The Romanow Commission: Tragedy of a One Man Band

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posted March 7, 2002
That report’s introduction reveals the futility of the task: “… a one-person, time-limited Commission cannot address every conceivable issue affecting the future of health care in Canada.” Take one man, add a budget of over $15 million, solicit the views of every interest group in the land for ten months, and the best you’re going to get is a vague statement of indecision.

The vapidity of Mr. Romanow’s commission is driven by the conflicting views of the special interests (sorry: “stakeholders”) that have informed him. Over one hundred groups presented their opinions during the Commission’s misnamed “Fact Finding Phase”. For example, the association which represents generic pharmaceutical manufacturers prescribed weakening patent laws, whereas a prominent brand-name drug maker argued for the liberalization of price controls on patented drugs.

Faced with these conflicting claims, it is not surprising that Mr. Romanow is unable to get out of neutral. Any one man could go mad trying to assess the merits of these groups’ competing cases.

Recognizing this, Mr. Romanow will get information in two other ways. Firstly, he has commissioned new research from health policy experts. Secondly, he is consulting with “ordinary Canadians” (a group which surprisingly includes Saskatchewan Premier Lorne Calvert and perennial activist Maude Barlow).

We do not know whom Mr. Romanow has tasked to carry out his research. However, he probably called upon the usual suspects: various health policy experts who have made careers of writing papers of just this sort. One side effect of Canadian medicare is the rise of a little industry of taxpayer-funded health policy experts whose self-interest is wrapped up in government monopoly health care.

They are unlikely to propose dismantling the centrally planned model and are generally uninterested in the views of ordinary Canadians. In the words of one of them, Jonathan Lomas, Executive Director of the Canadian Health Services Research Foundation: “I think we have to be very careful about empowering the consumer because they will make choices that are not in their own health interest.”

We cannot seriously expect that the public hearings, which began Monday in Regina, will allow ordinary Canadians to take power back from these experts. Ordinary Canadians have neither the time nor influence to do so. Nor would they agree on many things. For example, Mr. Romanow notes that: “Many feel that greater effort needs to be made to enable terminally ill people to spend the last moments of their lives at home, surrounded by family and friends.” However, “many” are not “all”. Some of us prefer to die in the hospital, or in the company of strangers, or even utterly alone. It is not a matter of Canadian values, but individual ones.

Until governments restore patient sovereignty in health care, by allowing Canadians to spend our own health care dollars, the experts who have brought us long waiting lists, demoralized doctors and nurses, and a disgraceful lack of diagnostic tools like MRI machines and CT scanners, will continue to win.

Dr. Carolyn Bennett, MP, a Liberal backbencher, recently spoke out against this type of individual choice in health care: “That’s not the kind of decision a parent with a sick child wants to make at 3 a.m.” That’s probably true, but compare it to the alternative: the opportunity, maybe, to have your voice heard for a few minutes in a public hearing during a traveling road show, by a man dealing with so much conflicting information that he won’t know which way is up, and be quickly forgotten – drowned out by the shouts and position papers of hundreds of competing lobbies.

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