Health-care workers, analysts and unions reacted positively Thursday to Roy Romanow's prescription to fix Canada's beleaguered health system. "I think it's a huge day," said Michael Decter, Chair of the Canadian Institute for Health Information.
Decter, a health-care economist and supporter of a publicly funded system, said many in the health-care field "always thought that medicare in Canada was unfinished business."
In a 356-page report, the former Saskatchewan premier recommended a $15-billion injection into Canada's health-care system over three years.
The money would bolster the existing health system, bring in a number of new programs in the coming decade and exclude for-profit health services.
Romanow's report makes 47 recommendations in 10 key areas that will improve and streamline the system and prepare it for the future.
Canada's family doctors say the federal and provincial governments should move quickly to implement the key findings of the report.
"The time for study is done," said Dr. Calvin Gutkin, CEO of The College of Family Physicians of Canada. "We urge all governments to now get down to making hard decisions about the future of health care in this country."
The college said it applauded Romanow's focus on primary health care but said it underestimated the significance of present and future shortages of family doctors.
The college issued a report recently saying Canada is currently short at least 3,000 family doctors. It warned that number could swell to 6,000 by 2011.
"There are no magic solutions to fixing health care in Canada without more family doctors," said Dr. Dominique Tessier, the college's past president.
Jennifer Price, a clinical nurse specialist at Sunnybrook Hospital in Toronto, called it "a very encouraging report."
"The increase in home care and pharmaceuticals is excellent," Price said. "That will help nurses move patients from the hospitals back to the community."
The Canadian Federation of Nurses Unions said "the commissioner got it right."
"The reforms to primary health care will particularly improve patient care," said CFNU President Kathleen Connors. "Nurses, doctors and other health-care providers working in teams will cut waiting times and patients' frustrations."
After 18 months of study, Romanow concluded that the state of medicare is not as dire as many Canadians would believe. However, he said the system needs better management, more accountability and more innovation.
"There are some encouraging signs," said Dr. Jim Ruderman of Sunnybrook. "What I'm looking for is how the integration of the community sector and the institutional sector, such as the hospitals, is going to take place."
"I need to see how this will translate into reality," Ruderman said.
The Canadian Medical Association said it will release its official response to the report Friday morning.
Judy Darcy, President of the Canadian Union of Public Employees, called the report "a blueprint for action."
"It's time for a fully public system," said Darcy, who represents more than a half-million workers across Canada, including 180,000 involved in health care. "The Chretien government has been sitting on the sidelines for far too long."
Darcy called for a stop to "dangerous privatization."
The Canadian Labour Congress also voiced strong support for Romanow's vision.
"The medicare debate is over, it's time to act," CLC President Ken Georgetti said in a release. "Ottawa and the provinces must now get to work expanding medicare to meet the public's needs."
Despite Romanow's disdain for a two-tiered health system, the head of what's been called Canada's first private hospital doesn't feel the report will signal the demise of private facilities.
"We do not run operations that are outside of the public sector," said Dr. Stephen Miller of Calgary's Health Resource Centre. "We don't allow users to come in and purchase services directly. Everything has to come through workers compensation boards or regional health authorities."
Miller told Canada AM that whatever path is taken, the choice must recognize that different regions have different needs.
"In the province of Alberta, we have taken an approach of solving our problems ourselves. There are a number of principles that we need to follow and they basically require that the patient comes first.
"I don't see a problem."
The Canadian Chamber of Commerce said it was disappointed in Romanow's rejection of private health-care delivery.
"We believe that if the private sector was given a greater role in health-care delivery, more resources would be injected into the system, and patient access and quality of care would be better," said chamber president and CEO Nancy Hughes Anthony.
However, the Council of Canadians praised Romanow for looking beyond "empty rhetoric of the free-market ideologues and provincial politicians."
"(Romanow) has proven that privatization will destroy, not improve our system," said council president Maude Barlow.