transplantation London, Ont.
Reference
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