Health care is fundamentally intertwined with Canada's values and future
By Roy Romanow
Globe and Mail
July 2, 2012
July 1, the birthdate of our great
nation, is also the birthdate of Canada's emblematic health-care system.
And this weekend we celebrated the 50th anniversary of the introduction
of medicare in Saskatchewan. Now often referred to as unsustainable,
this milestone provides an opportunity to reflect on the hard fought
accomplishments of the past, to re-evaluate today's system and to
consider the growing debate about its future.
Until 50 years ago,
Canada's health-care system was based on the private, for-profit model.
Patients individually paid for the services of medical professionals
and hospitals. Often, those who could not afford health care did not
receive it, and even some who could did so by deferring treatment,
hoping to save their family budget. Since then we have built a national
system, lauded around the world, that allows us all access to
The achievement of universal health care took a
long, acrimonious and protracted road. It is no surprise to me that
Saskatchewan was at the forefront of this journey. The province's
citizens learned many hard lessons during the desperation of the Great
Depression and the sacrifices of the Second World War. They learned
about generosity, about hardship and fairness, about boom and bust. They
learned about the imperative for co-operative action. They came to
understand that the notion of shared destiny was key to our existence.
And so it is
with other regions in Canada, where geography and demographics may vary,
where many waves of immigration began with an initial sense of
isolation, but where we all learned to see survival and progress as a
test of our ongoing ability to come together and to remain united around
Canada's history offers a strong and rich legacy
of success that has forged our country. It is this legacy of a shared
destiny that is key to understanding our young but dynamic history.
Today, as we find ourselves living in complicated times, I believe it is
this same legacy that remains the road map to our future, at home and
Before we give in to despair around the present-day
mantra that our system is unsustainable, there are a few things we must
consider. First, a universal, single-payer, public insurance model is
both less costly and produces better population health outcomes than
multipayer systems like the one that exists in the United States. This
has been proven time and time again by study after study. Questions of
sustainability can never be successfully addressed by moving
incrementally backward to a private, for-profit model, at least not the
sustainability of a system that remains accessible to all of us.
if our political leaders are genuine in their desire to rein in health
costs while maintaining a system for all of us, our task is clear, if
not without difficulties. We must lay the groundwork for including
catastrophic drug costs and bringing aspects of home care, long-term
care and access to advanced diagnostic services into our not-for-profit
system. Otherwise, costs will continue to escalate – without restraint
and with relentless abandonment of those in need.
Third, we must
also recognize that the well-being of our citizenry goes beyond health
care; it is dependent on preventing illness and tackling the more
fundamental barriers to good health, including social, economic and
environmental factors. How we treat the environment has a direct impact
on our health and the longevity of a sustainable economy. The growing
gap between the rich and poor directly affects our health and the fiscal
demands on our health-care system.
Every day, Canada faces new
challenges that prompt key questions about what kind of people we are
and what kind of future we wish to shape.
As we celebrate the
birth of our nation and of medicare, we must ask ourselves: What kind of
Canada do we want? Because, as I see it, the choice Canadians make
about health care is fundamentally intertwined with our values and
Roy J. Romanow is co-chair of the Canadian Index of
Wellbeing advisory board and a former commissioner of the Royal
Commission on the Future of Health Care in Canada.
H/T to Medicare's 50th Anniversary
Did You Know?
The leading cause of personal bankruptcy in the USA is inability to pay for medical and hospital bills!