“Improvements in a few short months”: Romanow

Roy Romanow has promised Canada's doctors that clarity and speedy action will be the watchwords for recommendations emerging from his much-anticipated report on the future of medicare.

Speaking at the CMA's 135th annual meeting Aug. 20, the former Saskatchewan premier said Canadians could start seeing improvements in medicare within “a few short months” of his report's November release, although some improvements will definitely take longer.

And governments will reject his report at their peril, he warned. “If the report … resonates with [Canadians'] values and with how they think the system can be repaired [and the government then rejects it], I think that is a prescription for political suicide.”

He also promised to concentrate on several key problem areas and will not offer “5500 recommendations.”

Although he is still finalizing those recommendations, Romanow dropped a couple of broad hints about issues they might address, including the Canada Health Act. “The CHA was … great for its time but I think it needs revision.”

One of the greatest challenges the system faces is public expectations about what medicare will and will not provide. Romanow argued that sustainability depends on realistic expectations. “No one thought in 1962 that medicare would cover everything for everybody.” With that in mind, the report will contain an evidence-based section on adequate funding.

Romanow also pledged to make the delivery of health care a healthier occupation: “A healthy workplace should be the first pillar of Canada's health human resource strategy.” The second pillar is a system that provides the best care in a timely fashion according to the best evidence available, and the third is adequate public funding.

Over the past 15 months, Romanow's commission has received 600 presentations from groups such as the CMA and more than 10 000 emails and letters. — Barbara Sibbald, CMAJ