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Collection of Responses to the Romanow Report
November, 2002

 



Ontario Coalition of Senior Citizens' Organizations:

Romanow Report Gets B+ From Ontario Seniors

November 28, 2002 - Toronto - The Ontario Society (Coalition) of Senior Citizens' Organizations (OCSCO) welcomes the Romanow Report’s emphasis on the value of keeping our public health care system universal, accessible to all on the basis of need, not the ability to pay.  We were particularly pleased to see his recommendation for lifting the federal transfer payments out of the block funding introduced several years ago to make provincial spending publicly accountable, for reviewing our laws on pharmaceutical patents to enable generic drugs to come to the market faster and for providing financial support to family care-givers.

While expanding our health care system to include home care, as the Report recommends, would be a significant step forward, we were disappointed that it omitted supportive care for the elderly as a priority in this area. Despite the clear proof provided last year by the National Evaluation of the Effectiveness of Home Care, that supportive care for those living with age-related and other disabilities was cost-effective, the Commissioner was content to leave it up to the provinces to expand home care into this area. With the record of Ontario’s present government in under-funding home care to a point where supportive care has been virtually squeezed out, it is hard for Ontario seniors to share Mr. Romanow’s confidence.

"Our organization fully supports most aspects of the Romanow report, including his strong opposition to the privatization of diagnostic services and hospitals as currently planned by our Provincial Minister of Health. We are concerned, however, that the services most important to seniors – supportive home care and long-term residential care -- seem to have fallen off the Commission’s radar screen” says Ethel Meade, Co-Chair of the Ontario Society (Coalition) of Senior Citizens' Organizations. “This same low priority for elder care is what we have been experiencing in Ontario since the present government was first elected.”

As an organisation representing over 140 organizations in Ontario with a combined membership of close to 500,000 seniors across the province, OCSCO has been and will continue to fight to keep seniors’ issues on the political agenda so that the quality of life for all seniors in Ontario and Canada can be improved.

For more information please contact

Victoria Boon
Communications, The Ontario Society (Coalition) of Senior Citizens' Organizations
416-785-8570

or,

Ethel Meade
Co-Chair, The Ontario Society (Coalition) of Senior Citizens' Organizations
416-785-8570
 



Canadian Health Coalition
MEDIA RELEASE

For Immediate Release
November 28, 2002

Romanow Hears the Call to Care

(Ottawa) - The Canadian Health Coalition issued the following statement in response to the release today of the Final Report
of the Romanow Commission on the Future of Health Care in Canada:

“Commissioner Roy Romanow’s Final Report is a comprehensive vision to protect and improve health care for all
Canadians, now and into the future. This Report is a milestone in the history of Canada’s best loved social program.
Canadians should be proud of the fact that our distinct identity as a country is linked to how we care for the sick. The
interpretative key to the thousands of pages in the Commissions’s report and research papers is that health care is a
human right that belongs in the public sector, and not a commodity to be sold to the highest bidder in the marketplace.
The Romanow Report is about care, not wealth creation. Everything else follows from there.

In the words of Commissioner Romanow: ‘It is a perversion of Canadian values to accept a system where money -
rather than need - determines who gets access to care.’ Failure, therefore, to stop the commercialization and
privatization of health care would represent a perversion of Canadian values and the principles of Medicare. Any
government that proceeds to privatize and commercialize health care delivery - faced with the Final Report’s
conclusive evidence that it is not in the public interest - will be deliberately destroying the foundations of Medicare,
and the heart and soul of Canada.

Today, Canadians are proud of the work of the Romanow Commission. They see and hear themselves reflected in this
Report. Medicare belongs to the people of Canada and not to corporate and government elites. Mr. Romanow has
tabled a plan from and for the Canadian people – grounded in ethics and based on evidence - to fix Medicare’s
problems and secure its future. Canadians assume the Prime Minister did not ask Romanow to draw up a plan to save
Medicare and then let it be sabotaged.

Now the First Ministers must move quickly to implement what Canadians have so passionately asked Commissioner
Romanow to report. In the coming days and weeks, the Canadian Health Coalition will be working with Canadians
everywhere to ensure that the federal, provincial and territorial governments implement the Romanow plan at the
First Ministers Conference. Failure to act quickly to save public health care will soon escalate into a crisis of
democracy.”

-30-

For More Information:
Michael McBane, National Coordinator
Canadian Health Coalition
Tel.: (613) 521-3400 Ext. 308
Cell: (613) 277-6295
 



Canadian Labour Congress and Canadian Health Coalition Preliminary Analysis of Romanow Report

Overview and Broad Principles
The Romanow Report on the Future of Health Care concluded that there is a consensus among Canadians that Medicare is a
moral enterprise, not a commercial venture.  Canadians believe that equal and timely access to medically necessary health
services on the basis of need alone is a right of citizenship.  The core values which underpin Medicare remain the same - equity,
fairness and solidarity.  As a result, Canadians reject diluting the principles of Medicare, scrapping national standards, paying
privately to get faster care, and treating health care as a business.

In his message to Canadians, Commissioner Romanow said, "I believe it is a far greater perversion of Canadian values to
accept a system where money, rather than need, determines who gets access to care."  The Report clearly states that
Romanow challenged those advocating user fees, medical savings accounts, de-listing public services, greater privatization, and
a parallel private system to provide him with evidence that these choices would improve or strengthen the health care system.
He clearly said that "The evidence has not been forthcoming."  There is no evidence that these solutions will deliver cheaper
care or improve access to care.  Further, the principles underlying these solutions are directly contradictory to the values of
Canadians and the values of Medicare.

For those reasons, the Romanow Report rejects a parallel tier of private, for-profit care for the delivery of what he calls direct
health care services such as medical, diagnostic and surgical care.  This conclusion is to be applauded.  It is based on evidence
that for-profit care will harm, not improve, Medicare.

However, the Report mistakenly says that a line can be drawn between health services and ancillary services such as laundry,
food preparation, cleaning, and maintenance services.  These services are said to be appropriate for delivery in the private
sector.  The labour movement disagrees with this approach.  These services are health services and those who provide them
are health care workers, and they see themselves as health care workers.  These services are pertinent to the health of
patients.  Good nutrition is critical to people who are sick, and the cleanliness of hospitals is essential to patients, staff and the
public.

While the Report has rejected a parallel tier of for-profit care, there does not appear to be a mechanism for ensuring that this
does not happen.  It does recommend that the Canada Health Act must be clarified to include these services under the Act.
The Report needs to be looked at more closely.

Overall, the Romanow Report offers some important steps forward to preserving and expanding Medicare for today's and
future generations, but it is just a starting point.  It has established some fundamental principles which need to be built and
expanded upon.

Public-Private Partnerships

The Report rejects the argument that Public-Private Partnerships to design, build and operate health facilities, such as hospitals,
will save the public money.  Romanow notes that these agreements have been shown to cost more over the longer term, and
can have the effect of hospital bed closures and a reduction in nurses and other health staff.  Romanow stops short of
recommending no Public-Private Partnerships.

Medical Savings Accounts, User Fees and Co-payments, Tax Credits, and Deductibles

Romanow rejects these alternative measures to raise more funding for Medicare.  In the end, all of these measures violate the
core principle of equity and equal access to care based on need for care.  These measures promote access based on ability to
pay.

MRIs and CT Scans

The Report calls all diagnostic services required to assess a patient's need for health services to come under the conditions of
the Canada Health Act, including the prohibitions of user fees, facility fees and extra-billing.  The CHA should be amended to
clarify this.

CHST

The Report calls for federal health funding to be taken out of the CHST and put into a new transfer - The Canada Health
Transfer.  This transfer would be a cash-only transfer and have an escalator clause so that federal funding would keep pace
with economic growth and our ability to pay.  The CLC has called for this since the CHST was put in place in 1995.

Expansion of the Public System

The Report recommends that the Canada Health Act should be revised to include home care services in priority areas.  This
would include post-acute home care, including drugs and rehab services, as well as coverage of palliative care in the home
during the last six months of life.  Also, it would include a program of support for informal care givers.  Home mental health
services should immediately come under the CHA.

It calls for a Catastrophic Drug Transfer to help provinces with their drug plans.  Eventually, the CHA would cover the cost of
prescription drugs.

It calls for a creation of a National Drug Agency to control costs and insure the safety of drugs and it also calls for the
establishment of a National Drug Formulary to help control costs.  Finally, it calls for a review of aspects of the Patent Act.

There must be an effective dispute mechanism maintained in the CHA.  The dedicated Health Transfer would be directly
connected to the principle and conditions in the Act.

The Report calls for the development of a Rural and Remote Access Fund to attract and retain health care providers, including
opportunities for health professionals in training to gain experience for doctors, nurses and other health providers.

The Report states that the current status of injured workers getting preferred access to care violates the principle of equal
access to care for all Canadians.  The Canada Health Act allows this to take place.  This exception needs to be reconsidered.

Accountability

The Report calls for the establishment of a new Canadian Health Covenant which would state Canadian values and would be a
guiding force for Medicare.

A Health Council of Canada would be established to analyze and assess the national health system as a whole.  Membership in
the Council would include the public, providers and governments.

The Canada Health Act should be revised to include a Sixth Principle of Accountability.

Trade and Health Care

In recognition of the threat to health care from globalization, Romanow sends a clear message to the federal government that
current protections for health care in trade agreements must not be weakened.  Future expansions and actions must be
protected in all future agreements.

The right to regulate health care policy should not be subject to claims from foreign companies.

Primary Care Reform

The Primary Care Transfer should drive changes to the primary care system.  We need a common national platform for health
care reform.  Prevention and promotion initiatives would be a part of this.  Primary care needs to be delivered in
multi-disciplinary teams in a community-based setting.

All funding sources for Aboriginal health care should be pooled into a new Aboriginal Health Partnerships Fund.  The goal is to
improve access to care and provide adequate, stable funding.

The system needs to reflect cultural diversity and language barriers to accessing care.

Funding - Making Medicare Sustainable

Civil Society organizations have called for the federal government to increase its share of health funding to 25% of publicly
insured health services.  The Romanow Report recommends that the federal government move to this standard by 2005-06
with increased funding in each of the next three years.

The Report calls for new federal funds to bring the federal share up to 25% of insured health spending provided under current
provincial plans.  This will require additional investments to be added to the current level of funding.  This would mean a new
investment of $3.5 billion next year, 2003-04, followed by an additional $5 billion the next year, 2004-05, and a $6.5 billion
increase in 2005-06.  By 2005-06, these increases will bring the federal cash transfer to $15.3 billion per year.  Romanow
assumes that this will equal 25% of the public health services insured under provincial health plans.  An escalator clause will
increase this cash floor according to economic growth. These funding arrangements need to be stable and predictable.

These funds would be targeted to specific spending areas over the next two years.
 

                                                   2003-04$ billion                 2004-05$ billion

Diagnostic Services Fund                     .75                                        .75
Rural and Remote Access                    .75                                        .75
Primary Health Care                            1.0                                        1.5
Home Care                                          1.0                                        1.0
Drugs                                                    --                                        1.0
                                                 __________________________________

TOTAL                                               3.0                                       5.0
 

In 2005-06, the federal transfer for that year would rise from $5 billion to $6.5 billion, bringing the total federal cash transfer to
$15.3 billion that year.
 



Council of Canadians
Romanow Report reflects Canadians’ Demand for Better Public Health Care

November 28, 2002

OTTAWA, ONTARIO - The Romanow Report constitutes a major step in the right direction and it
is hoped that the federal government will implement most of its recommendations, says the
Council of Canadians.

"Mr. Romanow has examined the empty rhetoric of the free-market ideologues and provincial
politicians, and has proven that privatization will destroy, not improve our system," says
Maude Barlow, Council chairperson and author of the book, "Profit is not the cure".

                     "Mr Romanow has a solid plan to build upon Canada’s effective and cherished public health
                     care system. He has examined the facts and demonstrated that the way forward is to expand
                     the public health system and reject the right wing provincial governments’ plans to open our
                     system to giant health corporations."

                     Colleen Fuller, a health care researcher and Council Board Member read the full report in the
                     lock up this morning. "I am very impressed with the comprehensiveness of the Commission’s
                     work. It is crucial that government adopt the recommendations to expand its role and financial
                     support for the public system and expand services in diagnostic, primary care, home care and
                     drugs."

                     However, while the body of the report addresses many crucial issues facing our health care
                     system, Fuller believes many of the recommendations do not go far enough. "Romanow comes
                     out against the ideology of greed represented by for-profit delivery, but it's nowhere in the
                     recommendations. We need to be very concerned that the Liberal government will increase
                     funding for health care but will then allow the provinces to pour that money into private health
                     care delivery."

                     "Canadians must be ready to speak out over the coming months to assure that the Liberal
                     government will stand up to the corporate lobby and adopt the Romanow recommendations,"
                     says Council Health Campaigner, Anil Naidoo. "We must also block every attempt to include
                     health care in the current trade negotiations in the FTAA and the WTO, and must convince the
                     government to adopt recommendation 44 that would prevent trade agreements from allowing
                     foreign corporations to sue us for our national health system."

                     The Council of Canadians along with many partner organizations will be hosting a national
                     forum on health care in Ottawa, February 7 – 9, 2003 to continue the efforts to improve our
                     public health care system.

                                                         -30-

                     For more information, please contact:
                     Guy Caron, Media Relations, Council of Canadians – 613.233.4487 ext. 234 or 613.795.8685
                     (cell.)
 



Canadian Centre for Policy Alternatives
FOR IMMEDIATE RELEASE
November 28, 2002

                 Romanow report: You get what you pay for
 

OTTAWA‹The Romanow report is a clear rejection of the status quo
and a pragmatic step in the right direction to secure the future of
public health care, according to CCPA economist Armine Yalnizyan.

Yalnizyan applauds Romanow¹s recommendation that the CHST be
scrapped in favour of a dedicated health fund which would allow
greater accountability for health care expenditures. She also cites the
national drug formulary as an important way to help control
pharmaceutical costs.

Bruce Campbell, Executive Director of the CCPA, applauded the
report¹s strong recommendation to protect Medicare from international
trade agreements. ³He clearly followed the recommendations of the
CCPA¹s report to the Commission on globalization and Medicare.²

Yalnizyan points out, however, ³The old saying Œyou get what you pay
for¹ has never been more relevant. The report is strong on process but
weak on money.²

While Romanow points to progressive taxation as the only sustainable
way to fund Medicare, the report is silent on where the money comes
from. ³This is not the time to be coy,² says Yalnizyan. Furthermore, the
$3.5 billion injection into the health care system for this year is
substantially less than recent estimates of what is needed, including
the Kirby report and Romanow¹s own backgrounder on these issues.

The Romanow report also does not address the issue of chronic care,
a glaring omission at a time when we are faced with the prospects of
an aging population.

Given this renewed commitment to a strong federal role, Yalnizyan
says, ³The Prime Minister and federal leadership contenders should
take note: there is a short window of opportunity to see meaningful
movement. Without immediate action, you can kiss a national health
care program good-bye.²

A more detailed analysis of the Romanow report is available on the
CCPA web site at http://www.policyalternatives.ca
 


Canadian Labour Congress
For immediate release    Thursday, November 28, 2002

MEDICARE DEBATE IS OVER; TIME TO ACT, SAYS LABOUR

OTTAWA and VANCOUVER – The Canadian Labour Congress, whose members’ families represent more than six million
health care users, today expressed strong support for the key recommendations of the final report of the Commission on the
Future of Health Care in Canada (the ‘Romanow Report’).

“The Medicare debate is over; it’s time to act,” said Ken Georgetti, Canadian Labour Congress President.  “The Romanow
Report is a blueprint of what needs to be done to preserve and improve Medicare.  Ottawa and the provinces must now get to
work expanding Medicare to meet the public’s needs.”

Georgetti commented from Vancouver, where he is attending the B.C. Federation of Labour Convention.

In Ottawa, Barb Byers, Canadian Labour Congress Executive Vice-President, called for the Romanow Report to be “job
one” for the federal government.  She added that concrete proposals should be in place for next January’s First Ministers’
Conference and the February federal budget.

“The Prime Minister has repeatedly said that his government was awaiting the findings of the Romanow Commission before
acting,” Byers said.  “Romanow has discredited the for-profit, private sector health care delivery model. The way is now clear
for swift action.”

However, Georgetti disagreed that such hospital services as laundry, food preparation and maintenance were medically
non-essential, opening the door to privatization.

“These in-house services are kept to high, exacting standards to ensure patient health and safety,” he noted.  “The Canadian
Labour Congress and its affiliates will vigorously fight any privatization moves at all levels of government.”

The Canadian Labour Congress, the national voice of the labour movement, represents 2.5 million Canadian workers. The
CLC brings together the majority of Canada's national and international unions along with the provincial and territorial
federations of labour and 137 district labour councils. Web site: www.clc-ctc.ca
    - 30 -

Contacts:    Jean Wolff, 613-526-7431 and 613-798-6040
        Jeff Atkinson, 613-526-7425 and 613-292-1413
        communications@clc-ctc.ca
 



NUPGE

8 November 2002

                Romanow is Right. Ottawa must act on report now!

           Public Medicare should be protected and expanded, final report recommends
 

Ottawa - The final report of the Romanow Commission is a responsible blueprint that will secure the future of
Medicare for today and for future generations. Canadian governments must now work together to immediately
implement the report's recommendations, says Canada's second largest union.

"Canadians told Mr. Romanow that they like, need and want public Medicare," says NUPGE president James
Clancy. "Mr. Romanow has listened. His prescription of increased public funding to shorten waiting lists and
curb privatization is the right remedy for health care," Clancy said following the release today of the Royal
Commission report on the future of health care in Canada.

"This report offers political leaders at all levels an unparalleled opportunity. They now have a simple choice to
make: strengthen and preserve Medicare by working together to implement the Romanow report immediately,
or preside over the death of public health care in Canada by leaving the report on the shelf to gather dust."

Clancy cited the results of two national polls this fall - one carried out by Vector Research and Development
and the other by Ipsos-Reid. Both found an overwhelming consensus that the time for study is over and the time
to take action to renew Canada's health care system has arrived.

"It is in times of great need and opportunity when true leaders emerge.  If the Prime Minister wants to do
something great for Canada and leave a lasting positive legacy, he must show the moral strength and political
courage needed to put the Romanow Commission's vision to work now," said Clancy.

In his final report Romanow reinforces the premise that health care is best delivered as a public good, not as a
commodity. Throughout his 18-month countrywide review, Mr. Romanow challenged those pushing private,
for-profit solutions (greater privatization, user-fees, medical savings accounts, de-listing services, a parallel
for-profit system, public-private partnerships) to come forward with the evidence that this approach would
improve the health care system. The evidence was not forthcoming and the Commission's final report rejects
these private 'innovations' as standard right-wing nostrums, concluding that protecting and expanding the public
system is the best way to achieve fairness and value for money.

"The debate about public not-for-profit versus private for-profit Medicare should now be put to rest forever,"
said Clancy.  "The evidence gathered by this Commission is clear: Canada's public Medicare represents the
triumph of values and economics."

Clancy did point out a weakness in the final report: the statement that laundry and food services, so-called
ancillary services, have no direct bearing on patient well-being and therefore should continue to be subject to
privatization and contracting-out.

"Private delivery of health care, including laundry and food services, is more expensive and provides poorer
quality of service, period," said Clancy. "Any recommendation to privatize these services is a slap in the face to
all the dedicated, well-trained public employees delivering those very important services. Clearly, the
companies wanting to provide these services have a profit margin in mind, not the care of patients."

Clancy added that "NUPGE will continue to oppose any recommendations and plans to contract out any health
care services and ensure the rights of those workers are protected."

"It's time for ideologically motivated governments to end their infatuation with private health care and get on with
the job of expanding the public system, as Romanow recommends, to cover home care and prescription
drugs,"

The National Union of Public and General Employees represents 325,000 workers across Canada,
including 75,000 health care workers.

 


 28 November 2002
 
 

NUPGE Report Card on the Romanow Report

By NUPGE Research
 
 

Since the beginning of our campaign to protect and build Canada's Medicare, the National Union of Public and General
Employees has recommended that the different levels of government work together to reach ten objectives. We believe that
these ten objectives are not only about the health of Canadians, they are also about the economic health of Canada. Achieving
these ten objectives is the best way to ensure that we have a sustainable health care system that reflects Canadian values and
lives up to Canadian standards for efficiency. We also believe that these ten objectives draw on the courage of the original
vision put forward by the pioneers of Canada's Medicare and fulfill that vision by restoring, rethinking, and reinvesting in public
Medicare and the people who provide health services. This report card is intended to evaluate how well the final report of the
Romanow Commission stacks up against the National Union's ten objectives.
 
 

Objective 1

Adequate and stable public funding

Romanow Report Grade:  A

The report recommends the federal government provide "adequate, predictable, and stable public funding for Medicare." To do
so, the report recommends a multi-billion dollar injection of federal funds until it reaches 25% minimum cash floor of CHA insured
services - $6.5 billion a year by 2006 - $3.5 Billion in 03/04, $5 billion on 04/05, and $6.5 Billion on 05/06.
 
 

As equally important, the report recommends that the new federal cash be used to "buy change" by attaching strings to the new
funds.
 
 

In addition, the report recommends that the CHST be abandoned and replaced with a separate fund for health care transfers to
the provinces (called the Canada Health Transfer) with a built-in escalator provision so that federal funding would keep pace with
economic growth. This is the kind of accountability and transparency that's necessary to ensure that any new health dollars
actually go to health care services rather than tax cuts or other areas and it is something the labour movement has called for the
last 8 years.
 
 

The Romanow report is much better than the Kirby report when it comes to increased public funding for Medicare. Kirby
proposed what amounts to a permanent user fee, payable by all tax payers, to be called the National Health Care Insurance
Premium, to be spent only on health care. Kirby's proposal would not raise enough funds and it does not meet the test of
fairness.
 
 

Objective 2

Never for profit

Romanow Report Grade:  B

The report states that: 'Medicare is a moral enterprise, not a commercial venture. Medicare is a right of citizenship. It is a far
greater perversion of Canadian values to accept a system where money, rather than need, determines who gets access to care. "
The report concludes that private, for-profit health care runs the risk of being more expensive, providing worse care and
undermining the value of fairness.
 
 

The report clearly states that Romanow challenged those advocating private sector solutions to provide the evidence but the
evidence was not forthcoming.
 
 

The Romanow report also recommends decisive action to curb the growing number of private for-profit MRI and other medical
services clinics, concluding that these private clinics lead to queue-jumping and this violates the principles of the Canada Health
Act. The report also recommends that there be no user fees, facility fees or extra billing fro MRIs and CT scans. On diagnostic
services, more specifically, the report proposes a Diagnostic Services Fund of $1.5 billion over 2 years and the report
recommends that CHA include coverage for all diagnostic services, a major area of current privatization. It also recommends
that Ottawa penalize those provinces that continue to allow private MRI clinics and similar medical services clinics.
 
 

The answer to Canadian health needs, the report concludes, does not lie in the private sector but in a better funded public
system. The report looks at Public-Private Partnerships and essentially concludes that they're not a good idea and will end up
costing taxpayers more than if the government had simply done the job itself in the first place. The report also notes that these
arrangements can have the effect of hospital bed closures and a reduction in staffing levels.
 
 

The Romanow report also recommends that user fees, medical savings accounts, deductibles and tax-based co-payments
continue to be banned by the CHA.
 
 

Clearly, this is much better than the Kirby report which has no problem with further commercialization, private for-profit ownership
and delivery.
 
 

HOWEVER, the report does have a major weakness on the issue of privatization: It offers reasons and suggests there is
evidence that contracting-out of non-medical services such as food preparation, laundry, maintenance and cleaning is okay. This
is not the right thing to recommend or the smart thing to recommend and therefore the report, on this point, is extremely
disappointing.
 
 

PLUS, while the report gives strong rationale for opposing private for-profit care, the report is missing a recommendation of a
specific mechanism for banning private, for-profit delivery of health services.
 
 

PLUS, while the report is critical of P3s it stops short of recommending they be banned and even suggests that they might be
useful in non-direct health areas such as developing "health information systems."
 
 

Objective 3

Debunk private health care myths

Romanow Report Grade:  A

The report is an eloquent defence of public Medicare. It offers unqualified support for the principles underlying public Medicare.
It dismisses the myth that public Medicare is on the brink of collapse. It debunks the myth that public Medicare is unsustainable
or unaffordable. It also challenges the myth that private, for-profit care is more efficient, would shorten waiting lines, and provides
better care (except when it comes to support services and this is a problem with the report). It also concludes that 'innovations'
such as user fees, medical savings accounts, P3s etc. are nothing more than standard right-wing nostrums that will do nothing to
improve Medicare.
 
 

Objective 4

A comprehensive national health human resources strategy

Romanow Report Grade:  C+

There are not enough substantial recommendations on this subject.
 
 

The report argues for a national database to track and forecast shortages and it also recommends that governments stop
recruiting health care workers from third world countries.
 
 

The report calls for a Rural and Remote Access Fund ($1.5 Billion over 2 years) to attract and retain health care providers,
including opportunities for health professionals to train and gain experience.
 
 

Objective 5

Primary Care Reform - Develop a system of blended care

Romanow Report Grade:  A

The report recommends a common national platform for primary care reform.
 
 

It recommends kick-starting primary care reform with a $2.5 billion investment over 2 years through a Primary Health Care
Transfer. The changes it proposes include: full-service community health clinics where patients can access a team of health
professionals 24-7and receive everything from a doctor's prescription to nutritional advice to physiotherapy and psychiatric help.
It also recognizes the need for cultural diversity and language barriers to accessing care in communities and says this must be
addressed.
 
 

Of course, service delivery is provincial jurisdiction, so Romanow recommends the federal government link the new funding to
provincial pursuit of the community clinic model.
 
 

The report also talks about the need to put more emphasis on wellness and prevention programs.
 
 

This recommendation is similar to Kirby's proposal of creating primary-care groups of different types of health-care providers.
However, Romanow's recommendation is better in that it calls on the federal government to use any new money to "buy the
changes needed in primary care reform" and it talks about wellness and prevention programs being critical to good health.
 
 

Objective 6

Add home care to the Canada Health Act

Romanow Report Grade:  B+

The report recommends that Ottawa kick-start the process to a national home care program by covering all priority home care
services - i.e. intervention services, home mental health services, palliative care, post-acute home care through a Home Care
Transfer of $2 billion over 2years.
 
 

The Kirby report called for a national home care program that would cover only those just released from hospital or those near
death. Romanow's report, however, wants all home care, including medical services required by the elderly and disabled, to be
fully covered under the CHA. Those who receive nursing or other medical care at home would no longer pay out-of-pocket
charges.
 
 

The Romanow recommendation is better than Kirby's proposal which is to expand public coverage only to acute home care and
palliative care situations, however, despite being a great first step it does not meet our objective entirely.
 
 

Objective 7

Add long term care to the Canada Health Act

Romanow Report Grade:  D

The Romanow report is very weak on this. It assumes, for the most part, that through home care reform that includes coverage
for acute care and palliative care, that you would be able reduce the demand for beds in long-term care institutions. The report
does not recommend national standards for long-term institutions and it does not recommend new immediate public funding for
long-term care.
 
 

Objective 8

Add a national pharmacare program to the Canada Health Act

Romanow Report Grade:  A-

The report concludes that the short term priority should be to provide public funding for "catastrophic drug costs" with the
Canada Health Act eventually covering the cost of prescription drugs.
 
 

It recommends the establishment of a National Drug Agency and a National Drug Formulary as a national strategy for dealing with
soaring drug costs, providing comprehensive coverage and objective and accurate information on drugs.
 
 

The Romanow report also calls for a review of current drug patent laws in Canada.
 
 

This recommendation falls short of our call for a National Pharmacare Program but it offers a huge step in the right direction,
especially on the review of patent law recommendation.
 
 

The Romanow recommendation is better than Kirby's proposal which calls for public coverage after $5,000 and does nothing to
address the root causes of soaring drug costs (patent law).
 
 

Objective 9

Exclude health services from all international trade deals

Romanow Report Grade:  A

The Romanow report offers a strong message on this issue. The report issues a 'warning flag' on globalization and trade deals
and their impact on the future expansion of public health care.
 
 

It recommends that governments must not delete the clauses in current trade deals that exempt public health care from trade
negotiations and liberalization.
 
 

It also states that any future efforts to expand public Medicare must also be protected from trade deals.
 
 

It also states that the right to regulate health policy should not be subject to claims from foreign companies.
 
 

The Romanow recommendation is better that the Kirby report which ignores altogether the risks posed by NAFTA and other
trade agreements that further privatization of health services would open the door to US and other foreign corporations to
penetrate our Medicare and take over its services.
 
 

Objective 10

Women's equality in health care

Romanow Report Grade:  A-

The report recommends that governments provide some kind of financial aid to those (overwhelmingly women) who have to
stay at home to care for sick, elderly or disabled relatives. The recommendation of increased public funding and reversing the
trend of privatization is also very helpful for health care workers the majority of whom are women. Not enough about addressing
the unique health needs of women and access issues.
 
 

However, the recommendation which offers reasons fro contracting-out support services would unevenly affect women workers
and so this aspect of the report could have been better.
 
 

The Romanow recommendation is much better than the Kirby report which ignores the uneven burden faced by women when it
comes to unpaid care giving in the home. Further the Kirby endorsement of private for-profit ownership of facilities and services
would actually exacerbate the uneven burden and unequal access to health services faced by women.
 
 

Other Important Recommendations
 
 

·        The report states that current status of injured workers getting preferred access to care violates the principle of equal
   access.

·        A new Canadian Health Covenant is proposed to express Canadians collective vision for health care and updating the
   Canada Health Act.

·        A New Health Council of Canada to foster collaboration amongst governments and stakeholders.

·        The report recommends that a 6th principle of "accountability" be added to the Canada Health Act.
 
 
 
 

FOR MORE INFORMATION:

Contact Mike Luff at

Phone: 613-228-9800

Fax:  613-228-9801

Email:  mluff@nupge.ca

Visit:    www.nupge.ca

      www.savemedicare.com

      www.youthformedicare.ca
 


<CUPE response to Romanow Comm 28Nov02.doc>> > >  <<FR-CUPE response to Romanow Comm 28Nov02.doc>>
>
> No room for privatization anywhere in health care
>
> OTTAWA - Canada> '> s largest union is pleased the Romanow report strongly rejects for-profit health care and is calling on
the Chrétien government to move immediately to strengthen our public health care services.
>
> "> We now have a blueprint for action. It> '> s time for a fully public system. The Chrétien government has been sitting on
the sidelines for far too long. Canadians want them front and center, taking action to stop dangerous privatization experiments
in the provinces and investing in better public health care,> ">  says Judy Darcy, National President of the Canadian Union of
Public Employees.
>
> CUPE made several presentations to the commission, including an expert briefing on the health, economic and trade dangers of
privatization and public private partnerships in health care.  Key to CUPE> '> s vision of better public health care is a
reformed and expanded system that> '> s public from top to bottom.
>
>  > "> Commissioner Romanow is right on the mark when he says for-profit health care won> '> t improve access or quality and
that> '> s true for the full range of services at the heart of health care,> ">  says Darcy.
>
> One area of concern in Romanow> '> s report was his laissez-faire attitude to privatization of key patient services in
hospital settings.
>
> "> A sterile operating room, clean laundry and nutritious food are absolutely critical to patient health.  Handing these
services over to big business makes no more sense than privatizing clinical care.  Patients will suffer while precious health
care dollars are diverted to corporate profits,> ">  says Darcy.
>
> Unlike other areas of his report, it does not appear that Romanow commissioned studies on the impact of privatizing hospital
support services.  But evidence from across Canada and around the world demonstrates that services suffer when profit becomes
the bottom line.  In the US, deaths linked to hospital germs represent the fourth leading cause of mortality among Americans.
>
>  > "> We know that privatization kills. Well germs kill too. Paying people - mainly women - minimum wage will lead to high
turnover.  Cutting corners and high turnover can be disastrous in a job where attention to detail can make the difference
between life and death,> ">  says Darcy.
>
>  > "> Higher costs, lower quality and increased staff turnover have plagued health services that are turned over to the
private sector. The report advocates an integrated approach to patient care. We agree. You can> '> t carve off pieces of the
system and put them up for sale,> ">  says Darcy.
>
> CUPE, as part of a broad coalition of labour and community groups, plans to step up the pressure on the federal government to
defend and strengthen our public health care system in the weeks and months to come. Last week, CUPE took legal steps to force
the federal government to live up to its responsibilities under the Canada Health Act.
>
> "> We know the federal Liberals will be hearing from literally thousands of Canadians, demanding the government finally take
action. And we expect them to listen,> ">  says Darcy.
>
> CUPE> '> s half-million members include 180,000 who work on the front line and behind the scenes in health care.  For more
information, visit cupe.ca.
>
> -- 30 --
>
> For information:
>
> Robert Fox, CUPE communications (613) 795-4977
>


         Romanow Report Strong, But Has Critical Weaknesses
 

                              Canadian Union of Public Employees

                                       November 28, 2002

The 47 recommendations made by Roy Romanow in his long awaited report on the future of health care
provide a solid framework for reform.
 

The strength of Romanow’s report lies in his steadfast promotion of publicly-funded health care as the best
model - one that is clearly sustainable - and in his recommendations to expand and strengthen the Canada
Health Act.  The weakness of his report is that he does not provide policy instruments to keep the for-profit
sector out of health services.
 

There are other problems, but Romanow’s most significant concession to the private sector is in his statement
that there must be a clear line drawn between direct health services and support services and that only direct
health services should be free from private, for-profit delivery.  This conclusion will embolden employers and
provincial governments to contract out dietary, laundry and cleaning services.  The consequence will be a
transfer of well-paying, unionized jobs with benefits to lower paying, non-union jobs with few benefits.  The
livelihoods of women, minorities and immigrant workers are being sacrificed to save money in the overall
system.
 

On the positive side, Romanow recommends that federal funding be increased to 25% of total health
expenditures and that a separate health transfer be created.  The federal government should inject $6.5 billion
over the next two years to ensure that recommendations are implemented.
 

Romanow reflects CUPE’s critical analysis of public private partnerships and says that they are “not a
panacea.”  However, he fails to rule them out absolutely as a viable alternative in some areas of health care
including health information systems.
 

User fees, extra billing, and medical savings accounts are all rejected as alternative funding mechanisms.
 

                                                                                            …/2

                                              - 2 -
 
 

Home care services (palliative care, post acute care and mental health) are to be incorporated into the Canada
Health Act and covered as “insured services.”  This is a significant step forward but does leave preventative
care, care for people with disabilities and long term care out of the equation.
 

The creation of a National Drug Agency and a national formulary will be major steps forward in monitoring and
controlling drugs, the fastest rising cost in the health care system.
 

Romanow is recommending that MRIs and other medically necessary diagnostic services be clarified and
included in the Canada Health Act.  This is welcome but does not represent a substantive change from the
current situation.  Under Romanow’s suggestion for-profit clinics are still likely to exist but may see their funding
flow dry up. Romanow is recommending the inclusion of workers’ compensation injuries as a Canada Health
Act insured service. WCB is currently a major revenue source for private clinics.
 

For other details see the CLC preliminary analysis at www.clc-ctc.ca <http://www.clc-ctc.ca/>.
 



Attention News Editors:

CAW applauds Romanow Commission
 

    TORONTO, Nov. 28 /CNW/ - Buzz Hargrove, president of the Canadian Auto
Workers union, sent the following letter to Prime Minister Jean Chrétien,
following release of the highly anticipated Romanow Report. As well, a similar
letter was sent to the Premiers urging the provinces to work with the federal
government to implement the Report's recommendations:
 

                                                          November 28, 2002
    The Right Honourable Jean Chrétien
    Prime Minister
    House of Commons
    Ottawa, Canada,

    Dear Prime Minister,

    I am writing to strongly urge that your government act immediately on
implementing the landmark Romanow Report, especially with respect to providing
increased federal funding. We do however want to highlight some shortcomings
which include drawing a line between medical and non-medical services which I
will elaborate upon further.
    The Canadian Auto Workers union applauds the Romanow Commission's report
on the Future of Health Care in Canada that offers both a diagnosis and a
prescription for securing our universal public health care system.
    I urge you as Prime Minister to act immediately, and work with provincial
governments to implement the Report's recommendations.
    Following extensive consultation and open debate with Canadians, the
report reflects Canadians' fundamental values of equity and fairness. The
report reaches the conclusion that access to health care must be based on
need, not wealth, rejecting a commercial, for-profit health care system.
    CAW welcomes the Report's recommendations that diagnostic services and
some home care services be included under the Canada Health Act, that federal
health care funding be increased and transferred on a stable predictable
basis, that Canada's health care system be protected from challenges under
international law and trade agreements, that Canada play a leadership role in
international efforts to improve health, and that Canada take the first step
towards pharmacare.
    Nevertheless, CAW does have concerns and believes the Report is not
without shortcomings. Drawing a line between the delivery of 'medical' and
'non-medical' services, omitting chronic home care from the national home care
proposal and expanding the scope of pharmacare are areas which government must
include in our national public health care system.
    The delivery of quality care includes food preparation and service, as
well as maintaining a sanitary environment. The continuous interaction between
front line medical staff and food service and maintenance staff is essential
if we are going to be providing the quality of care necessary in our
hospitals, chronic care and nursing homes. Romanow cannot draw an artificial
line between "medical" and "non-medical" services.
    The Report concludes that advocates of private for-profit health care
failed to support their argument that such a system would cut costs, enhance
access, and deliver quality care. To this end, the debate about for-profit
versus public universal care should be over and action on the Romanow Report
should be the focus.
    In the weeks ahead CAW members will be working with others across Canada
mobilizing their communities to pressure elected government officials to
implement these recommendations in the New Year.
 

                                               Sincerely
 

                                               BASIL "BUZZ" HARGROVE
                                               President
 

    cc: Hon, Anne McLellan, Minister of Health (613-943-0044)
        Steven Harper, Leader of the Opposition (613-047-0310)
        Alexa McDonough, Leader of the NDP (613-992-8569)
        Rt. Hon. Joe Clark, Leader PC (613-947-8898)
        Gilles Duceppe, Leader Bloc Quebecois (613-954-2121)
 
 
 
 

-30-

For further information: Contact: Jane Armstrong, CAW Communications
Dept., (416) 495-6548 or cell (416) 409-0106

CANADIAN AUTO WORKERS has 208 releases in this database.
 


Attention News Editors:

Models for good health care management: Steelworkers applaud Romanow Report

    TORONTO, Nov. 28 /CNW/ - The United Steelworkers National Director
Lawrence McBrearty says Thursday's release of the Romanow Commission Report on
the Future of Health Care in Canada is an important milestone in the evolution
and preservation of Canada's comprehensive, single-payer health care system.
    "Our union represents several thousand workers in the health sector,"
McBrearty said. "For that reason, and by virtue of the fact that all citizens
come in contact with the health care system several times during their lives,
our message of support for the Romanow recommendations is significant.
    "The pressure to move health care to a private model has been dismissed
by the research conducted by the commission," he added. "By receiving the
evidence and weighing it, Romanow has brought forward recommendations that
reflect the voice of Canadians."
    McBrearty said primary health reform is especially important to
Steelworkers, who initiated the long-standing group health centre in Sault
Ste. Marie. The centre was officially opened in October, 1963, and has been
operating successfully ever since.
    "The centre provides multi-disciplinary, community-based and managed
health care," said McBrearty. "Today, more than 50 per cent of citizens in the
Sault have their primary care needs served by the Group Health Centre.
    "As the union that took that first step two years before Medicare was
introduced nationally, we believe the Group Health Centre is a wonderful model
for other communities, large or small."
    McBrearty said Romanow has done his job, and now it is up to the
government to act quickly on the Report, to expand and modernize the health
care system that the majority of Canadians support.
    "The high profile of this commission must be followed by immediate
action," he said. "Members of our union will be watching and contacting their
MPs for progress on the recommendations."
    McBrearty noted the sentiments of retired Steelworkers, many of whom are
members of the Steelworkers Organization of Active Retirees (SOAR), and who
were on hand for several of the hearings held by the Romanow Commission.
    "We are happy that the commission is recommending national initiatives in
home care and pharmacare," he said. Many of our sisters and brothers are in
need of support to continue to live independently."
 
 
 
 

-30-

For further information: CONTACT: Lawrence McBrearty, (416) 575-2486

UNITED STEELWORKERS OF AMERICA has 192 releases in this database.
 



CFNU Press Release

------------------------------------------------------------------------------------------------
 

For immediate release                                                       28 November 2002
 
 

 “Romanow is right.   Reforms will shorten waiting time
                   and improve care,”  Connors, RN
 
 
 
 

Ottawa: The President of the largest organization of nurses in Canada predicted that Health Care Commissioner Roy
Romanow’s report would lead to a genuinely revitalized Medicare.  She also praised Prime Minister Jean Chrétien and urged
him to follow through on his intention to fully fund the Romanow reforms.
 
 

“The Commissioner’s reforms to Primary Health care will particularly improve patient care by giving nurses the opportunity to
use their skills and knowledge more fully,” said Connors.  “Nurses, doctors and other health care providers working in teams
will cut waiting times and patients’ frustrations.  By the way, nurses have called for this since I was in nursing school.
 
 

“Through this report, Medicare could take a giant step forward.  The Commissioner has called for including the following in the
Canada Health Act: Home Care, Diagnostic Services, Pharmacare, and a mechanism for Accountability.  He has also
recommended adequate additional funding.
 
 

“Medicare’s founder, Tommy Douglas, said long ago that Medicare needs to grow beyond the services his Medicare
covered.  In this sense, Roy Romanow has offered Canada Tommy Douglas II.  It will greatly improve the quality of care in
our public system.
 
 

“The Commissioner got it right because he started with the right outlook.  He said he would be guided by two things: The
Canadian values of fairness, equity and solidarity, and by the evidence.
 
 

“These values led him to recommend expanding public, not-for-profit Medicare to include Home Care and Pharmacare and to
recommend a genuine system of Primary Health Care.
 
 

“The evidence led him to ignore the pleadings of powerful private for-profit health care interests and, instead, recommend that
health care delivery remain in not-for-profit hands.
 
 

“On behalf of Canada’s nurses, I’d like to thank the Prime Minister for his wise appointment and I’d also urge him to not be
swayed from implementing these important reforms to Medicare.  The provinces won’t do it.  It will take strong leadership
from Prime Minister Jean Chrétien.
 
 

“Nurses look forward to participating in the full implementation of this report,” Connors concluded.
 
 

For more information: Kathleen Connors, RN, (c) 613-859-7060 or Tom O’Brien: 613-526-4661; (c) 613-294-3592

 



Federal NDP

From:   NDP/NPD Communications
> Sent: November 28, 2002 11:34 AM
> To:   -NDP Lobby/Antichambre NPD
> Subject:      Communiqué-FROM DESTRUCTION TO CONSTRUCTION: NDP SUPPORTS
> FINDINGS OF THE ROMANOW COMMISSION/ ET VLAN POUR LES TENANTS DE LA
> PRIVATISATION: LE NPD APPUIE LES CONCLUSIONS DE LA COMMISSION ROMANOW
>
>
> FOR IMMEDIATE RELEASE                 NOVEMBER 28, 2002
>
> FROM DESTRUCTION TO CONSTRUCTION:
> NDP SUPPORTS FINDINGS OF THE ROMANOW COMMISSION
>
> OTTAWA - The report of the Romanow Commission on the Future of Health Care
> in Canada sets out the fact-based arguments for rebuilding the
> not-for-profit health care system.  After exhaustive consultations and
> analysis, the Commission has concluded that a government willing to expand
> the funding and services covered under the Canada Health Act will best
> serve Canadians.
>
> "Canadians can celebrate that the answers they have been looking for to
> guarantee health services will be available where and when they need them,
> can be found in the report of the Romanow Commission," said New Democratic
> Party leader Alexa McDonough.  "The question that remains to be answered
> is whether the government has the will and the fortitude to implement the
> Commission's findings and take on the opponents of our not-for-profit
> health system."
>
> The Romanow report reveals that running the delivery of health care as a
> business is based on ideology rather than an objective review of what
> model best serves the health needs of Canadians.
>
> "Taking on today's political opponents of the Canadian model of health
> care delivery and their corporate backers will be no less a challenge than
> what the New Democratic Party founders of Medicare faced when ushering in
> this system more than 40 years ago," said McDonough.
>
> The Romanow Commission has provided all defenders of not-for-profit health
> care with a wealth of facts and figures to buttress their case.
>
> The Romanow report and the NDP both advocate increased public investment
> in the Canadian health care system and an end to for-profit erosion of
> Medicare. New Democrats have consistently called for the federal
> government to use the Canada Health Act as a tool to end the private
> delivery of care.  The NDP has also campaigned to re-establish a more
> equitable funding arrangement with the provinces, with the federal
> government providing at least 25% cash funding.
>
> "This is a great day for Canadians and the future of our health system,"
> said NDP Health Critic, Judy Wasylycia-Leis.  "The Liberal government can
> no longer delay dealing with the health care crisis in Canada- for far too
> long it has been hiding behind the preparation of this report as an excuse
> for inaction.  The report is in, the prescription has been issued, and the
> time for stalling is over."
>
> The Romanow report provides clear evidence that not-for-profit care
> guarantees superior health care coverage for Canadians, while for-profit
> health care delivery is more costly and leads to poorer service.  In line
> with these findings, the NDP has been calling for the implementation of a
> national homecare program while supporting the establishment of a
> pharmacare program that recognizes provincial experience in this area.
>
>  "The theme that emerges from this latest validation of the Canadian model
> of health care delivery is that the period of health care destruction has
> come to an end and it's time for reconstruction to begin," said
> Wasylycia-Leis.
>
> -30-
>
> For more information please contact:
> Gail Dugas (613) 720-6400 or Karl Belanger (613) 720-6463.
 



Generic Drug Industry

For immediate release

Government Must Act Now to Implement Romanow Recommendations on Drug Patent

Laws: Generic Industry
 
 

OTTAWA, November 28, 2002 - The federal government should take immediate action to stop costly
abuse of Canada's drug patent laws as recommended in the Final Report of the Commission on the
Future of Health Care, Jim Keon, President of the Canadian Generic Pharmaceutical Association
(CGPA) said today.
 
 

In its Final Report released today, the Commission recommended that the federal government
"immediately review the pharmaceutical industry practises related to patent protection,
specifically, the practises of evergreening and the notice of compliance regulations."
(Recommendation 41)
 
 

In June 2002, the House of Commons Standing Committee on Industry, Science and Technology
approved a motion by Liberal MP Dan McTeague to review the Patented Medicines (Notice of
Compliance) Regulations of Canada's Patent Act that allow brand-name drug companies to extend
their market monopolies beyond original 20-year patent terms. Today the CGPA urged the
Committee to initiate that review immediately as recommended by Commissioner Roy Romanow.
 
 

"Drug costs are the fastest rising cost in Canadian health care. Unless the federal government
takes action to rein in soaring prescription drug costs, the dream of a national pharmacare
program will remain just that: a dream," Keon said. "Abuse of drug patent laws that delay
Canadians' access to lower-cost generic drugs even after original 20-year patents expire is too
expensive to be allowed to continue."
 
 

The CGPA, along with private insurers, health-care organizations, unions and seniors groups,
had urged the Commission to recommend repealing or amending the Regulations.
 
 

Specific only to the pharmaceutical industry, the Regulations allow brand-name drug companies
to stop Health Canada approval of generic drugs simply by alleging patent infringement. The
automatic 24-month stay under the Regulations means that Health Canada cannot approve a generic
drug until any claim of alleged patent infringement is decided in court.
 
 

Brand name drug companies have developed a number of tactics, including filing several
additional patents on a single drug for minor changes like the product's monograph, to prolong
the litigation and delay competition from generics. These needless delays have cost Canada's
health-care system hundreds of million of dollars by forcing provincial governments, hospitals,
private insurers and consumers to pay for higher-priced brand versions for longer than they
should.
 
 

"One of the most unfortunate results of the Regulations is that brand name drug companies often
find it more lucrative to litigate than to innovate," said Keon.
 
 

The United States is the only other country in the world with similar provisions under its
patent laws. But on October 21, President George Bush announced he is taking action to close
loopholes in U.S. drug patent laws (Hatch-Waxman Act) that brand name drug manufacturers have
manipulated to unfairly delay the approval of competing generic drugs.
 
 

"It is very telling that the message from a Republican President and a former NDP Premier is
the same. Ending abuse of drug patent laws is just the right thing to do to protect our
health-care system," Keon said.
 
 

About the Canadian Generic Pharmaceutical Association

The Canadian Generic Pharmaceutical Association represents Canada's generic drug industry - a
dynamic group of entrepreneurial companies that specialize in the production of high quality,
affordable generic drugs and fine chemicals and in conducting the clinical trials required for
government approval of generic drugs. It plays an important role in helping control overall
healthcare costs by keeping the cost of medications down: generic drugs are priced, on average,
45% less than their brand-name equivalents.
 
 

-30-
 
 

For more information, please contact:

Jeff Connell

Director of Public Affairs

Canadian Generic Pharmaceutical Association

Tel: (416) 223-2333

Cell: (647) 274-3379

Email: jeff@canadiangenerics.ca
 



John Gerretsen
Ontario Liberal Long Term Care Critic
 

For Immediate Release      November 28, 2002

ROMANOW REFLECTS CANADIAN VALUES

Queen’s Park – With the release of Commissioner Romanow’s Report today, it is time for the Eves government to step back and rethink the direction it is taking this province.  Romanow heard from Canadians who said they value a one-tier, publicly funded health system said John Gerretsen, M.P.P., Kingston and The Islands.

“Ernie Eves and Mike Harris have been taking us down the road to a two tier system,” said Gerretsen.  “Now, Mr. Romanow has made it clear that we need one universal system, open and accessible to all Canadians.  The suggestion of including accountability as another cornerstone of the Canada Health Act is one the federal government should act on quickly to ensure that money transferred to the provinces is actually spent on health care and not on other whims like tax cuts for big business.”

Gerretsen, Long Term Care Critic for the Official Opposition, was particularly pleased to see the inclusion of a recommendation for a national home care.

“I have been talking to recipients and providers of home care in this province and I know that the Eves government is starving them.  For many people, their first choice is to stay at home as long as possible but they need the supports and those supports are just not there now.  Major studies show it is cost-effective to keep people in their homes.  Now, as part of a national home care program with a dedicated transfer to provide the funding foundation, Ontarians can have that opportunity if the Eves government will cooperate,” said Gerretsen.  “A recent poll showed that a great number of Canadians want a national home care program.  Romanow heard them.  Now, it’s time for Ernie Eves to get on with it and provide funding for home care in this province as Romanow points out “the next essential (health care) service.”

Romanow’s recommendations point to an update for the Canada Health Act to reflect the needs and values of all Canadians.  The specific recommendation to keep diagnostic tests like MRIs in the public domain is a vindication of the position taken by Dalton McGuinty and the Ontario Liberals.  Treatment must be based on medical opinion and not a cheque book Gerretsen went on to say.

“Commissioner Romanow has traveled the country and held extensive hearings.  He is a pragmatist.  I think the title of this final report ‘Building on Values’ is extremely apt.  Canadians value their health care and, I believe, want their provincial governments to get down to the business of working with the federal government and make these recommendations a reality,” said Gerretsen.  “I commend Commissioner Romanow on the work he has done on behalf of all Canadians.”

-30-

Contact: John Gerretsen, M.P.P., Kingston and The Islands
    Liberal Critic for Long Term Care
    416-325-9210
 



CUPE Ontario Division

Media Release

November 28, 2002      For Immediate Release

Eves’ government must heed Romanow,
and stop for-profit hospitals, MRI, CT and cancer clinics

Toronto - Now that Roy Romanow has released his report on medicare and is calling for
re-investment in the public system and more accountability from provincial governments, the Ontario Conservatives and health minister Tony Clement, in particular, must undergo a drastic mind-set change away from for-profit health care, says Sid Ryan the Ontario president of the Canadian Union of Public Employees (CUPE).

“It’s clear that the policies of the Eves’ government with their push to a for-profit, two-tier health care system, are in direct conflict to the recommendations made by Romanow.  We are calling on Eves to stop the construction of for-profit private hospitals, and to stop the opening of private MRIs, CT scans and cancer care clinics,” says Ryan.

In his commission report, released today, Romanow discounts the argument that for-profit-private solutions are the only way to reform our medicare system.

“Romanow challenges the myths that the Harris/Eves government is perpetuating that the system is not sustainable and that privatization is the only way forward.

“Romanow also says that he has seen no research to back up the myths that private delivery is cheaper and more efficient.  He confirms what we have been telling the Conversatives that every dollar spent on for-profit health care is a dollar less for front line services, is a dollar less for bedside nurses, for quality home care and for direct patients services in long-term care,” says Ryan who commends Romanow for his progressive and comprehensive report.

“However”, says Ryan, “it’s disheartening to see that despite his working class roots, Romanow   has given a green light to contract out the jobs of the lowest paid workers in the health care system.  What he is doing is promoting a low-wage underclass of workers, who are primarily immigrants and women.

“It’s unfortunate that he appears not have sourced the significant research available that shows that the introduction of for-profit housekeeping and dietary services leads to dirty hospitals that are a breeding ground for germs and infection and inedible slop being served to the sick.”
-30-
In Ontario CUPE represents over 45,000 health care workers and 195,000 members in Ontario province-wide.

For more information please contact:
Sid Ryan  President CUPE Ontario  (416) 209-0066
Stella Yeadon  CUPE Communications  (416) 578-8774

Opeiu343ec\f:share\mediarelease\rom021128
 



Ontario NDP
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November 28, 2002
Today’s focus:

1. Sudbury leaders' debate
2. NDP launches RomaNOW e-campaign
3. Romanow report hits right note
4. Cancel healthcare privatization in Ontario
5. Halt private hospitals
6. NDP scores victory for people's pensions

NDP LEADERS IN SUDBURY – Sudbury will welcome the candidates for federal NDP leader at a debate being sponsored by the Federal Party on Sun., Dec. 1, from1 to3 p.m. at the Ramada Hotel's Paris Ballroom, 85 St. Anne Rd.

SUPPORT ROMANOW ONLINE – The NDP is making it easy for people to register their support for Roy Romanow's health care report with a new online lobby campaign at www.ontariondp.on.ca. New Democrats will officially launch their RomaNOW campaign tomorrow.  It allows the many supporters of expanded and improved public Medicare to instantly create and send their messages of support from the NDP website. "People who want governments to work together to implement the Romanow recommendations now should click on the RomaNOW banner on our website and send out that message," NDP Leader Howard Hampton said. "It is crucial that people voice their support.  Public pressure is always a key to making things happen." The NDP will take the public's message to Conservatives and Liberals who refuse to slam the door on privatized, American-style, for-profit health care, Hampton said.

IMPLEMENT REPORT, NDP SAYS – The Romanow Report's call for greater public investment and more accountability in our Medicare system sets the bar for federal and provincial governments to ensure better health care for all, NDP Leader Howard Hampton says. "The people have said loudly and clearly through this report that they want a strong, expanded and, most important, public Medicare system," Hampton says. "New Democrats agree. We call on the Conservatives in Ontario and the Liberals in Ottawa to move quickly to implement this blueprint for better health care." Hampton said the report conclusively rejects the Conservative government's embrace of private, for-profit health care. Romanow firmly concludes that the public sector is the most efficient way to provide health care. "This shows clearly that any scheme promoting private sector health care is a sham. It's time the Conservatives reverse privatization in this province," he said.

CANCEL PRIVATE MRIs AND HOSPITALS – Health Critic Shelley Martel was pleased with Romanow's emphasis on the need to transform Medicare into a community-based system with a greater emphasis on health promotion, disease prevention and home care. Martel said the Conservatives should be moving quickly to close the privately run cancer treatment clinic at Sunnybrook, halt the move to private MRI clinics and for-profit hospital construction and ensure these health services are delivered in the public system. As well, the government must seriously begin real primary care reform as outlined in Romanow's report.  "We must start working now to make the Romanow vision a reality," Martel said. "We have an exciting window of opportunity to put in place these brighter ideas for health care in the 21st century.  The Conservatives must understand that the people of Ontario want an expanded Medicare system. They clearly don't want public health care funds going into for-profit pockets."

PENSION PROMISE – Bowing to pressure from the NDP and others, Ontario's Finance Minister today promised in writing never to proclaim the pension theft provisions in the Conservatives' Bill 198. She also said she'd be extending an NDP regulation governing surplus distribution that has resulted in the fair and equitable distribution of surpluses since 1991. “Let this be a lesson to the Eves government”, said MPP Gilles Bisson, speaking for labour and seniors' groups across Ontario. “You simply can’t wage an ongoing war on the pocketbooks of average Ontarians and get away with it. The people will simply not take it.” The pension theft legislation, buried deep in the recently tabled omnibus budget bill would have made it far easier for employers to dip into employee pension plans. It would also have given employers an almost unfettered right to take pension contribution holidays.  The bill would have replaced a regulation put into place by the former NDP government that required employees and employers to bargain over the distribution of surplus funds when pension plans were wound up.  "This is an important first step in the fight for real pension reform for the workers of Ontario", said Bisson, the NDP's champion fighter of Bill 198.
 

www.ontariondp.on.ca   -30-
 

 



 Ernie Eves
November 28, 2002

EVES SAYS SUCCESS OF ROMANOW REPORT DEPENDS ON FEDERAL GOVERNMENT
SAULT STE. MARIE -- Ernie Eves, Ontario’s Premier, today said the success of the Romanow Report depends on more money from the federal government.

"For almost 10 years now the federal government has been short-changing Ontario taxpayers. We pay more than enough in taxes to deserve a first rate health care system," said Eves. "The Ontario Government has done its part -- we have increased health care spending by $8 billion since 1995. Health care spending now represents 47 per cent of the provincial budget in the Province of Ontario. Now it’s time for the federal government to do its part."

Eves said, "The question now is how quickly the federal government will act on the report and once again become a full partner with us in funding medicare programs."

Eves said the Ontario government looks forward to working with provinces, territories, and the federal government to ensure our health care system continues to respond to the needs of Canadians throughout the 21st century.

"As the administrators of our health care system, our focus remains increasing access for patients through innovation and co-operation with the federal government," said Minister of Health and Long-Term Care Tony Clement. "We await a quick and decisive response from Ottawa. In the meantime we have a responsibility to work with health care providers to find new and better ways to deliver quality health care to Ontario patients."

Clement said that, in the summer of 2001, Ontario conducted its own Public Dialogue and heard back from more than 400,000 Ontarians and they said they wanted a universally accessible health system, additional health human resources, reduced waiting times, expanded access to diagnostic services and a focus on keeping people healthy before they get sick.

"The Romanow Report has many interesting ideas and recommendations, and I look forward to working collaboratively with my counterparts across the country," said Clement.

A federal/provincial/territorial health ministers’ meeting is planned on December 6 in Toronto.

"There has been a long line of reports examining the problems with our health care system and recommending fixes," said Clement. "There is one constant in each of those reports. It’s the need for more federal money. I hope the Chrétien government will support, as the Eves government does, the overall conclusion of the Romanow Report, that federal contributions for health care must increase significantly."

 

Canadian Centre for Policy Alternatives Backgrounder:
The Romanow Report: Hits and Misses
The Hits:

Rejection of the CHST ­ The report suggests putting all federal contributions for health care
into a specific cash transfer to the provinces. This will ensure that amounts spent on health
care can be tracked so that spending is consistent with the principles of the Canada Health Act.


Breakthrough in Potential for Cost Controls on Drugs ­ The report builds on the recent
announcement to assess clinical and cost effectiveness of new drugs at the federal level
through the Common Drug review. It recommends the development of a National Drug
Formulary, signals the potential for the federal government to achieve cost savings for the
provinces by bulk buying, and raises the need to review patent legislation.

Paying Progressively - Progressive taxation (income taxes) is stressed as the only justifiable
and sustainable source of financing for health care. Earmarked, or dedicated, taxes are
explicitly ruled out, consumption taxes (the GST) are implicitly ruled out.

Limiting Commercialization ­ Bringing diagnostic services into the definition of publicly
insured services covered by the Canada Health Act will limit the rapid commercialization of
these medically necessary procedures. It is not clear if this will challenge recent developments
in Ontario, Alberta and British Columbia, where free-standing investor-owned clinics have
recently been announced.

Protecting Public Health from Trade Pressures ­ A clear echo of the CCPA backgrounder
for Romanow, the report states that Canada should work with other nations to protect public
health provisions from developments in global trade agreements that view health care as a
commodity rather than as a basic human right.


The Misses:

Lowballing the Need for More Money ­ Romanow¹s recommendation for an immediate
reinfusion of $3.5 billion in the coming fiscal year, rising to $6.5 in three years may be optimistic
about what that money can achieve to sustain public health care. In order to avoid rapid
commercialization of basic health care services, investments in capital and labour need to be
made now. The Kirby report called for $9 billion more effective immediately ($4 billion for
existing hospital and doctor services, and $5 billion in new initiatives, requiring new resources).
Romanow¹s own backgrounder on the issue suggested at least $7 billion was required to bring
the feds back to their historic "bargain" with the provinces on medicare of 25% of health
spending.

How are we paying for it? - No comment from Romanow. Unlike the Kirby report - which at
least acknowledged you need to pay for improvements, there is no mention of where even the
minimalist $3.5 billion will come from. (As noted, he reinforces income taxes as the appropriate
source, and suggests that Canadians are willing to pay more, but does not recommend that
taxes should increase.) The Finance Minister estimates that the federal surplus will be $1
billion this year. Where will the new funds come from?

No blueprint for the future with an aging population ­ Chronic and continuing or long-term
care needs for the frail elderly and disabled are absent from this vision of reform. This is a
glaring gap given that major health reforms occur only once in a generation, and the aging of
the baby boomers needs to be planned for.

No direction on human resource planning ­ The report ignores that collective agreements
recently signed with doctors and registered nurses will cost provincial treasuries a minimum of
$2.5 billion over the next two to three years. This is the price of labour shortages: you have to
pay more to hang on to who you have. The report recommends that we do not deal with our
own labour shortage by poaching health professionals from other nations, but makes no
investment in training and upgrading skills of existing and new health care workers

Integration needs Information ­ Moving to a smoother continuum of health care requires
better information handling. While acknowledging the need for electronic patient records, and
lauding the plans in the Western provinces to reduce waiting lists through better information
handling, there is no new money behind this idea to make it occur across the country.



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SEIU Canada:
FOR IMMEDIATE RELEASE
Nov. 28, 2002 Attention: News and Assignment Editors

Health care workers urging immediate implementation of key recommendations of
Romanow report

TORONTO -- SEIU Canada is calling on the federal government to move quickly to adopt key
recommendations of Commissioner Roy Romanow’s report on Medicare, tabled today in the House of
Commons.

"The federal government has an immediate and urgent role to play," says SEIU Canada spokesperson Sharleen
Stewart. "We hope to hear Prime Minister Jean Chrétien's unequivocal support and commitment to the core
principles set out in the report. This includes the infusion of $8.5 billion over the next two years and $6.5 billion
in 2005-2006, bringing the federal share to 25%."

In keeping with the message of the report, federal funding must be tied to expanded public services.

The union, which represents more than 80,000 workers in Canada, is also warning provincial governments, such
as Alberta, B.C. and Ontario, not to obstruct the citizens of Canada in their aspirations to see a revitalized and
expanded public Medicare system.

The key theme, running through Romanow’s report, and in his comments today, is that private and for-profit
health care is fundamentally at odds with Medicare and with federal and provincial governments' ability to sustain
quality health care.

SEIU welcomes many aspects of this landmark report. However, a number of the recommendations do not go
far enough in curtailing corporations and private profiteers from undermining Medicare.

Specifically, many core home care services are not included in the recommendations. The report is also silent on
absolutely crucial aspects of long-term care over which many battles to retain quality public, not-for-profit
services are being fought. "This is the fastest-growing area of health care," said Stewart. "Seniors and 'boomers'
are not well-served by Romanow's report."

In addition, key in-hospital patient services, such as food services, cleaning, laundry and maintenance, must be
returned to and kept in the public sector.

FOR FURTHER INFORMATION: Lynn Simmons, SEIU Canada Communications (416) 447-2311, ext.
242.



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Revised analysis from NUPGE:
28 November 2002
NUPGE Report Card on the Romanow Report
By NUPGE Research

Since the beginning of our campaign to protect and build Canada's Medicare, the National Union of Public and General
Employees has recommended that the different levels of government work together to reach ten objectives. We believe that
these ten objectives are not only about the health of Canadians, they are also about the economic health of Canada. Achieving
these ten objectives is the best way to ensure that we have a sustainable health care system that reflects Canadian values and
lives up to Canadian standards for efficiency. We also believe that these ten objectives draw on the courage of the original
vision put forward by the pioneers of Canada's Medicare and fulfill that vision by restoring, rethinking, and reinvesting in public
Medicare and the people who provide health services. This report card is intended to evaluate how well the final report of the
Romanow Commission stacks up against the National Union's ten objectives.

Objective 1
Adequate and stable public funding
Romanow Report Grade: A

The report recommends the federal government provide "adequate, predictable, and stable public funding for Medicare." To do
so, the report recommends a multi-billion dollar injection of federal funds until it reaches a 25% minimum cash floor of Canada
Health Act insured services - $6.5 billion more per year by 2006 - $3.5 Billion in 03/04, $5 billion in 04/05, and $6.5 Billion in
05/06. NUPGE, the CLC, other unions and many of our health coalition partners have called on the federal government to
increase its share of health funding to 25% of publicly insured services. The Romanow report clearly reaches this benchmark.

As equally important as proposing increased federal funds, the report recommends that the new federal cash be used to "buy
change" by attaching strings (through earmarked funding initiatives) to the new funds. In addition, the report recommends that the
CHST be abandoned and replaced with a separate fund for health care transfers to the provinces (called the Canada Health
Transfer) with a built-in escalator provision so that federal funding would keep pace with economic growth. This is the kind of
accountability and transparency that's necessary to ensure that any new health dollars actually go to health care services rather
than tax cuts or other areas and it is something the labour movement has called for over the last 8 years.

The Romanow report is much better that the Kirby report when it comes to increased public funding for Medicare. Kirby
proposed what amounts to a permanent user fee, payable by all tax payers. Kirby's proposal would not raise enough funds and
it does not meet the test of fairness.

While we could argue that Medicare needs more money than what is being proposed, what is being offered is significant
(particularly if the federal government gets to the 25% minimum, using the existing progressive income tax system and its
revenues, with a built-in escalator) and this section of the report is positive and comes very close to meeting our Objective.

Objective 2
Never for profit
Romanow Report Grade: B

The report states that: 'Medicare is a moral enterprise, not a commercial venture. Medicare is a right of citizenship ... It is a far
greater perversion of Canadian values to accept a system where money, rather than need, determines who gets access to care. " The report concludes that private, for-profit health care runs the risk of being more expensive, providing worse care and
undermining the value of fairness.

The report clearly states that Romanow challenged those advocating private sector solutions to provide the evidence but that
evidence was not forthcoming. The answer to Canadian health needs, the report concludes, does not lie in the private sector but
in a better funded public system.

The Romanow report also recommends decisive action to curb the growing number of private for-profit MRI and other diagnostic
services clinics, concluding that these private clinics lead to queue-jumping and this violates the principles of the Canada Health
Act. The report recommends that diagnostic services be explicitly included under the definition of insured services under the
Canada Health Act. The report recommends that there be no user fees, facility fees or extra billing for MRIs and CT scans; thus, making it illegal for anyone to be charged an out-of-pocket fee for these services. The report recommends that Ottawa penalize any provinces that allow private delivery of diagnostic services. The report also states that the current status of injured workers (WCB claims) getting preferred access to care and being sent to private clinics violates the principle of equal access. Further, the report proposes a Diagnostic Services Fund of $1.5 billion over 2 years to improve wait times.

The report looks at Public-Private Partnerships and essentially concludes that they're not a good idea and will end up costing
taxpayers more than if the government had simply done the job itself in the first place. The report also notes that these
arrangements can have the effect of hospital bed closures and a reduction in staffing levels.

The Romanow report also recommends that user fees, medical savings accounts, deductibles and tax-based co-payments
continue to be banned by the CHA.

Clearly, this is much better than the Kirby report which has no problem with further commercialization, private for-profit ownership and delivery.

However, the report does have a major weakness on the issue of privatization. It offers reasons and suggests there is evidence
that contracting-out of non-medical services such as food preparation, laundry, maintenance and cleaning is okay. This is not the right thing to recommend or the smart thing to recommend and therefore the report, on this point, is extremely disappointing.

Further, while the report gives strong rationale for opposing private for-profit care, the report is missing a specific
recommendation of a specific mechanism for banning private, for-profit delivery of health services.

In addition, while the report is critical of P3s it stops short of recommending they be banned completely and even suggests that
they might be useful in non-direct health areas such as "health information systems."

This section of the report went far, but could have and should have gone even further. In any health care institution, germ-free
environments, properly sterilized laundry and food safety are critical to the well-being of patients - we can't afford to cut corners with for-profit laundry, dietary and maintenance services. The report should have said this but it didn't. Therefore, this section of the report does not completely meet our Objective.

Objective 3
Debunk private health care myths
Romanow Report Grade: A

The report is an eloquent defence of public Medicare. It offers unqualified support for the principles underlying public Medicare.
It dismisses the myth that public Medicare is on the brink of collapse. It debunks the myth that public Medicare is unsustainable
or unaffordable. It also challenges the myth that private, for-profit care is more efficient, would shorten waiting lines, and provides better care (except when it comes to support services and this is a problem with the report). It also concludes that 'innovations' such as user fees, medical savings accounts, P3s etc. are nothing more than standard right-wing nostrums that will do nothing to improve Medicare.

This part of the report is very positive and meets our Objective.

Objective 4
A comprehensive national health human resources strategy
Romanow Report Grade: B

The report suggests the need to look at changing the scopes and patterns of practice of health providers.
The report argues for a national database to analyze relevant human resource information, and track and forecast trends.
It also suggests that governments stop recruiting health care workers from third world countries.
The report calls for a Rural and Remote Access Fund ($1.5 Billion over 2 years) to attract and retain health care providers,
including opportunities for health professionals to train and gain experience.

There are not enough substantial recommendations on this subject - i.e. it does not make specific suggestions for training and
upgrading skills of existing health professionals and other workers. Most of the details of a national health human resources
strategy are left to be developed by a new Health Council of Canada. We were hoping for more substantive recommendations
and a national fund for a human resource strategy. We were also looking for a proposal to promote and market the various
health professions.

On this subject, the Romanow report only partially addresses the Objective we set out.

Objective 5
Primary Care Reform - Develop a system of blended care
Romanow Report Grade: A

The report recommends a common national platform for primary care reform.
It recommends a $2.5 billion investment over 2 years through a Primary Health Care Transfer in order to remove barriers to
change and kick-start reform. Of course, service delivery is provincial jurisdiction, so Romanow recommends the federal
government link the new funding to provincial pursuit of the community clinic model.

The changes it proposes include: full-service community health clinics where patients can access a team of health professionals
24-7and receive everything from a doctor's prescription to nutritional advice to physiotherapy and psychiatric help.

There is also an emphasis on the need for cultural diversity and removing language barriers to improve access to care.

The report also talks about the need to put more emphasis on wellness and disease prevention programs - tobacco, obesity
and physical activity are good choices to start with for health promotion.

In some ways this section of the Romanow report is similar to Kirby's proposal of creating primary-care groups of different types of health-care providers. However, Romanow's recommendation is better in that it calls on the federal government to use any new money to 'buy the changes needed in primary care reform' and it talks about wellness and prevention programs being
critical to good health.

The focus on primary care reform, integrated with health promotion and disease prevention is long over-due. This section of the
report and its related recommendations are very positive and come very close to meeting our Objective.

Objective 6
Add home care to the Canada Health Act
Romanow Report Grade: B

The report recommends that Ottawa kick-start a process (and provide the foundation for) a national home care program by
covering all priority home care services - i.e. intervention services, home mental health services, palliative care, post-acute
home care - through a Home Care Transfer of $2 billion over 2 years.

It is not clear what the report suggests should be done with home support / personal support services. It has no specific
recommendation on bringing these services under the CHA so we must assume it is okay with those services, for the most part,
being left out of the Act and therefore becoming out-of-pocket expenses for all intents and purposes. This would not be the right thing to do or the smart thing to do. These are services that allow people to live with dignity in their own homes. That both
improves care and saves money by keeping people out of hospitals.

The Kirby report called for a national home care program that would cover only those just released from hospital or those near
death.

This part of the report does not go all the way and recommend a new national program immediately, and not mentioning home
support services is disappointing, but it does propose a good step forward in the direction of including all home care services
under the CHA. It doesn't completely meet our Objective but it brings us a closer to a national home care program.

Objective 7
Add long term care to the Canada Health Act
Romanow Report Grade: D

The Romanow report is a dismal failure on this Objective. The report does not make any recommendations at all for institutional care.

It assumes, for the most part, that through home care reform and increased coverage of acute and palliative home care services
under the CHA, you would be able reduce the demand for beds in long-term care institutions.

The report does not recommend national standards for long-term institutions and it does not recommend new immediate public
funding for long-term care.

The total lack of recommendations in this area is clearly a major win for the huge private corporations involved in the long-term
care industry i.e. Extendicare.

Objective 8
Add a national pharmacare program to the Canada Health Act
Romanow Report Grade: A-

The report concludes that the short term priority should be to provide public funding for "catastrophic drug costs" with the
Canada Health Act eventually covering the cost of prescription drugs.

It recommends the establishment of a National Drug Agency and a National Drug Formulary as a national strategy for dealing with soaring drug costs, providing comprehensive coverage and objective and accurate information on drugs.

The Romanow report also calls for a review of current drug patent laws in Canada.

The Romanow recommendation is better than Kirby's proposal which calls for public coverage after $5,000 and does nothing to address the root causes of soaring drug costs (patent law).

This recommendation falls short of our Objective of a National Pharmacare Program but it offers a huge step in the right direction, especially on the recommendation to review patent laws.

Objective 9
Exclude health services from all international trade deals
Romanow Report Grade: A

The Romanow report offers a strong message on this issue. The report issues a 'warning flag' on globalization and trade deals
and their impact on the future expansion of public health care.

It recommends that governments must not delete from trade deals any of the current protections and exemptions for health care
and it states that Canada should work with other nations to protect public health care from trade agreements.

It also states that any future efforts to expand public Medicare must also be protected from trade deals.

It also states that the right to regulate health policy should not be subject to claims from foreign companies.

The Romanow recommendation is better than the Kirby report which ignores altogether the risks posed by NAFTA and other
trade agreements that further privatization of health services would open the door to US and other foreign corporations to
penetrate our Medicare and take over its services.

The report could have called for a renegotiation of trade deals which would provide even stronger protection for public health
services. There should have been a recommendation that the Canadian government take TeleHealth technology off any trade
negotiation table.

On the whole, the Romanow report is strong on this subject and comes very close to meeting our Objective.

Objective 10
Women's equality in health care
Romanow Report Grade: A-

The report recommends that governments provide some kind of financial aid to those (overwhelmingly women) who have to
stay at home to care for sick, elderly or disabled relatives. On principle this is an excellent recommendation and it takes us into
any area governments have not yet ventured. Of course, the devil will be in the details with respect to how the assistance is
provided - likely through the EI system

The recommendation of increased public funding and reversing the trend of privatization is also very helpful for health care
workers the majority of whom are women. Contradicting this, however, is the section of the report that offers reasons for
contracting-out support services. This would unevenly affect women workers and so this aspect of the report could have been
better.

The report does not offer enough to address the unique health needs of women and related access issues.

The Romanow recommendation is much better than the Kirby report which ignores the uneven burden faced by women when it
comes to unpaid care giving in the home. Further the Kirby endorsement of private for-profit ownership of facilities and services would actually exacerbate the uneven burden and unequal access to health services faced by women.

The report goes further than any other to address the uneven burden faced by unpaid care-givers (mostly women) and comes
close to meeting our Objective.

Other Important Recommendations

· A new Canadian Health Covenant is proposed to express Canadians collective vision for health care and updating the
Canada Health Act.

· A New Health Council of Canada to foster collaboration amongst governments and stakeholders.

· The report recommends that a 6th principle of "accountability" be added to the Canada Health Act.



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OPSEU Response:
For Immediate Release November 28, 2002

Health care workers applaud Romanow

TORONTO - Health care workers across Ontario are applauding federal health commissioner Roy Romanow following the
release of his long-awaited report on Medicare.

"Roy Romanow has made the case, convincingly and conclusively, that a well-funded, publicly-operated Medicare system is
best for all Canadians," said Leah Casselman, president of the Ontario Public Service Employees Union. "This report is a
major setback for those who howl for the chance to profit from the sickness of others and line their own pockets with public
dollars."

OPSEU represents over 20,000 Ontario health care workers, including professionals and support staff in hospitals and in the
community as well as in laboratories, ambulance services, home care programs, long-term care, mental health, and the Ontario
Ministry of Health.

"Health care workers will fight to make sure the new money Commissioner Romanow recommends is delivered to the front
lines of the health care system and that some of it reaches the dedicated workers who have been subsidizing it with low wages
and substandard working conditions for too long," she said.

"Romanow gave the supporters of private profit, like the Ontario Hospital Association, ample opportunity to make the case for
more private-sector involvement in the health care system and they failed to do so," Casselman said. "They failed because they
have no case. Adequately-funded public Medicare is better, cheaper, and fairer than any private sector alternative.

"We are calling on the Prime Minister and provincial leaders to throw their full financial and political support behind this
fantastic national program that is the envy of the world."

Casselman said the Romanow report identified several areas that could become key battlegrounds in the months ahead.

"Canadians should watch carefully what happens with home care and diagnostic services like MRI and CT scans," she said.
"These are the areas where the behaviour of our politicians will tell us whether we need to vote them out at the first opportunity.

"If Ontario Health Minister Tony Clement understands what this report means politically, he'll drop his private clinic plans right
now."

- 30 -

For more information: Randy Robinson (416) 788-9134

Jordan Berger (416) 702-4682



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November 28, 2002
**For Immediate Release**

>From the National Coordinating Group on Women and Health Reform and the
Canadian Women’s Health Network:

The Romanow Report: What Does it Mean for Women?

We applaud Romanow for demonstrating the sustainability of Medicare. A
publicly funded system delivered through non-profit services is crucial for
all women in Canada.

But like other reports on health care reform in the last decade, this report
fails to recognize the significant ways in which health care is an issue for
women. Women are 80% of paid health care providers, a similar proportion of
those providing unpaid personal care and a majority of those receiving care,
especially among the elderly.
The sustainability of the system is not just about finances -- it’s about
women’s work.

As paid workers women provide medical, nursing and diagnostic care as well
as cleaning, cooking and laundry services that are essential determinants of
health in the delivery of care. By drawing a distinction between “direct”
and “ancillary” health care services, Romanow ignores the skilled nature of
women’s paid work and their contributions to care. Moreover, he fails to
make recommendations to address the deteriorating conditions women face in
providing care.

Women also sustain the system as unpaid health care providers. Romanow’s
report fails to adequately address the full range of home care women
provide, especially long-term and chronic care. While he reports “that
caregiving is becoming an increasing burden on many in our society,
especially women,” his recommendation for caregiver leave through the
Employment Insurance Program will not benefit the many women who do not have
forms of paid work that would make them eligible for such leave.
Romanow recognizes gender as a determinant of health. He also offers
valuable recommendations for primary health care reform that could benefit
women, but only if attention is paid to women’s particular needs. Finally,
although women constitute up to 3/4 of those in long-term care facilities,
the report is virtually silent on these services.

Sustaining an efficient, affordable and effective health care system must
mean sustaining women in providing and receiving care. Like Romanow, we
agree that “we need more than rhetoric; we need action”. We need to make
the health care system work for women.

For interviews, contact:
Dr. Pat Armstrong, Chair
National Coordinating Group on Health Care Reform and Women,
The Centres of Excellence for Women’s Health Program
Phone: (647) 292-2216
Email: patarmst@yorku.ca
Website:http://www.cewh-cesf.ca/en/index.html
Or:
Kathleen O’Grady, Director of Communications
Canadian Women’s Health Network
Email: news@cwhn.ca
Phone: (514) 886-2526; Fax: (204) 989-2355
Website:http://www.cwhn.ca

Mona Dupré-Ollinik, BSW, BA
Coordonatrice de liaison/Outreach Coordinator
Canadian Women's Health Network/Réseau canadien pour la santé des femmes
419, avenue Graham, Suite 203
Winnipeg (MB) R3C 0M3

Tel: (204) 942-5500 ext,/poste 13
Fax/Télécopieur: (204) 989-2355
Toll free/Numéro sans frais: 1-888-818-9172
www.cwhn.ca
e-mail/courriel: outreach@cwhn.ca

TTY 204-942-2806
TTY toll free number 1-866-694-6367



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November 28, 2002
Council on Aging Initial Response to Romanow Report

Kingston, Ontario Contact: Christine McMillan
613 549-3126

Frontenac-Kingston Council on Aging President Christine
McMillan today made the Council’s initial response to the
Romanow Commission Report. The report has received an overall
positive response from the Council, who nonetheless hope for
further consideration of seniors’ health concerns as the report is
implemented. Ms. McMillan issued the following statement.
“Our reaction is positive. First, financial stability of health
care will be assured through the recommendation of a five- year
funding plan. The report also speaks to provincial accountability
and recommends a dedicated transfer of health care funds. This
will ensure that citizens know that health care funds will actually
be spent on health care. We lost provincial accountability when
individual federal transfer payments to the provinces for health,
education and social services were lumped into one payment.
Mr. Romanow has made a major step in the right direction.

We are also delighted with the recommendation to
establish a Health Council of Canada to set benchmarks for care
and ways to measure performance. Taxpayers are weary of using
universal health care as a political football. The Health Council,
with provincial representation including taxpayers, may help in
defusing the political rhetoric around this issue and deal directly
with benchmarks for care and measuring performance and
outcomes.
The Council on Aging believes Mr. Romanow’s position on
pharmacare is a foot in the door. Assistance will be provided for
people suffering with some chronic and life threatening illnesses
by moving their medication costs under the management of
primary health care, where they will be covered by the medicare
budget. His additional recommendations to reform the Drug
Patent Act are vital if we are to stop the escalating cost of new,
life saving or pain killing medications. Too many have to choose
between buying their medications and eating. It is important to
realize that international drug companies get a bonus in Canada
as it is less costly to run trials in some provinces like Quebec,
where the cost of prescription drugs is included in their health
care plan.” Continued, page two






Council on Aging response to Romanow Report, page two

“Part of Mr. Romanow’s support for funding for home care is most
welcome, and supports our own longtime position that family caregivers
be recognized as an important economic contribution to our health care
system. (At this time, if you leave the workforce to provide care for
an ailing family member you are penalized by the Canada Pension Plan.)
The Romanow Report recommends that caregivers will be treated in the
same manner as employees taking parental leave and will receive
credit for the time they are out of the workforce providing home care.

The Council’s two concerns with the report are in regards its somewhat
limited response to home care needs and the fact that institutional
long term care is not addressed. Home care needs to go further. Seniors
and disabled persons need to be assured access to these services, to be
able to live independently, and both of these groups have been left out
of home care recommendations.


With the dramatic increase in fees charged to people requiring long term
care this past summer, it isbecoming obvious that chronic care in a long
term care facility is going to be out of reach of most middle-income
individuals. There were stories in the media a few days ago about
seniors in Newfoundland being evicted from nursing homes because their
nest eggs were depleted. Since people now enter nursing homes much
older and frailer than ever before, The Council on Aging would like to
see long term care become part of the provision of universal health
care. With an aging population this is a tall order, but it is
something we desperately need to address.

The Council on Aging commends The Romanow Commission on a thorough and
transparent consultation process. This report is reflective of what
Canadians have said -and assures that we will continue to have a
national, universal health care programme.”
-30-



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French Language Health
Services Network of
Eastern Ontario
COMMUNIQUÉ
For immediate release
ROMANOW REPORT: OTTAWA AND QUEEN’S PARK WILL NEED TO BE MORE PROACTIVE


Ottawa, November 29, 2002 – The Chair of the French Language Health Services Network of Eastern Ontario, Mr. Jean-Claude Le Blanc, nevertheless welcomed the Final Report of the Commission on the Future of Health Care in Canada.

“The Romanow Report maintains the integrity of the public system by reiterating that the principles of accessibility and universality are fundamental to our health insurance plan. And the Report also contains the key elements required to ensure continuity of health services and eliminate current barriers,” Mr. Le Blanc stated. However, the Report opens wide the door to an integrated health service approach by recommending, in particular, changes in home care, support for health prevention and promotion initiatives, and broader-scoped training for health human resources, with respect to medical and nursing staff as well as other health professionals. Mr. Marc Bisson, Executive Director of the Centre de santé communautaire de l’Estrie and Chair of the Network’s Communications Committee, stated that he was “pleased with the important role the Commission gives to health prevention and promotion.”

Commissioner Romanow’s report recognizes that official language minorities’ access to health care in French remains a problem. In its submission, the Network had stressed the fact that language is an essential criterion to the quality and effectiveness of health services, a point that the Commissioner has confirmed. However, by limiting the scope of his recommendation on improving access for linguistic minorities, the Commissioner has failed in his duty to fully protect these minorities and, by the same token, to protect the Canadian public interest.

This despite the fact that the Network urged the Commissioner to include the values of justice and equity as fundamental societal values in his reflections, by asking him to add the principle of linguistic duality to the Canada Health Act.

Nevertheless, the Commissioner has adopted one of the values fundamental to the Network’s operations by recommending collaboration among federal and provincial governments, provincial and regional health authorities, health agencies, and minority language communities. The Network and its partners will insist that all stakeholders respect the spirit of the Commissioner’s recommendation and work toward developing, maintaining, and assessing quality French language health services in Ontario.

With this goal in mind, the Network considers it essential to establish a federal/provincial official language health program as well as other French language health networks elsewhere in the province.

The French Language Health Services Network of Eastern Ontario works closely with the Ministry of Health and Long-Term Care, hospital facilities, health care agencies, and postsecondary educational institutions in the region to develop and deliver quality French language health services to Francophones in Eastern Ontario.


- 30 –

Spokespersons: Jean-Claude Le Blanc Marc Bisson
Chair Member of the Board of Directors
Ottawa Cornwall

Information: Natalie Béland, Communications Officer
(613) 747-7431



--------------------------------------------------------------------------------

CEP
Romanow - A Tonic for Canadians and the Canadian Economy

For immediate release
November 28, 2002

OTTAWA -- Romanow has confirmed what Canadians believe - our public health
system is less costly, more fair and of higher quality than privatized care. "Now it's
time for the federal government to put the money behind our values," said Brian
Payne, President of CEP.

"This is also good news for the Canadian economy", Payne added, "and employers
should be supporting public health care. With Romanow's help, we can avoid the US
scenario of fighting for health care at the bargaining table."

In the US, 55% of Americans rely on employer-based plans for health care. As
costs have risen, employers have cut back on health care coverage, which has
become the number one bargaining issue in the US. With the average premium for
family coverage costing American employers $5800 (US) per worker per year,
Canadian employers have everything to gain from our public system.

"There's no doubt that public health care is a major competitive advantage for
Canadian business," said Payne. In Canada, cutbacks in publicly provided services
have meant more costs under extended health care plans provided at work.
Employers have been faced with rapidly increasing insurance premiums to cover
work-based health plans, especially the cost of drugs. Increased funds for public
health care and controls on drug costs can only be good for the bottom line.

Payne added a cautionary note: "In health care, public is best and this needs to be
applied consistently. We oppose Romanow's acceptance of privatization of health
care support services, like food and laundry in hospitals."

"Let's keep health care off the negotiating table and get it back where it belongs - in
a stable publicly funded program," concluded Payne.

For more information:
Julie White at (613) 230-5200, ext. 241
or
Fred Wilson at (613) 230-5200, ext. 229.



--------------------------------------------------------------------------------

Canadian Women's Health Network
Reading Romanow on Women's Health: Now is the Time for
Governments to Reinvest in Medicare

**For Immediate Release**

The Romanow Report on the Future of Health Care is clear: Canadians want a
publicly funded health system that is universally accessible and offers equal and
timely service to all. The Report also documents that such a system, built on the
successes of Medicare and augmenting its role in publicly provided health services,
is possible with provincial and federal cooperation.

"Implementation of the Romanow Report is now the key issue", says Madeline
Boscoe, Executive Director of the Canadian Women's Health Network (CWHN).
"Romanow has provided a good first step for sustaining a publicly insured health
care system that addresses the diverse health needs of Canadians -- now we need
to see swift government action on the Romanow recommendations".

The CWHN applauds the Report's emphasis on access to health care for those living
in rural and remote areas, on holistic approaches to aboriginal health, on the health
needs of new Canadians and visible minorities, and an expanded national homecare
program. "But women have been left out of the equation", Boscoe observes, noting
that women represent the majority of paid health providers, and also provide the bulk
of unpaid caregiving in communities and homes. As well, women are the most
frequent users of health care services, yet women's specific health needs do not
receive comprehensive assessment in the Romanow report. This failure to
appropriately address gender differences in health care use and delivery means that
many of the recommendations in the Report fail to protect and promote women's
health, leaving women vulnerable and without the necessary support.

Abby Lippman, Professor of Epidemiology at McGill University and Co-Chair of the
CWHN notes, for example, that the Report's recommendations on a national
prescription

drug program do not go far enough, addressing only acute health care requirements,
"To meet the needs of most women more than 'catastrophic' situations must be
covered in a comprehensive pharmacare program".

The CWHN also believes that the report fails to focus meaningfully on measures that
address health promotion and disease prevention, highlighting only methods of
treatment and intervention, which are often costly and inefficient. Lippman states
that "while we welcome attention to the provision of primary care, this seems to
assume preventive approaches based on changes by individuals rather than on
structural changes that will promote the diverse health needs of all women in
Canada". Lippman also notes that the report does not address the impact of
economic and social disparities on individual health status, "Government programs
and policies should require health impact assessments and programs that address
structural inequities", Lippman concludes.

The CWHN believes that a renewed vision of healthcare must reflect and support the
principles of equity and social justice for all Canadians, and strongly endorses the
general recommendations of the Romanow Report. "A renewed commitment to
access based on need and not on the ability to pay is an essential component of
the Romanow Commission findings", Boscoe notes, "and it is one that is wholly
supported by the Canadian Women's Health Network. The time for action is now".

To see the complete CWHN "Submission to the Commission on the Future of
Health Care in Canada" visit: http://www.cwhn.ca/resources/romanow/index.html

For interviews, contact:
Madeline Boscoe, Executive Director
Canadian Women's Health Network
Phone: (204) 952-9784
Or (204) 942-5500 ext. 11
Email: ed@cwhn.ca
Website: http://www.cwhn.ca

Prof. Abby Lippman, Co-Chair
Canadian Women's Health Network
Phone: (514) 398-6266
Email: abby.lippman@mcgill.ca
Website: http://www.cwhn.ca

Kathleen O'Grady, Director of Communications
Canadian Women's Health Network
Email: news@cwhn.ca
Phone: (514) 886-2526; Fax: (204) 989-2355
Website: http://www.cwhn.ca

The Canadian Women's Health Network is a national, voluntary bilingual organization
of individuals and groups concerned with women's health.